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Exploring influences and risk of bias of studies on return to sport and work after lateral ankle sprain:A systematic review and metaanalysis

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World Journal of Meta-Analysis 2024年第1期12卷 11-25页

作者： Priscilla A Maria Gwendolyn Vuurberg Gino MMJ Kerkhoffs Department of Orthopaedic Surgery and Sports Medicine Amsterdam UMC-Location AMCAmsterdam 1105 AZNetherlands Amsterdam Movement Sciences Amsterdam UMCAmsterdam 1105 AZNetherlands Amsterdam Collaboration on Health and Safety in Sports Amsterdam UMCAmsterdam 1105 AZNetherlands Academic Center for Evidencebased Sports medicine Amsterdam UMCAmsterdam 1105 AZNetherlands Faculty of Medicine University of AmsterdamAmsterdam 1105 AZNetherlands Department of Radiology and Nuclear Medicine Rijnstate ArnhemArnhem 6815ADNetherlands Department of Radiology and Nuclear Medicine Amsterdam UMCAmsterdam 1105 AZNetherlands Faculty of Medicine University of AmsterdamAmsterdam1105 AZNetherlands

BACKGROUND Lateral ankle sprains are the most common traumatic musculoskeletal injuries of the lower extremity,with an incidence rate of 15%-20%.The high incidence and prevalence highlights the economic impact of this *** sprains lead to a high socioeconomic burden due to the combination of the high injury incidence and high medical *** to 40%of patients who suffer from an ankle sprain develop chronic ankle *** instability can lead to prolonged periods of pain,immobility and injury *** of factors that influence return to work(RTW)and return to sports(RTS)after a lateral ankle sprain(LAS)may help seriously reduce healthcare *** To explore which factors may potentially affect RTW and RTS after sustaining an *** EMBASE and PubMed were systematically searched for relevant studies published until June *** criteria were as follows:(1)Injury including LAS or chronic ankle instability;(2)Described any form of treatment;(3)Assessment of RTW or RTS;(4)Studies published in English;and(5)Study designs including randomized controlled clinical trials,clinical trials or cohort *** criteria were:(1)Studies involving children(ageankle injury besides lateral ankle ligament damage.A quality assessment was performed for each of the included studies using established risk of bias *** quality of evidence was assessed using the GRADEpro tool in cases where outcomes were included in the quantitative analysis.A best evidence synthesis was performed in cases of qualitative outcome *** all studied outcomes suitable for quantitative analysis a forest plot was created to calculate the effect on RTW and *** A total of 8904 patients were included in 21 studies,10 randomized controlled trials,7 retrospective cohort studies and 4 prospective cohort *** studies were eligible for *** overall RTS rate ranged wer

关键词： ankle sprain Prognostic factors Bias Return to work Return to sport Preoperative motivation

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Most ankle sprain research is either false or clinically unimportant:A 30-year audit of randomized controlled trials

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Journal of Sport and Health Science 2021年第5期10卷 523-529页

作者： Chris M.Bleakley Mark Matthews James M.Smoliga School of Health Science Ulster UniversityCounty AntrimNorthern IrelandBT370QBUK School of Sport Ulster UniversityCounty AntrimNorthern IrelandBT370QBUK Department of Physical Therapy Congdon School of Health ScienceHigh Point UniversityHigh PointNC 27268USA

Background:Lateral ankle sprain is the most common musculoskeletal *** clinical research in this field is growing,there is a broader concern that clinical trial outcomes are often false and fail to translate into patient ***:We audited 30 years of experimental research related to lateral ankle sprain management(n=74 randomized controlled trials)to determine if reports of treatment effectiveness could be validated beyond statistical ***:A total of 77%of trials reported positive treatment effects,but there was a high risk of false *** trials were unregistered and relied solely on statistical significance,or lack of statistical significance,rather than on interpreting key measures of minimum clinical importance(e.g.,minimal detectable change,minimal clinically important difference).Conclusion:Future clinical trials must adopt higher standards of reporting and data *** includes consideration of the ethical responsibility to preregister their research and interpretation of clinical outcomes beyond statistical significance.

