M Van Reijen1, I Vriend2, V Zuidema3, W van Mechelen4, E A Verhagen5. 1. Amsterdam Collaboration on Health and Safety in Sports, IOC Research Center, VUmc/AMC, The Netherlands; Department of Public & Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Centre, The Netherlands. 2. Amsterdam Collaboration on Health and Safety in Sports, IOC Research Center, VUmc/AMC, The Netherlands; Department of Public & Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Centre, The Netherlands; Consumer Safety Institute VeiligheidNL, The Netherlands. 3. Consumer Safety Institute VeiligheidNL, The Netherlands. 4. Amsterdam Collaboration on Health and Safety in Sports, IOC Research Center, VUmc/AMC, The Netherlands; Department of Public & Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Centre, The Netherlands; School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Ireland; School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Australia; UCT/MRC Research Unit for Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, South Africa. 5. Amsterdam Collaboration on Health and Safety in Sports, IOC Research Center, VUmc/AMC, The Netherlands; Department of Public & Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Centre, The Netherlands; UCT/MRC Research Unit for Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, South Africa; Australian Centre for Research into Injury in Sport and its Prevention, Federation University Australia, Australia. Electronic address: e.verhagen@vumc.nl.
Abstract
OBJECTIVES:Recurrent ankle sprains can be reduced by a neuromuscular training program (NMT). The way NMT is delivered may influence the incidence of long term recurrent injuries, residual pain and disability. DESIGN: This RCT with a follow-up of twelve months, evaluated whether the implementation method of a proven effective NMT program delivered by a mobile application or a written instruction booklet, resulted in differences in injury incidence rates, functional ankle disability/pain in the long term, assuming equal compliance - as is shown in previous research - with the 8-week intervention. METHODS:220 athletes with a history of ankle sprain were recruited for this RCT. 110 athletes were offered the freely available "Strengthen your ankle App" and the other 110 received a printed Booklet. Primary outcome measure was incidence density of ankle sprains. Secondary outcome measures were residual pain/disability and the individual cumulative number of ankle sprains during follow-up. RESULTS: The incidence densities of self-reported ankle sprain recurrences were not significantly different between both groups (HR 1.06; 95% CI 0.76-1.49). Median FADI (Functional Ankle and Disability Index) scores increased equally over time in both groups, indicating a lower rate of limitation and pain in both groups at follow-up. Neither FADI scores nor cumulative recurrent injuries were significantly different between groups. CONCLUSIONS: This study showed that the implementation method of a NMT program by using an App or a Booklet did neither lead to different injury incidence rates in the long term nor did it influence residual functional disability/pain. Assuming equal compliance during the 8-week intervention, both methods show similar effectiveness in twelve-month follow-up.
RCT Entities:
OBJECTIVES: Recurrent ankle sprains can be reduced by a neuromuscular training program (NMT). The way NMT is delivered may influence the incidence of long term recurrent injuries, residual pain and disability. DESIGN: This RCT with a follow-up of twelve months, evaluated whether the implementation method of a proven effective NMT program delivered by a mobile application or a written instruction booklet, resulted in differences in injury incidence rates, functional ankle disability/pain in the long term, assuming equal compliance - as is shown in previous research - with the 8-week intervention. METHODS: 220 athletes with a history of ankle sprain were recruited for this RCT. 110 athletes were offered the freely available "Strengthen your ankle App" and the other 110 received a printed Booklet. Primary outcome measure was incidence density of ankle sprains. Secondary outcome measures were residual pain/disability and the individual cumulative number of ankle sprains during follow-up. RESULTS: The incidence densities of self-reported ankle sprain recurrences were not significantly different between both groups (HR 1.06; 95% CI 0.76-1.49). Median FADI (Functional Ankle and Disability Index) scores increased equally over time in both groups, indicating a lower rate of limitation and pain in both groups at follow-up. Neither FADI scores nor cumulative recurrent injuries were significantly different between groups. CONCLUSIONS: This study showed that the implementation method of a NMT program by using an App or a Booklet did neither lead to different injury incidence rates in the long term nor did it influence residual functional disability/pain. Assuming equal compliance during the 8-week intervention, both methods show similar effectiveness in twelve-month follow-up.
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