Point of Care Ultrasound Guided Management of Lateral Ankle Sprains: A Case Series.

IF 1.6 Q3 SPORT SCIENCES
International Journal of Sports Physical Therapy Pub Date : 2024-08-02 eCollection Date: 2024-01-01 DOI:10.26603/001c.121601
Matthew Bush, Jon Umlauf, Bryan Pickens
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引用次数: 0

Abstract

Background: Lateral ankle sprain (LAS) is a common injury with incidence rates reported at 7.2 per 1000 person-years. Physical examination strategies provide limited information to guide rehabilitation that can maximize clinical outcomes. Early and accurate diagnostic information using ultrasound imaging enables individualized care and the ability to monitor healing along with its response to activity and rehabilitation.

Purpose: The purpose of this study was to describe and observe the outcomes associated with Point of Care Ultrasound (POCUS) guided early management of acute and sub-acute lateral ankle sprains.

Study design: Case series.

Methods: Individuals with a LAS within the prior 28 days underwent a clinical evaluation to include a POCUS exam to assess ligamentous integrity. Objective and POCUS findings were integrated to classify each LAS into one of four categories. Each grade of ankle sprain corresponded to levels of bracing for the protection of injured structures with each patient receiving physical therapy care based on rehabilitation guidelines. Participants completed the Foot and Ankle Ability Measure (FAAM) activities of daily living and Sports subscale, the Foot and Ankle Outcome Score (FAOS), Patient Reported Outcomes Measurement Information Systems Global Health, Tampa Scale of Kinesiophobia (TSK-11), Cumberland Ankle Instability Tool (CAIT), and the Numeric Pain Rating Scale as well as the Ankle Lunge Test and Figure 8 measurements at baseline, 4 weeks, 8 weeks and 12 weeks post enrollment. The FAAM Sport subscale, all FAOS subscales, and the TSK-11 were also collected at 24 weeks while the CAIT was collected at baseline and 24 weeks.

Results: Fourteen participants were enrolled with 11 participants completing all data collection. FAAM Sport scores significantly improved at 4, 8, 12 and 24 weeks. All components of the FAOS significantly increased except for Sport scores at four weeks and Quality of Life scores at four and eight weeks.

Conclusion: POCUS guided early management and ligamentous protection of LASs resulted in significant short and long-term improvement in function and return to sporting activity. This case series highlights the feasibility of using ultrasound imaging to assess the severity of ligamentous injury and align bracing strategies for ligamentous protection. The observations from this case series suggest that functional bracing strategies focused on ligamentous protection to promote healing and reduce re-injury rates does not delay improvement in functional outcomes.

Level of evidence: Level IV, Case Series.

超声波引导下的外侧踝关节扭伤治疗:病例系列。
背景:外踝扭伤(LAS)是一种常见损伤,据报道其发病率为每千人年 7.2 例。体格检查策略只能提供有限的信息来指导康复治疗,从而最大限度地提高临床疗效。目的:本研究旨在描述和观察在护理点超声(POCUS)指导下对急性和亚急性外侧踝关节扭伤进行早期治疗的相关结果:研究设计:病例系列:研究设计:病例系列。方法:对 28 天内发生过外侧踝关节扭伤的患者进行临床评估,其中包括评估韧带完整性的 POCUS 检查。综合客观检查和 POCUS 检查结果,将每个 LAS 分为四类。每个踝关节扭伤等级都对应不同程度的支撑,以保护受伤结构,每位患者都将根据康复指南接受物理治疗。参与者在入组后的基线、4周、8周和12周分别完成了足踝能力测量(FAAM)日常生活活动和运动分量表、足踝结果评分(FAOS)、患者报告结果测量信息系统全球健康状况、坦帕运动恐惧症量表(TSK-11)、坎伯兰踝关节不稳定性工具(CAIT)、数字疼痛评分量表以及踝关节跳跃测试和图8测量。在 24 周时还收集了 FAAM 运动分量表、所有 FAOS 分量表和 TSK-11 量表,并在基线和 24 周时收集了 CAIT 量表:结果:共有 14 名参与者参加,其中 11 人完成了所有数据收集。在 4、8、12 和 24 周时,FAAM 运动得分明显提高。除了四周时的运动得分以及四周和八周时的生活质量得分外,FAOS 的所有组成部分均有明显提高:结论:在 POCUS 的指导下,对 LAS 进行早期管理和韧带保护,可在短期和长期内明显改善其功能并恢复运动能力。本系列病例强调了使用超声成像评估韧带损伤严重程度和调整韧带保护支撑策略的可行性。本系列病例的观察结果表明,以韧带保护为重点的功能性支撑策略可促进愈合并降低再次受伤率,但不会延迟功能性结果的改善:证据等级:IV 级,病例系列。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.50
自引率
5.90%
发文量
124
审稿时长
16 weeks
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