关键词： ankle sprain False discovery MCID MDC

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Acute ankle sprain in athletes:Clinical aspects and algorithmic approach

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World Journal of Orthopedics 2020年第12期11卷 534-558页

作者： Farzin Halabchi Mohammad Hassabi Department of Sports and Exercise Medicine Tehran University of Medical SciencesTehran 14167-53955Iran Department of Sports and Exercise Medicine Shahid Beheshti University of Medical SciencesTehran 19979-64151Iran

Acute ankle sprain is the most common lower limb injury in athletes and accounts for 16%-40%of all sports-related *** is especially common in basketball,American football,and *** majority of sprains affect the lateral ligaments,particularly the anterior talofibular *** its high prevalence,a high proportion of patients experience persistent residual symptoms and injury recurrence.A detailed history and proper physical examination are diagnostic *** is not indicated for the majority of ankle sprain cases and should be requested according to the Ottawa ankle *** interventions have been recommended in the management of acute ankle sprains including rest,ice,compression,and elevation,analgesic and anti-inflammatory medications,bracing and immobilization,early weight-bearing and walking aids,foot orthoses,manual therapy,exercise therapy,electrophysical modalities and surgery(only in selected refractory cases).Among these interventions,exercise and bracing have been recommended with a higher level of evidence and should be incorporated in the rehabilitation *** exercise program should be comprehensive and progressive including the range of motion,stretching,strengthening,neuromuscular,proprioceptive,and sport-specific ***-making regarding return to the sport in athletes may be challenging and a sports physician should determine this based on the self-reported variables,manual tests for stability,and functional performance *** are some common myths and mistakes in the management of ankle sprains,which all clinicians should be aware of and *** include excessive imaging,unwarranted non-weightbearing,unjustified immobilization,delay in functional movements,and inadequate *** application of an evidence-based algorithmic approach considering the individual characteristics is helpful and should be recommended.

关键词： ankle sprain Rehabilitation Athlete Sport injury Return to play Exercise therapy

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Chronic ankle Instability: Therapeutic Exercise and Data Analysis

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Open Journal of Orthopedics 2024年第5期14卷 201-217页

作者： Rosa Grazia Bellomo Giulia Barletta Mirco Brunetti Claudia Barbato Department of Biomolecular Sciences University of Study of Urbino Carlo Bo Urbino Italy

Background and Objectives: ankle injuries are the most common type of injury in healthy active individuals. If not treated properly, recurrent sprains can lead to a condition of chronic ankle instability (CAI). The present paper examines some subjects with a previous history of acute inversion ankle sprain who have developed a subsequent condition of instability, grouping them according to inclusion criteria and analyzing them through four field tests considered objective by the scientific literature: SEBT test, BEES test, TIBT test, SHT test. The data obtained were stored in order to compare them following a re-education protocol aimed at improving proprioception, balance, walking and strengthening the extrinsic and intrinsic muscles of the foot. per year. The subjects were then divided into two categories: subjects with CAI > 1 year and subjects with CAI ≤ 1 year. A protocol lasting 6 weeks was administered to both groups, trying to work on improving balance in single stance, improving static and dynamic stability, strengthening the gluteus medius and maximus (pelvis stabilizers) and strengthening of the intrinsic muscles of the foot. At the end of the protocol the subjects were all re-evaluated with the same field tests used previously and the data obtained were compared both with the pre-protocol data and with the data measured by the control subjects.

关键词： ankle Instability ankle sprain ankle Injuries Exercise

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Patients’perspectives on the conventional synthetic cast vs a newly developed open cast for ankle sprains

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World Journal of Orthopedics 2020年第11期11卷 492-498页

作者： Byung Cho Min Ji Soo Yoon Chin Youb Chung Moon Seok Park Ki Hyuk Sung Kyoung Min Lee Department of Orthopaedic Surgery Seoul National University Bundang HospitalSeongnam 463-707GyeonggiSouth Korea

