Ankle-GO score valid and robust score to predict return to sport in patients after lateral ankle sprain: Study

Lateral ankle sprain (LAS) is the most common sports-related injury. However, there are currently no published evidence-based criteria to guide the patient’s return to sport (RTS) and this decision is generally time-based.

Picot et al conducted a study to assess the psychometric properties of a new score (Ankle-GO) and its predictive ability for RTS at the same level of play after LAS. The article has been published in ‘Sport health’ journal.

The Ankle-GO was administered to 30 healthy participants and 64 patients at 2 and 4 months after LAS. The score was calculated as the sum of 6 tests for a maximum of 25 points. Construct validity, internal consistency, discriminant validity, and test-retest reliability were used to validate the score. The predictive value for the RTS was also validated based on the receiver operating characteristic (ROC) curve.

Ankle-GO is a composite score based on the sum of 7 components for an objective evaluation of the main deficits associated with LAS or CAI and which can result in a risk of reinjury.It was calculated from 4 functional tests: the single leg stance test (SLS) on a firm surface, the modified star excursion balance test (mSEBT), the side hop test (SHT), and the figure-of-8 test (F8T). In addition, 2 patient self-reported questionnaires were used: the Foot and Ankle Ability Measure, involving 2 subscales evaluating activities in daily life (FAAM adl) and sports (FAAMsport ), and the Ankle Ligament Reconstruction- Return to Sport after Injury (ALR-RSI).

Key findings of the study were:

• The internal consistency of the score was good (Cronbach’s alpha coefficient of 0.79) with no ceiling or floor effect.

• Test-retest reliability was excellent (intraclass coefficient correlation = 0.99) with a minimum detectable change of 1.2 points.

• The 2-month scores were significantly lower than 4-month and control group scores (7.7 ± 4, 13.9 ± 4.6, and 19.6 ± 3.4 points, respectively, P < 0.01).

• Ankle-GO values were also significantly higher in patients who returned to their preinjury level at 4 months compared with those who did not (P < 0.01).

• The predictive value of the 2-month Ankle-GO score was fair for a RTS at the same or higher than preinjury level at 4 months (area under ROC curve, 0.77; 95% CI, 0.65-0.89; P < 0.01).

Clinical Relevance: Ankle-GO is the first objective score to help in the decision-making of the RTS after LAS. At 2 months, patients with an Ankle-GO score <8 points are unlikely to RTS at the same preinjury level.

The authors concluded that – “Ankle-GO is a valid and reliable score when assessing patients after LAS during the RTS continuum. This inexpensive clinical tool composed of functional test and self-reported questionnaires seems relevant to discriminate and predict the level of RTS. At 2 months after injury, a patient exhibiting an Ankle-GO score <8 points are unlikely to resume at the same preinjury level at 4 months.”

Prospective diagnostic study Level of Evidence: Level 2. Key Words: ankle sprain, decision, functional testing, psychological readiness, return to sport, Picot et al, SPORTS HEALTH, Ankle-GO Score.

Further reading: Development and Validation of the Ankle-GO Score for Discriminating and Predicting Return-to-Sport Outcomes After Lateral Ankle Sprain Picot et al SPORTS HEALTH DOI: 10.1177/19417381231183647