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

Background: E-health has the potential to facilitate implementation of effective measures to prevent sports injuries. Aim: We evaluated whether an interactive mobile application containing a proven effective exercise programme to prevent recurrent ankle sprains resulted in higher compliance as compared with regular written exercise materials. Methods: 220 athletes participated in this randomised controlled trial with a follow-up of 8 weeks; 110 athletes received a booklet explaining an 8-week neuromuscular training programme; 110 athletes participated in the same programme in an interactive mobile App (Strengthen your ankle). The primary outcome was compliance with the exercise programme. Secondary outcome measure was the incidence density of self-reported recurrent ankle sprains. Results: The mean compliance to the exercise scheme was 73.3% (95% CI 67.7% to 78.1%) in the App group, compared with 76.7% (95% CI 71.9% to 82.3%) in the Booklet group. No significant difference in compliance was found between groups. The incidence densities of self-reported time-loss recurrences were not significantly different between both groups (HR 3.07; 95% CI 0.62 to 15.20). Summary: This study shows that the method of implementing the exercises by using an App or a Booklet does not lead to different compliance rates. New findings: The use of a mobile App or a Booklet lead to similar compliance and injury rates in the short term. Trial registration number: The Netherlands National Trial Register NTR 4027. The NTR is part of the WHO Primary Registries.