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Increasing compliance with neuromuscular training to prevent ankle sprain in sport: does the ‘Strengthen your ankle’ mobile App make a difference? A randomised controlled trial
  1. M Van Reijen1,
  2. I Vriend1,2,
  3. V Zuidema2,
  4. W van Mechelen1,3,4,
  5. E A Verhagen1,5,6
  1. 1Department of Public & Occupational Health, Amsterdam Collaboration on Health & Safety in Sports, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
  2. 2Consumer Safety Institute VeiligheidNL, Amsterdam, The Netherlands
  3. 3Physiotherapy and Population Sciences, School of Public Health, University College Dublin, Dublin, Ireland
  4. 4Faculty of Health and Behavioural Sciences, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
  5. 5Faculty of Health Sciences, Department of Human Biology, UCT/MRC Research Unit for Exercise Science and Sports Medicine (ESSM), University of Cape Town, South Africa
  6. 6Australian Center for Research into Injury in Sport and its Prevention, Federation University Australia, Ballarat, Victoria, Australia
  1. Correspondence to Dr Evert Verhagen, Department of Public & Occupational Health, VU University Medical Center, Van der Boechorststraat 7, Amsterdam 1081 BT, NH, The Netherlands; e,verhagen@vumc,nl


Background E-health has the potential to facilitate implementation of effective measures to prevent sports injuries.

Aim We evaluated whether an interactive mobile application containing a proven effective exercise programme to prevent recurrent ankle sprains resulted in higher compliance as compared with regular written exercise materials.

Methods 220 athletes participated in this randomised controlled trial with a follow-up of 8 weeks; 110 athletes received a booklet explaining an 8-week neuromuscular training programme; 110 athletes participated in the same programme in an interactive mobile App (Strengthen your ankle). The primary outcome was compliance with the exercise programme. Secondary outcome measure was the incidence density of self-reported recurrent ankle sprains.

Results The mean compliance to the exercise scheme was 73.3% (95% CI 67.7% to 78.1%) in the App group, compared with 76.7% (95% CI 71.9% to 82.3%) in the Booklet group. No significant difference in compliance was found between groups. The incidence densities of self-reported time-loss recurrences were not significantly different between both groups (HR 3.07; 95% CI 0.62 to 15.20).

Summary This study shows that the method of implementing the exercises by using an App or a Booklet does not lead to different compliance rates.

New findings The use of a mobile App or a Booklet lead to similar compliance and injury rates in the short term.

Trial registration number The Netherlands National Trial Register NTR 4027. The NTR is part of the WHO Primary Registries.

  • Ankle
  • Injuries
  • Physical activity
  • Randomised controlled trial
  • Exercise rehabilitation

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