This examination included pressure thresholds (tenderness on palpation) of the ventral, distal and dorsal malleoli lateralis, an active range of motion test (Gerber et al 1998), and a functional stability test that was a modification of Romberg’s test (Freeman et al 1965). For the active range of motion test we used an electronic digital inclinometera. Sitting with the knees in zero degrees and the ankle in maximal plantar flexion, participants performed maximal dorsiflexion ZD1839 concentration of the ankle. We calculated the differences in score between the sprained

and the unsprained ankle. Objective instability was assessed by participants standing on one leg for a maximum of one selleck screening library minute with the eyes open, and standing

on one leg for a maximum of 30 seconds with the eyes closed. Balance time on one leg was recorded. Instability of the sprained ankle was scored positive when the sprained ankle was less stable than the non-sprained ankle. These possible prognostic factors were taken in consideration for a subgroup analysis. The subgroup consisted of the non-recovered participants at 3 months follow-up and considered prognosis of their outcome at 12 months follow-up. To reduce bias and improve efficiency, values were multiple imputed for the 9.6% of missing data in the dataset. We generated ten imputed datasets Mephenoxalone using chained equations (van Buuren et al 1999). Descriptive statistics were applied to summarise patient characteristics and outcome. The outcome ‘recovery’ was dichotomised, with non-recovery being a score of 9 or lower on the 0-10 point scale, and full recovery a score of 10. The following baseline characteristics were taken into consideration to evaluate the possible association with the outcome at 12 months follow-up: demographics (age, gender, BMI), clinical factors (randomly allocated treatment, setting, injury grade, swelling, Ankle Function Score and pain during walking), and work and sport load. Potential prognostic factors in the group of participants defined

as non-recovered at 3 months follow-up were demographic factors (age, gender, BMI), clinical factors (setting, intervention at baseline), and outcome measures at 3 months follow-up (degree of recovery on the numerical rating scale, re-sprains, Ankle Function Score, and pain at rest, walking, and running.) Linear regression models (for the outcomes recovery and pain during running) and logistic regression models (for the outcomes instability and re-sprains) were constructed for the total population, using the potential prognostic factors from baseline, and separately for the non-recovered participants at 3 months follow-up, using the prognostic factors from the physical examination and the 3-month questionnaire.