Background: The most common ankle injury is the lateral ankle sprain.
Dutch annual sports-related ankle sprain costs can roughly be estimated at
€187,200,000. Research has shown that proprioceptive training accounts for an
approximated overall 50% reduction in ankle sprain recurrence rate.
Hypothesis: An unsupervised proprioceptive training program to reduce
the recurrence of lateral ankle sprains will reduce overall health care costs.
Design: Cohort study (economic analysis); Level of evidence, 2.
Methods: The study included 522 male and female athletes: 256 athletes
(120 female and 136 male) in the intervention group, and 266 athletes (128 female and
138 male) in the control group. Both groups received treatment according to usual
care. Athletes allocated to the intervention group received an 8-week proprioceptive
training program in addition to usual care. Costs per athlete and costs per injured
athlete were calculated. Costs related to ankle sprain recurrences were measured from
a societal perspective using cost diaries. Bootstrapping was used to analyze the
cost-effectiveness data. Follow-up was 1 year.
Results: Mean total costs in the intervention group were €81 (standard
deviation, €134) per athlete and €114 (€325) per injured athlete. Mean overall costs
in the control group were €149 (€836) per athlete and €447 (€1403) per injured
athlete. Statistically significant differences in total costs were found per athlete
(mean difference, −€69; 95% confidence interval, −€200 to −€2) and per injured
athlete (−€332; −€741 to −€62) in favor of the intervention group. A
cost-effectiveness plane showed the effect of the intervention was larger and the
costs were lower in the intervention group than the control group.
Conclusion: The use of a proprioceptive training program after usual
care of an ankle sprain is cost-effective for the prevention of ankle sprain
recurrences in comparison with usual care alone. In the Netherlands, an estimated
annual €35.9 million in medical and lost productivity costs can be saved solely by
advocating a proprioceptive training program as in the present study.
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