Table 2 Included studies in qualitative synthesis

Hiller et al. 2008[17]

Prospective cohort

Adolescent dancers 14.2 ± 1.8 yrs

13 months

116

Ankle instability (CAIT)

36% of all dancers unstable

71% of sprainers unstable

Ankle joint laxity (mod ant draw)

37% right, 47% left ankles moderate to very lax

Self report

50% of total had history of sprain

22% of total had history of ≥2 sprains

38 sprains were sustained by 33 participants

Incidence of sprains 0.21/1000 hours of dancing

Hollwarth et al. 1985[19]

Retrospective

Patients with high ankle sprain, severe trauma for inclusion

6 yrs

96

Subjective complaints; rolling over, pain, swelling, meterosensitivity

31.3% subjective complaints

16 (range: 9–21) yrs

X-ray (AP and lateral) injured side, talar tilt stress x-ray both sides

17.7% ligament avulsions

Ligament stiffness, pain during supination or palpation of, fibular ligaments or syndesmosis

38.5% “pathologic clinical findings”

Abnormal talar tilt (> 5 deg)

42% abnormal

Marchi et al. 1999[20]

Prospective cohort

Patients with moderate to severe ankle injury 6–15 yrs. 26 female (48%)

3 yrs

220

Medical report of objective (limited joint mobility, pain on pressure, axial deviations, weakness, or shortening of a limb) and subjective (pain at rest or during exercise, sense of unsteadiness, or paraesthesia) symptoms

42% had objective or subjective symptoms (3 yrs follow up)

12 yrs

54

23% had permanent symptoms (Risk ratio: 1.79, p = 0.10) (12 yrs follow up)

Soderman et al. 2001[21]

Prospective cohort

Adolescent female soccer players 15.9 ± 2.1 (range: 14–19) yrs

1 season

153

Medical report of re-injuries

56% of sprainers had recurrent sprain

Steffen et al. 2008[22]

Prospective cohort

Female soccer players 15.4 ± 0.8 (range: 14–16) yrs

-

1430

Self report of sprain history

Players with previous ankle injury (PI) more likely to sustain new ankle injury than those without (NH) (Rate ratio = 1.2 [1.1; 1.3] p < .001).

FAOS

92.0 ± 11.3 (PI), 97.3 ± 6.0 (NH) mean difference: −5.3 (95% CI = −6.0 to −4.5)

Pain

62.8 ± 11.1 (PI), 68.2 ± 9.7 (NH) mean difference: −5.4 (95% CI = −6.3 to −4.5)

Symptoms

96.3 ± 7.5 (PI), 98.7 ± 4.2 (NH) mean difference: −2.3 (95% CI = −2.9 to −1.8)

Activities of daily living

89.0 ± 16.2 (PI), 96.3 ± 8.4 (NH) mean difference: −7.3 (95%CI = −8.4 to −6.2)

Sport and recreation function

71.3 ± 12.4 (PI), 76.3 ± 10.0 (NH) mean difference: −5.0 (95% CI = −5.9 to −4.0)

Ankle-related quality of life

411.5 ± 46.8 (PI), and 436.7 ± 26.8 (NH) mean difference: −25.2

(95% CI = −28.5 to −21.9)

Swenson et al. 2009[23]

Descriptive epidemiology study

High school students

-

100 high schools 13755 injuries

Medical report of re-injury

Ankle most frequently diagnosed site for recurrent injury in basketball (boys: 58.4%, girls: 43.6%), volleyball (42.7%), soccer (boys: 34.8%, girls: 37.2%), football (29.8%), softball (26.3%), and wrestling (20.1%)

28% of all recurrent injuries were ankle injuries

More recurrent (28%) than new ankle injuries (19%) (Injury Proportion Ratio = 1.47; 95% CI, 1.31-1.65)

Timm et al. 2005[24]

Prospective cohort

Emergency department patients with ankle injury

6 weeks

199

Medical report of:

Pain with activity

24 (34%) OW, 14 (15%) NW, RR = 2.25 (95% CI = 1.25-4.02)

Range: 8–18 yrs

Persistent swelling and/or weakness

22 (31%) OW, 12 (13%) NW, RR = 2.40 (95% CI = 1.28-4.52)

Re-injury

17 (24%) OW, 14 (15%) NW, RR = 1.60 (95% CI = 0.84-3.01)

OW mean age = 13.9 yrs

6 months

171

Pain with activity

19 (41%) OW, 19 (16%) NW, RR = 2.57 (95% CI = 1.50-4.39)

NW mean age = 13.5 years.

Persistent swelling and/or weakness

16 (34%) OW, 18 (15%) NW, RR = 2.28 (95% CI = 1.28-4.08)

Re-injury

12 (26%) OW, 19 (16%) NW, RR = 1.62 (95% CI = 0.86-3.06)

31 (44%) of OW had persistent ankle symptoms at 6 months compared with 24 (26%) NW (RR, 1.70; 95% CI, 1.10-2.61)

Tyler et al. 2006[25]

Cohort study

Male high school football players

3 seasons

152

Medical report of sprain history

50 (33%) had history of previous ankle sprain 15 non-contact ankle sprains were incurred. Of the 11 players who had a previous ankle sprain and sustained a noncontact sprain in this study, 9 (82%) injured the same ankle (incidence 2.1)

Weir & Watson 1996[26]

Prospective cohort

Physical education students

1 yr

266

Self report of injuries

230 injuries were incurred. The most common injuries were ankle sprains.

Males (56%): 14.3 ± 0.85 (range: 12–15) yrs

7 overuse injuries of the ankle were incurred. 100% of overuse injuries of the ankle were re-injuries.

Females: 14.1 ± 0.90 (range: 12–15) yrs