Some conservative strategies are effective when added to controlled mobilisation with external support after acute ankle sprain: a systematic review.

C Bleakley, Suzanne M McDonough, Domhnall C MacAuley

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

QUESTIONS: Which intervention(s) best augment early mobilisation and external support after an acute ankle sprain? What is the most appropriate method of preventing re-injury? DESIGN: A systematic review of randomised controlled trials published from 1993 to April 2005. PARTICIPANTS: People with an acute ankle sprain. INTERVENTION: Any pharmacological, physiotherapeutic, complementary or electrotherapeutic intervention added to controlled mobilisation with external support. Immobilisation, surgical intervention, and use of external ankle supports in isolation were excluded. OUTCOMES: Pain, function, swelling, re-injury, and global improvement; assessed at short, intermediate, and long-term follow-up. RESULTS: 23 trials were included with a mean PEDro score of 6/10. There was strong evidence that non-steroidal anti-inflammatory drugs can reduce pain and improve short-term ankle function. There was moderate evidence that neuromuscular training decreases functional instability and minimises re-injury; and that comfrey root ointment decreases pain and improves function. There was also moderate evidence that manual therapy techniques improve ankle dorsiflexion. There was no evidence to support the use of electrophysical agents or hyperbaric oxygen therapy. Very few long-term follow-ups were undertaken, and few studies focused on preventing long-term morbidity. CONCLUSIONS: Non-steroidal anti-inflammatory drugs, comfrey root ointment, and manual therapy can significantly improve short-term symptoms after ankle sprain, and neuromuscular training may prevent re-injury. More high quality studies are needed to develop evidence-based guidelines on ankle rehabilitation beyond the acute phases of injury management.
LanguageEnglish
Pages7-20
JournalThe Australian journal of physiotherapy
Volume54
Issue number1
Publication statusPublished - Mar 2008

Fingerprint

Ankle Injuries
Ankle
Comfrey
Wounds and Injuries
Musculoskeletal Manipulations
Ointments
Pain
Anti-Inflammatory Agents
Early Ambulation
Hyperbaric Oxygenation
Immobilization
Pharmaceutical Preparations
Rehabilitation
Randomized Controlled Trials
Pharmacology
Guidelines
Morbidity

Keywords

  • Systematic Review
  • Ankle Sprain
  • Management

Cite this

@article{bfdc56db790549f3a976711b80d9724f,
title = "Some conservative strategies are effective when added to controlled mobilisation with external support after acute ankle sprain: a systematic review.",
abstract = "QUESTIONS: Which intervention(s) best augment early mobilisation and external support after an acute ankle sprain? What is the most appropriate method of preventing re-injury? DESIGN: A systematic review of randomised controlled trials published from 1993 to April 2005. PARTICIPANTS: People with an acute ankle sprain. INTERVENTION: Any pharmacological, physiotherapeutic, complementary or electrotherapeutic intervention added to controlled mobilisation with external support. Immobilisation, surgical intervention, and use of external ankle supports in isolation were excluded. OUTCOMES: Pain, function, swelling, re-injury, and global improvement; assessed at short, intermediate, and long-term follow-up. RESULTS: 23 trials were included with a mean PEDro score of 6/10. There was strong evidence that non-steroidal anti-inflammatory drugs can reduce pain and improve short-term ankle function. There was moderate evidence that neuromuscular training decreases functional instability and minimises re-injury; and that comfrey root ointment decreases pain and improves function. There was also moderate evidence that manual therapy techniques improve ankle dorsiflexion. There was no evidence to support the use of electrophysical agents or hyperbaric oxygen therapy. Very few long-term follow-ups were undertaken, and few studies focused on preventing long-term morbidity. CONCLUSIONS: Non-steroidal anti-inflammatory drugs, comfrey root ointment, and manual therapy can significantly improve short-term symptoms after ankle sprain, and neuromuscular training may prevent re-injury. More high quality studies are needed to develop evidence-based guidelines on ankle rehabilitation beyond the acute phases of injury management.",
keywords = "Systematic Review, Ankle Sprain, Management",
author = "C Bleakley and McDonough, {Suzanne M} and MacAuley, {Domhnall C}",
year = "2008",
month = "3",
language = "English",
volume = "54",
pages = "7--20",
journal = "Australian Journal of Physiotherapy",
issn = "0004-9514",
number = "1",

}

TY - JOUR

T1 - Some conservative strategies are effective when added to controlled mobilisation with external support after acute ankle sprain: a systematic review.

