Meta-Analysis
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Mar 18, 2024; 12(1): 87026
Published online Mar 18, 2024. doi: 10.13105/wjma.v12.i1.87026
Exploring influences and risk of bias of studies on return to sport and work after lateral ankle sprain: A systematic review and meta-analysis
Priscilla A Maria, Gwendolyn Vuurberg, Gino MMJ Kerkhoffs
Priscilla A Maria, Gwendolyn Vuurberg, Gino MMJ Kerkhoffs, Department of Orthopaedic Surgery and Sports Medicine, Amsterdam UMC-Location AMC, Amsterdam 1105 AZ, Netherlands
Priscilla A Maria, Gwendolyn Vuurberg, Gino MMJ Kerkhoffs, Amsterdam Movement Sciences, Amsterdam UMC, Amsterdam 1105 AZ, Netherlands
Priscilla A Maria, Gino MMJ Kerkhoffs, Amsterdam Collaboration on Health and Safety in Sports, Amsterdam UMC, Amsterdam 1105 AZ, Netherlands
Priscilla A Maria, Gwendolyn Vuurberg, Gino MMJ Kerkhoffs, Academic Center for Evidence-based Sports medicine, Amsterdam UMC, Amsterdam 1105 AZ, Netherlands
Priscilla A Maria, Faculty of Medicine, University of Amsterdam, Amsterdam 1105 AZ, Netherlands
Gwendolyn Vuurberg, Department of Radiology and Nuclear Medicine, Rijnstate Arnhem, Arnhem 6815AD, Netherlands
Gwendolyn Vuurberg, Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam 1105 AZ, Netherlands
Gino MMJ Kerkhoffs, Faculty of Medicine, University of Amsterdam, Amsterdam, 1105 AZ, Netherlands
Author contributions: Maria PA participated in the design of the study, data acquisition and analysis, and interpretation of the collected data, and drafted the manuscript and was involved in making critical revisions and approval of the final version; Vuurberg G participated in the design of this study, assisted in data analysis and interpretation of collected data, drafted the manuscript, was involved in making critical revisions and approved the final version; Kerkhoffs GMMJ participated in the study design, making critical revisions and approved the final version.
Conflict-of-interest statement: All the authors declare that they have no conflicts of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gino MMJ Kerkhoffs, BSc, Doctor, MSc, PhD, Full Professor, Department of Orthopaedic Surgery and Sports Medicine, Amsterdam UMC-Location AMC, Meibergdreef 9, Amsterdam 1105 AZ, Netherlands. g.m.kerkhoffs@amsterdamumc.nl
Received: July 19, 2023
Peer-review started: July 19, 2023
First decision: August 17, 2023
Revised: September 26, 2023
Accepted: January 2, 2024
Article in press: January 2, 2024
Published online: March 18, 2024
ARTICLE HIGHLIGHTS
Research background

Lateral ankle sprains (LAS) are a highly prevalent musculoskeletal injury affecting both athletes and non-athletes, constituting 80% of all ankle sprains with an incidence of 15%-20%. Up to 40% of LAS cases progress to chronic ankle instability, causing prolonged pain and reduced mobility. This interplay of high incidence, prevalence, workdays lost and substantial medical expenses underscores the profound socioeconomic impact of LAS.

Research motivation

The consequences of ankle sprains extend beyond pain and functional impairment. Despite the alarmingly high incidence and chronic ankle instability risk, only around half of LAS patients seek medical attention.

Research objectives

In light of these compelling circumstances, the primary objective of this systematic review and meta-analysis was to comprehensively investigate the factors that may exert an influence on return to work (RTW) and return to sport (RTS) following LAS.

Research methods

EMBASE and PubMed were systematically searched for relevant studies published until June 2023. Quality assessments were carried out for each study using established risk of bias tools, and the quality of evidence was evaluated using the GRADEpro tool for quantitative outcomes. Qualitative outcome analysis was subjected to a best evidence synthesis, and for outcomes amenable to quantitative analysis, forest plots were generated to ascertain the impact on RTW and RTS.

Research results

The RTS rates were 80% and 83% in both the all treatments and surgical treatments groups, respectively. Mean RTS times ranged from 23-93 d, with an overall RTS rate of 89%. The average time to RTW ranged from 5.8-8.1 d. Preoperative motivation, early mobilization and postoperative weight bearing resulted in a shorter time to RTS.

Research conclusions

Overall, our findings indicated that all treatments yielded comparable results. Given the variety of factors that affected RTW and RTS after LAS, tailored interventions targeting both psychological and physical factors have the great potential to improve recovery and accelerate return to normal activities.

Research perspectives

Future studies should assess the weight of psychological factors in RTS and RTW. Treatment plans that address physical, psychological and social aspects of recovery may aid regaining mobility, overall well-being and returning to preinjury levels of activities after LAS.