Possible savings of a training program to prevent ankle sprain injury

The ankle sprain: ubiquitous injury with significant health care costs
Throughout the world, acute ankle injuries are the most common musculoskeletal injuries, with lateral ankle sprains being the most frequent among them. In the U.S., roughly 23,000 ankle sprains are sustained each day, making them a high priority in the health care system due to high medical costs and loss of productivity associated with them. A number of intervention strategies that aim to prevent ankle sprains have recently emerged, and research has shown some of them to reduce ankle sprain recurrence, but there is yet to be a cost-effectiveness analysis in such a program’s impact on the health-care system. To better understand possible economic effects of a proprioceptive training program aimed at reducing ankle sprain recurrence, a cohort study was conducted.

Sufficient sample size records details of life
Athletes who had sustained an ankle sprain were recruited from a number of locations, and a total of 522 subjects were chosen as the study group, who were further randomized into either the intervention group (256) or control group (266). Both groups received a standard course of treatment following their initial injury, but the intervention group received an additional eight-week proprioceptive training program consisting of three sessions per week after the standard treatment. In the one-year follow-up, subjects reported any sudden inversions of their initially injured ankle and details of their sports participation on a monthly basis. They were also asked to provide details on any ankle sprain recurrences and to fill out a cost diary that documented absence from work and any other health-care related changes from the time of their injury until full recovery.

Training program can dramatically save money for health-care system
During the one-year follow-up, 56 subjects in the intervention group (22%) and 89 in the control group (33%) reported ankle sprain recurrence, which Cox regression analysis interpreted as a significantly lower risk of recurrence in the intervention group. The total costs per athlete in the intervention group were only $36, with the mean total costs logged at $106 for each athlete in that group and $196 per control group athlete. Based on this, there was a statistically significant cost-benefit of $93 in favor of the intervention group. In addition, total health-care costs and costs of productivity loss per athlete were significantly higher in the control group. In terms of costs for injured athletes, the intervention group again showed an overall cost-benefit of $434 and better health-care costs. These results prove that a proprioceptive training program has the potential to lead to substantial savings in medical and lost productivity costs. This warrants the implementation of such a program into the clinical guidelines on the treatment of ankle sprains in order to reduce ankle sprain recurrence and lower health-care costs.

-Summarized by Greg Gargiulo

-As reported in the August ’10 edition of The American Journal of Sports Medicine