Ankle sprain as a work-related accident: status of proprioception after 2 weeks

Classification of chronic ankle instability using machine learning technique based on ankle kinematics during heel rise in delivery workers

Objective

Ankle injuries in delivery workers (DWs) are often caused by trips, and high recurrence rates of ankle sprains are related to chronic ankle instability (CAI). Heel rise requires joint angles and moments similar to those of the terminal stance phase of walking that the foot supinates. Thus, our study aimed to develop, determine, and compare the predictive performance of statistical machine learning models to classify DWs with and without CAI using ankle kinematics during heel rise.

Methods

In total, 203 DWs were screened for eligibility. Seven predictors were included in our study (age, work duration, body mass index, calcaneal stance position angle [CSPA] in the initial and terminal positions during heel rise, calcaneal movement during heel rise [CMHR], and plantar flexion angle during heel rise). Six machine learning algorithms, including logistic regression, decision tree, AdaBoost, Extreme Gradient boosting machines, random forest, and support vector machine, were trained.

Results

The random forest model (area under the curve [AUC], 0.967 [excellent]; F1, 0.889; accuracy, 0.925) confirmed the best predictive performance in the test datasets among the six machine learning models. For Shapley Additive Explanations, old age, low CMHR, high CSPA in the initial position, high PFA, long work duration, low CSPA in the terminal position, and high body mass index were the most important predictors of CAI in the random forest model.

Conclusion

Ankle kinematics during heel rise can be considered in the classification of DWs with and without CAI.

Decreased patient visits for ankle sprain during the COVID-19 pandemic in South Korea: A nationwide retrospective study

Social distancing measures including school closure and the cancelation of sports activity were enforced during the early phase of the coronavirus disease 2019 (COVID-19) pandemic to reduce the spread of severe acute respiratory syndrome coronavirus 2 in South Korea. To assess the impact of the COVID-19 pandemic on the nationwide burden of musculoskeletal injury in 2020, we analyzed data on the number of patient visits for ankle sprain in South Korea. We collected national reimbursement data on the number of patient visits for ankle sprain between August 2010 and July 2020. To quantify the impact of the COVID-19 pandemic on the number of reductions in patient visits for ankle sprain, we developed a regression model adjusting for the annual cycle of the patient visit during 2016/17-2018/19. During the COVID-19 pandemic in South Korea, the overall number of patient visits for ankle sprain dropped by 7.9%. The number of patient visits for ankle sprain substantially reduced by 23.4% among school-aged children (6-19 years) during the COVID-19 pandemic in South Korea. Our findings suggest that the social distancing measure has had a positive impact on reducing the burden of medical usages for ankle sprain.

Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021

This revised clinical practice guideline (CPG) addresses the distinct but related lower extremity impairments of those with a first-time lateral ankle sprain (LAS) and those with chronic ankle instability (CAI). Depending on many factors, impairments may continue following injury. While most individuals experience resolution of symptoms, complaints of instability may continue and are defined as CAI. The aims of the revision were to provide a concise summary of the contemporary evidence since publication of the original guideline and to develop new recommendations or revise previously published recommendations to support evidence-based practice. J Orthop Sports Phys Ther 2021;51(4):CPG1-CPG80. doi:10.2519/jospt.2021.0302.