Ankle Sprain CPG: 2021 update

Question 1

Ankle Sprain CPG: how to ID clinical course - acute lateral ankle sprain

Answer 1

B: include: age, BMI, pain coping strategies, report of instability, hx, ability to WB, pain with WB, ankl DF ROM, medial jt line tendenrness, balance, jump and land
in IE

Question 2

Ankle Sprain CPG: how to ID clinical course - chronic ankle instability

Answer 2

C: include: prior tx, number of sprains, pain level, self report of function. assessment of: sensorimotor movement of foot/ankle/knee/hip during dynamic postural contorl and funcitonal movements.

Question 3

Ankle Sprain CPG: diagnosis for acute lateral ankle sprain

Answer 3

B: use: reverse anterolateral drawer, anterolateral talar palpation, anterior drawer. plus history and physical exam

Question 4

Ankle Sprain CPG: diagnosis for chronic ankle instability

Answer 4

B: Cumberland ankle instability tool, plus functional perofmrance tests

Question 5

Ankle Sprain CPG: Outcome measures

Answer 5

A: FAAM, LEFS
C: Pain Self Efficacy Questionnair in acute LAS
FABQ for CAI

Question 6

Ankle Sprain CPG: Exam - physical impairment measures

Answer 6

A: ankle swelling, ROM, talar translation, talar inversion, single leg balance. DF ROM with WB lunge test, static single leg balance on firm surface with EC, dynamic balance with star excursion balance test
C: CAI: hip abd, ext, ER strength

Question 7

Ankle Sprain CPG: Exam: activity limitation/physical performance measures

Answer 7

B: measures of single limb hopping

Question 8

Ankle Sprain CPG: Interventions: primary prevention for first time lateral ankle sprain

Answer 8

A: use of prophylactic brace to decrease risk of first time LAS if they have risk factors
C: use of balance exercises for those who have not had LAS

Question 9

Ankle Sprain CPG: secondary prevention of recurrent lateral ankle sprains following initial sprain

Answer 9

A: prophylactic bracing, proprioceptive and balance focused therex.

Question 10

Ankle Sprain CPG: interventions - acute and postacute LAS - protection and optimal loading

Answer 10

A: use external supports (brace or taping) and progressive WBing.
A: severe injuries: immobilization for up to 10days post injury

Question 11

Ankle Sprain CPG: Interventions: acute and postacute lateral ankle sprains: therex

Answer 11

A: therex with AROM, stretching, NMR, postural ed, balance training. In clinic and as HEP
D: conflicting: use individuals specific learning needs and access for giving HEP instructions

Question 12

Ankle Sprain CPG: interventions: acute and postacute LAS: occupational and sports related training

Answer 12

B: RTW/S schedule and use brace early in rehab/training

Question 13

Ankle Sprain CPG: interventions, acute LAS: manual therapy

Answer 13

A: lymphatic drainage, active and passive STM and jt mobs, AP talar mobs within pain free movement. PLUS therex.
reduce swelling, improve pain free ankle ROM, normalize gait.

Question 14

Ankle Sprain CPG: interventions: acute and postacute LAS: acupuncture

Answer 14

D: conflicting evidence

Question 15

Ankle Sprain CPG: interventions: acute and postacute LAS: physical agents

Answer 15

A: ultrasound: DO NOT USE
C: cryotherapy, can use it
C: diathermy: can use it
C: low level laser: can use it
D: electrotherapy: conflicting evidence

Question 16

Ankle Sprain CPG: interventions: acute and postacute LAS: NSAIDS

Answer 16

C: can prescribe if practice act allows

Question 17

Ankle Sprain CPG: intervention: CAI: external support

Answer 17

B: should NOT use braces/taping as stand alone intervention

Question 18

Ankle Sprain CPG: intervention CAI: therex and theract

Answer 18

A: proprioceptive and NMR exercise to improve dynamic postural stability

Question 19

Ankle Sprain CPG: interventions: CAI: manual therapy

Answer 19

A: graded jt mobs, manips, NWB and WB MWM. improve WB ankle DF and dynmaic balance in short term

Question 20

Ankle Sprain CPG: intervention CAI: dry needling

Answer 20

C: could use it to fibularis muscle group in conjunction with proprioceptive training program

Question 21

Ankle Sprain CPG: internvention: CAI: combined treatments

Answer 21

B: use multiple interventions for balance training, combine exercise and manual

Question 22

Ankle Sprain CPG: intervention to address psychological factors during course of rehab

Answer 22

E: psychologically informed techniques: motivational interviewing, to maximize pt self efficacy and address uncomplicated psychological correlates and mediators of injury.

Question 23

Risk factors: acute LAS

Answer 23

female sex, hip abd and ext weakness, poor performance on balance and hopping tests, court sports

Question 24

Risk Factors: CAI

Answer 24

not using prophylactic bracing, not participating in exercise-balance program, poor functional performance after LAS, participating in sports, higher BMI