Acute ankle ligament injuries: clinical therapeutic applications and recovery acceleration

Aim

To establish decrease in full rehabilitation time in correlation with clinical therapeutic applications according to the healing process phases.

Materials - Methods

From 1997-2002 132 athletes with acute ankle sprains were included in our study. Patients were divided in two groups: those who followed the prescribed rehabilitation program in full detail, and those who failed to comply with the instructions. All cases were initially classified in 4 grades (I, II, IIIA & IIIB) according to our classification criteria. The protocol consisted of PRICE and isometric exercises during phase 1 (inflammation), AROM and stretching exercises during phase 2 (fibroproductive) followed by isotonic and eccentric exercises during remodelling phase (phase 3). We recorded the time ("recovery" duration) needed for executing the advanced hop test without clinical discomfort. No modalities were used during all phases. SPSS for Windows were used for statistical analysis. The probability level was set at 0.01.

Results

In group A, 42 cases were grade I and needed 8.03 days (SD=4.45) for recovery, 38 grade II needed 13.35 days (SD=3.85), 16 grade IIIA needed 16.81 days (SD=8.37) and 5 IIIB patients needed 28 days (SD=7.84). In group B, 17 grade I cases needed 12.9 days (SD=3.17), 9 grade II needed 26.55 days (SD=5.71), 4 grade IIIA "recovered" in 36.5 days (SD=3.77) while 1 patient with grade IIIB sprain needed 54 days for "recovery". Statistical comparisons between groups (IIIB excluded) showed highly significant difference.

Conclusions

Application of PRICE, flexibility and strengthening exercises along the rehabilitation course of ankle sprains, especially when applied in accordance with the healing process stages, can lead to faster recovery, making rehabilitation focused in certain goals.

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