Author(s): SHENHAR, M., DAR, G., FINESTONE, A., WITCHALLS, J., WADDINGTON, G., STEINBERG, N., Institution: THE ACADEMIC COLLEGE LEVINSKY-WINGATE, WINGATE CAMPUS, Country: ISRAEL, Abstract-ID: 483

INTRODUCTION:
Ankle sprain is a common injury in soldiers and comprises approximately 10% of all musculoskeletal injuries in the military. An ankle sprain is a risk factor for recurrent sprains and may impair the soldier’s functional abilities. The aim of the study was to examine the associations between ankle sprains and functional abilities such as balance, agility, strength and proprioception in newly recruited soldiers during infantry training.
METHODS:
One hundred and seventy-nine soldiers, all males between the ages of 18-21, were assessed throughout their infantry training at baseline (Pre), after 12 weeks (Post), and after additional 10 weeks (Follow up). The assessments included dynamic balance (Y-Balance test YBT), agility (Hexagon hop test), muscle strength (heel raise test) proprioception (Active Movement Extent Discrimination Assessment AMEDA), and 3,000m run. In addition, the participants filled out the Cumberland Ankle Instability Tool (CAIT) for perceived ankle instability. Injury data were collected once every two weeks on personal encounters of the physiotherapist with the soldiers throughout the first 12 weeks of the training. A repeated measures 2-way ANOVA [time (Pre, Post, Follow up) and injury (yes/no sprain)] was performed.
RESULTS:
Fifty-two soldiers (29%) were diagnosed with ankle sprains in the first 12 weeks of training.
Time effect was found for hexagon, heel raise and YBT (p=0.005, p<0.001, p<0.001 respectively), the uninjured soldiers improved their performance throughout the training and the injured did not. In the AMEDA the injured improved and the uninjured did not (p<0.001), and in 3,000m run both groups improved (p<0.001). In the CAIT, both groups worsened (p<0.001).
Injury effect was found for YBT, Hexagon, Heel raise (p<0.001, p<0.001, p<0.001 respectively) where the uninjured performed better that the injured; and for the CAIT, where the uninjured reported more ankle stability than the injured (p<0.001).
Time*injury interactions were found for Hexagon (F1,143=15.999, p<0.001) and YBT (F1,144=10.324, p=0.<0.001), in both measurements the uninjured improved from Pre to Follow up, and the injured did not improve; for AMEDA (F1,137=3.409, p=0.034) in which the injured improved from Pre to Follow up and the uninjured did not improve; and for the CAIT (F1,154=13.547, p<0.01) where both groups worsened from Pre to Follow up.
CONCLUSION:
Soldiers who sprained their ankles during basic infantry training performed worse than their uninjured peers at Post and Follow up assessments. An ankle sprain affects the soldiers’ balance, strength, agility and aerobic fitness. Surprisingly, the injured soldiers’ proprioception ability improved throughout the training. The injured soldiers may have been more attentive to the ankle from fear of recurrent sprains and attrition. An intervention program for the prevention of ankle sprains in infantry training is recommended.