Short-term natural recovery of ankle sprains following discharge from emergency departments

• Published in: The journal of orthopaedic and sports physical therapy 2008-09, Vol.38 (9), p.566-571
• Main Authors: Aiken, Alice B, Pelland, Lucie, Brison, Robert, Pickett, William, Brouwer, Brenda
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Ankle Injuries - classification; Ankle Injuries - physiopathology; Ankle Injuries - rehabilitation; Cohort Studies; Emergency Service, Hospital; Female; Humans; Male; Middle Aged; Outcome Assessment (Health Care); Patient Discharge; Prospective Studies; Sprains and Strains - classification; Sprains and Strains - physiopathology; Sprains and Strains - rehabilitation; Trauma Severity Indices; Young Adult
• ISSN: 0190-6011; 1938-1344
• DOI: 10.2519/jospt.2008.2811

Prospective cohort study. To examine the natural recovery from grade I and II ankle injuries over a 1-month period. There is a high rate of injury recurrence and persistence of symptoms following ankle sprains, suggesting that these injuries may not be adequately managed. However, little is known about the recovery process after discharge from emergency departments. Clinical assessment of ankle swelling, strength, and joint mobility and laboratory assessment of peak torque and joint range of motion (ROM) were performed 4 and 30 days following initial clinical assessment in the emergency department. Analyses for repeated measures determined change over time and differences between injured and noninjured ankles. Self-assessed ankle function was evaluated on day 4 and day 30, and its relationship to clinical and laboratory assessments determined. Forty-six subjects entered the study and complete datasets were obtained from 28. Significant swelling, weakness, and mobility restrictions were evident on initial assessment. Symptoms improved over time and, while clinical variables were normal by day 30, laboratory assessment indicated weakness of plantar flexors and limited active and passive ROM at 1 month. Swelling and reduced passive ROM were associated with overall function and limitations in sports and recreation activities, as well as quality of life 1 month postinjury. Clinically assessed strength and ankle dorsiflexion mobility suggested full recovery at 1 month post injury, yet more sensitive measures of ankle impairment and performance detected residual deficits. Persistent impairment and incomplete recovery of self-assessed function suggest the need for management beyond standard emergency department care. Associations between impairment measures and function may provide guidance for treatment intervention.