Noninvasive Interactive Neurostimulation Therapy for the Treatment of Low-Grade Lateral Ankle Sprain in the Professional Contact Sport Athlete Improves the Short-Term Recovery and Return to Sport: A Randomized Controlled Trial.

Ankle injuries are very common between professional athletes and recreational sports. Lateral stable ligaments injury can be treated conservatively. Noninvasive interactive neurostimulation (NIN) is a form of electric therapy that works by locating areas of lower skin impedance. The objective of this prospective, double-blinded, randomized controlled trial was to compare the results in terms of improvement of a foot functional score, lower level of reported pain, and return to sports in 2 groups of contact sport athlete affected by a grade I or II lateral ankle sprain. Patients were randomized using random blocks to the NIN program (group I) or a sham device (group II). The outcome measurements were the use of a self-reported Inability Walking Scale, patient-reported subjective assessment of the level of pain using a standard visual analogue scale, and daily intake of nonsteroidal antiinflammatory drugs (etoricoxib 60 mg). Patients were also reached by telephone at 2 and 4 months of follow-up to register their return to sport activity. Beyond baseline evaluation, follow-ups were done after 5 (1 week) and 10 sessions (2 weeks) of treatment, and then at 30 days after the end of therapy. Of the 70 athletes admitted to the study, 61 eligible patients were randomized using random blocks to group I (n = 32) and group II (n = 29). Group I patients showed better improvement in terms of functional impairment (Inability Walking Scale), reported pain (visual analogue scale), and daily intake of etoricoxib 60 mg. Athletes of group I registered a faster resuming of sport activities. This prospective, randomized trial showed NIN can improve short-term outcomes in athletes with acute grade I or II ankle sprain and that it can hasten resuming of sport activities.

[Sprain of the thumb metacarpal-phalangeal with lesion of the ulnar collateral ligament]. / Entorse de l'articulation métacarpo-phalangienne du pouce avec lésion du ligament collatéral ulnaire.

The sprain of the thumb metacarpal-phalangeal joint must be treated in an adapted way in order to avoid chronic laxity. The comparative and bilateral clinical exam is the main element that will allow to detect laxity. In the case of non laxity, a conservative treatment with a splint makes sense. In the case of laxity with Stener effect, a surgical procedure is recommended in order to reintegrate the collateral ligament. In the case of laxity without Stener effect, the choice of treatment is contentious. A US or MRI would be useful if the Stener effect could be underlying. For whichever treatment opted, rehabilitation is to be started as soon as at week 4, in order to reduce risks of stiffness. The return to any sport or training will depend on the sprain stage and on the possibility to wear a rigid splint or not.

L'entorse de l'articulation métacarpo-phalangienne du pouce doit être traitée de manière adaptée pour éviter une laxité chronique. L'examen clinique bilatéral et comparatif est l'élément central pour dépister une laxité. Il doit être précédé d'une radiographie. En cas d'absence de laxité, un traitement conservateur par attelle se justifie. En cas de laxité avec effet Stener, un traitement chirurgical est indispensable pour réinsérer le ligament collatéral. En cas de laxité sans effet Stener, le traitement est controversé. Un US ou une IRM sont utiles en cas de suspicion d'effet Stener pour statuer sur l'état du ligament. Quel que soit le traitement, la rééducation est débutée dès la 4e semaine pour limiter l'enraidissement. Le retour à la pratique sportive dépend du stade de l'entorse et de la possibilité de porter une attelle rigide.

Terminology and classification of muscle injuries in sport: the Munich consensus statement.

