Article

OBJECTIVE: To estimate adherence to and effectiveness of rehabilitation after acute ankle sprain.
METHOD: Patients with acute ankle sprain attending four
emergency departments were recruited between February and July 2009. After the
initial examination (classification of the severity of the sprain), each patient
received an Aircast((R)) ankle brace and the same, standardized rehabilitation
program. Between two and three months later; the patient was contacted by phone
(always by the same investigator) in order to find out whether he/she had
performed the prescribed rehabilitation, establish whether the physiotherapist
had complied with the prescribed rehabilitation programme and assess subjective
recovery. If a patient failed to respond to three phone calls, he/she was
excluded from the study. RESULTS: Of the 245 patients initially included, 111 (67
men and 44 women; 17 mild sprains, 67 moderate sprains and 27 severe sprains)
answered the "phone questionnaire". In terms of treatment adherence by the
patient, 92 patients (82.9%) performed their rehabilitation (beginning an average
of 13.8 days after the injury). In terms of prescription compliance by the
physiotherapist, 88 patients (95.6%) received massage, 71 (77.2%) underwent
physiotherapy, 83 (90.2%) performed weight training and 87 (94.5%) received
proprioceptive training. Eighty-two patients said that they had received
manipulative therapy that was not part of the prescribed programme. Impact on
recovery: 61 patients (55%) considered that their injury had healed (10 mild, 42
medium and nine severe sprains), whereas 50 had not healed (seven mild, 25 medium
and 18 severe sprains). There was no statistically significant association
between recovery and compliance with rehabilitation. However, the application of
massage (p=0.004) and proprioceptive training (p=0.017) were significantly
associated with recovery, while physiotherapy, weight training and manipulative therapy were not. CONCLUSION: In acute ankle sprain, adherence with
rehabilitation is good and the treating physiotherapists comply with the
prescription. However, there was no statistically significant link between
rehabilitation compliance and subjective recovery at 3 months. Revaluation of
these patients at one year may be necessary for estimating the impact of rehabilitation on ankle function and the rate of injury recurrence.
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Langue : ANGLAIS ; FRANCAIS