In a collaboration with our colleagues at the Erasmus Medical Center, we studied the impact of initial healthcare on the outcome of neuromuscular training (NMT) for recurrent sprains. Ankle sprains remain one of the most common traumas to the musculoskeletal system, and have long-lasting impact on physical function and the use of medical care, up to 12 months after the injury. Based on our previous preventive studies we questioned whether there is an association between the healthcare provider who treated the index sprain and the effect of NMT on recurrent ankle sprains and, also, whether athlete characteristics differ between the different type of healthcare providers. These characteristics will be useful for healthcare providers to take into account when choosing intervention strategies or determine prognosis.
Methods
From three previous trials evaluating NMT for the prevention of ankle sprain recurrences, we extracted data on athlete characteristics, type of initial healthcare and whether a recurrent sprain occurred during study follow-up. IN total out of three trials, we had access to 705 participants. Multilevel logistic regression analyses were used to test the impact of initial healthcare on the outcome of NMT on recurrent sprains.
Number of recurrent sprains during one-year follow-up (%).
Results
After NMT, 39.7% of the athletes visiting paramedical care reported a recurrent sprain, 21.8% of secondary and 34.0% of primary care. Athletes who visited a physiotherapist reported more recurrent sprains, than those not visiting a physiotherapist (adjusted OR 3.15;95%CI 1.88-5.23). Athletes visiting paramedical (49.7%) and primary care (48.4%) used more braces and/or tape during sport than those not visiting any care (34.2%).
What we found
We concluded that the initial type of healthcare of athletes with an ankle sprain, that consecutively received NMT, seems to impact the occurrence of recurrent sprains. Why that is? Physiotherapists may be visited by athletes with a poorer prognosis, which may be explained by different athlete characteristics.
The full article can be found here (paid access)
Mailuhu AKE, et al.Outcome of a neuromuscular training program on recurrent ankle sprains. Does the initial type of healthcare matter? J Sci Med Sport (2020),