Weerasekara R M I M, Tennakoon S U B, Suraweera H J
Department of Physiotherapy, Faculty of Allied Health Sciences (RMIMW), University of Peradeniya, Peradeniya, Sri LankaDepartment of Community Medicine, Faculty of Medicine (TMSUBT), University of Peradeniya, Peradeniya, Sri LankaPeradeniya Teaching Hospital, Peradeniya, Sri Lanka (HJS)
Department of Physiotherapy, Faculty of Allied Health Sciences (RMIMW), University of Peradeniya, Peradeniya, Sri LankaDepartment of Community Medicine, Faculty of Medicine (TMSUBT), University of Peradeniya, Peradeniya, Sri LankaPeradeniya Teaching Hospital, Peradeniya, Sri Lanka (HJS).
Foot Ankle Spec. 2016 Aug;9(4):307-23. doi: 10.1177/1938640016640885. Epub 2016 Apr 1.
Objective This study was conducted to determine the most effective thermal modality; heat or contrast therapy-in reducing pain, reducing swelling, and increasing range of movement (ROM) of the grade I and II lateral ankle sprain in the prechronic stage of the subacute phase. Design Randomized control trail. Methods One hundred and fifteen participants of both genders who were diagnosed as having grade I or II lateral ankle sprain were randomly assigned to the study on the fifth day of injury. Pain, volume, and ROM were recorded before and after treatment continuously for 3 days. Results Effects were evaluated as "Immediately after application" and "3 days after continuous application." Immediately after application, there was no difference between the 2 modalities on ankle ROM; heat reduced pain over contrast therapy, and both modalities increased swelling. When considering the effects after continuous application for 3 days, no difference was found between the 2 modalities on ROM and the reduction of pain. Contrast therapy reduced swelling while heat caused increased swelling even after 3 days. Conclusion The use of different thermal modalities during the transition from the acute to chronic phase of injury can be suggested as effective treatment options according to the objectives of injury management: pain reduction, improve ROM, and swelling management.
Therapeutic, Level II: Randomized clinical trial.
目的 本研究旨在确定在亚急性期的慢性前期，对于减轻Ⅰ级和Ⅱ级外侧踝关节扭伤的疼痛、肿胀以及增加活动范围（ROM）而言，哪种热疗方式（热敷或对比疗法）最为有效。设计 随机对照试验。方法 115名被诊断为Ⅰ级或Ⅱ级外侧踝关节扭伤的男女参与者在受伤后第5天被随机分配至本研究。在连续3天的治疗前后持续记录疼痛、肿胀程度和活动范围。结果 疗效评估分为“应用后即刻”和“连续应用3天后”。应用后即刻，两种方式在踝关节活动范围上无差异；热敷在减轻疼痛方面优于对比疗法，且两种方式均使肿胀加剧。在考虑连续应用3天后的效果时，两种方式在活动范围和疼痛减轻方面无差异。对比疗法减轻了肿胀，而即使在3天后热敷仍导致肿胀加剧。结论 根据损伤管理的目标（减轻疼痛、改善活动范围和控制肿胀），在损伤从急性期向慢性期转变的过程中，不同的热疗方式可作为有效的治疗选择。
治疗性，Ⅱ级：随机临床试验。
