Green T, Refshauge K, Crosbie J, Adams R
Physiotherapy Department, Calvary Hospital, PO Box 254, Jamison, Australian Capital Territory 2614 Australia.
Phys Ther. 2001 Apr;81(4):984-94.
Passive joint mobilization is commonly used by physical therapists as an intervention for acute ankle inversion sprains. A randomized controlled trial with blinded assessors was conducted to investigate the effect of a specific joint mobilization, the anteroposterior glide on the talus, on increasing pain-free dorsiflexion and 3 gait variables: stride speed (gait speed), step length, and single support time.
Forty-one subjects with acute ankle inversion sprains (<72 hours) and no other injury to the lower limb entered the trial.
Subjects were randomly assigned to 1 of 2 treatment groups. The control group received a protocol of rest, ice, compression, and elevation (RICE). The experimental group received the anteroposterior mobilization, using a force that avoided incurring any increase in pain, in addition to the RICE protocol. Subjects in both groups were treated every second day for a maximum of 2 weeks or until the discharge criteria were met, and all subjects were given a home program of continued RICE application. Outcomes were measured before and after each treatment.
The results showed that the experimental group required fewer treatment sessions than the control group to achieve full pain-free dorsiflexion. The experimental group had greater improvement in range of movement before and after each of the first 3 treatment sessions. The experimental group also had greater increases in stride speed during the first and third treatment sessions. DISCUSSION AND CONCLUSION Addition of a talocrural mobilization to the RICE protocol in the management of ankle inversion injuries necessitated fewer treatments to achieve pain-free dorsiflexion and to improve stride speed more than RICE alone. Improvement in step length symmetry and single support time was similar in both groups.
物理治疗师通常将被动关节活动术作为急性踝关节内翻扭伤的一种干预方法。本研究开展了一项评估者盲法的随机对照试验，以调查一种特定的关节活动术，即距骨的前后向滑动，对增加无痛背屈以及3个步态变量（步速、步长和单支撑时间）的影响。
41名急性踝关节内翻扭伤（<72小时）且下肢无其他损伤的受试者进入本试验。
受试者被随机分配至2个治疗组中的1组。对照组接受休息、冰敷、加压包扎和抬高患肢（RICE）方案。试验组除接受RICE方案外，还接受前后向松动术，施加的力量以避免引起疼痛加剧为准。两组受试者均每隔一天接受一次治疗，最长持续2周或直至达到出院标准，所有受试者均接受在家继续应用RICE的方案。在每次治疗前后测量结果。
结果显示，试验组达到完全无痛背屈所需的治疗次数少于对照组。试验组在前3次治疗的每次前后，其活动范围的改善更大。试验组在第一次和第三次治疗期间的步速增加也更大。
在踝关节内翻损伤的治疗中，在RICE方案基础上增加胫距关节松动术，与单纯RICE相比，达到无痛背屈和提高步速所需的治疗次数更少。两组在步长对称性和单支撑时间方面的改善相似。
