Physiotherapeutic management of acute ankle sprains : a survey of clinical practice in the Western Cape and comparison thereof to evidence based guidelines

[摘要] ENGLISH ABSTRACT: Ankle sprains are reportedly the most common lower limb injury amongst activeindividuals.Aim: The aim of this study was to investigate whether treatment interventionsemployed by physiotherapists during the first week of functional rehabilitation of anankle sprain, at primary care level, were aligned with evidence-based guidelines foracute ankle sprains.Design: A descriptive cross-sectional study was conducted.Participants: A total of 91 physiotherapists from the Western Cape Metropole(WCM) completed questionnaires.Method: Physiotherapists' treatment interventions were recorded based on a casestudy of a typical moderately sprained ankle. According to classification of the WestPoint Ankle Grading System, a moderate sprain is a partial macroscopic tear of theligaments with moderate pain, swelling and tenderness with some loss of motion andmild to moderate instability of the joint. Anticipated return to sport is two to six weeks.Relative occurrence of selected interventions during the first week of rehabilitationwas calculated. Chi-square tests were used to compare differences betweenphysiotherapists' responses and the recommendations of the practice guidelines.Results: Physiotherapists' overall selections of treatment interventions were inalignment with the Koninklijk Nederlands Genootschap voor Fysiotherapie (KNGF)guidelines and correlated positively to the recommendations stipulated by KNGFtherein. Physiotherapists indicated many interventions for which good evidenceexists: compression, cryotherapy, early mobilisation, and neuromuscular exercises. Itis of concern that 49% – 91% (n = 91) physiotherapists indicated some form ofmanual mobilisations for which there is a lack of evidence, and more than two-thirdsindicated the application of an electrotherapy intervention, which is notrecommended in the guidelines.Conclusion: Physiotherapists should reconsider interventions for which there is noevidence as this may reduce cost of care, without compromising patient outcomes.

[发布机构] Stellenbosch University