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The immediate effects of different types of ankle support introduced 6 weeks after surgical internal fixation for ankle fracture on gait and pain : a randomized crossover trial
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Keene, David J., Willett, Keith and Lamb, S. E. (Sallie E.) (2016) The immediate effects of different types of ankle support introduced 6 weeks after surgical internal fixation for ankle fracture on gait and pain : a randomized crossover trial. Journal of Orthopaedic & Sports Physical Therapy, 46 (3). pp. 157-167. doi:10.2519/jospt.2016.6212
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Official URL: http://dx.doi.org/10.2519/jospt.2016.6212
Abstract
Study Design
Randomized 3-treatment, 3-period crossover trial.
Background
There is variation in clinical practice regarding the type of ankle support used to aid recovery after ankle fracture internal fixation surgery.
Objective
To determine the immediate effects of different ankle supports commonly issued to patients 6 weeks after surgery.
Methods
Participants were 18 adults, 6 weeks after internal fixation for transsyndesmotic/infrasyndesmotic fracture, in a major trauma center in the UK. Interventions were a stirrup brace and walker boot compared with Tubigrip. Outcomes were (1) step-length and single-limb support time asymmetry (percentage comparing injured and uninjured limbs), (2) step width, (3) gait velocity, and (4) pain during walking (visual analog scale, 0–100).
Results
Participants (mean ± SD age, 47 ± 14 years) included 8 women and 10 men, 6 weeks after surgical internal fixation for ankle fracture. Single-limb support time asymmetry reduced by 3% (95% confidence interval [CI]: 0%, 6%; P = .02) in the stirrup brace and by 5% (95% CI: 2%, 7%; P = .001) in the walker boot compared with Tubigrip. Step width was 1.2 cm (95% CI: 0.6, 1.7; P<.001) wider in the walker boot than in Tubigrip. Self-reported pain was lower in the walker boot (5/100) and in the stirrup brace (13/100) compared to the Tubigrip (18/100, P = .03). No significant differences were found in the effects of the supports on step-length asymmetry between the walker boot or stirrup brace and Tubigrip.
Conclusion
At 6 weeks after surgical internal fixation for ankle fracture, pain and single-limb support time asymmetry over a short distance and for a short-term walk were immediately reduced with the use of a walker boot use and, to a lesser extent, a stirrup-brace compared to Tubigrip. Step width also widened in a walker boot, which may confer some additional gait stability. These results apply to immediate effects, so studies with longer-term follow-up are now indicated. The trial was registered at http://www.isrctn.com/ (ISRCTN84536917).
| Item Type: | Journal Article | ||||
|---|---|---|---|---|---|
| Subjects: | R Medicine > R Medicine (General) | ||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | Journal of Orthopaedic & Sports Physical Therapy | ||||
| Publisher: | American Physical Therapy Association * Orthopedic Section | ||||
| ISSN: | 0190-6011 | ||||
| Official Date: | 26 January 2016 | ||||
| Dates: |
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| Volume: | 46 | ||||
| Number: | 3 | ||||
| Page Range: | pp. 157-167 | ||||
| DOI: | 10.2519/jospt.2016.6212 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access |
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