OBJECTIVE: To provide a clear terminology and classification of muscle injuries in order to facilitate effective communication among medical practitioners and development of systematic treatment strategies. METHODS: Thirty native English-speaking scientists and team doctors of national and first division professional sports teams were asked to complete a questionnaire on muscle injuries to evaluate the currently used terminology of athletic muscle injury. In addition, a consensus meeting of international sports medicine experts was established to develop practical and scientific definitions of muscle injuries as well as a new and comprehensive classification system. RESULTS: The response rate of the survey was 63%. The responses confirmed the marked variability in the use of the terminology relating to muscle injury, with the most obvious inconsistencies for the term strain. In the consensus meeting, practical and systematic terms were defined and established. In addition, a new comprehensive classification system was developed, which differentiates between four types: functional muscle disorders (type 1: overexertion-related and type 2: neuromuscular muscle disorders) describing disorders without macroscopic evidence of fibre tear and structural muscle injuries (type 3: partial tears and type 4: (sub)total tears/tendinous avulsions) with macroscopic evidence of fibre tear, that is, structural damage. Subclassifications are presented for each type. CONCLUSIONS: A consistent English terminology as well as a comprehensive classification system for athletic muscle injuries which is proven in the daily practice are presented. This will help to improve clarity of communication for diagnostic and therapeutic purposes and can serve as the basis for future comparative studies to address the continued lack of systematic information on muscle injuries in the literature. WHAT ARE THE NEW THINGS: Consensus definitions of the terminology which is used in the field of muscle injuries as well as a new comprehensive classification system which clearly defines types of athletic muscle injuries. LEVEL OF EVIDENCE: Expert opinion, Level V.

Acute muscle strain injuries: a proposed new classification system.

PURPOSE: To better define and classify acute muscle strain injuries. METHODS: Historically, acute muscle strains have been classified as grade I, II and III. This system does not accurately reflect the anatomy of the injury and has not been shown to reliably predict prognosis and time for return to sport. RESULTS: We describe an imaging (magnetic resonance or ultrasound) nomenclature, which considers the anatomical site, pattern and severity of the lesion in the acute stage. By site of injury, we define muscular injuries as proximal, middle and distal. Anatomically, based on the various muscular structures involved, we distinguish intramuscular, myofascial, myofascial/perifascial and musculotendinous injuries. CONCLUSIONS: This classification system must be applied to a variety of muscle architectures and locations to determine its utility; additional studies are therefore needed prior to its general acceptance. LEVEL OF EVIDENCE: V.

Acromioclavicular joint injuries and reconstructions: a review of expected imaging findings and potential complications.

Shoulder injuries, including acromioclavicular (AC) joint separations, remain a common reason for presentation to the emergency room. Although the diagnosis can be made apparent through proper history and physical examination by the emergency medicine physician, ascertaining the degree of injury can be difficult on the basis of clinical evaluation alone. While there is consensus in the literature that low-grade AC joint injuries can be treated with conservative management, high-grade injuries will generally require surgical intervention. Furthermore, the treatment of grade 3 injuries remains controversial, making it incumbent upon the radiologist to become comfortable with distinguishing this diagnosis from lower or higher grade injuries. Imaging of AC joint injuries after clinical evaluation is generally initiated in the emergency room setting with plain film radiography; however, on occasion, an alternative modality may be presented to the emergency room radiologist for interpretation. As such, it remains important to be familiar with the appearance of AC joint separations on a variety of modalities. Another possible patient presentation in both the emergent and nonemergent setting includes new onset of pain or instability in the postsurgical shoulder. In this scenario, the onus is often placed on the radiologist to determine whether the pain or instability represents the sequelae of reinjury versus a complication of surgery. The purpose of this review is to present an anatomically based discussion of imaging findings associated with AC joint separations as seen on multiple modalities, as well as to describe and elucidate a variety of potential complications which may present to the emergency room radiologist.

Comparison of magnetic resonance imaging to physical examination for syndesmotic injury after lateral ankle sprain.

