None listed
Conditions
Brief summary
Lateral ankle sprains are the most prevalent musculoskeletal injury sustained by individuals who participate in sports. They also have the highest recurrence rate of all musculoskeletal injuries; between 32% to 74% of individuals will experience a re-injury and/or report persistent injury-associated symptoms. The high prevalence (40%) of re-injury and persistent injury-associated symptoms experienced within the 1-year time period following first-time acute lateral ankle sprain injury suggests that current management practices may be insufficient. A study of US high school athletes identified that 71% to 75% of athletes return to sport (RTS) within 3 days of incurring an acute lateral ankle sprain injury, whilst 95% of athletes RTS within 10 days of injury. Based on these timeframes, it is not surprising that sensorimotor impairments associated with acute lateral ankle sprains are still present when athletes RTS. Early, and symptomatic, RTS after an acute lateral ankle sprain injury could heighten the risk of persistent injury-associated symptoms, future injury risk and the development of secondary problems, such as ankle joint osteoarthritis. There are a number of likely reasons why sportspersons RTS early, and with impairments, after incurring an acute lateral ankle sprain injury. First, lateral ankle sprains are often assumed to be minor injuries and consequently over half of individuals do not seek formal medical treatment. Thus, in these individuals, injury-associated sensorimotor impairments are never addressed with specific targeted rehabilitation. Second, there are currently no criteria-based guidelines to guide RTS decision making for individuals with an acute lateral ankle sprain injury. In light of the lack of evidence for RTS criteria following acute lateral ankle sprain injury, and lack of literature addressing this question, there is need to determine and collate expert opinion to inform RTS practice. The Delphi process is one method that can be used to collate and refine expert opinion. This approach has been undertaken to inform the development of RTS criteria for hamstring injuries. Information gained by this process can be used to inform the development of RTS criteria for acute lateral ankle sprains and provide the basis for prospective cohort studies to test the use of the proposed criteria for successful RTS. The aim of this study is to use a Delphi approach to develop consensus for RTS criteria for individuals who have sustained an acute lateral ankle sprain injury.
Interventions
A Delphi approach will be used to establish consensus of opinion from a panel of experts on RTS criteria and the definition of successful RTS after an acute lateral ankle sprain injury. There are three planned Delphi rounds, that will be 1-2 months apart. The process for each Delphi round will involve: data collection via an online survey (using the SurveyMonkey platform), analysis of responses, and provision of feedback to panelists. The goal of the Delphi process is to achieve consensus, a pri
A Delphi approach will be used to establish consensus of opinion from a panel of experts on RTS criteria and the definition of successful RTS after an acute lateral ankle sprain injury. There are three planned Delphi rounds, that will be 1-2 months apart. The process for each Delphi round will involve: data collection via an online survey (using the SurveyMonkey platform), analysis of responses, and provision of feedback to panelists. The goal of the Delphi process is to achieve consensus, a priori defined as >70% agreement between panelists. For each Delphi round, expert panelists will be sent an email invitation with a link to an anonymous online survey. The first round of the Delphi survey will include a combination of structured and open response questions informed by a review of the literature. The second and third Delphi rounds will predominantly use structured questions with Likert rating responses (“Yes”, “No” or “Unsure/I do not know”). These rounds aim to quantify findings from the previous round and form a consensus among participants. Content analysis will be used to identify themes from open response questions. Responses will initially be read for familiarisation and then re-read for identification of themes. Once themes are identified, data will be categorised. For trustworthiness and to decrease risk of bias, this process will be undertaken independently by two researchers. Analyses will be discussed between the two researchers to achieve agreement, and any items for which agreement is not achieved will be discussed with a third party. This will culminate in a list of RTS criteria from the open responses that will be developed into structured questions for the subsequent Delphi round. Structured questions that reach consensus (>70% of panelists agreed on the inclusion or exclusion of the RTS criteria for use in sportspersons after a lateral ankle sprain) will be removed from the survey for the following round. A participant’s opinion to include a RTS criteria is defined as selection of the “Yes” Likert option, and an opinion to exclude a RTS criteria is defined a selection of the “No” option. Between each round, feedback on the previous round will be provided to participants via email. Data from structured questions will be presented back to participants as the percentage of panelists who selected each answer category. Data from open response questions will be summarised as new RTS criteria/themes that have come out of participant responses. A thematic summary of explanation of responses will be included after each structured question that did not reach consensus in the previous round.
Sponsors
Dr Michelle Smith
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Eligibility criteria for participants (expert panelists) are: i) health professional (e.g. physiotherapist, athletic trainer/therapist, sports medicine physician); ii) currently working with athletes competing in nationally selected representative teams or teams in Tier/Division 1 national competitions (e.g. English Premier League, NCAA Division 1, Suncorp Super Netball); iii) currently working in field or court sports in which the primary gross motor skills are running and jumping/landing or changing direction and there is a high prevalence of lateral ankle sprain injuries; iv) involved in making RTS decisions for individuals with an acute lateral ankle sprain injury; v) proficiency in the English language. The sports to be targeted for this study include: basketball, volleyball, netball, handball, korfball, soccer, rugby, American/Canadian football, Australian rules football, Gaelic football, lacrosse, field hockey, hurling, camogie, tennis, badminton and squash.
Exclusion criteria
Participants will be excluded from this study if they are not proficient in the English language. Individuals who are solely working with Paralympic, Invictus Games or other groups of disabled athletes, or athletes from selective populations (such as military or World Maccabiah Games athletes) are not eligible for inclusion.
Outcome results
None listed