PT  - JOURNAL ARTICLE
AU  - Michelle D Smith
AU  - Bill Vicenzino
AU  - Roald Bahr
AU  - Thomas Bandholm
AU  - Rosalyn Cooke
AU  - Luciana De Michelis Mendonça
AU  - François Fourchet
AU  - Philip Glasgow
AU  - Phillip A Gribble
AU  - Lee Herrington
AU  - Claire E Hiller
AU  - Sae Yong Lee
AU  - Andrea Macaluso
AU  - Romain Meeusen
AU  - Oluwatoyosi B A Owoeye
AU  - Duncan Reid
AU  - Bruno Tassignon
AU  - Masafumi Terada
AU  - Kristian Thorborg
AU  - Evert Verhagen
AU  - Jo Verschueren
AU  - Dan Wang
AU  - Rod Whiteley
AU  - Erik A Wikstrom
AU  - Eamonn Delahunt
TI  - Return to sport decisions after an acute lateral ankle sprain injury: introducing the PAASS framework—an international multidisciplinary consensus
AID  - 10.1136/bjsports-2021-104087
DP  - 2021 Jun 22
TA  - British Journal of Sports Medicine
PG  - bjsports-2021-104087
4099  - http://bjsm.bmj.com/content/early/2021/06/22/bjsports-2021-104087.short
4100  - http://bjsm.bmj.com/content/early/2021/06/22/bjsports-2021-104087.full
AB  - Background Despite being the most commonly incurred sports injury with a high recurrence rate, there are no guidelines to inform return to sport (RTS) decisions following acute lateral ankle sprain injuries. We aimed to develop a list of assessment items to address this gap.Methods We used a three-round Delphi survey approach to develop consensus of opinion among 155 globally diverse health professionals working in elite field or court sports. This involved surveys that were structured in question format with both closed-response and open-response options. We asked panellists to indicate their agreement about whether or not assessment items should support the RTS decision after an acute lateral ankle sprain injury. The second and third round surveys included quantitative and qualitative feedback from the previous round. We defined a priori consensus being reached at >70% agree or disagree responses.Results Sixteen assessment items reached consensus to be included in the RTS decision after an acute lateral ankle sprain injury. They were mapped to five domains with 98% panellist agreement—PAASS: Pain (during sport participation and over the last 24 hours), Ankle impairments (range of motion; muscle strength, endurance and power), Athlete perception (perceived ankle confidence/reassurance and stability; psychological readiness), Sensorimotor control (proprioception; dynamic postural control/balance), Sport/functional performance (hopping, jumping and agility; sport-specific drills; ability to complete a full training session).Conclusion Expert opinion indicated that pain severity, ankle impairments, sensorimotor control, athlete perception/readiness and sport/functional performance should be assessed to inform the RTS decision following an acute lateral ankle sprain injury.Trial registration number ACTRN12619000522112.Data are available upon reasonable request.