Which motor-behavioural impairments are assessed in prospective studies including patients with an acute ankle sprain: A scoping review

INTRODUCTION: Lateral ankle sprains (LAS) are one of the most common musculoskeletal injuries, with up to forty percent of patients developing chronic ankle instability (CAI). Current etiological models suggest that CAI may be underpinned by a wide variety of motor-behavioral impairments that develop after an initial LAS, but this must be validated through prospective research. The aims of this scoping review were to determine the extent to which prospective research assesses motor-behavioral impairments after LAS, and the respective measurement tools used.
EVIDENCE ACQUISITION: We searched six databases (Cochrane Library, PEDro, PubMed, Scopus, SPORTDiscus and Web of Science) for prospective studies of adults with acute LAS, incorporating at least one assessment of motor-behavioral impairment.
EVIDENCE SYNTHESIS: Six studies totaling 210 patients met the inclusion criteria. The following motor-behavioral impairments were assessed: balance (five studies), altered movement patterns (three studies), muscle strength (two studies) and reflex inhibition (one study). Balance was assessed statically and dynamically using single-limb stance and the star-excursion balance test, respectively. Movement patterns (kinematics) were recorded during a range of functional activities including, gait, going up and down stairs, drop vertical jump, and single-leg drop landing. Peak power and isometric strength were measures of muscle strength. Time to restore from sudden perturbation was used to assess reflex inhibition.
CONCLUSIONS: Motor-behavioral impairments have been prospectively assessed after LAS, but these focus primarily on measures of balance and joint kinematics. Future prospective studies must incorporate more clinically applicable outcomes to assess the entire spectrum of motor-behavioral impairments (neuromuscular inhibition, altered reflexes, muscle weakness, balance, altered movement patterns, decreased physical activity).