Author(s): YUTO, U., MASASHI, K., YUSUKE, K., AKIRA, O., TAKUMI, K., HIROYUKI, W., NAONOBU, T., Institution: KITASATO UNIVERSITY, Country: JAPAN, Abstract-ID: 1712

INTRODUCTION:
ateral ankle sprain (LAS) is one of the most common sports injuries, and suboptimal return-to-sport timing may increase the risk of prolonged dysfunction and reinjury. In athletes with grade II–III injuries, clinicians must estimate return-to-training time and individualize rehabilitation from an early stage. Although patient-reported outcome measures (PROMs) such as the Cumberland Ankle Instability Tool (CAIT) and the Foot and Ankle Ability Measure (FAAM) are widely used, their prognostic value for time to return to team training remains unclear. Therefore, this study aimed to determine whether PROMs obtained at the initial rehabilitation visit predict the time to full return to team training and to identify the most clinically useful self-reported predictor.
METHODS:
This single-center prospective cohort study included 125 consecutive patients diagnosed with grade II or III LAS between April 2021 and January 2026 using radiography and ultrasonography. Mean age was 19.9 ± 9.7 years (64 males, 61 females). At the initial rehabilitation session, participants completed CAIT, FAAM-ADL, FAAM-Sports, and the single-item sports function rating included in the FAAM (0–100; 100 = preinjury sports-level function). The endpoint was days to full return to team training. PROM scores were dichotomized at the median and compared using Kaplan–Meier curves and log-rank tests. A multivariable Cox proportional hazards model was constructed including age, BMI, sex, weight-bearing lunge test (WBLT), and the single-item sports function rating included in the FAAM. Statistical significance was set at p < 0.05.
RESULTS:
CAIT (p = 0.714), FAAM-ADL (p = 0.181), and FAAM-Sports (p = 0.714) were not significantly associated with return-to-training timing in Kaplan–Meier analyses. In contrast, the single-item sports function rating included in the FAAM significantly stratified outcomes (p < 0.001). Median return-to-training time was 37 days (95% CI, 31–39) in the favorable group and 46 days (95% CI, 42–49) in the unfavorable group.
In the multivariable Cox model, the single-item sports function rating included in the FAAM remained an independent predictor of earlier return to training (hazard ratio 1.014, 95% CI 1.002–1.025, p = 0.017). WBLT was also significant (HR 1.053, 95% CI 1.010–1.097, p = 0.014), whereas age, BMI, and sex were not.
CONCLUSION:
Among PROMs obtained at the initial rehabilitation visit, only the single-item sports function rating included in the FAAM independently predicted time to full return to team training after acute grade II–III LAS. This simple global self-rating may provide practical prognostic information for individualized rehabilitation and return-to-sport decision-making.