Qin Qi-Ning, Zhang Xin, Cai Ying-Feng, Tian Tian-Zhao, Zhou Jian-Peng, Li Lin, Shi Min, Huang Peng, Liang Hao-Dong, Li Jia-Hui, Tan Zhan-Liang, Fang Yi-Xuan, Wang Jia-Wen, Zheng Fang, Liu Bao-Xin
Department of Orthopedics, traditional Chinese medicine hospital affiliated to Guangzhou medical university, No. 16 Zhuji Road, Liwan District, Guangzhou, 510130, China.
Guangzhou University of Chinese Medicine, No. 12 Jichang Road, Baiyun District, Guangzhou, 510405, China.
BMC Musculoskelet Disord. 2025 Jul 8;26(1):666. doi: 10.1186/s12891-025-08881-9.
Ankle sprain is one of the common traumatic injuries in daily life, and PRICE (protection, rest, ice, compression pressure bandaging, elevation of the affected limb) principle is routinely recommended at its early stage. In traditional Chinese medicine (TCM), bone-setting technique (BST) can quickly relieve ankle pain and improve walking function, but physicians require high skills and physical strength. In this study, we designed an exercise-heel kicking exercise (HKE) based on the principles and methods of BST. This study aims to observe its true efficacy and safety.
68 patients (18-45 years old) with grade I and II lateral ankle sprain within 48 h were recruited from TCM hospital affiliated to Guangzhou medical university and 60 cases meeting the criteria were enrolled and randomized into control group and intervention group (30 cases separately). The patients in both groups were treated with the PRICE and ankle pump exercise, and the ones in intervention group added heel kicking exercise (HKE). The visual analogue scale (VAS) for pain, swelling degree, and American orthopedic foot & ankle society ankle-hindfoot scale (AOFAS) score before and after the intervention (within 4 W), and Karlsson score (the 26th week follow-up) were measured.
Before treatment, there were no significant differences in VAS scores, swelling degrees and AOFAS scores between two groups. During the treatment for 4 weeks, VAS scores and swelling degrees of the patients in both groups gradually decreased, and the AOFAS score gradually increased (p < 0.01). In addition, patients in the intervention group were observed to get a quicker pain reliever, swelling subsiding, and ankle function restore than those in control group at most of time points of observation (1st d, 3rd d, 1st w, 2nd w, 4th w) (p < 0.05, p < 0.01). But there was no significant difference in Karlsson scores between two groups at the 26th week follow-up.
HKE is a method designed to provide rapid movement rehabilitation for patients with ankle sprains, which can be used as one of its basic treatments.
This study was registered in China Clinical Trial Center (NO. ChiCTR2300073709). Trial registration date: August 16th 2022.
踝关节扭伤是日常生活中常见的创伤性损伤之一，早期通常推荐采用PRICE（保护、休息、冰敷、加压包扎、抬高患肢）原则。在中医中，正骨技术（BST）可以快速缓解踝关节疼痛并改善行走功能，但对医生的技术和体力要求较高。在本研究中，我们基于BST的原理和方法设计了一种运动——足跟踢击运动（HKE）。本研究旨在观察其真实疗效和安全性。
从广州医科大学附属中医医院招募68例48小时内I度和II度外侧踝关节扭伤患者（年龄18 - 45岁），60例符合标准的患者被纳入并随机分为对照组和干预组（各30例）。两组患者均采用PRICE和踝关节泵运动治疗，干预组在此基础上增加足跟踢击运动（HKE）。测量干预前后（4周内）的疼痛视觉模拟量表（VAS）、肿胀程度、美国矫形足踝协会踝关节——后足量表（AOFAS）评分，以及第26周随访时的卡尔森评分。
治疗前，两组患者的VAS评分、肿胀程度和AOFAS评分无显著差异。在4周的治疗过程中，两组患者的VAS评分和肿胀程度逐渐降低，AOFAS评分逐渐升高（p < 0.01）。此外，在大多数观察时间点（第1天、第3天、第1周、第2周、第4周），干预组患者的疼痛缓解更快、肿胀消退更快、踝关节功能恢复更快，与对照组相比差异有统计学意义（p < 0.05，p < 0.01）。但在第26周随访时，两组患者的卡尔森评分无显著差异。
足跟踢击运动是一种为踝关节扭伤患者提供快速运动康复的方法，可作为其基本治疗方法之一。
本研究在中国临床试验中心注册（注册号：ChiCTR2300073709）。试验注册日期：2022年8月16日。
