Clinical trial NCT00797368: Manual Therapy and Exercise Versus Home Exercises in the Management of Patients Status Post Ankle Sprain
Official title: Manual Therapy and Exercise Versus Home Exercises in the Management of Patients Status Post Ankle Sprain: A Multi-Center Randomized Clinical Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Ankle Sprain
Keywords: ankle sprain
manual therapy
exercise
physical therapy
Patients who have sustained an inversion ankle sprain
Lead sponsor: Franklin Pierce University
Sponsor class: OTHER
First posted: 2008-11-25
Enrollment: 74
Sex: ALL
Minimum age (years): 16
Maximum age (years): 60
Standard ages: CHILD
ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: A recent study has demonstrated that a physical therapist directed exercise program did not result in greater reductions in disability and pain when compared to a home exercise program. However, no manual therapy procedures were incorporated into the physical therapy treatment program despite recent evidence suggesting that thrust and non-thrust manual therapy techniques may be beneficial in reducing disability, pain and improving gait. Therefore, the purpose of this study is to compare the effectiveness of a physical therapy management approach consisting of manual therapy and exercise to a home program of exercise only. The investigators hypothesize that the group receiving manual therapy and exercise will have better outcomes.


Eligibility criteria: Inclusion/Exclusion Criteria:

* A combination of physical examination and self-report measures will be used to assess the patient's potential eligibility according to each inclusion/exclusion criterion.
* The following inclusion criteria will be used to determine eligibility for this study:

  * Primary complaint of ankle pain, status post inversion ankle sprain.
  * The investigators decided to include patients with both acute and chronic ankle sprains since our previous work has shown that patients from both stage have exhibited positive benefits with manual therapy.66
  * Age between 16-60 years old
  * NPRS score \> 3 points (average score) over past 24 hrs.
  * Does not meet criteria for needing radiographs per the Ottawa Ankle Rules
* The following exclusion criteria will be used to determine ineligibility for this study:

  * Red flags noted in the patient's Medical Screening Questionnaire (i.e. tumor, fracture, RA, osteoporosis, prolonged history of steroid use, severe vascular disease, etc.)
  * Prior surgery to the distal tibia, fibula, ankle joint, or rearfoot region (proximal to the base of the metatarsals).
  * Grade III ankle sprain (as defined by the West Point Ankle Sprain Grading System and/or tenderness along the anterior medial malleolus as described by,51 fracture, or other absolute contraindications to manual therapy.
  * Insufficient English language skills to complete all questionnaires
  * Inability to comply with treatment and follow-up schedule

Primary outcomes:
measure: Foot and Ankle Ability Measure
timeFrame: 4-weeks and 6-months
Secondary outcomes:
measure: Numeric Pain Rating Scale
timeFrame: 4-weeks and 6-months
Other outcomes:
Locations:
city: Denver
country: United States
facility: Colorado University
state: Colorado
city: Denver
country: United States
facility: Regis University
state: Colorado
city: Concord
country: United States
facility: Concord Hospital
state: New Hampshire
Study officials:
References:
citation: Cleland JA, Mintken PE, McDevitt A, Bieniek ML, Carpenter KJ, Kulp K, Whitman JM. Manual physical therapy and exercise versus supervised home exercise in the management of patients with inversion ankle sprain: a multicenter randomized clinical trial. J Orthop Sports Phys Ther. 2013;43(7):443-55. doi: 10.2519/jospt.2013.4792. Epub 2013 Apr 29.