Evaluation of the implementation effectiveness of the 'Strengthen your Ankle' app to prevent recurrent ankle sprains


  • VeiligheidNL

  • the Australian Centre for Research into Injury in Sport and its Prevention


This project is funded through The Netherlands Organisation for Health Research and Development (ZonMw); project number 50-52500-98-014. onMw funds health research and stimulates use of the knowledge developed to help improve health and healthcare in the Netherlands.


Ankle sprains continue to pose a significant burden to the individual athlete, as well as society as a whole. However, despite ankle sprains being the single most common athletic injury and despite an active approach by various Dutch organizations in implementing our epidemiological knowledge on cost-effectiveness, large-scale community uptake of preventive measures, and thus actual prevention of ankle sprains, is lagging well behind. In an attempt to bridge this implementation gap VeiligheidNL looked into the possible role of new (social) media and has developed an freely available interactive App (‘Versterk je enkel’; available for iOS and Android) that contains - next to general advice on bracing and taping - the cost-effective neuromuscular program. This provides the user with, amongst others, video’s and an interactive exercise schedule. It is general belief that such interactive, online and mobile methods of information transfer are the way forward in implementation efforts. However, this has not yet been formally established for the uptake of evidence injury preventive measures, and - although user reviews are positive - the ‘Versterk je enkel’ App has not been evaluated against the ‘regular’ approach to advocate the neuromuscular program on paper and DVD.


The aim of this project is to evaluate the implementation value of the ‘Versterk je enkel’ App as compared to the usual practice of providing injured athletes written materials. Our hypothesis is that use of the ‘Versterk je enkel’ App will increase compliance to the prescribed program and, consequently, will decrease ankle sprain recurrence incidence.


This study is a randomised controlled trial. One group receives care as usual, i.e. a standardized eight-week proprioceptive training programme consisting of a balance board and an instructional booklet. The other group will receive the same programme and balance board. However, for this group the instructional booklet is exchanged by the interactive ‘Versterk je enkel’ App. The primary outcome measure is compliance to the prescribed eight-week program. Secondary outcome measures include injury recurrence incidence, costs of injury (and cost-effectiveness of the intervention), as well as barriers and facilitators towards the use of the eight-week training program, including knowledge and attitude regarding the prevention of ankle sprain recurrences.

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