What have we learnt from quantitative case reports of acute lateral ankle sprains injuries and episodes of ‘giving-way’ of the ankle joint, and what shall we further investigate?

Figures & data

Figure 1. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram.

Table 1. Chronological list of studies, case numbers and individual’s characteristics

Study		Case#	Event setting	Sex	Age [years]	Height [m]	Mass [kg]
a)	Fong et al., 2009	1	Laboratory	Male	23	1.75	62.6
b)	Mok et al., 2011a #1	2	Competition	Female	29	1.85	57.6
	Mok et al., 2011a #2	3	Competition	Male	24	1.72	72.0
c)	Kristianslund et al., 2011	4	Laboratory	Female	22	1.73	63.7
d)	Fong et al., 2012 #1	5	Competition	Male	27	1.93	79.0
	Fong et al., 2012 #2	6	Competition	Male	23	1.83	81.6
	Fong et al., 2012 #3	7	Competition	Female	18	1.73	58.0
	Fong et al., 2012 #4	8	Competition	Female	20	1.77	58.0
	Fong et al., 2012 #5	9	Competition	Female	26	1.75	60.0
e)	Gehring et al., 2013	10	Laboratory	Male	23	1.83	75.0
f)	Terada & Gribble, 2015	11	Laboratory	Male	20	1.80	80.0
g)	Panagiotakis et al., 2017 #1	12	Competition	Male	33	2.11	111.1
	Panagiotakis et al., 2017 #2	13	Competition	Male	32	2.03	102.1
	Panagiotakis et al., 2017 #3	14	Competition	Male	24	1.91	94.3
	Panagiotakis et al., 2017 #4	15	Competition	Male	27	2.11	105.2
h)	Lysdal et al., 2018	16	Laboratory	Male	26	1.74	75.5
i)	Remus et al., 2018	17	Laboratory	Male	22	1.78	97.0
j)	Kosik et al., 2019	18	Laboratory	Male	23	1.88	97.7
k)	Li et al., 2019 #1	19	Laboratory	Female	20	1.71	70.0
	Li et al., 2019 #2	20	Laboratory	Female	19	1.66	63.0
l)	Trejo Ramírez et al., 2020	21	Laboratory	Male	31	1.83	84.0
m)	Chin et al., 2021	22	Laboratory	Female	18	1.60	57.0
n)	Fong et al., 2021	23	Competition	Male	29	1.72	68.0
o)	Takeda et al., 2021	24	Laboratory	Female	18	1.61	51.3
Mean (SD)					24.0 (4.4)	1.81 (0.13)	76.0 (17.0)

Figure 2. Peak ankle joint angle (a, d, g), time to peak ankle joint angle (b, e, h), and peak ankle joint velocity (c, f, i) of the case reports with respect to each study. Adapted and updated based on (Fong et al., 2021).

Table 2. Summarising table of initial contact ankle joint angles and shoe-surface contact location

Study		Case#	Initial inversion [deg]	Initial plantarflexion [deg]	Initial internal rotation [deg]	Initial shoe-floor contact location
a)	Fong et al., 2009	1	15.0	−11.0	−14.0	Medial heel
b)	Mok et al., 2011a #1	2	30.0	5.0	28.0	Lateral heel
	Mok et al., 2011a #2	3	7.0	−41.0	4.0	Heel
c)	Kristianslund et al., 2011	4	3.0	−14.0	0.0	-
d)	Fong et al., 2012 #1	5	10.0	−18.0	10.0	Heel
	Fong et al., 2012 #2	6	18.5	12.0	7.0	Flat
	Fong et al., 2012 #3	7	18.5	15.0	−6.0	Tip
	Fong et al., 2012 #4	8	17.0	16.0	4.0	Flat
	Fong et al., 2012 #5	9	2.0	−10.0	40.0	Lateral forefoot
e)	Gehring et al., 2013	10	−2.0	10.0	−3.5	Medial heel
f)	Terada & Gribble, 2015	11	−3.5	41.0	-	-
g)	Panagiotakis et al., 2017 #1	12	4.0	1.0	−5.0	-
	Panagiotakis et al., 2017 #2	13	2.0	17.5	9.0	-
	Panagiotakis et al., 2017 #3	14	16.0	−10.0	3.0	-
	Panagiotakis et al., 2017 #4	15	8.0	19.0	4.5	-
h)	Lysdal et al., 2018	16	26.0	35.0	33.5	Lateral forefoot
i)	Remus et al., 2018	17	-	-	-	Heel
j)	Kosik et al., 2019	18	−17.0	37.0	-	-
k)	Li et al., 2019 #1	19	8.5	30.0	3.5	-
	Li et al., 2019 #2	20	16.0	35.0	9.5	-
l)	Trejo Ramírez et al., 2020	21	8.0	−10.0	0.0	Heel
m)	Chin et al., 2021	22	−5.0	12.0	−15.5	Forefoot
n)	Fong et al., 2021	23	−2.0	33.0	18.0	Medial forefoot
o)	Takeda et al., 2021	24	-	-	-	Heel
Mean (SD)			8.2 (10.7)	9.3 (21.1)	6.5 (13.9)

