Department of Rehabilitation Sciences, University of Kentucky, Lexington, KY, USA.
Department of Biostatistics, University of Kentucky, Lexington, KY, USA.
J Sci Med Sport. 2014 Jan;17(1):23-8. doi: 10.1016/j.jsams.2013.04.006. Epub 2013 May 17.
OBJECTIVES: Although ankle sprains have the highest recurrence rate of any musculoskeletal injury, objective estimates of when an athlete is likely to return-to-play (RTP) are unknown. The purpose was to compare time to return-to-play probability timelines for new and recurrent ankle sprains in interscholastic athletes. DESIGN: Observational. METHODS: Ankle sprain data were collected at seven high schools during the 2007-2008 and 2008-2009 academic years. Ankle sprains were categorized by time lost from participation (same day return, next-day return, 3-day return, 7-day return, 10-day return, >22-day return, no return [censored data]). Time-to-event analyses were used to determine the influence of ankle injury history on return-to-play after an ankle sprain. RESULTS: 204 ankle sprains occurred during 479,668 athlete-exposures, 163 were new (4 censored) and 35 recurrent (1 censored). There was no significant difference (p=0.89) between the time-to-event curves for new and recurrent ankle sprains. The median (inter-quartile rage) time to return-to-play for new sprains (inter-quartile range)=3 days (same day to 7 day return); recurrent sprains=next day return (next day to 7 day return). Noteworthy probabilities [95% CIs] include: same day return (new=25.2[18.7, 31.9], recurrent=17.1[6.6, 30.3]); next-day return (new=43.6[35.3, 52.7], recurrent=51.4[32.5, 67.5]); and 7-day return (new=85.9[73.8, 94.4], recurrent=94.3[47.8, 99.5]). CONCLUSIONS: Previous injury history did not affect time until return-to-play probabilities for ankle sprains. Time until return-to-play analyses that describe the likelihood of return-to-play are useful to clinicians by providing prognostic guidelines and can be used for educating athletes, coaches, and parents about the likely timeframe of being withheld from play.
目的:尽管踝关节扭伤是肌肉骨骼损伤中复发率最高的,但运动员何时可能重返赛场(RTP)的客观估计尚不清楚。本研究旨在比较新踝关节扭伤和复发性踝关节扭伤运动员重返赛场概率的时间轨迹。
设计:观察性研究。
方法:在 2007-2008 学年和 2008-2009 学年,在七所高中收集踝关节扭伤数据。根据参与度丧失时间(当天返回、次日返回、3 天返回、7 天返回、10 天返回、>22 天返回、未返回[已删失数据])对踝关节扭伤进行分类。使用时间事件分析来确定踝关节扭伤史对踝关节扭伤后重返赛场的影响。
结果:在 479668 名运动员暴露中发生了 204 次踝关节扭伤,其中 163 次为新(4 次删失),35 次为复发性(1 次删失)。新踝关节扭伤和复发性踝关节扭伤的时间事件曲线之间没有显著差异(p=0.89)。新发踝关节扭伤的重返赛场中位(四分位间距)时间[四分位间距]=3 天(当天至 7 天返回);复发性踝关节扭伤=次日返回(次日至 7 天返回)。值得注意的概率[95%CI]包括:当天返回(新=25.2[18.7, 31.9],复发性=17.1[6.6, 30.3]);次日返回(新=43.6[35.3, 52.7],复发性=51.4[32.5, 67.5]);以及 7 天返回(新=85.9[73.8, 94.4],复发性=94.3[47.8, 99.5])。
结论:既往损伤史并不影响踝关节扭伤重返赛场的时间概率。描述重返赛场可能性的重返赛场时间分析对临床医生很有用,可提供预后指南,并可用于教育运动员、教练和家长关于停赛的可能时间框架。
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