Re-sprains during the first 3 months after initial ankle sprain are related to incomplete recovery: an observational study

Question: What are prognostic factors for incomplete recovery, instability, re-sprains and pain intensity 12 months after patients consult primary care practitioners for acute ankle sprains? Design: Observational study. Participants: One hundred and two patients who consulted their general practitioner or an emergency department for an acute ankle sprain were included in the study. Outcome measures: Possible prognostic factors were assessed at baseline and at 3 months follow-up. Outcome measures assessed at 12 months follow-up were self-reported recovery, instability, re-sprains and pain intensity. Results: At 3 months follow-up, 65% of the participants reported instability and 24% reported one or more re-sprains. At 12 months follow-up, 55% still reported instability and more than 50% regarded themselves not completely recovered. None of the factors measured at baseline could predict the outcome at 12 months follow-up. Additionally, prognostic factors from the physical examination of the non-recovered participants at 3 months could not be identified. However, among the non-recovered participants at 3 months follow-up, re-sprains and self-reported pain at rest at 3 months were related to incomplete recovery at 12 months. Conclusion: A physical examination at 3 months follow-up for the non-recovered ankle sprain patient seems to have no additional value for predicting outcome at 12 months. However, for the non-recovered patients at 3 months follow-up, self-reported pain at rest and re-sprains during the first 3 months of follow-up seem to have a prognostic value for recovery at 12 months. [van Middelkoop M, van Rijn RM, Verhaar JAN, Koes BW, Bierma-Zeinstra SMA (2012) Re-sprains during the first 3 months after initial ankle sprain are related to incomplete recovery: an observational study. Journal of Physiotherapy 58:181-188]