Athletic trainers (ATs) inconsistently apply Rehabilitation-Oriented Assessments (ROASTs) when deciding return-to-activity readiness for ankle sprain patients. Facilitators and barriers that are most influential to ATs' assessment selection remain unknown.


To examine facilitators of and barriers to ATs' selection of outcome assessments when determining return-to-activity readiness for patients with an ankle sprain.


Cross-sectional study


Online survey

Patients or Other Participants

We sent an online survey to 10,000 clinically practicing ATs. The survey was accessed by 676 individuals, of which 574 submitted responses (85% completion rate) and 541 respondents met inclusion criteria.

Main Outcome Measures

The survey was designed to explore facilitators and barriers influencing ATs' selection of pain, swelling, range of motion, arthrokinematics, strength, balance, gait, functional capacity, physical activity level, and patient-reported outcomes assessments when making return-to-activity decisions for patients following an ankle sprain. The survey asked for reasons that participants choose to use, or not use, each measure (e.g., previous education, personal comfort, most appropriate, available/feasible, perceived value). The survey included 12 demographic items that characterized the sample of respondents and were examined as potential influences of the facilitators and barriers. Chi-square analyses identified relationships among participant demographics and facilitators or barriers to assessment selection.


Selection of each ROAST and non-ROAST was most commonly facilitated by previous education, availability/feasibility, or perceived value. Avoidance of each ROAST was most commonly caused by lack of previous education, a lack of availability/feasibility, or a lack of perceived value. The presence of facilitators and barriers was affected by various demographic variables.


A variety of facilitators and barriers affect ATs' implementation of expert-recommended assessments when determining return-to-activity readiness in patients with an ankle sprain. Some subpopulations of ATs experience more favorable or prohibitive conditions for assessment use.

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