Service de rhumatologie, CHU de la Cavale-Blanche, 29609 Brest cedex, France; Cabinet de médecine du sport du Questel, ZA du Questel, 29200 Brest, France.
Ann Phys Rehabil Med. 2013 Oct;56(7-8):503-14. doi: 10.1016/j.rehab.2013.06.007. Epub 2013 Jul 19.
To assess the impact of rehabilitation on healing and recurrence rate of ankle sprain, 1year apart, 111 patients, who suffered an ankle sprain (67 men and 44 women; 17 mild sprains, 67 medium and 27 severe), were included by emergency physicians of four emergency rooms (ER) of Finistère. The physician was free to prescribe, or not, further investigations. He prescribed systematically to patients RICE (rest, ice, compression, elevation) protocol, put an ankle brace, and gave a prescription of standardized rehabilitation. The prescription was the same for the four ER. All patients were recalled to 1year. Of the 111 patients initially included, 21 patients were excluded for lack of response after three phone calls. In the end, 90 patients were assessable (56 men and 34 women), mean age 31.4±12.6years (range 15-55) at the time of initial trauma. Emergency physicians had diagnosed, initially, 16 mild sprains (17.8%), 56 medium sprains (62.2%) and 18 severe sprains (20%). Of the 90 patients, 73 patients have been rehabilitated (81.1%). Of the 44 accidents of everyday life, 31 were rehabilitated (70.5%). Of the 27 sports accidents, 25 were rehabilitated (92.6%). Of the 19 work-related injuries, 17 were rehabilitated (89.5%). There is no significant relationship between rehabilitation and no recurrence (P=0.45) nor between rehabilitation and full recovery of the ankle (P=0.59).
We find no association between rehabilitation and prevention of recurrence, nor between rehabilitation and healing of patients. However, our study is limited by the small size of the non-rehabilitated group.
评估康复对踝关节扭伤愈合和复发率的影响,在相隔 1 年的时间里,有 111 名患者(67 名男性和 44 名女性;17 名轻度扭伤、67 名中度扭伤和 27 名重度扭伤),由 4 个急诊室(ER)的急诊医师纳入研究。医师可以自由选择是否进行进一步的检查。他为患者开具 RICE(休息、冰敷、加压包扎、抬高)方案、踝关节支具,并开具标准化康复治疗的处方。四个 ER 的处方相同。所有患者在 1 年后均被召回。最初纳入的 111 名患者中,有 21 名因 3 次电话随访后无应答而被排除。最后,90 名患者可进行评估(56 名男性和 34 名女性),最初创伤时的平均年龄为 31.4±12.6 岁(范围 15-55 岁)。急诊医师最初诊断为 16 例轻度扭伤(17.8%)、56 例中度扭伤(62.2%)和 18 例重度扭伤(20%)。90 名患者中,有 73 名(81.1%)接受了康复治疗。在 44 例日常生活事故中,有 31 例(70.5%)接受了康复治疗。在 27 例运动事故中,有 25 例(92.6%)接受了康复治疗。在 19 例与工作相关的伤害中,有 17 例(89.5%)接受了康复治疗。康复与无复发之间(P=0.45)或康复与踝关节完全康复之间(P=0.59)无显著关系。
我们没有发现康复与预防复发之间的关联,也没有发现康复与患者痊愈之间的关联。然而,我们的研究受到未康复组样本量较小的限制。