Figueroa-García Juan, Granados-García Víctor, Martínez-Valverde Silvia, Salinas-Escudero Guillermo, Hernández-Rivera Juan Carlos H, Rojano-Mejía David
Centro de Investigación Educativa y Formación Docente, OOAD Sur de la Ciudad de México, Instituto Mexicano del Seguro Social, Mexico City, MEX.
Unidad de investigación epidemiológica y en servicios de salud, área envejecimiento, Instituto Mexicano del Seguro Social, Mexico City, MEX.
Cureus. 2025 Jun 24;17(6):e86664. doi: 10.7759/cureus.86664. eCollection 2025 Jun.
Ankle sprains (AS) are among the most common musculoskeletal injuries, with physical rehabilitation being a cornerstone of treatment. Telerehabilitation has emerged as an effective alternative for managing various musculoskeletal conditions; however, evidence supporting its use specifically for AS remains limited. This study aimed to evaluate whether the addition of structured telerehabilitation to usual care (UC) improves functional recovery in patients with grade I-II AS more effectively than UC alone in a primary care setting.
Eighty-two participants were randomized into two groups (41 each): 1) Intervention group (IG): UC (standard primary care management) plus a four-week telerehabilitation program (30-minute daily exercises, five days/week) delivered via a digital platform with pre-recorded videos; Control group (CG): UC only. The primary outcome was ankle functionality measured using the Foot and Ankle Ability Measure (FAAM), including subscales for activities of daily living (FAAM-ADL) and sports (FAAM-Sports). Secondary outcomes included pain perception and work disability days.
At four weeks, the IG demonstrated superior outcomes; at functionality, mean between-group differences favored the IG (FAAM-ADL: +8.3 points [95% CI 3.8-12.7]; FAAM-Sports: +13.4 points (6.7-20)). Pain: Significant reduction in VAS scores for grade II AS only (-0.9 points (-1.5 to -0.4)). Subgroup analysis: Clinically meaningful improvements in functionality were observed for both grades, but pain reduction was significant only in grade II AS. Grade I AS showed improvement limited to FAAM-Sports.
Telerehabilitation, as an adjunct to UC, significantly enhances functional recovery in AS, with particularly pronounced effects in grade II (moderate) sprains. However, pain reduction exhibits grade-dependent variability. These findings support incorporating telerehabilitation into primary care management protocols for AS.
踝关节扭伤（AS）是最常见的肌肉骨骼损伤之一，物理康复是治疗的基石。远程康复已成为管理各种肌肉骨骼疾病的有效替代方法；然而，支持其专门用于AS的证据仍然有限。本研究旨在评估在初级保健环境中，在常规护理（UC）基础上增加结构化远程康复是否比单纯UC更有效地改善I-II级AS患者的功能恢复。
82名参与者被随机分为两组（每组41名）：1）干预组（IG）：UC（标准初级保健管理）加上为期四周的远程康复计划（每天30分钟锻炼，每周五天），通过带有预录制视频的数字平台提供；对照组（CG）：仅UC。主要结局是使用足踝能力测量（FAAM）评估的踝关节功能，包括日常生活活动（FAAM-ADL）和运动（FAAM-Sports）子量表。次要结局包括疼痛感知和工作残疾天数。
四周时，IG显示出更好的结局；在功能方面，组间平均差异有利于IG（FAAM-ADL：+8.3分[95%CI 3.8-12.7]；FAAM-Sports：+13.4分[6.7-20]）。疼痛：仅II级AS的视觉模拟评分（VAS）得分显著降低（-0.9分[-1.5至-0.4]）。亚组分析：两个等级的功能均有临床意义的改善，但疼痛减轻仅在II级AS中显著。I级AS的改善仅限于FAAM-Sports。
远程康复作为UC的辅助手段，可显著提高AS患者的功能恢复，在II级（中度）扭伤中效果尤为明显。然而，疼痛减轻表现出等级依赖性差异。这些发现支持将远程康复纳入AS的初级保健管理方案。
