Infographics

Br J Sports Med: first published as 10.1136/bjsports-2018-099935 on 10 September 2018. Downloaded from http://bjsm.bmj.com/ on 10 September 2018 by guest. Protected by copyright.
International Ankle Consortium This is evidenced by the high propen-
sity for the development of long-term
injury-associated symptoms. Individ-
Rehabilitation-Oriented Assessment uals who have incurred an acute lateral
ankle sprain injury often experience
Eamonn Delahunt,1,2 Chris M Bleakley,3 Daniela S Bossard,1,2 ankle joint instability, regular occur-
rences of ‘giving way’ of the ankle joint,
Brian M Caulfield,1,4 Carrie L Docherty,5 Cailbhe Doherty,4 as well as recurrent sprains during the
Francois Fourchet,6 Daniel T P Fong,7 Jay Hertel,8 Claire E Hiller,9 months and years after their initial
Thomas W Kaminski,10 Patrick O McKeon,11 Kathryn M Refshauge,9 injury; these are the characteristic
features of chronic ankle instability.5–8
Alexandria Remus,4 Evert A Verhagen,12 Bill T Vicenzino,13
Erik A Wikstrom,14 Phillip A Gribble15 Why it is important to assess
both mechanical and functional
Epidemiology of lateral ankle across patients and healthcare profes- insufficiencies
sprains sionals; indeed, up to 50% of individ- Chronic ankle instability has been
Lateral ankle sprains are one of the most uals who incur an acute lateral ankle theorised to develop due to the inter-
prevalent lower limb musculoskeletal inju- sprain do not seek formal healthcare action of mechanical and sensorimotor
ries incurred by individuals who partici- management for their injury. 3 All too impairments that manifest following
pate in recreational physical activities and often colloquial terms such as a ‘rolled’ acute lateral ankle sprain injury.9 As
sports.1 2 ankle or ‘twisted’ ankle are used to such, it is logical to assume that clin-
describe an acute lateral ankle sprain ical assessment should evaluate whether
Propensity for the development of injury. In reality, acute lateral ankle a patient in the acute phase following
chronic ankle instability sprains are rarely ever a ‘simple’ injury.4 lateral ankle sprain injury exhibits
The misconception that acute lateral
ankle sprains are innocuous injuries
that require little treatment is common

1
School of Public Health, Physiotherapy and Sports
Science, University College Dublin, Dublin, Ireland
2
Institute for Sport & Health, University College Dublin,
Dublin, Ireland
3
Department of Physical Therapy, High Point University,
High Point, North Carolina, USA
4
Insight Centre for Data Analytics, University College
Dublin, Dublin, Ireland
5
School of Public Health, Indiana University,
Bloomington, Indiana, USA
6
Motion Analysis Laboratory, Hôpital De La Tour,
Meyrin, Geneva, Switzerland
7
National Centre for Sport & Exercise Medicine, School
of Sport, Exercise & Health Sciences, Loughborough
University, Loughborough, UK
8
Department of Kinesiology, Curry School of Education,
University of Virginia, Charlottesville, Virginia, USA
9
Faculty of Health Sciences, School of Physiotherapy,
University of Sydney, Sydney, New South Wales,
Australia
10
Department of Kinesiology & Applied Physiology,
University of Delaware, Newark, Delaware, USA
11
Department of Exercise & Sport Sciences, School of
Health Sciences & Human Performance, Ithaca College,
Ithaca, New York, USA
12
Amsterdam Collaboration on Health and Safety in
Sports & Department of Public & Occupational Health,
Amsterdam Movement Science, VU University Medical
Center, Amsterdam, The Netherlands
13
School of Health and Rehabilitation Sciences,
University of Queensland, Brisbane, Queensland,
Australia
14
Department of Exercise & Sport Science, University
of North Carolina at Chapel Hill, Chapel Hill, North
Carolina, USA
15
Division of Athletic Training, College of Health
Sciences, University of Kentucky, Lexington, Kentucky,
USA
Correspondence to Professor Eamonn Delahunt,
School of Public Health, Physiotherapy & Sports Science,
University College Dublin, Dublin 4, Ireland;
​eamonn.​delahunt@​ucd.​ie

Delahunt E, et al. Br J Sports Med Month 2018 Vol 0 No 0    1

Infographics
any mechanical and/or sensorimotor
impairments.
Recommendations for clinical
assessment
A modified Delphi study was completed
under the auspices of the executive
committee of the International Ankle
Consortium. The primary aim was to
develop recommendations, based on
expert consensus, for structured clinical
assessment of acute lateral ankle sprain
injuries. Through consensus, the expert
panel developed the International Ankle
Consortium Rehabilitation-Oriented
ASsessmenT (ROAST).10 11
Key features of the International Ankle
Consortium ROAST include assessing a
patient’s:
►► Ankle joint pain.
►► Magnitude of ankle joint swelling.
►► Ankle joint range of motion.
►► Ankle joint arthrokinematics.
►► Ankle joint strength.
►► Static and dynamic postural balance.
►► Gait.
►► Level of physical activity.
►► Self-reported ankle joint function.
This consensus statement and set
of recommendations from the Inter-
national Ankle Consortium aims to
be a key resource for clinicians who
regularly assess individuals who have
incurred an acute lateral ankle sprain
injury. It is envisaged that the Inter-
national Ankle Consortium ROAST
will help clinicians objectively identify
2 Delahunt E, et al. Br J Sports Med Month 2018 Vol 0 No 0
the mechanical and/or sensorimotor
impairments that manifest in the acute
phase of lateral ankle sprain injury. The
identification of these impairments
could then be used to guide the design
of optimised rehabilitation protocols.
Competing interests None declared.
Patient consent Not required.
Provenance and peer review Not commissioned;
internally peer reviewed.
Author note This infographic is based upon the
following article: Delahunt E, Bleakley CM, Bossard
DS, Caulfield BM, Docherty CL, Doherty C, Fourchet
F, Fong DT, Hertel J, Hiller CE, Kaminski TW, McKeon
PO, Refshauge KM, Remus A, Verhagen EA, Vicenzino
BT, Wikstrom EA, Gribble PA. Clinical assessment
of acute lateral ankle sprain injuries (ROAST): 2019
consensus statement and recommendations of the
International Ankle Consortium. Br J Sports Med.
2018 Jun 9. pii: bjsports-2017-098885. doi: 10.1136/
bjsports-2017-098885. [Epub ahead of print] PMID:
29886432.
© Author(s) (or their employer(s)) 2018. No commercial
re-use. See rights and permissions. Published by BMJ.
To cite Delahunt E, Bleakley CM, Bossard DS, et al.
Br J Sports Med Epub ahead of print: [please include
Day Month Year]. doi:10.1136/bjsports-2018-099935
Accepted 17 August 2018
Br J Sports Med 2018;0:1–2.
doi:10.1136/bjsports-2018-099935
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