None listed
Conditions
Brief summary
Purpose The aim of this study was to determinate the effects of a 12- week standardised but individually suited training program (training group) versus usual care (control group) after plaster removal in adults with surgically treated ankle fractures. Methods In total, 110 men and women, 18-64 years of age, with surgically treated ankle fracture were included and randomised to either a 12-week training program or to a control group. Six and twelve months after the injury the subjects were examined by the same physiotherapist Gertrud Nilsson (GN), blinded to the treatment group. The main outcome measure was the Olerud-Molander Ankle Score (OMAS) measuring symptoms and subjectively scored function. Secondary outcome measures were: quality of life (SF-36), timed walking tests, ankle mobility tests, muscle strength tests and radiological status. Results 52 patients were randomised to the training group and 58 to the control group. Five patients dropped out before the six-month follow-up resulting in 50 patients in the training group and 55 in the control group. Nine patients dropped out between the six- and twelve-month follow-up resulting in 48 patients in both groups. When analysing the results in a mixed model analysis on repeated measures including interaction between age-group and treatment effect the training group demonstrated significantly improved results compared to the control group in subjects less than 40 years of age regarding OMAS (p=0.028), muscle strength in the plantar flexors (p=0.029) and dorsiflexors (p=0.030). Conclusion The results of this study suggest that when adjusting for interaction between age-group and treatment effect the training model employed in this study based on neuromuscular training principles was superior to usual care in patients under the age of 40. There is need for further studies to elucidate how a training program should be composed to increase and optimise function in patients middle-aged or older.
Interventions
A neuromuscular training program, that started within one week after plaster removal and continued for 8-12 weeks. The patient trained at the nearby physiotherapist in the primary care two times per week. The duration of each session was one hour and between the sessions home exercises relevant at the moment had to be performed. The home exercises had to be performed every day except the day when training was performed at the phyiotherapist. The type of exercises varied during the rehabilitation
A neuromuscular training program, that started within one week after plaster removal and continued for 8-12 weeks. The patient trained at the nearby physiotherapist in the primary care two times per week. The duration of each session was one hour and between the sessions home exercises relevant at the moment had to be performed. The home exercises had to be performed every day except the day when training was performed at the phyiotherapist. The type of exercises varied during the rehabilitation process and the phyiotherapist had to determine what type, number that should be perofmred and frequence during tha day. For example strengt training could be 15 x 3 while stretching could be performed 30 sec x 3. That is the home exercises varied on case by case. Mobility exercises, strengt training, stretching and functional execises like different type of walking exercises, jumping and so on were peroformed. The physiotherapists were carefully informed that the training had to be on a level that not increased swelling or pain.
Sponsors
Skane County Council, Primary Health Care
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
18 Years to 64 Years
Healthy volunteers
No
Inclusion criteria
Surgically treated ankle fracture
Exclusion criteria
co-existing fractures, psychiatric diagnosis, drug abuse, symptom giving osteoarthritis in the lower extremity, systemic diseases, delayed surgery due to complications
Outcome results
None listed