This is a timely and interesting study by van Rijn and colleagues,1 in which they investigated recovery from lateral ankle sprain. Re-injury is common after ankle sprain, and recovery often is incomplete. But what exactly does recovery mean for individuals who have sustained a lateral ankle sprain, and how can this recovery best be measured? These are the fundamental questions addressed in this article. There are good reasons to investigate these questions. One reason is that the recovery is fundamentally relevant to both patients and clinicians alike. Understanding recovery from the patient's perspective can assist clinicians in tailoring treatment appropriately to optimize recovery. Another reason is that a measure of recovery that is meaningful to patients aligns with the current paradigm of patient-centered health care.2,3 A third reason is that this knowledge will enable development of a standardized measure of recovery for use in clinical trials.
Currently, there exists a great disparity in how recovery from ankle sprain is measured. Approaches include using pain or function scores as a proxy for recovery, reports of “giving way” of the ankle, or the patient's perception of overall recovery. One obvious problem with the heterogeneity of these outcome measures is that the same construct clearly is not being measured. The consequence of this problem is high variability in reported outcomes, which confounds meaningful interpretation of the literature. A parallel situation exists in the field of low back pain. In a systematic review of all clinical trials in the past 10 years that measured recovery from back pain as …