BACKGROUND: Clinical assessment of syndesmotic injury usually consists of two tests: the ankle external rotation test and squeeze test. This study sought to determine the sensitivity and specificity of both for syndesmotic injury secondary to lateral ankle sprain. METHODS: Fifty-six patients with sprained ankles underwent clinical examination for syndesmotic injury with the aforementioned tests. Clinical findings were compared against magnetic resonance imaging (MRI) of the ankle. Sprains were graded on anatomical and functional classification scales, and correlation and agreement between both scales were assessed. RESULTS: The MRI prevalence of syndesmotic injury in patients with lateral ankle sprains was 17.8%. Sensitivity and specificity were 30% and 93.5% for the squeeze test, and 20% and 84.8% for the external rotation test, respectively. Using the anatomical scale for sprain grading, 40% of syndesmotic injuries occurred in Grade I, 40% in Grade II, and 20% in Grade III sprains. Ten percent of patients with syndesmotic injury had no lateral ligament injury on MRI, 70% had injury of the anterior talofibular (ATFL) ligament, and 20% had injury to the ATFL and calcaneofibular (CFL). CONCLUSION: The sensitivity of the squeeze test and external rotation test was low, suggesting that physical examination often fails to diagnose syndesmotic injury. Conversely, specificity was very high; nearly all patients with a positive test actually had syndesmotic injury. Severity of ankle sprain was not associated with prevalence of syndesmotic injury.

[Supination external rotation lesions of the ankle joint in osteoporotic lower leg specimens. Experimental induction and review of the literature]. / Die Supinations-Eversions-Verletzung des OSG in osteoporotischen Unterschenkelpräparaten. Experimentelle Induktion und Literaturübersicht.

BACKGROUND: Knowledge of the pathomechanism and the detailed extent of ankle joint lesions determines adequate therapy and success of treatment. MATERIAL AND METHODS: Supination external rotation lesions were induced in 29 human cadavera with a testing apparatus; 27 of these specimens were from elderly women. Bone mineral density was measured. The literature review includes experimental studies of this fracture entity. RESULTS: We induced stage II in 42%; applying an additional lateral force on the fibula raised the incidence. The syndesmosis stayed intact in 50% although the fibula fractured at the level of the tibial plafond. Stage IV lesions were registered in 25%. The overall low bone mineral density showed a positive correlation to the angle at which the fibula fracture occurred. CONCLUSIONS: We reproduced supination external rotation lesions according to Lauge-Hansen in osteoporotic ankles. There is a certain discrepancy between the obligatory lesion of the inferior anterior tibiofibular syndesmosis at stage II according to Lauge-Hansen, as we observed an intact syndesmosis in 50% at stage II. Stage IV defining medial malleolar fractures were reproduced after Lauge-Hansen and Michelson et al.

Outcome of the functional treatment of first-time ankle inversion injury.

BACKGROUND: Avulsion fractures of the lateral malleoli in ankle inversion injuries are often undetected on routine radiographs. Undetected avulsion fractures have been managed as ankle sprain, which may affect the outcome of the treatment of the ankle sprain. The purposes of this study are to compare the outcomes of functional treatment between the first-time severe ligament injury and avulsion fracture of the lateral ankle, and to investigate how the anterior talofibular ligament (ATFL) view or the calcaneofibular ligament (CFL) view affects the diagnosis of the avulsion fracture and outcome of functional treatment of the ankle inversion injury. METHODS: A total of 276 consecutive patients with a first-time severe ankle inversion injury were classified into a ligament injury group (group I) or an avulsion fracture group (group II) on the basis of physical examination and radiographs. The patients with a negative finding on routine radiographs and a positive finding on the ATFL or CFL view derived from group II (group IIA). Age, sex, and activity level were analyzed. Patients were treated by stirrup splint. RESULTS: A total of 202 (73.2%) patients were in group I and 74 (26.8%) were in group II. In all, 50 patients in group II showed negative standard radiographs and a positive ATFL or CFL view. Altogether, 240 patients were followed up for at least 1 year and assessed clinically and radiographically. Differences in age, sex, and activity level before injury between groups were not statistically significant. Clinical and radiographic results of group II were inferior to those of group I. The outcome of group IIA was comparable to that of group I. CONCLUSIONS: The outcome of functional treatment of avulsion fracture was inferior to that of ligament injury. The ATFL and CFL views provide a more precise diagnosis but do not affect the outcome of the functional treatment.

