Clinical research studyWhat Is the Clinical Course of Acute Ankle Sprains? A Systematic Literature Review
Section snippets
Literature Search
One author (RvR) conducted a database search using MEDLINE (from 1966 to August 2006), CINAHL, PEDro, EMBASE (from 1984 to August 2006) and the Cochrane Controlled Trial Register. The terms “disorder,” “location,” and “design” were linked by the Boolean operator “AND.” For each of the terms, one or more synonyms were used (Table 1).
The selected studies had to fulfill the following criteria for inclusion in the review: the adult subjects had to suffer from an acute lateral ankle sprain; the
Characteristics of Identified Studies
Our search strategy resulted in 1652 potentially relevant articles. From title and abstract, we identified 120 relevant articles. Reviewing the full text, 29 publications met our selection criteria. After screening the reference lists, another 2 studies were included, resulting in 31 relevant articles (Figure 1). Information about these 31 studies is presented in Table 3 (available online).
Four studies were retrospective and 27 were prospective. In these studies, the follow-up period ranged
Discussion
This review summarizes the results on the course of pain, re-sprain, subjective instability, and subjective recovery in patients with an acute lateral ankle sprain. Within 2 weeks, a rapid improvement of pain experience was seen in the majority of patients with acute ankle sprains. Further improvement occurred after these 2 weeks, although more slowly. Re-sprains occurred within periods ranging from 2 weeks to 96 months after the initial injury, and ranges from 3% to 34% of the patients. The
Conclusion
In conclusion, this review presents the clinical course of pain, objective and subjective instability, and subjective recovery of adult patients with conventionally treated ankle sprains. During the first 2 weeks there is a rapid decrease in pain, after which it continues to improve more slowly. After 3 years follow-up, some patients still have residual symptoms of their initial sprain. There is a wide variation in reported subjective instability, re-sprains, and subjective recovery among the
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