Rehabilitation strategies for lateral ankle sprain do not reflect established mechanisms and risk factors for re-injury: A scoping review

Jente Wagemans, C M Bleakley, Jan Taeymans, Alexander-Philipp Schurz, Kevin Kuppens, Heiner Baur, Dirk Vissers

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Introduction: Many athletes suffer recurrent lateral ankle sprain (LAS) on return to sport. Common inciting events for re-injury include changing direction and jumping/landing; this is often mediated by excessive supination at initial contact and/or delay in Peroneus muscle activation. To optimally reduce the risk of recurrent LAS, rehabilitation interventions must reflect the aetiology and mechanisms of these injuries.

Aim: Determine if rehabilitation programs in the current literature address common impairments and mechanisms underpinning recurrent LAS

Materials and methods: We searched six electronic databases. Inclusion criteria were RCT’s including patients with acute LAS, managed through exercise-based rehabilitation. Each exercise was categorised by the primary impairment(s) addressed (muscle strength, mobility, neuromuscular training, joint positional sense), and by its: direction of movement (uni- vs multiplanar); base of support (single vs double limb); open vs closed chain; and use of a flight phase.

Results: The most addressed impairment was sensorimotor function (48%), followed by plantar flexion muscle strength (29%), and sagittal plane mobility (14%). Most exercises were limited to the sagittal plane (48%), with only 30% incorporating multiplanar movements. Two thirds of exercises (118/177) involved closed kinetic chain training, of which, half were undertaken on single leg (59/120). Just 18% of all exercises (33/177) incorporated a flight phase.

Conclusion: Rehabilitation strategies for LAS largely comprise simple exercises that do not reflect established mechanisms and risk factors associated with re-injury. Future interventions can be enhanced by incorporating more open chain joint position sense training, multiplanar single limb challenges, and jumping and landing exercises.
Original languageEnglish
Number of pages1
Publication statusPublished online - 26 Aug 2022
Event4th World Congress of Physical Therapy - Nyborg, Denmark
Duration: 26 Aug 202228 Aug 2022


Conference4th World Congress of Physical Therapy
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