Cost-Effectiveness Analysis of Adding Telerehabilitation to Standard Care for Ankle Sprains Compared with Standard Care Alone.

Abstract

Background: Ankle sprain (AS) is a common musculoskeletal injury. While telerehabilitation is an effective treatment for various musculoskeletal conditions, evidence on its cost-effectiveness for AS is lacking.

Methods: A cost-effectiveness study was conducted through a 4-week randomized controlled trial in individuals with AS. The control group (n = 41) received standard care, while the intervention group (n = 41) received standard care plus asynchronous telerehabilitation. Effectiveness was measured using the Foot and Ankle Ability Measure (FAAM) with subscales for daily living (FAAM-ADL) and sports activities (FAAM-sports). The economic evaluation used the Mexican health system's official price list, including work incapacity costs, updated to 2024 (U.S. dollars). A one-way sensitivity analysis was also performed.

Results: At 4 weeks, the intervention group showed a gain of 78 points in functionality for FAAM-ADL and 80.2 points for FAAM-sports, while the control group scored 69.1 and 61.6, respectively. When the costs of work incapacity were considered, the incremental cost-effectiveness ratio (ICER) of adding telerehabilitation per point gained in FAAM-ADL functionality was US$ -14.4 and US$ -8.5 for FAAM-sports. When work incapacity costs were excluded, the ICER was US$ -0.7 and US$ -0.4, respectively.

Conclusions: Adding telerehabilitation to standard care for AS was cost-saving, achieving greater effectiveness at a lower cost. This is more evident when direct costs are considered together with the costs of work incapacity.