Wikstrom Erik A, Cain M Spencer, Chandran Avinash, Song Kyeongtak, Regan Tasha, Migel Kimmery, Kerr Zack Y
1 Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.
2 MOTION Science Institute, University of North Carolina at Chapel Hill.
J Athl Train. 2020 Nov 5. doi: 10.4085/168-20.
To evaluate the evidence surrounding the association between lateral ankle sprain (LAS) history and subsequent LAS risk, as well as sex-differences in the observed associations.
PubMed, CINAHL, and SPORTDiscus were searched through July 2020 for articles reporting LAS injury history and injury incidence during a study period.
Studies were included if they were prospective in nature, reported the number of participants with and without a history of LAS at study initiation, and reported the number of participants from each group that sustained a LAS during the study period.
Data included study design parameters as well as the number of participants with and without a LAS history, and the number of subsequent LAS that occurred to both groups. Risk ratios (RR) with 95% confidence intervals (CI) compared the risk of LAS within the study period between those with and without a LAS history for each included investigation.
Nineteen studies with a total of 6,567 patients were included. Follow-up periods ranged from 14 weeks to 2 years. Quality assessment scores indicate moderate to high quality studies were included. A significantly higher risk of LAS within the study period was observed among those with a history of LAS in 10 out of 15 studies (RR range=1.29-6.06). Similar associations were seen in four out of six studies that included an all-male sample (RR Range=1.38-8.65), and one out of four studies with an all-female sample (RR=4.28).
There is strong evidence to support that a previous LAS increases the risk of a subsequent LAS injury. Males but not females with a history of a LAS appear to be at a higher risk of sustaining a subsequent LAS but further data are needed to draw definitive conclusions based on the limited number of sex specific studies.
评估踝关节外侧扭伤（LAS）病史与后续LAS风险之间关联的相关证据，以及观察到的关联中的性别差异。
截至2020年7月，检索了PubMed、CINAHL和SPORTDiscus，以查找在研究期间报告LAS损伤病史和损伤发生率的文章。
纳入的研究需具有前瞻性，报告研究开始时有无LAS病史的参与者数量，并报告在研究期间每组发生LAS的参与者数量。
数据包括研究设计参数以及有无LAS病史的参与者数量，以及两组随后发生的LAS数量。对于每项纳入的研究，风险比（RR）及其95%置信区间（CI）比较了有和无LAS病史者在研究期间发生LAS的风险。
纳入了19项研究，共6567例患者。随访期从14周至2年。质量评估分数表明纳入的研究质量为中等至高。在15项研究中的10项中，有LAS病史者在研究期间发生LAS的风险显著更高（RR范围=1.29 - 6.06）。在纳入全男性样本的6项研究中的4项中观察到类似关联（RR范围=1.38 - 8.65），在纳入全女性样本的4项研究中的1项中观察到类似关联（RR = 4.28）。
有强有力的证据支持既往LAS会增加后续LAS损伤的风险。有LAS病史的男性而非女性似乎后续发生LAS的风险更高，但基于有限数量的性别特异性研究，需要更多数据才能得出明确结论。
