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A Simple Ankle Value to Differentiate Copers and Patients Likely to Develop Chronic Ankle Instability After Lateral
Ronny Lopes1, Alexandre Hardy2, Thomas Barnavon3
1Centre Orthopédique Santy, FIFA Medical Center of Excellence, Hôpital Privé Jean Mermoz, Groupe Ramsay, Lyon, France.
Background:
Lateral ankle sprain (LAS) is the most common injury in sports, and only 30% of patients will fully recover (copers). Currently, no single objective tool exists to help clinicians decide on return to sport between LAS copers and patients likely to develop chronic ankle instability (CAI). The Simple Ankle Value (SAV) is a score developed recently to evaluate function among patients with ankle injury.
Objective:
To evaluate the ability of the SAV to distinguish between LAS copers and patients likely to develop CAI.
Setting:
Clinic.
Design:
Cross-sectional study.
Patients Or Other Participants:
A total of 66 participants (34 women, 32 men; age = 32.4 ± 9.3 years) comprising 15 copers, 32 patients with CAI, and 19 healthy controls.
Main Outcome Measures:
Participants completed the SAV, which consisted of a single question rated from 0% to 100%, with 100% corresponding to normal ankle function. The SAV scores were compared among the 3 groups (coper, patients with CAI, and control) via analysis of variance and post hoc Bonferroni correction. The area under the receiver operating characteristic curve with the optimal cutoff score was determined to assess the ability of the SAV to discriminate between copers and patients likely to develop CAI.
Results:
Both LAS copers (96.3% ± 6.8%) and controls (92.8% ± 6.5%) presented higher SAV scores than patients with CAI (74.4% ± 18.0%; F 2,63 = 19.04, P < .001, η2 = 0.37). Post hoc analysis revealed no difference between LAS copers and controls (P = .14). The SAV showed a fair-to-good ability to discriminate between copers and patients with CAI (area under the receiver operating characteristic curve = 0.83; 95% CI = 0.72, 0.95; P < .01). A Youden index of 0.65 was observed for an SAV score of 87%, which corresponded to a sensitivity of 87% and a specificity of 78%.
Conclusions:
The SAV is a simple and practical tool that helps distinguish copers from patients at risk of developing CAI after LAS. Scores of ≤87% suggest incomplete recovery. As a complementary patient-reported outcome measure, the SAV should be integrated into a comprehensive clinical assessment to support return-to-sport decision-making in the context of CAI.
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