{"id":11404,"date":"2024-12-06T06:00:23","date_gmt":"2024-12-06T05:00:23","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=11404"},"modified":"2024-12-05T23:02:11","modified_gmt":"2024-12-05T22:02:11","slug":"ankle-go-a-novel-and-simplified-way-for-ensuring-safe-return-to-sport-following-ankle-sprain","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2024\/12\/06\/ankle-go-a-novel-and-simplified-way-for-ensuring-safe-return-to-sport-following-ankle-sprain\/","title":{"rendered":"Ankle-GO\u2122 Part 1: A novel and simplified way for ensuring safe return to sport following ankle sprain"},"content":{"rendered":"

Gain insights into the application of this new composite score and familiarize yourself with all critical cut-offs.<\/span><\/p>\n

Keywords:<\/b>\u00a0ankle sprain, return to sport, assessment\u00a0<\/span><\/p>\n

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Why is this study important?<\/strong><\/p>\n

Lateral ankle sprain is the most prevalent injury in sports, with a high recurrence rate and approximately 40% of patients develop chronic ankle instability. However, around 30% of individuals fully recover from an initial sprain. A crucial factor in achieving full recovery is the management of return to sport (RTS). To date, return to play decisions following lateral ankle sprains remain unclear, as no objective criteria have been established [1,2].<\/span><\/p>\n

How did the study go about this?<\/strong><\/p>\n

In this paper we evaluated the predictive capacity of the Ankle-GO\u2122<\/span>\u00a0score in identifying future copers and facilitating a safe return to sport, while minimizing the risk of recurrence [3]. Copers are defined as patients who return to their pre-injury sport without functional loss and report no episodes of re-injury or giving way 12 months after a lateral ankle sprain. The Ankle-GO\u2122<\/span>\u00a0is a concise tool comprising four functional tests and two self-reported questionnaires, yielding a maximum score of 25 points. It requires minimal equipment and can be easily administered by physiotherapists. The selection of these components was based on a\u00a02022 narrative review identifying the most relevant functional performance tests and self-reported questionnaires to assist clinicians in making RTS decision following recurrent ankle sprains or surgical ankle stabilization [4]. This approach aligns with the PAASS framework recommended by the International Ankle Consortium [5].<\/span><\/p>\n

Ankle-GO\u2122<\/span>\u00a0is a composite score that integrates 7 components to provide an objective assessment of the key deficits associated with lateral ankle sprain or chronic ankle instability, both of which contribute to an increased risk of re-injury. \u00a0It is derived from 4 functional tests:\u00a0<\/span><\/p>\n

    \n
  1. the single-leg stance test (SLS) on a firm surface<\/span><\/li>\n
  2. the modified star excursion balance test (mSEBT)<\/span><\/li>\n
  3. the side hop test (SHT)<\/span><\/li>\n
  4. the figure-of-8 test (F8T).\u00a0<\/span><\/li>\n<\/ol>\n

    Additionally, 2 self-reported questionnaires are employed: the Foot and Ankle Ability Measure, which includes subscales for assessing daily activities (FAAMadl) and sports activities (FAAMsport), as well as the Ankle Ligament Reconstruction-Return to Sport after Injury (ALR-RSI). Practitioners can efficiently calculate their patients\u2019 score via the free website\u00a0<\/span>https:\/\/anklego.com\/<\/span><\/a>. Based on our clinical experience, it requires approximately 20-30 minutes to complete the entire assessment on both limbs, with no need for specialized equipment.<\/span><\/p>\n

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    What did the study find?<\/strong><\/p>\n

    The Ankle-GO\u2122<\/span>\u00a0was initially validated in patients following an ankle sprain, demonstrating good internal consistency with no ceiling or floor effects [6]. Test-retest reliability was excellent, with a minimum detectable change of 1.2 points. It exhibited a good discriminant ability when comparing healthy subjects to patients, and a fair predictive value, with an Ankle-GO\u2122<\/span>\u00a0score at 2 months predicting RTS at 4 months, using a cut-off of 8 points. In a recent study, an Ankle-GO\u2122<\/span>\u00a0score below 8 points at 2 months was associated with a 9 fold increased risk of recurrence after a LAS, with women showing higher re-injury risk [7]. In the study recently published in the BJSM [3], we concluded that patients with an Ankle-GO\u2122<\/span>\u00a0score above 11 points after 2 months of rehabilitation had a 12 -fold greater likelihood of becoming copers one-year post-injury. Female patients, however, were at higher risk of failing to achieve Coper status. None of the 7 components of the Ankle-GO\u2122<\/span>\u00a0score, when considered in isolation, was sufficient to discriminate and identify potential copers.<\/span><\/p>\n

    What are the key take-home points?<\/strong><\/p>\n