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Return-to-play after ankle sprain

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Return-to-play

after ankle sprain

Aude AGUILANIU

(3)

TITRE

SOUSTITRE

(4)

Grade & time to RTP

AFTER ANKLE SPRAIN

Grade 1 à 12 days Grade 2 à 2-6 weeks

Grade 3 à 26 weeks

AVO

ID

Because

Does not reflect the clinical symptoms

(5)

The Return-to-play :

A continuum

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3 Main phases RTP PROCESS (Ardern et al. 2016) Return to participation Return to sport Return to performance Ap tit ude to re tur n-to -pl ay time

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Assessments RTP PROCESS Ap tit ude to re tur n to pl ay Return to activity Return to sport Return to performance time assessments assessments assessments

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Which are the criteria

we have to assess ?

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No criteria consensus (Tassignon et al. 2019) Lack of evidence (Wikstrom et al. 2019)

Criteria in literature ?

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Established criteria IN PROGRESS… Best RTP criteria (Congress IAC, Smith et al. 2019) (Tassignon et al. 2019) 154 healthcare stakeholders Long list of RTP criteria

International Delphi study

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First conclusions for :

lateral ankle sprain return-to-sport assessment

P : Pain

A : Ankle perceptions A : Ankle impairments

S : Sensorimotor control system S : Sport testing

PAASS

FROM A DELPHI STUDY (SMITH et al.)

(Congress IAC, Smith et al. 2019) (Tassignon et al. 2019)

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Examples of assessments

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Pain scale

Pain

MEASURABLE ASSESSMENTS (Hawker et al., 2011) 0 1 2 3 4 5 6 7 8 9 10 General

During sport activity …

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Pain scale

Pain

HELPFUL TO GUIDE REHABILITAION

(Sibernajel K et al., 2007)

0 1 2 3 4 5 6 7 8 9 10

Pain ok Too much pain During exercises

After exercises …

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Questionnaires

(French version validated)

FAAM-ADL à 20 items FAAM-Sport à 8 items (Borloz et al. 2011) CAIT à 9 items (Geerink et al. 2019)

Ankle perceptions

INSTABILITY

A

( Smith et al. 2019)

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Ankle perceptions

PSYCHOLOGICAL ASPECTS Psychological readiness I – PRRS à 6 items (Douglas et al., 2009)

A

( Smith et al. 2019)

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Weight Bearing Lunge Test (measurable meter)

Ankle Impairments

MEASURE OF MOBILITY Reliable (Langarika-Rocafort et al., 2016) Valid (Hall et Docherty, 2016)

Norms : Right ≠ Left < 3 cm > 10 cm

(Clanton et al., 2012; Delbarre Grossemy, 2008; Hoch et McKeon, 2011)

A

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Ankle Impairments

MEASURE OF MUSCLE STRENGTH

Muscle strength

(Hand Held Dynamometer)

Reliable intratester (Kelln et al. 2008)

Valid (Hall et al. 2015)

A

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Dynamic balance

Y-Balance test

Sensorimotor control

BALANCE MEASURE

Medial posterior Medial lateral anterior

(Picot et al. 2018)

Norm MP > 77.5%

(Attenborough et al. 2017)

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Sport testing

MEASURABLE ASSESSMENTS Think about the sport requirements

à adapted tests T-test agility (Paulo et al. 2000) Hop test (Eechaute et al. 2012) ( Smith et al. 2019)

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ASSESSMENTS

IN PROGRESS…

Create norms

use quantitative measures

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Conclusion

The Return-to-play is a continuum Participation – Sport – Performance

Feeling, experience, adaptation… +

Quantitative assessments =

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TITRE

SOUSTITRE Aude AGUILANIU Sport physiotherapist PhD student contact : aude.aguilaniu@uliege.be

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