Urabe Y1, Suzuki Y1,2, Tashiro T1, Sasadai J1, Maeda N1
1Hiroshima University, Graduate School of Biomedical and Health Sciences, Department of Sports Rehabilitation, Hiroshima, Japan, 2Matterhorn Rehabilitation Hospital, Hiroshima, Japan
Background: Ankle sprains are the most common sports injuries and it is with high risk of recurrence. The recurrence injury rate is up to 70% (Yeung et al., 1994), many athletes suffer from pain, edema, disfunction, joint instability and time loss from activity. To prevent the recurrence of ankle sprains, it is necessary to appropriately proceed treatment and returning to play after ankle sprains. In Japan, athletes with ankle sprains are often restricted outpatient visit due to the medical insurance system.
Purpose: First, to clarify the trend of physical therapy and the criteria for returning to play after ankle sprains in Japan. Secondly, to compare the current status in Japan with worldwide standards of treatment after ankle sprains.
Methods: The internet-based questionnaire was offered to 316 sports physical therapists belonging to The Japanese Physical Therapy Association member. The questionnaire was consisted of the contents of treatment, number of days until return to play, the criteria for returning to play and the cases with difficulty returning to play.
Results: 166/316 sports physical therapists responded the questionnaire, and the response rate was 53%. 25% (41 therapists) was engaged in hospitals, 44% (73 therapists) was in sports or orthopedic clinics and 22% (36 therapists) was in sports facilities or sports teams. The therapists who treat ankle sprains frequently in regular work was 38% (63 therapists). The component of treatment was chosen that control of swelling and pain (33%), improvement of range of motion (20%), surrounding ankle joint muscular strength training (14%), activity-specific training such as a jumping, cutting or stepping drills (12%) and balance training (6%). The standard time to return to play was 1 to 2 weeks for Grade I (elongation) injury, 4 to 6 weeks for Grade II (partial rupture of ligament) injury and 8 to 12 weeks for Grade III (total rupture) injury. The criteria of returning to play was judged by relieve pain (46%), consultation or judgement of medical doctor (41%), restoration of sports-specific motion (38%), improvement of ankle range of motion (21%) and of muscle strength (15%).
Conclusion(s): There were not many sports physical therapists who are regularly engaged in the treatment of ankle sprains in Japan. This was because that the workplace of sports physical therapists was not only the sports clinics or sports teams but also hospitals. The component of treatment was appeared to be reasonable. However, neuromuscular and proprioceptive training such as balance exercise seemed not to be performed much compared with worldwide standards for treatment of ankle sprains. When deciding to return to play, some physical therapists were obeyed only the judgment of the medical doctor without evaluating physical function. In Japan, there is insufficient of the unified evaluation and target values for returning to play after ankle sprains. For prevention of recurrence of ankle sprains, it is important to set the specific evaluation and indicators. In the future, it is necessary to investigate whether the athletes are emphasizing ankle sprains.
Implications: This is a research contributing to the prevention of recurrence of ankle sprain.
Keywords: Ankle sprains, Sports Physical therapist, Prevention of recurrent injuries
Funding acknowledgements: We have no funding acknowledgement in this study.
Purpose: First, to clarify the trend of physical therapy and the criteria for returning to play after ankle sprains in Japan. Secondly, to compare the current status in Japan with worldwide standards of treatment after ankle sprains.
Methods: The internet-based questionnaire was offered to 316 sports physical therapists belonging to The Japanese Physical Therapy Association member. The questionnaire was consisted of the contents of treatment, number of days until return to play, the criteria for returning to play and the cases with difficulty returning to play.
Results: 166/316 sports physical therapists responded the questionnaire, and the response rate was 53%. 25% (41 therapists) was engaged in hospitals, 44% (73 therapists) was in sports or orthopedic clinics and 22% (36 therapists) was in sports facilities or sports teams. The therapists who treat ankle sprains frequently in regular work was 38% (63 therapists). The component of treatment was chosen that control of swelling and pain (33%), improvement of range of motion (20%), surrounding ankle joint muscular strength training (14%), activity-specific training such as a jumping, cutting or stepping drills (12%) and balance training (6%). The standard time to return to play was 1 to 2 weeks for Grade I (elongation) injury, 4 to 6 weeks for Grade II (partial rupture of ligament) injury and 8 to 12 weeks for Grade III (total rupture) injury. The criteria of returning to play was judged by relieve pain (46%), consultation or judgement of medical doctor (41%), restoration of sports-specific motion (38%), improvement of ankle range of motion (21%) and of muscle strength (15%).
Conclusion(s): There were not many sports physical therapists who are regularly engaged in the treatment of ankle sprains in Japan. This was because that the workplace of sports physical therapists was not only the sports clinics or sports teams but also hospitals. The component of treatment was appeared to be reasonable. However, neuromuscular and proprioceptive training such as balance exercise seemed not to be performed much compared with worldwide standards for treatment of ankle sprains. When deciding to return to play, some physical therapists were obeyed only the judgment of the medical doctor without evaluating physical function. In Japan, there is insufficient of the unified evaluation and target values for returning to play after ankle sprains. For prevention of recurrence of ankle sprains, it is important to set the specific evaluation and indicators. In the future, it is necessary to investigate whether the athletes are emphasizing ankle sprains.
Implications: This is a research contributing to the prevention of recurrence of ankle sprain.
Keywords: Ankle sprains, Sports Physical therapist, Prevention of recurrent injuries
Funding acknowledgements: We have no funding acknowledgement in this study.
Topic: Sport & sports injuries
Ethics approval required: Yes
Institution: Matterhorn Rehabilitation Hospital
Ethics committee: Ethics Committee
Ethics number: MRH17005
All authors, affiliations and abstracts have been published as submitted.