BACKGROUND Orthopedic physicians typically apply a cast to immobilize a body part that has been *** have been no significant structural changes or advances in synthetic casts since the development of the modern *** Opencast®is a recently developed type of cast that allows ventilation and direct visual inspection of the skin to avoid cast-related *** this novel cast appears to have more benefits than the conventional synthetic cast,its clinical efficacy and advantages have not been *** To investigate the clinical efficacy and advantages of the newly developed Opencast®based on patients’perspectives in those with ankle inversion *** A specifically designed questionnaire consisting of 19 items was used to compare patients’opinions and concerns of the Opencast®and the conventional synthetic *** items were focused on subjective patient satisfaction,discomfort,and adverse effects while wearing the *** with an ankle inversion injury diagnosed as a high-grade ankle sprain were *** subjects were randomized and instructed to fill the questionnaire after wearing a synthetic cast or an Opencast®for 2 *** were then required to fill the questionnaire again,after switching to the alternative type of cast for 2 more *** A total of 22 subjects participated in the *** synthetic cast appeared to be more rigid and stable than the Opencast®,but there was no significant difference in the amount of pain *** likelihood of adverse effects when wearing the synthetic cast was significantly *** satisfaction tended to be rated higher after wearing the Opencast®.Opencast®showed more subjective vulnerability than the synthetic cast,but there was no significant difference in the redo *** were more anxious about removal of the synthetic cast than of the Opencast®.CONCLUSION The results indicate that the Opencast®could replace the conventional synthetic cast as it offers i

关键词： Clinical utility Comparison Open cast Conventional cast Cast material ankle sprain

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Corticospinal activity during a single-leg stance in people with chronic ankle instability

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Journal of Sport and Health Science 2022年第1期11卷 58-66页

作者： Masafumi Terada Kyle B.Kosik Ryan S.McCann Colin Drinkard Phillip A.Gribble College of Sport and Health Science Ritsumeikan UniversityKusatsuShiga 525-8577Japan Department of Athletic Training&Clinical Nutrition University of KentuckyLexingtonKY 40536-0200USA School of Rehabilitation Sciences Old Dominion UniversityNorfolkVA 23529USA Westlake High School Athletics AustinTX 78746USA

Purpose:The aim of the study was to determine whether corticospinal excitability and inhibition of the tibialis anterior during single-leg standing differs among individuals with chronic ankle instability(CAI),lateral ankle sprain copers,and healthy ***:Twenty-three participants with CAI,23 lateral ankle sprain copers,and 24 healthy control participants *** motor threshold(AMT),normalized motor-evoked potential(MEP),and cortical silent period(CSP)were evaluated by transcranial magnetic stimulation while participants performed a single-leg standing ***:Participants with CAI had significantly longer CSP at 100%of AMT and lower normalized MEP at 120%of AMT compared to lateral ankle sprain copers(CSP100%:p=0.003;MEP120%:p=0.044)and controls(CSP100%:p=0.041;MEP120%:p=0.006).Conclusion:This investigation demonstrate altered corticospinal excitability and inhibition of the tibialis anterior during single-leg standing in participants with *** research is needed to examine the effects of corticospinal maladaptations to motor control of the tibial anterior on postural control performance in those with CAI.

关键词： ankle sprain Joint instability Motor cortex Postural control

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The relationship between pain and associated characteristics of chronic ankle instability:A retrospective study

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Journal of Sport and Health Science 2020年第1期9卷 96-101页

作者： Saeed Al Adal Martin Mackey Fereshteh Pourkazemi Claire E.Hiller Faculty of Health Sciences University of SydneySydneyPO Box 170LidcombeNSW1825Australia Faculty of Applied Medical Sciences Najran UniversityNajranPO Box 1988Saudi Arabia

Background'. Up to 74% of people with a history of ankle sprain develop chronic ankle instability (CAI). One commonly reported residualimpairment is ankle pain;however, it has not been included in models or inclusion criteria for CAL We investigated the prevalence of pain inpeople with CAI and the association between presence of pain and other CAI ***'. Retrospective data from 1147 participants with CAI (age 26.6 ± 10.7 years, 59% female) were collated from previous studies that usedthe Cumberland ankle Instability Tool as an assessment tool. Pain was assessed from Item 1 of the Cumberland ankle Instability Tool, whichasks participants about ankle pain. Responses were divided into 3 categories: pain during daily activities, pain during moderate/vigorous physicalactivities, and no pain. The presence of pain was analyzed with descriptive statistics, the correlation between pain category and CAI characteris・tics was analyzed by /2 tests and factors associated with each pain category were analyzed by logistic ***'. Among the participants, 60.1% (n = 689) reported ankle pain. Of all participants, 12.4% (n = 142) reported pain during daily activities,47.7% (n = 547) reported pain during moderate/vigorous physical activities, and 39.9% (n = 458) reported no pain. There was a strong associationbetween ankle instability and ankle pain (/2 = 122.2, p ankle instability,age and unilateral ankle sprains were independently associated with pain (ankle instability: /2 = 43.29, p ankle sprains: /2 = 6.25, p ankle instability. Number of sprains, age, genderand unilateral or bilateral sprain did not modify this result except for the first pain category (pain duri

