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Evaluation of the implemention effectiveness of the ‘Versterk je Enkel’ App to prevent recurrent ankle sprains; Injury prevention in your pocket?!

Projectomschrijving

Met ongeveer 480.000 gevallen per jaar is lateraal enkelbandletsel (een blessure aan de buitenste banden) een van de meest voorkomende sportblessures in Nederland. Het risico op herhaald letsel is bovendien groot. De maatschappelijke kosten van enkelblessures in Nederland zijn zo’n 187 miljoen euro per jaar. Alleen al daarom is effectieve preventie van groot belang. Een achtweeks trainingsprogramma vermindert dit risico, maar alleen als een sporter tenminste driekwart van het programma uitvoert. Versterk je Enkel draagt hier met twee toegankelijke tools aan bij, te weten een mobiele App en een informatieve folder. Uit gerandomiseerd onderzoek blijkt nu dat beide tools effectief de therapietrouw vergroten. Het aanbieden van het programma op deze twee manieren maakt het mogelijk voor atleten en (para)medici om de gewenste methode te kiezen. Dit komt de therapietrouw ten goede omdat bij een vrije keuze de methode van aanbieden beter aansluit bij de patiënt. Deze keuzevrijheid faciliteert verdere therapietrouw van het gebruik en de naleving van het Versterk je enkel programma.

Producten

Titel: Users’ Perspectives, Opportunities, and Barriers of the Strengthen Your Ankle App for Evidence-Based Ankle Sprain Prevention: Mixed-Methods Process Evaluation for a Randomized Controlled Trial
Auteur: van Reijen, Miriam, Asscheman, Marianne, Vriend, Ingrid, van Mechelen, Willem, Verhagen, Evert
Magazine: Journal of Medical Internet Research
Titel: Compliance with Sport Injury Prevention Interventions in Randomised Controlled Trials: A Systematic Review
Auteur: van Reijen, Miriam, Vriend, Ingrid, van Mechelen, Willem, Finch, Caroline F., Verhagen, Evert A.
Magazine: Sports Medicine
Titel: Preventing recurrent ankle sprains: Is the use of an App more cost-effective than a printed Booklet? Results of a RCT
Auteur: Van Reijen, M., Vriend, I., van Mechelen, W., Verhagen, E. A.
Magazine: Scandinavian Journal of Medicine and Science in Sports
Titel: The “Strengthen your ankle” program to prevent recurrent injuries: A randomized controlled trial aimed at long-term effectiveness
Auteur: Van Reijen, M., Vriend, I., Zuidema, V., van Mechelen, W., Verhagen, E.A.
Magazine: Scandinavian Journal of Medicine and Science in Sports
Titel: The implementation effectiveness of the 'Strengthen your ankle' smartphone application for the prevention of ankle sprains: design of a randomized controlled trial
Auteur: Miriam Van Reijen, Ingrid I Vriend, Victor Zuidema, Willem van Mechelen and Evert A Verhagen
Titel: Increasing compliance with neuromuscular training to prevent ankle sprain in sport: does the ‘Strengthen your ankle’ mobile App make a difference? A randomised controlled trial
Auteur: Van Reijen, M, Vriend, I, Zuidema, V, van Mechelen, W, Verhagen, E A
Magazine: British Journal of Sports Medicine

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Eindverslag

Met ongeveer 480 duizend gevallen per jaar is lateraal enkelbandletsel (een blessure aan de buitenste banden) een van de meest voorkomende sportblessures in Nederland. Het risico op herhaald letsel is bovendien groot. De maatschappelijke kosten van enkelblessures in Nederland zijn zo’n 187 miljoen euro per jaar. Alleen al daarom is effectieve preventie van groot belang. Een achtweeks trainingsprogramma vermindert dit risico, maar alleen als een sporter tenminste driekwart van het programma uitvoert. Versterk je Enkel draagt hier met twee toegankelijke tools aan bij, te weten een mobiele App en een informatieve folder. Uit gerandomiseerd onderzoek blijkt nu dat beide tools effectief de therapietrouw vergroten. Het aanbieden van het programma op deze twee manieren maakt het mogelijk voor atleten en (para) medici om de gewenste methode te kiezen. Dit komt de therapietrouw ten goede omdat bij een vrije keuze de methode van aanbieden beter aansluit bij de patiënt. Deze keuzevrijheid faciliteert verdere therapietrouw van het gebruik en de naleving van het Versterk je enkel programma.

