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急性外踝扭伤的临床评估(ROAST):2019 年国际踝关节联合会共识声明及建议。

Clinical assessment of acute lateral ankle sprain injuries (ROAST): 2019 consensus statement and recommendations of the International Ankle Consortium.

机构信息

School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.

Institute for Sport and Health, University College Dublin, Dublin, Ireland.

出版信息

Br J Sports Med. 2018 Oct;52(20):1304-1310. doi: 10.1136/bjsports-2017-098885. Epub 2018 Jun 9.

Abstract

Lateral ankle sprain injury is the most common musculoskeletal injury incurred by individuals who participate in sports and recreational physical activities. Following initial injury, a high proportion of individuals develop long-term injury-associated symptoms and chronic ankle instability. The development of chronic ankle instability is consequent on the interaction of mechanical and sensorimotor insufficiencies/impairments that manifest following acute lateral ankle sprain injury. To reduce the propensity for developing chronic ankle instability, clinical assessments should evaluate whether patients in the acute phase following lateral ankle sprain injury exhibit any mechanical and/or sensorimotor impairments. This modified Delphi study was undertaken under the auspices of the executive committee of the International Ankle Consortium. The primary aim was to develop recommendations, based on expert (n=14) consensus, for structured clinical assessment of acute lateral ankle sprain injuries. After two modified Delphi rounds, consensus was achieved on the clinical assessment of acute lateral ankle sprain injuries. Consensus was reached on a minimum standard clinical diagnostic assessment. Key components of this clinical diagnostic assessment include: establishing the mechanism of injury, as well as the assessment of ankle joint bones and ligaments. Through consensus, the expert panel also developed the International Ankle Consortium Rehabilitation-Oriented ASsessmenT (ROAST). The International Ankle Consortium ROAST will help clinicians identify mechanical and/or sensorimotor impairments that are associated with chronic ankle instability. This consensus statement from the International Ankle Consortium aims to be a key resource for clinicians who regularly assess individuals with acute lateral ankle sprain injuries.

摘要

外侧踝关节扭伤是参与运动和娱乐性体育活动的个体最常见的肌肉骨骼损伤。初次受伤后,很大一部分人会出现长期与损伤相关的症状和慢性踝关节不稳定。慢性踝关节不稳定的发展是急性外侧踝关节扭伤后出现的机械和感觉运动不足/损伤相互作用的结果。为了降低发展为慢性踝关节不稳定的倾向,临床评估应评估急性外侧踝关节扭伤后患者是否存在任何机械和/或感觉运动损伤。这项改良 Delphi 研究是在国际踝关节联合会执行委员会的支持下进行的。主要目的是根据专家(n=14)的共识,为急性外侧踝关节扭伤的结构化临床评估制定建议。经过两轮改良 Delphi 研究,专家组就急性外侧踝关节扭伤的临床评估达成了共识。对急性外侧踝关节扭伤的最低标准临床诊断评估达成了共识。该临床诊断评估的关键组成部分包括:确定损伤机制,以及评估踝关节骨骼和韧带。通过共识,专家小组还制定了国际踝关节联合会康复导向评估(ROAST)。国际踝关节联合会 ROAST 将帮助临床医生识别与慢性踝关节不稳定相关的机械和/或感觉运动损伤。这份来自国际踝关节联合会的共识声明旨在成为经常评估急性外侧踝关节扭伤患者的临床医生的主要资源。

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