Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, Iowa.
Sports Health. 2010 Nov;2(6):460-70. doi: 10.1177/1941738110384573.
High ankle sprains are common in athletes who play contact sports. Most high ankle sprains are treated nonsurgically with a rehabilitation program.
All years of PUBMED, Cochrane Database of Systematic Reviews, CINAHL PLUS, SPORTDiscuss, Google Scholar, and Web of Science were searched to August 2010, cross-referencing existing publications. Keywords included syndesmosis ankle sprain or high ankle sprain and the following terms: rehabilitation, treatment, cryotherapy, braces, orthosis, therapeutic modalities, joint mobilization, massage, pain, pain medications, TENS (ie, transcutaneous electric nerve stimulation), acupuncture, aquatic therapy, strength, neuromuscular training, perturbation training, and outcomes.
Level of evidence, 5. A 3-phase rehabilitation program is described. The acute phase is directed at protecting the joint while minimizing pain, inflammation, muscle weakness, and loss of motion. Most patients are treated with some form of immobilization and have weightbearing restrictions. A range of therapeutic modalities are used to minimize pain and inflammation. Gentle mobilization and resistance exercises are used to gain mobility and maintain muscle size and strength. The subacute phase is directed at normalizing range of motion, strength, and function in activities of daily living. Progressive mobilization and strengthening are hallmarks of this phase. Neuromuscular training is begun and becomes the central component of rehabilitation. The advanced training phase focuses on preparing the patient for return to sports participation. Perturbation of support surfaces, agility drills, plyometrics, and sport-specific training are central components of this phase.
The rehabilitation guidelines discussed may assist clinicians in managing syndesmotic ankle sprains.
接触性运动项目运动员常发生高位踝关节扭伤。大多数高位踝关节扭伤采用康复方案进行非手术治疗。
2010 年 8 月检索了所有年份的 PubMed、Cochrane 系统评价数据库、CINAHL Plus、SPORTDiscus、Google Scholar 和 Web of Science，并交叉参考了现有出版物。关键词包括距腓联合踝关节扭伤或高位踝关节扭伤和以下术语：康复、治疗、冷疗、支具、矫形器、治疗方式、关节松动术、按摩、疼痛、止痛药、经皮神经电刺激（TENS）、针灸、水疗、力量、神经肌肉训练、扰动训练和结果。
证据水平 5。描述了一个 3 阶段康复方案。急性期的目的是在保护关节的同时尽量减少疼痛、炎症、肌肉无力和运动丧失。大多数患者接受某种形式的固定，并限制负重。使用各种治疗方式来减轻疼痛和炎症。温和的松动术和抗阻运动用于获得活动度并保持肌肉大小和力量。亚急性期的目的是使日常生活活动中的活动度、力量和功能正常化。渐进式的活动度和强化是这一阶段的特点。神经肌肉训练开始并成为康复的核心组成部分。高级训练阶段侧重于使患者为重返运动做好准备。表面扰动、敏捷训练、增强式训练和专项训练是这一阶段的核心组成部分。
讨论的康复指南可能有助于临床医生管理距腓联合踝关节扭伤。