Quantitative assessments of static and dynamic balance performance in patients with chronic ankle instability.

Patients with chronic ankle instability (CAI) have postural-control deficits during center-of-pressure excursions than do healthy individuals. While an external analysis of center-of-pressure excursions in CAI has been performed, a quantitative analysis of center-of-gravity movements, to detect the balance deficits associated with CAI, has yet to be performed. Therefore, the aim of the study is to quantify the balance deficits in patients with unilateral CAI.Forty-four patients with unilateral CAI (24 men; age, 31.7 ±â€Š5.5 years) and 26 uninjured volunteers (12 men; age, 28.6 ±â€Š5.9 years) underwent Neurocom Balance Manager assessments of dynamic and static balance responses in limits of stability, unilateral stance, and forward lunge tests.In the limits of stability test, there were no significant group differences in the forward direction; however, reaction times were longer in the CAI group than in the control group in the backward (P = .037, effect size [ES] = 0.49) and rightward directions (P = .032, ES  = 0.47). Furthermore, the CAI group showed more excursions in the rightward (P = .046, ES = 0.50) and leftward directions (P = .002, ES = 0.80), and less directional control in the leftward direction (P = .036, ES = 0.59). In the unilateral stance test, the center of gravity sway velocity was faster in the CAI group than in the control group, whether eyes were opened or closed (P < .05). There were no significant group differences in forward lunge-test outcomes.Patients with CAI have poor static and dynamic balance performance compared to that in healthy counterparts. Thus, balance retraining should be an essential component of rehabilitation programs for patients with CAI.

Factors that distinguish serious versus less severe strain and sprain injuries: an analysis of electric utility workers.

BACKGROUND: Occupational sprain and strain injuries are one of the most common types of nonfatal occupational injuries and a significant source of lost workdays. This study examines factors associated with severe work-related sprain/strain injuries to the back, shoulder, and knees. METHODS: A synthetic case-control study was performed (controls were selected from the same pool of utility workers as cases). Cases included all electric utility workers who had experienced a severe work-related sprain/strain injury to the back, knee, or shoulder. Primary controls were selected from all workers who had sustained a minor injury. Secondary controls were selected from employees with a minor sprain/strain injury to the back, knee, or shoulder. Multivariate logistic regression models were used to estimate odds ratios and 95% confidence intervals. RESULTS: Workers 41 years and older were more likely to have experienced severe shoulder sprain/strain injuries [Age 41-50: OR = 3.62, 95% CI: 1.71-7.65; age 51 and older: OR = 4.49, 95% CI: 1.89-10.67] and severe back sprain/strain injuries [Age 41-50: OR = 1.70, 95% CI: 1.06-2.33; age 51 and older: OR = 1.5, 95% CI: 0.90-2.52]. Line workers and maintenance workers had an increased risk of serious sprain/strain injuries. Gender and day of week were not significantly associated with sprain/strain injuries. DISCUSSION: Though this study is limited by available data, future studies may benefit from this preliminary examination of occupational and demographic characteristics associated with serious sprain/strain injuries among electric utility workers.

Focus on echocardiographic right ventricular strain analysis in cystic fibrosis adults without cardiovascular risk factors: a case-control study.

