The Cost-Effectiveness of Measures to Prevent Recurrent Ankle Sprains Results of a 3-Arm Randomized Controlled Trial

Abstract

Background: Ankle sprains are the most common sports-related injury, associated with a high rate of recurrence and societal costs. Recent studies have emphasized the effectiveness of both neuromuscular training and bracing for the secondary prevention of ankle sprains.

Purpose: To evaluate the cost-effectiveness of the separate and combined use of bracing and neuromuscular training for the prevention of the recurrence of ankle sprains.

Study Design: Economic and decision analysis; Level of evidence, 2.

Methods: A total of 340 athletes (157 male and 183 female; aged 12-70 years) who had sustained a lateral ankle sprain up to 2 months before inclusion were randomized to a neuromuscular training group (n = 107), brace group (n = 113), and combined intervention group (n = 120). Randomization was stratified by medical treatment of the inclusion sprain. Participants in the neuromuscular training group underwent an 8-week home-based exercise program. Participants in the brace group received a semirigid ankle brace to be worn during all sports activities for a period of 12 months. Participants allocated to the combined group underwent both interventions, with the ankle brace to be worn during all sports activities for a period of 8 weeks. The recurrence of ankle sprains and associated costs were registered during the 1-year follow-up.

Results: There were no differences between groups at baseline with regard to age, sex, sports participation, previous injury, or knowledge of preventive measures. The incremental cost-effectiveness ratio (ICER) of the brace group in comparison with the combined group was −€2828.30 (approximately –US$3865.00), based on a difference in the mean cost of −€76.16 (approximately –US$104.00) and a difference in the mean effects of 2.68%. The ICER of the neuromuscular training group in comparison with the combined group was €310.08 (approximately US$424.00), based on a difference in the mean cost of −€28.37 (approximately –US$39.00) and a difference in the mean effects of 9.15%.

Conclusion: Bracing was found to be the dominant secondary preventive intervention over both neuromuscular training and the combination of both measures.

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Autor / Fonte:Kasper W. Janssen, Marike R.C. Hendriks, Willem van Mechelen, and Evert Verhagen. Am J Sports Med July 2014 vol. 42 no. 7 1534-1541
Link: http://ajs.sagepub.com/content/42/7/1534.full.pdf+html