Ankle Sprains Risk Factors in a Sample of French Firefighters: A Preliminary Prospective Study

Abstract

Context: Firefighters participating in mandatory physical exercise sessions are exposed to a high risk of ankle sprain injury. Although both physiological and psychological risk factors have been identified, few prospective studies considered the complex interaction of these factors in firefighters. Objective: To prospectively determine whether intrinsic physical risk factors and work-related environments predict ankle sprains occurring during on-duty physical exercise in firefighters during an 8-month follow-up period. Design: Prospective. Setting: Fire Department and Rescue Service. Participants: Thirty-nine firefighters were selected based on convenience sampling. Intervention: Participants performed physical tests and completed questionnaires. Main Outcome Measures: Lower Quarter Y-Balance Test, Weight-Bearing Lunge Test, anthropometric measures, postural stability, chronic ankle instability (Cumberland Ankle Instability Tool) scores, previous injuries, and perceived psychosocial work environment (Copenhagen Psychosocial Questionnaire [COPSOQ]). Results: During the follow-up, 9 firefighters sustained an injury. Lower Quarter Y-Balance Test and Weight-Bearing Lunge Test performances, Cumberland Ankle Instability Tool scores, history of previous ankle sprain, and specific dimensions of the COPSOQ significantly differed between injured and uninjured firefighters. Lower-limbs asymmetries of the Lower Quarter Y-Balance Test (ie, anterior, posteromedial, and posterolateral directions) and the Weight-Bearing Lunge Test were predictors of ankle sprains. Conclusions: These findings originally provide evidence that intrinsic factors mainly contribute to ankle sprains, although psychosocial work environment assessment could also characterize firefighters at risk.

Incidence of injuries and factors related to injuries in combat soldiers

“…As expected, the subjective ankle stability score (identified by the CAIT questionnaire) was found to be related to injuries among our soldiers. Similar to our results, Vaulerin et al 29 reported that CAIT scores significantly differ between injured and non-injured firefighters. No previous study measured whether the subjective assessment of ankle instability among soldiers is related to the risk of injuries.…”

Systematic Review and Meta-Analysis of the Y-Balance Test Lower Quarter: Reliability, Discriminant Validity, and Predictive Validity

“…Lai et al 39 reported asymmetries of 9cm in the posteromedial reach direction and 3cm in the posterolateral direction resulted in a sensitivity of 17.1% and 54.9% (respectively), while specificity was reported as 89.9% and 54.6% (respectively). Valuerin et al 74 and Siupsinskas et al 73 reported varying values for asymmetry in reach directions or limb differences, though no relationships to future injury risk were noted. Finally, Butler et al 3 did not observe significant differences in reach asymmetry between injured and uninjured football players.…”

“…Twelve studies 34,36,39,48,50,57,64,68,69,[72][73][74] investigated the injury prediction ability of the YBT-LQ anterior reach asymmetry (Subjects: n=3,986). Five of these studies 34,50,57,64,68 examined anterior reach asymmetry using a cut off of ≥4 cm; three 34,57,64 reported raw numbers of subjects falling above and below this cut off score.…”

“…The remaining seven studies varied in interpretation of anterior reach performance. Five studies 39,48,69,72,74 utilized anterior asymmetry cut off values varying from 2-3cm; of these, Valuerin et al 74 found an asymmetry of ≥2cm was predictive of ankle sprains. Siupsinksaks et al 73 reported only limb difference scores and did not find an association to injury in elite female basketball players.…”

“…Ten studies 3,34,36,39,57,64,68,[72][73][74] examined the relationship between posteromedial and/or posterolateral reach asymmetry and future injury risk. Gonell et al 34 reported an OR of 3.86 (95%CI 1.46-10.95) for male soccer players with a posteromedial asymmetry of 4cm or greater.…”