Assessment of Patient-Reported Outcomes at Return-to-Sport Following Lateral Ankle Sprain Injuries: A Report from the Athletic Training Practice-Based Research Network.

Abstract

Context There is limited evidence regarding the assessment of single-item patient-reported outcomes when patients are medically cleared to return-to-sport following a lateral ankle sprain (LAS) injury. Objective To evaluate self-report of improvement in health status, pain, function, and disability at return-to-sport following a LAS. Design Descriptive study. Setting Sixty-nine athletic training facilities across 24 states. Patients or Other Participants Six hundred and thirty-seven patients (male=53.2%) were included in our final analysis. Patients were diagnosed with a LAS, restricted from sport following injury, and subsequently medically cleared to return-to-sport within 60 days were included. Main Outcome Measures Descriptive statistics were used to summarize scores for health status (Global Rating of Change), pain (Numeric Pain Rating Scale), function (Global Rating of Function), and disability (Global Rating of Disability). Mann-Whitney U Tests were used to compare score differences between sexes. A Kaplan-Meier analysis was performed to provide a visual depiction of sex differences in time to return-to-sport. Results Most patients sustained a LAS injury while participating in basketball, football, or soccer and cleared to return-to-sport 8 days following injury. Over two-thirds of patients reported a meaningful improvement in health status between time of injury and return-to-sport. However, many reported some level of deficits related to pain (65.1%), function (86.2%), and disability (35.8%) at return-to-sport. No differences were noted between males and females for pain (p=.90), function (p=.68), change (p=.45), or disability (p=.21) at return-to-sport. Males, however, returned to sport slightly sooner than females (p=.025). Conclusions Despite self-perceived improvements in health status from time of injury, patients typically return-to-sport with deficits in pain, function, and disability following a LAS. Patients may be returning to unrestricted sport participation before they feel their bodies have fully recovered from the injury. Level of Evidence Level III; retrospective cohort study.