Digital Rehabilitation for Acute Ankle Sprains: Prospective Longitudinal Cohort Study.
acute ankle sprains
ankle
cohort
digital health
digital therapy
fatigue
home-based digital rehabilitation
longitudinal
outcome
pain
physical rehabilitation
physical therapy
prospective
rehabilitation
soft tissue
sprain
therapy
Journal
JMIR rehabilitation and assistive technologies
ISSN: 2369-2529
Titre abrégé: JMIR Rehabil Assist Technol
Pays: Canada
ID NLM: 101703412
Informations de publication
Date de publication:
30 Sep 2021
30 Sep 2021
Historique:
received:
15
06
2021
accepted:
30
07
2021
revised:
16
07
2021
pubmed:
10
9
2021
medline:
10
9
2021
entrez:
9
9
2021
Statut:
epublish
Résumé
Ankle sprains are one of the most prevalent soft-tissue injuries worldwide. Physical therapy, especially progressive exercise, has proven effective in improving function, while preventing recurrence. We aim to present the results of a fully remote and digitally guided rehabilitation program for acute ankle sprains. We performed a prospective longitudinal cohort study of individuals eligible for workers' compensation, who were referred for digital rehabilitation therapy for a sprained ankle. Therapeutic exercise sessions were to be performed independently by the patient at home using the biofeedback device provided by SWORD Health. Primary endpoints were the change in self-reported Numerical Pain Rating Scale (NPRS) and Foot and Ankle Ability Measure-activities of daily living (FAAM-ADL) and FAAM-Sports scores. Participants were assessed at baseline, end of the program, and 6 months after program completion. Secondary outcomes included digital therapy dosage, pain and fatigue during sessions, and satisfaction. In total, 93 (89.4%) patients completed the program and 79 (76.0%) were available for follow-up. Changes in the primary outcomes between baseline and the 6-month follow-up were both significant (P<.001) and clinically meaningful: mean difference of -2.72 points (95% CI -3.31 to -2.13) on the NPRS (49.8% reduction), 21.7 points (95% CI 17.13-26.27) on the FAAM-ADL (41.1% increase), and 37.8 points (95% CI 30.45-45.15) on the FAAM-Sports (151.8% increase). Longer waiting periods between the accident date and treatment initiation were found to negatively impact functional status at baseline and at the end of the program, triggering an extension in the program duration. The total training volume (12.5 hours, SD 10.5 hours) was similar to that of other interventions for ankle sprains, but the dosage per week was much higher (2.4 hours per week, SD 0.87 hours per week). The mean patient satisfaction score was 8.8 (SD 1.57) out of 10. Among program completers, 83.9% attained full recovery and were discharged with no residual disability. Being far less demanding in terms of human resources, the digital program presented constituted a viable, clinically effective, and convenient solution for ankle sprain rehabilitation, particularly during the pandemic. This is the first study presenting a fully remote home-based rehabilitation program for acute ankle sprains, with patients achieving sustained long-term results. This was a prospective cohort study and, as such, did not include a control group, but the results appear comparable to those published for face-to-face interventions. ClinicalTrials.gov NCT04819022; https://clinicaltrials.gov/ct2/show/NCT04819022.
Sections du résumé
BACKGROUND
BACKGROUND
Ankle sprains are one of the most prevalent soft-tissue injuries worldwide. Physical therapy, especially progressive exercise, has proven effective in improving function, while preventing recurrence.
OBJECTIVE
OBJECTIVE
We aim to present the results of a fully remote and digitally guided rehabilitation program for acute ankle sprains.
METHODS
METHODS
We performed a prospective longitudinal cohort study of individuals eligible for workers' compensation, who were referred for digital rehabilitation therapy for a sprained ankle. Therapeutic exercise sessions were to be performed independently by the patient at home using the biofeedback device provided by SWORD Health. Primary endpoints were the change in self-reported Numerical Pain Rating Scale (NPRS) and Foot and Ankle Ability Measure-activities of daily living (FAAM-ADL) and FAAM-Sports scores. Participants were assessed at baseline, end of the program, and 6 months after program completion. Secondary outcomes included digital therapy dosage, pain and fatigue during sessions, and satisfaction.
RESULTS
RESULTS
In total, 93 (89.4%) patients completed the program and 79 (76.0%) were available for follow-up. Changes in the primary outcomes between baseline and the 6-month follow-up were both significant (P<.001) and clinically meaningful: mean difference of -2.72 points (95% CI -3.31 to -2.13) on the NPRS (49.8% reduction), 21.7 points (95% CI 17.13-26.27) on the FAAM-ADL (41.1% increase), and 37.8 points (95% CI 30.45-45.15) on the FAAM-Sports (151.8% increase). Longer waiting periods between the accident date and treatment initiation were found to negatively impact functional status at baseline and at the end of the program, triggering an extension in the program duration. The total training volume (12.5 hours, SD 10.5 hours) was similar to that of other interventions for ankle sprains, but the dosage per week was much higher (2.4 hours per week, SD 0.87 hours per week). The mean patient satisfaction score was 8.8 (SD 1.57) out of 10. Among program completers, 83.9% attained full recovery and were discharged with no residual disability.
CONCLUSIONS
CONCLUSIONS
Being far less demanding in terms of human resources, the digital program presented constituted a viable, clinically effective, and convenient solution for ankle sprain rehabilitation, particularly during the pandemic. This is the first study presenting a fully remote home-based rehabilitation program for acute ankle sprains, with patients achieving sustained long-term results. This was a prospective cohort study and, as such, did not include a control group, but the results appear comparable to those published for face-to-face interventions.
TRIAL REGISTRATION
BACKGROUND
ClinicalTrials.gov NCT04819022; https://clinicaltrials.gov/ct2/show/NCT04819022.
Identifiants
pubmed: 34499038
pii: v8i3e31247
doi: 10.2196/31247
pmc: PMC8517823
doi:
Banques de données
ClinicalTrials.gov
['NCT04819022']
Types de publication
Journal Article
Langues
eng
Pagination
e31247Informations de copyright
©Fernando D Correia, Maria Molinos, Carlos Neves, Dora Janela, Diana Carvalho, Sara Luis, Gerard E Francisco, Jorge Lains, Virgilio Bento. Originally published in JMIR Rehabilitation and Assistive Technology (https://rehab.jmir.org), 30.09.2021.
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