The trAPP-study: Treatment of acute ankle sprains in general practice

PROJECT PARTNERS

•  ErasmusMC

FUNDING

This project is funded by a grant of The Netherlands Organisation for Health Research and Development (ZonMw)(project number 80-83910-98-13003) and the Dutch Arthritis Foundation. 

BACKGROUND

Ankle sprains are one of the most frequent injuries of the musculoskeletal system, with yearly around 680.000 new sprains in the Netherlands. Of these, about 130.000 people will visit the general practitioner (GP) each year. In addition, patients have an increased risk of a recurrent ankle sprain and about a third report at least one re-sprain. No optimal treatment strategy has proven to be effective in general practice. However, promising results were achieved by a recent preventive trial conducted among athletes in the Netherlands. An unsupervised neuromuscular training program was effective in the prevention of re-sprains. When this intervention also appears to be effective in general practice and could reduce the number of re-sprains, direct treatment tools will be available for the GP for acute ankle sprains

OBJECTIVES

The aim of this project is to examine the (cost)-effectiveness of an unsupervised e-health supported neuromuscular training program in combination with usual care in general practice compared to usual care alone in patients with acute ankle sprains in general practice.

DESIGN

This study is a multi-center, open-label randomized controlled trial, with a one-year follow-up. Patients with an acute lateral ankle sprain, aged between 14 and 65 years and visiting the GP within three weeks of injury are eligible for inclusion. Patients will be randomized in two study groups. The intervention group will receive, in addition to usual care, a standardized eight-week neuromuscular training program guided by an App. The control group will receive usual care in general practice alone. The primary outcome of this study is the total number of ankle sprain recurrences reported during one year follow-up. Secondary outcomes are subjective recovery after one year follow-up, pain at rest and during activity, function, return to sport, cost-effectiveness and compliance of the intervention. Measurements will take place monthly for the study period of 12 months after baseline measurement


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