In order to evaluate the effectiveness of therapeutic interventions and to guide management decisions, clear insight into the course of recovery after ankle sprain is needed. This information is helpful to inform patients about the expected clinical course and in the identification of relevant subgroups of patients with a better or worse prognosis. The factors predicting persistent complaints from ankle sprains are largely unknown (van Rijn et al 2008). Until now, only one

study has evaluated prognostic factors for incomplete recovery and re-sprains. Sporting activity at a high level was found to be a prognostic factor for residual symptoms (Linde et al 1986). www.selleckchem.com/products/gsk-j4-hcl.html However, this study showed methodological shortcomings and the full range and impact of residual complaints was not investigated (Braun 1999, Cross et al 2002, de Bie et al 1997, Linde et al 1986). Therefore our first research question was: 1. What are baseline prognostic factors for incomplete recovery, instability, re-sprains, and pain intensity during 12 months of follow-up in adult

patients who consulted primary care for an acute lateral ankle sprain? What is already known on this topic: Ankle sprains find more are common and a substantial proportion of these sprains do not fully resolve within one year. Ongoing instability and re-sprains are also common during the first year after the original sprain. What this study adds: At the time of the sprain, none of a range of demographic and clinical factors accurately predicts incomplete recovery or re-sprains at one year. However, among patients whose sprain has not resolved within three months, re-sprains and self-reported pain at rest at three months were predictors of incomplete recovery at one year. The data used for this study were derived from a

randomised clinical trial investigating the effectiveness of supervised exercises for acute ankle sprain in primary care (van Rijn et al 2007). Patients who had an acute injury of the lateral collateral ligaments of the below ankle and who presented themselves to one of the participating general practitioners or at an emergency department were considered for inclusion. The general practitioner or emergency department physician carried out a standardised clinical examination. Based on these findings (stability, intensity and location of swelling, pain, and haemorrhage), the injuries were graded as mild, moderate, or severe (Birrer et al 1999). After acquiring baseline information, each patient was randomised into either the usual care group or the physical therapy group. All participants (n = 102) in both groups received the same standard treatment from their physician (general information about early mobilisation, home exercises, early weight bearing, tape, bandage or brace). Participants in the physical therapy group participated additionally in an individual and progressive training program supervised by a physical therapist.