Samenvatting van de aanvraag

BACKGROUND Ankle sprains continue to pose a significant burden to the individual athlete, as well as society as a whole. However, despite ankle sprains being the single most common athletic injury and despite an active approach by various Dutch organizations in implementing our epidemiological knowledge on cost-effectiveness, large-scale community uptake of preventive measures, and thus actual prevention of ankle sprains, is lagging well behind. In an attempt to bridge this implementation gap VeiligheidNL looked into the possible role of new (social) media and has developed an freely available interactive App ('Versterk je enkel'; available for iOS and Android) that contains - next to general advice on bracing and taping - the cost-effective neuromuscular program. This provides the user with, amongst others, video's and an interactive exercise schedule. It is general belief that such interactive, online and mobile methods of information transfer are the way forward in implementation efforts. However, this has not yet been formally established for the uptake of evidence injury preventive measures, and - although user reviews are positive - the 'Versterk je enkel' App has not been evaluated against the 'regular' approach to advocate the neuromuscular program on paper and DVD. AIM The aim of the proposed project is to evaluate the implementation value of the 'Versterk je enkel' App as compared to the usual practice of providing injured athletes written materials. Our hypothesis is that use of the 'Versterk je enkel' App will increase compliance to the prescribed program and, consequently, will decrease ankle sprain recurrence incidence. DESIGN The proposed study will be a randomised controlled trial. After stratification for ankle sprain severity and main medical caregiver participants will be randomised to two study groups. One group will receive care as usual, i.e. a standardized eight-week proprioceptive training programme [10,11] consisting of a balance board and an instructional booklet. The other group will receive the same programme and balance board. However, for this group the instructional booklet is exchanged by the interactive 'Versterk je enkel' App. OUTCOME MEASURES & FOLLOW-UP The primary outcome measure will be compliance to the prescribed eight-week program. Secondary outcome measures include injury recurrence incidence, costs of injury (and cost-effectiveness of the intervention), as well as barriers and facilitators towards the use of the eight-week training program, including knowledge and attitude regarding the prevention of ankle sprain recurrences. Compliance (primary outcome) follow-up measurements will commence after randomisation (i.e. after treatment and at the start of the allocated intervention), and will take place weekly for the duration of the program (8 weeks). The follow-up measurements will gather information for each participant on the number, sets and repetitions of prescribed exercises undertaken. In addition questions will be asked about the clarity of the instructions and difficulty of the exercises. After 8 weeks a follow-up questionnaire will measure residual complaints of the initial ankle sprain. Both pain and feeling of giving way will be scored on five-point Likert scale for a series of questions. At this last follow-up knowledge, attitude, barriers and facilitators regarding (recurrent) ankle sprain prevention will be measured again in all participants. Recurrence injury incidence and cost of injury outcomes will take place once a month for a total period of 12 months. The follow-up measurements will gather information for each participant on ankle sprains sustained during the preceding month (including details & mechanisms of this sprain and absence from sports due to the ankle sprain recurrence as a measure of recurrence severity), and time at risk during the preceding month (exposure). Finally, the follow-up questionnaires will measure residual complaints of the initial ankle sprain. Both pain and feeling of giving way will be scored on five-point Likert scale for a series of questions, e.g. do you feel pain when being active, do you feel pain when getting out of bed in the morning, do you feel your ankle giving way when walking across the street, etc. At the last follow-up (12 months) knowledge, attitude, barriers and facilitators regarding (recurrent) ankle sprain prevention will be measured again in all participants. In order to evaluate the cost-effectiveness of the allocated interventions, subjects who sustain an ankle sprain recurrence will receive a cost-diary. From these cost-diaries direct and indirect costs resulting from the sustained ankle sprain recurrence can be calculated for use in an economic evaluation. The economic evaluation will be performed from a societal perspective.

Onderwerpen

Kenmerken

Projectnummer:
525001003
Looptijd: 100%
Looptijd: 100 %
2013
2016
Onderdeel van programma:
Gerelateerde subsidieronde:
Projectleider en penvoerder:
Prof. dr. E.A.L.M. Verhagen
Verantwoordelijke organisatie:
Amsterdam UMC - locatie VUmc