关键词： ankle impairments ankle instability ankle sprain CAIT Pain

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ankle injuries in athletes:A review of the literature

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World Journal of Meta-Analysis 2021年第2期9卷 128-138页

作者： Jenita Jona James Oday Al-Dadah The Medical School Newcastle UniversityNewcastle-upon-Tyne NE24HHUnited Kingdom Translational and Clinical Research Institute Faculty of Medical SciencesNewcastle UniversityNewcastle-upon-Tyne NE24HHUnited Kingdom

ankle injuries are commonplace in the athletic population, with lateral ligamentsprains accounting for the majority of them. The medial ligament complex, thedistal tibiofibular syndesmosis as well as any of the bones that constitute the anklejoint can also be injured. Typical mechanisms of injury include inversion-plantarflexionand external rotation on a supinated, dorsiflexed or pronated foot. Lesionsof the ankle present with similar symptoms of pain, swelling and ***, a thorough history and physical examination must be obtained to makethe correct diagnosis. This is especially critical for athletes as certain injuries canlead to termination of their career if not treated accurately on time. Imaging maybe useful in some cases to confirm or rule out differential diagnoses. Most injuriescan be managed conservatively using the Protection, Rest, Ice, Compression andElevation protocol followed by a comprehensive rehabilitation *** is reserved for grade III ligament tears that are refractory to initial nonoperativetreatment and displaced fractures that are unlikely to unite withoutsurgical intervention. The objective of this review is to discuss the common ankleinjuries encountered in the athletic population and the approaches to theirdiagnosis and management.

关键词： ankle sprain Athlete Deltoid ligament Lateral ligament Syndesmosis Fracture

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Lower extremity injury in female basketball players is related to a large difference in peak eversion torque between barefoot and shod conditions

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Journal of Sport and Health Science 2014年第3期3卷 227-232页

作者： Jennifer M.Yentes Max J.Kurz Nicholas Stergiou Nebraska Biomechanics Core Facility Department of HealthPhysical Education and Recreation.University of Nebraska at Omaha Munroe-Meyer Institute.Department of Physical Therapy University of Nebraska Medical Center College of Public Health Department of Environmental HealthOccupational Health and ToxicologyUniversity of Nebraska Medical Center

Background： The majority of injuries reported in female basketball players are ankle sprains and mechanisms leading to injury have been debated. Investigations into muscular imbalances in barefoot versus shod conditions and their relationship with injury severity have not been performed. The purpose of this study was to investigate the effects of wearing athletic shoes on muscular strength and its relationship to lower extremity injuries, specifically female basketball players due to the high incidence of ankle injuries in this population. Methods： During pre-season, 11 female collegiate basketball players underwent inversion and eversion muscle strength testing using an iso- kinetic dynamometer in both a barefoot and shod conditions. The difference between conditions was calculated for inversion and eversion peak torque, time to peak torque as well as eversion-to-inversion peak torque percent strength ratio for both conditions. Lower extremity injuries were documented and ranked in severity. The ranked difference between barefoot and shod conditions for peak torque and time to peak torque as well as percent strength ratio was correlated with injury ranking using a Spearman rho correlation （p） with an a level of 0.05. Results： The ranked differences in barefoot and shod for peak eversion and inversion torque at 120°/s were correlated with their injury ranking. Ranking of the athletes based on the severity of injuries that were sustained during the season was found to have a strong, positive relationship with the difference in peak eversion torque between barefoot and shod （p = 0.78; p = 0.02）. Conclusion： It is possible that a large discrepancy between strength in barefoot and shod conditions can predispose an athlete to injury. Nar- rowing the difference in peak eversion torque between barefoot and shod could decrease propensity to injury. Future work should investigate the effect of restoration of muscular strength during barefoot and shod exercise on injury rates

关键词： ankle sprain Isoklnetic dynamometer Muscular imbalance Strength

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