Washington DC: It’s better to deal with your ankle sprains on your own at home than to visit a physiotherapist. A study published by The BMJ reveals that physiotherapy does not benefit recovery when compared to basic self management of the injury at home, says ANI.
Fewer than half of patients had not reached ‘excellent recovery’ by six months after injury, and there was little clinical difference between those who had received physiotherapy versus usual standard care. Experts say the finding is important because management of ankle sprains has substantial financial costs, and alternative treatments should be sought to help recovery.
Ankle sprains are one of the most common musculoskeletal injuries and are associated with a high number of visits to an emergency department. Morbidity has been reported among 30-70% of patients, from six months to seven years after injury.
Most ankle sprains are mild or moderate ligament sprains, but clinical standards for the treatment of these injuries are not well defined. In addition, there is a lack of high quality evidence on role of physiotherapy. So a team of Canadian researchers carried out the largest randomised controlled trial to evaluate the benefits of physiotherapy for ankle sprains.
The study included 503 patients, aged 16-79 years, presenting with mild or moderate ankle sprain injuries to one of two hospitals in Kingston, Canada, between 2009 and 2013. They were randomly assigned to a control group where they received usual care, or usual care plus physiotherapy.
Usual care consisted of medical assessment and a one page written summary of instruction for basic management of the injury at home. Recommendations focused on ankle protection, rest, ice, application of compression bandage, elevation, use of painkillers, graduated weight bearing activities and information about expected recovery.
The physiotherapy group included a regime of up to seven 30 minute sessions, along with usual care. Participants were required to complete a questionnaire assessing recovery at 1, 3 and 6 months. Questions focused on pain, symptoms, function in activities of daily living, function in sport and recreation, and quality of life.
Results show that 43% (90/208) of participants in the physiotherapy group and 38% (75/195) in the control group had not reached ‘excellent recovery’ by six months. However, a limitation of the study may be that the strict protocol for the recruitment of patients may have led to bias in the sample