AU - Bleakley, C

AU - McDonough, Suzanne M

AU - MacAuley, Domhnall C

PY - 2008/3

Y1 - 2008/3

N2 - QUESTIONS: Which intervention(s) best augment early mobilisation and external support after an acute ankle sprain? What is the most appropriate method of preventing re-injury? DESIGN: A systematic review of randomised controlled trials published from 1993 to April 2005. PARTICIPANTS: People with an acute ankle sprain. INTERVENTION: Any pharmacological, physiotherapeutic, complementary or electrotherapeutic intervention added to controlled mobilisation with external support. Immobilisation, surgical intervention, and use of external ankle supports in isolation were excluded. OUTCOMES: Pain, function, swelling, re-injury, and global improvement; assessed at short, intermediate, and long-term follow-up. RESULTS: 23 trials were included with a mean PEDro score of 6/10. There was strong evidence that non-steroidal anti-inflammatory drugs can reduce pain and improve short-term ankle function. There was moderate evidence that neuromuscular training decreases functional instability and minimises re-injury; and that comfrey root ointment decreases pain and improves function. There was also moderate evidence that manual therapy techniques improve ankle dorsiflexion. There was no evidence to support the use of electrophysical agents or hyperbaric oxygen therapy. Very few long-term follow-ups were undertaken, and few studies focused on preventing long-term morbidity. CONCLUSIONS: Non-steroidal anti-inflammatory drugs, comfrey root ointment, and manual therapy can significantly improve short-term symptoms after ankle sprain, and neuromuscular training may prevent re-injury. More high quality studies are needed to develop evidence-based guidelines on ankle rehabilitation beyond the acute phases of injury management.

AB - QUESTIONS: Which intervention(s) best augment early mobilisation and external support after an acute ankle sprain? What is the most appropriate method of preventing re-injury? DESIGN: A systematic review of randomised controlled trials published from 1993 to April 2005. PARTICIPANTS: People with an acute ankle sprain. INTERVENTION: Any pharmacological, physiotherapeutic, complementary or electrotherapeutic intervention added to controlled mobilisation with external support. Immobilisation, surgical intervention, and use of external ankle supports in isolation were excluded. OUTCOMES: Pain, function, swelling, re-injury, and global improvement; assessed at short, intermediate, and long-term follow-up. RESULTS: 23 trials were included with a mean PEDro score of 6/10. There was strong evidence that non-steroidal anti-inflammatory drugs can reduce pain and improve short-term ankle function. There was moderate evidence that neuromuscular training decreases functional instability and minimises re-injury; and that comfrey root ointment decreases pain and improves function. There was also moderate evidence that manual therapy techniques improve ankle dorsiflexion. There was no evidence to support the use of electrophysical agents or hyperbaric oxygen therapy. Very few long-term follow-ups were undertaken, and few studies focused on preventing long-term morbidity. CONCLUSIONS: Non-steroidal anti-inflammatory drugs, comfrey root ointment, and manual therapy can significantly improve short-term symptoms after ankle sprain, and neuromuscular training may prevent re-injury. More high quality studies are needed to develop evidence-based guidelines on ankle rehabilitation beyond the acute phases of injury management.

KW - Systematic Review

KW - Ankle Sprain

KW - Management

M3 - Article

VL - 54

SP - 7

EP - 20

JO - Australian Journal of Physiotherapy

T2 - Australian Journal of Physiotherapy

JF - Australian Journal of Physiotherapy

SN - 0004-9514

IS - 1

ER -