Restorative Physical Function and Patient-Reported Outcomes Following Acute Lateral Ankle Sprain in High School Athletes.

ABSTRACT

CONTEXT Limited longitudinal data exists on patient-reported outcomes (PROs) following acute lateral ankle sprain (LAS). The impact of prospective hop testing on PROs at return to play (RTP) and 6-months post RTP is unclear. OBJECTIVE: Determine if high school athletes with a LAS who return to baseline physical function as measured by a single-leg hop for distance (SLHOP) have better PROs relative to individuals who return to symmetry. DESIGN: Cohort Study. SETTING: Ten high schools over two years. PATIENTS OR OTHER PARTICIPANTS: Two hundred six high school athletes who sustained a LAS were included. Baseline SLHOP testing was completed pre-injury. PROs were recorded at time of injury, RTP, and 6-months post RTP. Participants were classified as symmetry (n=134) or restorative (n=72). Symmetry was defined as achieving a SLHOP performance within 10% of the uninjured limb at RTP. Restorative was defined as achieving a SLHOP performance within 10% of pre-injury levels. MAIN OUTCOME MEASURES: FAAM-ADL, FAAM-Sport, PROMIS Anxiety, and PROMIS Depression were analyzed using a two-way non-parametric ANOVA. The interaction term of group by time was the main comparison of interest and was interpreted if significant. Post-hoc multiple comparisons were performed using the Tukey-Kramer test. RESULTS: The restorative group reported better FAAM scores at RTP and 6-months post RTP (p<0.05) relative to the symmetry group. There were no differences in PROMIS Anxiety scores at time of injury, RTP, or 6-months post RTP between groups (p>0.05). There were no differences in PROMIS Depression scores at time of injury between groups (p=0.34), but the restorative group had worse PROMIS Depression scores at RTP (p=0.03). CONCLUSIONS: The restorative group reported better FAAM-ADL and FAAM-Sport scores at RTP and 6-months post RTP relative to the symmetry group. Restoring individuals to baseline physical function rather than limb symmetry may ensure better PROs following a LAS.