Treatment of acute ankle sprains in general practice

Rationale: Ankle sprains are the most frequent traumas of the musculoskeletal system, with yearly around 650.000 new sprains in the Netherlands. Of these, about 130.000 people will visit the general practitioner (GP) each year. The Dutch NHG-guideline summarizes the evidence on the potential treatments for acute ankle sprains; however there is very little guidance for treatment. No optimal treatment modality has proven to be effective in general practice.

Objective: To examine the effectiveness of an unsupervised e-health supported neuromuscular training program in combination with usual care in general practice compared to usual care alone in patients with acute lateral ankle sprains in general practice.

Study design: Randomized Controlled Trial (RCT)

Study population: Patients with an acute lateral ankle sprain, aged between 14 and 65 years, and visiting the general practitioner within three weeks of injury.

Intervention: The intervention group will receive, in addition to usual care, a standardized eight-week neuromuscular training program guided by an App. The control group will receive usual care in general practice alone.

Main study parameters/endpoints: The total number of re-sprains reported after 1-year follow-up.

An unsupervised e-health supported neuromuscular training program, in addition to usual care in general practice, is more effective compared to usual care alone as a treatment for patients with acute lateral ankle sprains in general practice.

Online questionnaires will be administered monthly: at baseline, after 4, 8, 12, 16, 21, 26, 31, 35, 39, 43, 47, and 52 weeks follow-up.

Group 1. The neuromuscular training program:
Subjects allocated to the intervention group receive a standardized eight-week neuromuscular training program, based on the training program described by Hupperets et al. (2008), in addition to usual care (information leaflet).