Osteopathic Consultation in the Emergency Department for Fresh Lateral Ligament Sprain

Study Overview
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Brief Summary
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The study consists in recruiting patients with ankle sprains who visit the emergency department (ED). Each patient will be tested by an osteopath who we will measure pain, swelling and/or edema, and mobility of the ankle. Patients will be asked to reproduce exercises such as to hold on one foot, to stand on tiptoes... Then, patients will be divided into two groups. The first group will undergo medical treatment during the ED visit, while the second group will undergo osteopathic treatment. Three time points will be planned. The first one will be the patient's consultation in the ED where treatment will be carried out according to its assignment, as well as the clinical measures previously described. The second time point will be seven days later (plus or minus three days), where only clinical measurements will be performed. The third time point will be three weeks later (plus or minus three days), when the ankle sprain has consolidated, in order to carry out the clinical measurements again. These clinical measurements will allow to evaluate the effectiveness of a single osteopathic consultation in the ED. The investigators expect a reduction in immediate pain, and thereafter, a reduction in swelling, and an improved mobility and stability of the ankle.

Official Title
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Osteopathic Consultation in the Emergency Department for Fresh Lateral Ligament Sprain : a Randomized Controlled Trial

Conditions
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Ankle Sprains

Intervention / Treatment
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* Other: Medical treatment
* Other: osteopathic treatment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 years and older Unilateral sprain Stage 1 or 2 sprain Recent sprain < 72 hours With or without the presence of edema and/or hematoma Receiving prior consultation from an ED physician Understanding French Agreeing to participate in the study and having signed the consent form Apyretic Patient affiliated to a social security schem Exclusion Criteria: Fractured foot, tibia, fibula Stage 3 ankle sprain Operated sprain Current use of drugs/alcohol Altered mental state Chronic ankle injury on the contralateral side Person deprived of liberty by a judicial or administrative decision Neoplasia Any contraindication to osteopathy

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: participants will be assigned to one of two or more groups in parallel for the duration pot the study
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Osteopathic treatment / Usual care<br>osteopathic treatment will be applied in this intervention group. | Other: Medical treatment<br>* Medical treatment will be based on functional treatment and the doctor will prescribe the RICE protocol. For this, the patient will have to : place an ice pack on the sprain apply sports rest for three weeks compress the sprain with a compression stocking when standing in order to prevent phlebitis. In addition, to avoid this complication, the doctor will prescribe an anticoagulant. raise the foot with crutches during the day elevate the foot at night or when doing an activity in a sitting position, using a cushion for example. In addition, the doctor will prescribe anti-inflammatory drugs to ease the pain and physiotherapy to establish proprioception, muscle strength, joint range and dynamic postural balance of the sprain.<br>Other: osteopathic treatment<br>* Each patient will be treated as a whole and within a time limit of 45 minutes. The consultation will start with a medical history followed by medical tests. Then, the osteopath will perform osteopathic tests and manual treatment.<br>|
| Active Comparator: Usual care<br>Classic medical treatment | Other: Medical treatment<br>* Medical treatment will be based on functional treatment and the doctor will prescribe the RICE protocol. For this, the patient will have to : place an ice pack on the sprain apply sports rest for three weeks compress the sprain with a compression stocking when standing in order to prevent phlebitis. In addition, to avoid this complication, the doctor will prescribe an anticoagulant. raise the foot with crutches during the day elevate the foot at night or when doing an activity in a sitting position, using a cushion for example. In addition, the doctor will prescribe anti-inflammatory drugs to ease the pain and physiotherapy to establish proprioception, muscle strength, joint range and dynamic postural balance of the sprain.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ankle mobility | measure ankle dorsiflexion range of motion - the injured ankle should have identical mobility to the healthy one | Week 3 |