Ankle sprains are an extremely common musculoskeletal injury with a high probability of recurrence and chronic sequelae, such as weakness and instability. Given its high prevalence, recurrence risk, and consequences, it is associated with an extremely high financial burden. Despite the recommendation to start rehabilitation early in recent clinical practice guidelines, evidence of the impact of early rehabilitation is lacking.
The researchers reviewed data from 6,150 beneficiaries of the U.S. Military Health system who received rehabilitation for ankle sprains. They determined the effect of rehabilitation on timing on recurrence and ankle sprain-related medical care use at one year after injury through linear and non-linear analyses.
This study had the advantage of including complete data from an entire health system, and thus enrolling a large number of subjects.
Only one in four people received rehabilitation. Comorbidities with a potential confounding effect such as chronic pain, insomnia, depression, and substance abuse did not influence the benefits of early rehabilitation. The decrease in medical costs associated with early rehabilitation was up to $1,400 per sprain.
> From: Rhon et al., J Orthop Sport Phys Ther 51 (2021) 619-627 . All rights reserved to Journal of Orthopaedic & Sports Physical Therapy. Click here for the online summary.
Want to read the whole paper? A free full text version is available online here!
Expert opinion
The possibility of studying the beneficiaries of an entire health system (such as in the military) has the advantages of obtaining larger samples, and thus more robust data. In this case, it became clear that early rehabilitation decreases recurrence risk and medical costs.
While the benefits of decreasing recurrence risk, such as increased participation and quality of life, may be more easily understandable, decreasing medical costs may have a more covert but widespread long-term impact. Less spending means that this budget may be directed to patients where costs are unavoidable, whether it is in the military or civilian health system. The $1,400 saved in a single ankle sprain may be directed for the care of someone in need of urgent action.
This is why studies showing decreases in medical care use have implications reaching far beyond the population being studied; decreasing healthcare costs ultimately benefits all of us. The full text of this article is free to access and is thus worth checking out.
