E-health intervention for preventing recurrent ankle sprains: a randomised controlled trial in general practice

Abstract

Background: Ankle sprains are frequent injuries in general practice. However, no effective treatment is available yet. Aim: To examine the effectiveness of an unsupervised e-health supported neuromuscular training program in combination with usual care compared to usual care alone in patients with acute lateral ankle sprains in general practice. Design and setting: Randomised controlled trial with one-year follow-up among patients (14-65 years) who visited the general practitioner with an acute lateral ankle sprain within three weeks of injury. Methods: The intervention group received, in addition to usual care, an unsupervised e-health supported neuromuscular training program, and the control group received usual care alone. The primary outcome was self-reported re-sprains during 52 weeks of follow-up. Secondary outcomes were ankle function, pain in rest and during activity, subjective recovery and return to the same type and level of sport. Results: 165 Participants (mean age 38.3 years and 41.8% male) were included. No statistically significant difference in the occurrence of a re-sprain were found between the intervention 20.7% (17/82) and control group 24.1% (20/83)(HR 1.14; 95% CI 0.59-2.21). Also, no statistically significant differences in secondary outcomes were found between groups. The adherence rate to the program was low (6.1%). Conclusion: Although the rate of re-sprains was relatively high, an unsupervised e-health supported neuromuscular training program does not yield meaningful effects and does not encourage adherence in preventing re-sprains in patients in general practice. More research is necessary to indicate the best treatment modality and way of delivery for these patients.