Department of Public Health Sciences, Queen's University, K7L 3N6 Kingston, ON, Canada.
Department of Public Health Sciences, Queen's University, K7L 3N6 Kingston, ON, Canada; Department of Emergency Medicine, Queen's University, K7L 3N6 Kingston, ON, Canada.
Ann Phys Rehabil Med. 2019 Jan;62(1):8-13. doi: 10.1016/j.rehab.2018.08.006. Epub 2018 Oct 2.
Ankle sprains are common injuries that may lead to long-term morbidity. Individuals with obesity are at increased risk for ankle sprains; however, prognostic associations between body mass index (BMI) and recovery are less well understood. This study investigated whether BMI status affects recovery from ankle sprains.
We included individuals≥16 years old with grade 1 or 2 ankle sprains who sought emergency department treatment in Kingston, Ontario, Canada. Height in centimeters and weight in kilograms were measured at baseline by using a height rod and a standard medical column scale, respectively. BMI was calculated and categorized as non-overweight,<25.0kg/m; overweight, 25.0-29.9kg/m; and obese,≥30kg/m. Recovery was assessed at 1, 3 and 6 months post-injury by the Foot and Ankle Outcome Score (FAOS). Continuous FAOS and binary recovery status were compared by BMI group at each assessment using a repeated measures linear mixed effects model and logistic regression, respectively.
In total, 504 individuals were recruited and 6-month follow-up data were collected for 80%. We observed no significant differences in recovery at 1 and 3 months post-injury. At 6 months, between 53% and 66% of the participants were considered to have recovered according to the FAOS. The mean difference in unadjusted FAOS between participants classified as obese and non-overweight was -23.02 (95% confidence interval, -38.99 to -7.05) but decreased after adjusting for confounders. The odds ratio for recovery was 0.60 (0.37-0.97) before adjustment and 0.74 (0.43-1.29) after adjustment. Six-month recovery was significantly lower for participants with obesity than non-overweight participants on the FAOS Pain and Function in Daily Living subscales but were not clinically meaningful.
All BMI groups showed improvements from ankle sprain over time. However, at 6 months, a sizeable proportion of the participants had not fully recovered particularly among individuals classified as obese. The findings suggest that individuals with obesity may benefit from specialized interventions focused on symptom management and functional activity.
踝关节扭伤是常见的损伤，可能导致长期发病。肥胖个体患踝关节扭伤的风险增加；然而，体重指数（BMI）与恢复之间的预后关联了解较少。本研究调查 BMI 状况是否会影响踝关节扭伤的恢复。
我们纳入了在加拿大安大略省金斯顿寻求急诊治疗的 16 岁及以上、1 级或 2 级踝关节扭伤的个体。基线时使用身高杆和标准医用柱秤分别测量身高（厘米）和体重（公斤）。计算 BMI 并分类为非超重，<25.0kg/m；超重，25.0-29.9kg/m；肥胖，≥30kg/m。损伤后 1、3 和 6 个月通过足踝结局评分（FAOS）评估恢复情况。使用重复测量线性混合效应模型和逻辑回归分别比较 BMI 组在每次评估时的连续 FAOS 和二进制恢复状态。
共招募了 504 名个体，80%收集了 6 个月的随访数据。我们在损伤后 1 和 3 个月时没有观察到恢复方面的显著差异。在 6 个月时，根据 FAOS，有 53%至 66%的参与者被认为已经恢复。根据 FAOS，肥胖组与非超重组之间未经调整的 FAOS 平均差值为-23.02（95%置信区间，-38.99 至-7.05），但在调整混杂因素后有所下降。调整前，恢复的优势比为 0.60（0.37-0.97），调整后为 0.74（0.43-1.29）。肥胖组在 FAOS 疼痛和日常生活功能子量表上的恢复明显低于非超重组，但无临床意义。
所有 BMI 组在随访期间均从踝关节扭伤中有所改善。然而，在 6 个月时，相当一部分参与者尚未完全恢复，尤其是肥胖个体。研究结果表明，肥胖个体可能受益于专注于症状管理和功能活动的特殊干预措施。