Table 3. Summarising table of peak ankle joint kinematics

Study		Case#	(A) Peak inversion [deg]	(B) Time of peak inversion [s]	(C) Peak inversion velocity [deg/s]	(D) Peak plantarflexion [deg]	(E) Time of peak plantarflexion [s]	(F) Peak plantarflexion velocity [deg/s]	(G) Peak internal rotation [deg]	(H) Time of peak internal rotation [s]	(I) Peak internal rotation velocity [deg/s]
a)	Fong et al., 2009	1	48.0	0.20	632	1.0	0.04	370.0	10.0	0.20	271.0
b)	Mok et al., 2011a #1	2	142.0	0.08	1752	52.0	0.18	-	52.0	0.16	-
	Mok et al., 2011a #2	3	78.0	0.08	1397	16.0	0.17	-	45.0	0.12	-
c)	Kristianslund et al., 2011	4	35.0	0.18	559	20.0	0.30	-	55.0	0.17	-
d)	Fong et al., 2012 #1	5	94.0	0.12	1488	30.0	0.16	1748.0	46.0	0.26	1170.0
	Fong et al., 2012 #2	6	48.0	0.08	506	28.0	0.10	381.0	26.0	0.06	412.0
	Fong et al., 2012 #3	7	59.0	0.12	837	31.0	0.03	561.0	99.0	0.12	2124.0
	Fong et al., 2012 #4	8	67.0	0.17	724	37.0	0.46	571.0	84.0	0.26	1312.0
	Fong et al., 2012 #5	9	126.0	0.44	800	−8.0	0.07	325.0	75.0	0.41	530.0
e)	Gehring et al., 2013	10	45.0	0.06	1290	50.0	0.05	1240.0	13.0	0.16	580.0
f)	Terada & Gribble, 2015	11	14.0	0.15	-	40.0	0.00	-	-	-	-
g)	Panagiotakis et al., 2017 #1	12	92.7	0.17	1161	3.2	0.13	168.6	3.4	0.10	66.3
	Panagiotakis et al., 2017 #2	13	77.4	0.13	975	26.4	0.10	433.0	38.2	0.13	149.1
	Panagiotakis et al., 2017 #3	14	96.6	0.23	482	12.0	0.20	281.7	28.0	0.17	98.0
	Panagiotakis et al., 2017 #4	15	107.5	0.23	873	53.9	0.47	252.5	46.6	0.40	1039.1
h)	Lysdal et al., 2018	16	36.7	0.09	468	49.6	0.12	341.0	66.9	0.12	299.0
i)	Remus et al., 2018	17	-	-	1734	-	-	797.0	-	-	1088.0
j)	Kosik et al., 2019	18	2.0	0.18	-	38.0	0.02	-	-	-	-
k)	Li et al., 2019 #1	19	55.0	0.16	927	30.0	0.00	−710.0	27.0	0.16	600.0
	Li et al., 2019 #2	20	58.0	0.12	647	40.0	0.00	−900.0	49.0	0.16	600.0
l)	Trejo Ramírez et al., 2020	21	44.0	-	780	9.0	-	510.0	30.0	-	770.0
m)	Chin et al., 2021	22	22.0	0.15	-	47.0	0.27	-	50.0	0.15	-
n)	Fong et al., 2021	23	114.0	0.24	1262	33.0	0.00	440.0	69.0	0.20	677.0
o)	Takeda et al., 2021	24	-	-	204	-	-	280.0	-	-	346.0
	Mean (SD)		66.5 (36.0)	0.20 (0.08)	928 (418)	29.1 (17.2)	0.10 (0.14)	394 (567)	45.7 (24.3)	0.20 (0.09)	674 (504)

Figure 3. Scatterplot of total ankle joint displacement angle (y-axis) and time to peak displacement (x-axis). The homogenous linear function illustrates the correlation between total joint displacement and time from initial contact to peak joint displacement.

Figure 4. The two phases of the non-contact ankle inversion twist.

Table 4. Summarising table of peak ankle joint kinetics

Study		Case#	Inversion moment [Nm]	Plantarflexion moment [Nm]	Internal rotation moment [Nm]
c)	Kristianslund et al., 2011	4	79	175	64
e)	Gehring et al., 2013	10	175	30	220
j)	Kosik et al., 2019	18	54	264	-
k)	Li et al., 2019 #1	19	−85	70	−36
	Li et al., 2019 #2	20	−95	112	−33
m)	Chin et al., 2021	22	51	−177	23
Mean (SD)			30 (94)	79 (137)	48 (94)

Table 5. Case distinction

Laboratory/test event (A)	Game/competition event (B)
1. Fong et al., 2009 4. Kristianslund et al., 2011 10. Gehring et al., 2013 11. Terada & Gribble, 2015 16. Lysdal et al., 2018	2. Mok et al., 2011a (#1) 3. Mok et al., 2011b (#2) 5. Fong et al., 2012 (#1) 6. Fong et al., 2012 (#2) 8. Fong et al., 2012 (#4) 12. Panagiotakis et al., 2017 (#1) 14. Panagiotakis et al., 2017 (#3) 15. Panagiotakis et al., 2017 (#4) 23. Fong et al., 2021	Time-loss injury (1)
17. Remus et al., 2018 18. Kosik et al., 2019 19. Li et al., 2019 (#1) 20. Li et al., 2019 (#2) 21. Trejo Ramírez et al., 2020 22. Chin et al., 2021 24. Takeda et al., 2021	7. Fong et al., 2012 (#3) 9. Fong et al., 2012 (#5) 13. Panagiotakis et al., 2017 (#2)	No Time-loss or giving-way (2)

Bold italic numbers reflect the chronological case numbers reported in Table 1. (A) and (B) denote the event setting, and (1) and (2) denote whether the event resulted in injury.

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Data availability statement

The authors are happy to share the data upon reasonable request.