Table 2

Description of prevention studies (n=2)

Reference (Country)Study characteristicsPrevention methodOutcomesCostsResults
Full economic evaluations on prevention methods
Hupperets et al3 (Netherlands)Design: CEA alongside a RCT; Perspective: societal; Population: athletes with lateral ankle sprain <2 months; Follow-up: 1 year; Sample size: I: 256; C: 266.I: usual care + 8-week neuromuscular training consisting of exercises on and off a balance board, three training sessions per week, up to 30 min per session. C: usual care.Ankle sprain incidence (# incident ankle sprains/1000 h of exposure). Recurrences leading to loss of sports time and recurrences resulting in healthcare costs or lost productivity costs or both.Intervention costs, direct healthcare costs, paid and unpaid productivity loss. Index year: not reported.Clinical: incidence per 1000 h of sports was 1.86 (95% CI 1.37 to 2.34) in the intervention group compared with 2.90 (95% CI 2.30 to 3.50) in the controls. RR for recurrence comparing intervention to control: 0.63 (95% CI 0.45 to 0.88). Absolute risk reduction=11%. NNT to prevent one ankle sprain recurrence was 9. Economic: mean total cost difference (per athlete) =€−103 (−253; −23); mean total cost difference (per re-injured athlete) = €−332 (−741; −62). Total healthcare costs and costs of lost productivity significantly higher in the control group. Usual care and neuromuscular training dominated usual care: €889 saved per prevented recurrent ankle sprain.
Cost analyses
Mickel et al29Design: cost analysis alongside a RCT; Perspective: athletic programme; Follow-up: one season (10 weeks); Sample size: I: 48; C: 45.I: semirigid ankle brace; C: conventional ankle taping.Number of ankle sprain.Cost for taping, trainer time to apply tape, wholesale cost of semirigid ankle brace, time of trainer to fit brace and provide instruction on use. Index year: not reported.Clinical: no statistically significant difference in mean number of ankles sprains (intervention: 0.83 ankle sprains per 1000 exposures; control: 0.77 sprains per 1000 exposures, p>0.05). Economic: material cost of taping = US$40, cost of brace = US$28. Trainer time during season to tape ankles per athlete =3 h 14 min compared with time required to fit and instruct athlete on use of brace.
  • AUS$, Australian dollars; C, control group; CEA, cost-effectiveness analysis; CT, controlled trial; CUA, cost-utility analysis; DM, Deutsche Mark; I, intervention group; GBP, British pounds; PF/DF, plantarflexion/dorsiflexion; RCT, randomised control trial; ROM, range of motion; SIP, Sickness impact profile; US$, US dollars.