Strain echocardiography is able to detect subclinical ventricular systolic and diastolic dysfunction. Prolonged survival to cystic fibrosis favors heart and vessel involvement. The purpose of the present study was to compare clinically stable adult patients affected by cystic fibrosis without overt pulmonary hypertension with controls to evaluate right ventricular (RV) systolic and diastolic function by means of strain and tissue Doppler imaging (TDI), respectively. 22 adults affected by cystic fibrosis and 24 healthy volunteers matched for age and sex were enrolled. None had known cardiovascular risk factors or overt pulmonary hypertension. All people underwent blood pressure measurement and transthoracic echocardiography. Cystic fibrosis patients showed higher sPAP [median 25 (IQR 21-30) vs 22 (22-22) mmHg; p = 0.02] and more frequent RV diastolic dysfunction (p < 0.001). Among cases, some RV systolic parameters were significantly altered than controls, such as TAPSE [20 (18-24) vs. 23 (21-28) mm; p = 0.001], FAC [34 (26-44) vs. 49 (48-50)%; p < 0.001], midwall tissue strain [- 25.0 (- 31.3 to - 22.8) vs. - 30.5 (- 31.8 to - 29.3)%; p = 0.03], apical tissue strain [- 22 (- 29.3 to - 19.0) vs. - 30.5 (- 32.8 to - 28.3)%; p = 0.001] and 2D strain [- 22.0 (- 25.1 to - 19.0) vs. - 29.5 (- 31.8 to - 27.3)%; p < 0.001]. Finally, 2D strain correlated with spirometric FEV1 (ρ = - 0.463, p = 0.03) and nearly with FEF25-75% (ρ = - 0.393, p = 0.07). Our study confirmed a RV subclinical systo-diastolic dysfunction in clinically stable patients affected by cystic fibrosis without overt pulmonary hypertension nor cardiovascular risk factors. This may be due to systemic inflammation and temporary recurrent pulmonary hypertension. We retain that RV 2D strain and TDI echocardiography could become an important tool in the follow-up of these patients.

MR imaging evaluation of subtle Lisfranc injuries: the midfoot sprain.

MR imaging offers the great advantage over other imaging modalities by demonstrating ligament injuries directly rather than relying on secondary signs of bony abnormalities. Based on the literature at present, it has been shown that MR imaging can demonstrate tears of the Lisfranc ligament complex. There is, however, limited information on diagnostic accuracy.

Cross-cultural adaptation of the Brazilian-Portuguese version of the Cumberland Ankle Instability Tool (CAIT).

PURPOSE: To develop and psychometrically test a Brazilian-Portuguese version of the Cumberland Ankle Instability Tool (CAIT), the only questionnaire that provides a numeric measure for functional ankle instability. METHODS: The CAIT was translated and adapted into Brazilian-Portuguese according to the Guidelines for the process of cross-cultural adaptation of self report measures. The Brazilian-Portuguese version of the CAIT was tested for internal consistency, test-retest reliability, ceiling and floor effects and responsiveness in 131 participants. Participants were recruited from the general community in Brazil (N = 101, community group) and from those seeking treatment for an ankle sprain from 2 clinics in Brazil (N = 30, treatment group). RESULTS: The Brazilian-Portuguese version of the CAIT had high internal consistency (Cronbach alpha = 0.86 for right ankles and 0.88 for left ankles), reliability (ICC = 0.95, 95% CI 0.93-0.97); and good responsiveness (ES = 0.75, 95% CI 0.49-1.00). No ceiling or floor effects were observed. CONCLUSIONS: The Brazilian-Portuguese version of the CAIT is as reliable as the English version of the questionnaire, has high internal consistency and good responsiveness. It thus provides the first tool that can be used to assess functional ankle instability by clinicians and researchers working among Brazilian-Portuguese speakers.

Short-term natural recovery of ankle sprains following discharge from emergency departments.

STUDY DESIGN: Prospective cohort study. OBJECTIVES: To examine the natural recovery from grade I and II ankle injuries over a 1-month period. BACKGROUND: There is a high rate of injury recurrence and persistence of symptoms following ankle sprains, suggesting that these injuries may not be adequately managed. However, little is known about the recovery process after discharge from emergency departments. METHODS AND MEASURES: Clinical assessment of ankle swelling, strength, and joint mobility and laboratory assessment of peak torque and joint range of motion (ROM) were performed 4 and 30 days following initial clinical assessment in the emergency department. Analyses for repeated measures determined change over time and differences between injured and noninjured ankles. Self-assessed ankle function was evaluated on day 4 and day 30, and its relationship to clinical and laboratory assessments determined. RESULTS: Forty-six subjects entered the study and complete datasets were obtained from 28. Significant swelling, weakness, and mobility restrictions were evident on initial assessment. Symptoms improved over time and, while clinical variables were normal by day 30, laboratory assessment indicated weakness of plantar flexors and limited active and passive ROM at 1 month. Swelling and reduced passive ROM were associated with overall function and limitations in sports and recreation activities, as well as quality of life 1 month postinjury. CONCLUSION: Clinically assessed strength and ankle dorsiflexion mobility suggested full recovery at 1 month post injury, yet more sensitive measures of ankle impairment and performance detected residual deficits. Persistent impairment and incomplete recovery of self-assessed function suggest the need for management beyond standard emergency department care. Associations between impairment measures and function may provide guidance for treatment intervention.

