Health and Rehabilitation Sciences Research Institute, School of Health Sciences, University of Ulster, Jordanstown, Newtownabbey, Co Antrim BT37 0QB.
BMJ. 2010 May 10;340:c1964. doi: 10.1136/bmj.c1964.
To compare an accelerated intervention incorporating early therapeutic exercise after acute ankle sprains with a standard protection, rest, ice, compression, and elevation intervention.
Randomised controlled trial with blinded outcome assessor.
Accident and emergency department and university based sports injury clinic.
101 patients with an acute grade 1 or 2 ankle sprain.
Participants were randomised to an accelerated intervention with early therapeutic exercise (exercise group) or a standard protection, rest, ice, compression, and elevation intervention (standard group).
The primary outcome was subjective ankle function (lower extremity functional scale). Secondary outcomes were pain at rest and on activity, swelling, and physical activity at baseline and at one, two, three, and four weeks after injury. Ankle function and rate of reinjury were assessed at 16 weeks.
An overall treatment effect was in favour of the exercise group (P=0.0077); this was significant at both week 1 (baseline adjusted difference in treatment 5.28, 98.75% confidence interval 0.31 to 10.26; P=0.008) and week 2 (4.92, 0.27 to 9.57; P=0.0083). Activity level was significantly higher in the exercise group as measured by time spent walking (1.2 hours, 95% confidence interval 0.9 to 1.4 v 1.6, 1.3 to 1.9), step count (5621 steps, 95% confidence interval 4399 to 6843 v 7886, 6357 to 9416), and time spent in light intensity activity (53 minutes, 95% confidence interval 44 to 60 v 76, 58 to 95). The groups did not differ at any other time point for pain at rest, pain on activity, or swelling. The reinjury rate was 4% (two in each group).
An accelerated exercise protocol during the first week after ankle sprain improved ankle function; the group receiving this intervention was more active during that week than the group receiving standard care.
Current Controlled Trials ISRCTN13903946.
比较急性踝关节扭伤后早期治疗性运动与标准保护、休息、冰敷、加压包扎和抬高干预相结合的加速干预措施。
盲法结局评估的随机对照试验。
急诊室和大学运动损伤诊所。
101 例急性 1 级或 2 级踝关节扭伤患者。
参与者被随机分配到早期治疗性运动的加速干预组（运动组）或标准保护、休息、冰敷、加压包扎和抬高干预组（标准组）。
主要结局是主观踝关节功能（下肢功能量表）。次要结局包括休息和活动时疼痛、肿胀以及受伤后 1、2、3、4 周的身体活动。受伤后 16 周评估踝关节功能和再损伤率。
整体治疗效果有利于运动组（P=0.0077）；在第 1 周（治疗基线调整差异 5.28，98.75%置信区间 0.31 至 10.26；P=0.008）和第 2 周（4.92，0.27 至 9.57；P=0.0083）均有统计学意义。运动组的活动水平显著更高，表现为行走时间（1.2 小时，95%置信区间 0.9 至 1.4 比 1.6，1.3 至 1.9）、步数（5621 步，95%置信区间 4399 至 6843 比 7886，6357 至 9416）和轻强度活动时间（53 分钟，95%置信区间 44 至 60 比 76，58 至 95）。在其他任何时间点，两组在休息时疼痛、活动时疼痛或肿胀方面均无差异。再损伤率为 4%（两组各 2 例）。
急性踝关节扭伤后第 1 周的加速运动方案可改善踝关节功能；接受该干预措施的组在该周的活动度高于接受标准护理的组。
当前对照试验 ISRCTN81655564。
