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软性支具或贴扎对踝关节外侧扭伤的影响:一项评估一年复发率和残余症状的非随机对照试验

Effects of soft bracing or taping on a lateral ankle sprain: a non-randomised controlled trial evaluating recurrence rates and residual symptoms at one year.

作者信息

Kemler Ellen, van de Port Ingrid, Schmikli Sandor, Huisstede Bionka, Hoes Arno, Backx Frank

机构信息

Department of Rehabilitation, Nursing Science and Sport, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, PO Box 85500, 3508 GA The Netherlands ; Consumer Safety Institute, Amsterdam, The Netherlands.

Department of Rehabilitation, Nursing Science and Sport, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, PO Box 85500, 3508 GA The Netherlands ; Revant Rehabilitation Centre, Breda, The Netherlands.

出版信息

J Foot Ankle Res. 2015 Apr 14;8:13. doi: 10.1186/s13047-015-0069-6. eCollection 2015.

Abstract

BACKGROUND

After sustaining an ankle sprain, taping is often the standard treatment in primary care. Ankle braces are sometimes used as an alternative. This study aimed to compare the effects of four weeks of soft bracing or taping following acute lateral ankle ligamentous sprain (ALALS) on sprain recurrence rates and residual symptoms at one year.

METHODS

In this pragmatic, non-randomised controlled trial, 157 adult participants with an ALALS caused by an inversion trauma were alternately allocated to a four week treatment with a soft brace (intervention group) or a four week treatment with ankle tape (control group) in order of presentation. The primary outcome was the 1-year incidence of the self-reported recurrence of ALALS. The secondary outcome was the occurrence of residual symptoms.

RESULTS

Baseline characteristics did not differ appreciably between the treatment groups. Thirteen patients (17%) in the brace group reported a re-injury versus 11 patients (14%) treated with tape, corresponding to a risk difference of 3.1% (relative risk 1.2, 95% CI 0.6 to 2.6). Cox regression analysis showed a hazard ratio of self-reported ankle sprain recurrence within 52 weeks in the brace group compared to the tape group of 0.9 (95% CI 0.4 to 1.9). After one year, patients in the brace group had poorer scores on the manual anterior ankle test, corresponding to a risk difference of 15.4% (RR 2.4, 95% CI 1.1 to 5.0).

CONCLUSION

ALALS recurrences and residual symptoms appear to be similar at one year when an ALALS is treated with four weeks of soft bracing or taping.

TRIAL REGISTRATION

ISRCTN92030205.

摘要

背景

踝关节扭伤后,在初级医疗保健中,贴扎通常是标准治疗方法。踝关节支具有时用作替代方法。本研究旨在比较急性外侧踝关节韧带扭伤(ALALS)后四周的软支具或贴扎治疗对一年时扭伤复发率和残留症状的影响。

方法

在这项实用的非随机对照试验中,157名因内翻创伤导致ALALS的成年参与者按照就诊顺序交替分配至接受四周软支具治疗(干预组)或四周踝关节贴扎治疗(对照组)。主要结局是自我报告的ALALS复发的1年发生率。次要结局是残留症状的发生情况。

结果

治疗组之间的基线特征没有明显差异。支具组中有13名患者(17%)报告再次受伤,而接受贴扎治疗的患者有11名(14%),风险差异为3.1%(相对风险1.2,95%CI 0.6至2.6)。Cox回归分析显示,与贴扎组相比,支具组在52周内自我报告的踝关节扭伤复发的风险比为0.9(95%CI 0.4至1.9)。一年后,支具组患者在前踝手法检查中的得分较低,风险差异为15.4%(RR 2.4,95%CI 1.1至5.0)。

结论

当用四周的软支具或贴扎治疗ALALS时,一年时的ALALS复发和残留症状似乎相似。

试验注册号

ISRCTN92030205。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02c3/4404115/8fc3364ee45c/13047_2015_69_Fig1_HTML.jpg

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