Hogeschool van Amsterdam Amsterdam - Institute of Allied Health Education

Welcome to our Web Based Project for Evidence Based Practice III.1 and III.2. We are all students from the last year of the European School of Physiotherapy (Hogeschool van Amsterdam), an accelerated study programme of three years leading to a Bachelor of Health (Physiotherapy).

Introduction A traumatic injury to the lateral capsular ligament of the ankle is well known within the medical field as an acute ankle sprain injury. The typical mechanism leading to an injury of the lateral ligaments occurs during plantar flexion and inversion of the ankle. The lateral ankle ligaments are composed of the posterior talofibular ligament, anterior tibiofibular ligament and the calcaneofibular ligament. Ankle sprains are classified according to level of severity, the grades goes from I to III (mild, moderate and severe). An acute ankle sprain defines the time period of 6 weeks after the injury. It is believed that this impairment is the most common traumatic injury with approximately 25,000 ankle sprains taking place a day around the world (Rimando et al 2005). In the Netherlands alone, the incidence of injuries to the lateral capsular ligaments of the ankle is around 1575 per day (575,000 per year) according to the KNGF guidelines, and approximately 60,000 of the affected patients are referred to physiotherapists. Although it has been shown that this injury has a very high incidence, there are no worldwide guidelines for its treatment. There are however guidelines per country. In the UK, for example, PRICE (protection, rest, ice, compression, elevation) is used as a standard treatment for soft tissue injuries in the first 72 hours (Chartered Society of Physiotherapy). According to a review done by Wolfe et al in USA, PRICE was also recommended (for grade I and II ankle sprain), in addition to exercises or manipulation for maintenance of range of motion and the use of an ankle support.	According to MacAuley (2005) there is little research evidence concerning the benefits of different management strategies. The Netherlands, however, does have a professional and qualified organization (Koninklijk Nederlands Genootschap voor Fysiotherapie - KNGF) which provides physiotherapists with evidence based guidelines. An overview of the treatments used is needed; the data collected by this research can be used in further research in the future by different organizations (i.e. KNGF). It is not known how many physiotherapists do actually follow evidence based guidelines, nor have an evidence based approach to treatment of ankle sprain. For the reasons given above, we are unable to speculate which type of treatment are most used by physiotherapists around the world, and as a consequence we can’t do any comparisons between treatments used by them in different countries. Our main goal with this project is to find out what is the most commonly performed treatment strategy used by physiotherapists to treat acute ankle sprain. As we are all students from the "Hogeschool van Amsterdam" and some of us have even done their clinical affiliation here, we decided to concentrate our research area on private practices located in this city. In our report, we will compare the statistical results of our data in regard to the treatment approach used in Amsterdam to treat acute ankle sprain with the one suggested by the KNGF' guidelines. Due to high incidence of this kind of injury here in the Netherlands we find it relevant to our profession to perform this research and formulate an evidence based answer to our research question: "What are the most used treatments for acute inversion ankle sprain applied by physiotherapists working at private clinics in Amsterdam?" Link to: A Patient's Guide to Ankle Sprain and Instability