Encapsulation of benznidazole in nanostructured lipid carriers and increased trypanocidal activity in a resistant Trypanosoma cruzi strain

Abstract Chagas disease is a neglected parasitic disease caused by Trypanosoma cruzi, whose treatment has remained unsatisfactory for over 50 years, given that it is limited to two drugs. Benznidazole (BZN) is an efficient antichagasic drug used as the first choice, although its poor water-solubility, irregular oral absorption, low efficacy in the chronic phase, and various associated adverse effects are limiting factors for treatment. Incorporating drugs with such characteristics into nanostructured lipid carriers (NLC) is a promising alternative to overcome these limiting obstacles, enhancing drug efficacy and bioavailability while reducing toxicity. Therefore, this study proposed NLC-BZN formulations in different compositions prepared by hot-melt homogenization followed by ultrasound, and the optimized formulation was characterized by FTIR, DRX, DSC, and thermogravimetry. Biological activities included in vitro membrane toxicity (red blood cells), fibroblast cell cytotoxicity, and trypanocidal activity against epimastigotes of the Colombian strain of T. cruzi. The optimized NLC-BZN had a small size (110 nm), negative zeta potential (-18.0 mV), and high encapsulation (1.64% of drug loading), as shown by infrared spectroscopy, X-ray diffraction, and thermal analysis. The NLC-BZN also promoted lower in vitro membrane toxicity (<3% hemolysis), and 50% cytotoxic concentration (CC50) for NLC-BZN in L929 fibroblast cells (110.7 µg/mL) was twice the value as the free BZN (51.3 µg/mL). Our findings showed that the NLC-BZN had higher trypanocidal activity than free BZN against the epimastigotes of the resistant Colombian strain, and this novel NLC-BZN formulation proved to be a promising tool in treating Chagas disease and considered suitable for oral and parenteral administration

Immediate effects of manipulation of the talocrural joint on stabilometry and baropodometry in patients with ankle sprain.

OBJECTIVE: This study assessed the immediate effects of talocrural joint manipulation on stabilometric and baropodometric outcomes in patients with grade II ankle sprain. METHODS: Fifty-two field hockey players (35 men and 17 women) between 18 and 40 years old (mean = 22.5 years, SD = 3.6 years) were included in this study. A simple blind, intrapatient, placebo-controlled, and repeated-measures study was carried out. All the patients underwent a baropodometric study performed with a Foot Work force platform (4 times; pre-post placebo group and pre-post intervention group). The sample was subjected to two techniques of manipulative treatment: (a) talocrural joint manipulation and (b) posterior gliding manipulation over the talus. In a second instance, placebo manipulation was applied. Unilateral analysis of variance and multivariate analysis of variance were used for statistical analysis. RESULTS: The results in the intervention group revealed significant differences in the percentage of posterior load on the foot (P = .015) and the percentage of bilateral anterior load (P = .02) before and after the manipulation. The placebo group did not show any change in any of the variables except for area (P = .045). Intergroup comparison revealed statistically significant differences in the increase in percentage of posterior load on the manipulated foot, percentage of bilateral posterior load, percentage of anterior load on the manipulated foot, and percentage of bilateral anterior load (with the exception of the total load on the foot). CONCLUSIONS: The application of caudal talocrural joint manipulation, as compared with placebo manipulation, in athletic patients with grade II ankle sprain redistributed the load supports at the level of the foot.

A prospective, randomized clinical investigation of the treatment of first-time ankle sprains.

