Effect of usual care versus accelerated rehabilitation on pain, range of motion, and function in patients with acute lateral ankle sprain: A pilot randomized clinical trial.

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Date: Sept-Dec 2020
From: Saudi Journal of Sports Medicine(Vol. 20, Issue 3)
Publisher: Medknow Publications and Media Pvt. Ltd.
Document Type: Article
Length: 3,320 words
Lexile Measure: 1320L

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Byline: Kriti. Sharma, Sarah. Quais, Aamir. Siddiqui, Ammar. Suhail

Objective: The study's objective is to compare the effects of usual care group (UCG) versus accelerated rehabilitation group (ARG) on pain, range of motion (ROM), and function. Methods: A total of thirty participants participated in the study; they were randomly allocated to two groups. They were allocated to either the UCG or AR group, and baseline characteristics were documented. Outcome measures were measured on two occasions, before starting treatment protocol and second after completing the study's protocol. The interventions were administered for 2 weeks, with four sessions a week for eight sessions. The principal outcome measure was pain measured using the Numeric Pain Rating Scale. The secondary outcome measure was ankle ROM and function measured on the Lower Extremity Functional Scale. Results: Within-group analysis showed significant improvements in both the groups. There was no significant difference between the groups at the end of the treatment protocol. Conclusion: The groups did not differ at 2 weeks postacute inversion ankle sprains in the measured outcome measures.



Ankle sprains (ASs) are one of the most frequent ankle injuries among sedentary people and athletes.[1],[2] ASs are of two types: low and high ASs, the former being more common.[2],[3] Depending on the injury mechanism, we can differentiate low ASs as lateral ASs (LASs) or eversion ASs presenting as acute and chronic. Most commonly, LAS is caused by a combination of inversion and adduction of the foot.[1],[4],[5] LAS shows age- and gender-related differences, too, with the majority occurring among individuals under 35 years of age, most commonly in those aged 15-19 years.[2],[6]

LAS occurs one for every 10,000 people each day, constituting 7%-10% of all admissions to hospital emergency departments.[6] In other reports, the prevalence is estimated to be 7 LASs per 1000 exposures.[7] According to the severity of the injury, LAS is divided into three grades.[1] The most common ligaments which get injured are lateral ligament complex (i.e., anterior talofibular ligament [ATFL], calcaneofibular ligament, and posterior talofibular ligament); the ATFL is the first ligament to get sprained in most of the cases.[1],[7] Nearly, all ASs presenting in emergency departments are Grade 1 and Grade 2, with Grade 3, the minimum.[8] LAS is associated with high health-care costs and associated morbidity.[7],[8],[9],[10] Although benign, nearly 70% of patients report short- and long-term disability.[3],[7],[8],[11] Studies have focused on different intervention strategies to reduce disability and enhance return to activity.[8]

Ligament healing stages are the guide for choosing appropriate management strategies. Ligament healing is divided into three stages: (1) the inflammatory phase (until 10 days after trauma), (2) the proliferation phase (4th-8th week), and (3) the remodeling or maturation phase.[4] LAS's treatment strategies are based on stages of soft-tissue healing to decrease symptoms associated with LAS. Different management strategies (immobilization, cryotherapy, nonsteroidal anti-inflammatory drug, supervised physical therapy, braces, electrical stimulation, therapeutic ultrasound, manual therapy, and surgery) have been reported with variable efficacies.[1],[3],[4],[7],[8],[9],[10],[12],[13],[14],[15] Recently, the use of cryotherapy is rebutted during the stage of inflammation.[16] Over the year, there...

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Gale Document Number: GALE|A654197305