BACKGROUND: Acute ankle ligament sprains are treated with the use of controlled mobilization with protection provided by external support (eg, functional treatment); however, there is little information regarding the best type of external support to use. HYPOTHESIS: There is no difference between elastic wrapping, bracing, bracing combined with elastic wrapping, and casting for treatment of acute, first-time ankle ligament sprains in terms of the time a patient requires to return to normal function. STUDY DESIGN: Randomized controlled clinical trial; Level of evidence, 1. METHODS: Patients suffering their first ligament injury were stratified by the severity of the sprain (grades I, II, or III) and then randomized to undergo functional treatment with different types of external supports. The patients completed daily logs until they returned to normal function and were followed up at 6 months. RESULTS: Treatment of grade I sprains with the Air-Stirrup brace combined with an elastic wrap returned subjects to normal walking and stair climbing in half the time required for those treated with the Air-Stirrup brace alone and in half the time required for those treated with an elastic wrap alone. Treatment of grade II sprains with the Air-Stirrup brace combined with the elastic wrap allowed patients to return to normal walking and stair climbing in the shortest time interval. Treatment of grade III sprains with the Air-Stirrup brace or a walking cast for 10 days followed by bracing returned subjects to normal walking and stair climbing in the same time intervals. The 6-month follow-up of each sprain severity group revealed no difference between the treatments for frequency of reinjury, ankle motion, and function. CONCLUSION: Treatment of first-time grade I and II ankle ligament sprains with the Air-Stirrup brace combined with an elastic wrap provides earlier return to preinjury function compared to use of the Air-Stirrup brace alone, an elastic wrap alone, or a walking cast for 10 days.

The role of fibular tape in the prevention of ankle injury in basketball: A pilot study.

STUDY DESIGN: Prospective nonrandomized controlled trial. OBJECTIVES: To determine the effect of fibular repositioning tape (FRT) on incidence and severity of ankle injury. BACKGROUND: Pain and functional disability is common following ankle sprain and a major problem in sport. A novel method of taping, FRT, which has been described to prevent ankle sprain, requires less tape than traditional methods and is easier to apply. The objective of this study was to determine the effect of FRT on the incidence and severity of ankle injury in basketball. METHODS AND MEASURES: One hundred twenty-five male basketball players were assigned at time of play to either the control (209 exposures) or FRT (224 exposures) condition in a manner of convenience. Control participants had the choice on the use and type of prophylaxis, excluding FRT. FRT participants were taped using the method described by Mulligan. Ankle injury data were collected after each exposure. Injury severity was determined by functional limitation, pain levels, and days to return to play. RESULTS: Four hundred forty-three measured basketball exposures resulted in 11 ankle injuries. All injuries occurred in subjects with a history of previous ankle sprain. Significantly less ankle injuries were sustained by members of the FRT condition (n = 2), compared to members of the control condition (n = 9) (Fisher exact test, P = .03). The odds ratio of sustaining an ankle injury was 0.20 (P = .04; 95% confidence interval [CI]: 0.04, 0.93) when taped with FRT and the number needed to treat was 22 (95% CI, 12-312). CONCLUSIONS: This study provides preliminary data regarding the prophylactic effects of FRT on ankle injury in male basketball players.

Acute lateral ankle sprains in track and field athletes: an expanded classification.

We present a longitudinal observational study on classification of acute lateral ankle ligament injuries in track and field athletes, based on objective criteria. These very common and sometimes troublesome sports injuries are treated functionally, but there is a lack in international literature on predicting the time needed for full recovery. Taking into consideration (1) active range of motion, (2) edema, (3) stress radiographs findings, and (4) full rehabilitation time, we divided grade III sprains in IIIA and IIIB, proposing that these injuries can be classified in four categories (I, II, IIA, IIIB). The range of motion-edema-stress radiographs classification that we propose evaluates the severity of lateral ankle injuries, is an easy and practical method, and predicts full return in athletic activities without residual complaints, if the proper rehabilitation program is executed.