By Critically Appraising Relevant Evidence Discuss How a Progressive Exercise Programme Might Be Used to Promote Tissue Healing and Restore Function.
Essay Title for BR0107 year 2010/11
A 35 year-old mother of two pre-school children sustained a grade 2 sprain of the lateral ankle ligaments of her right leg whilst stepping off an escalator 2 days ago. She is currently mobilising independently using 2 elbow crutches. By critically appraising relevant evidence discuss how a progressive exercise programme might be used to promote tissue healing and restore function.
Lateral ankle sprains, like the one this 35 year old mother suffered, are among the most common orthopaedic conditions treated by healthcare professionals (Stanley 1991). The mechanism of injury associated with ankle sprains, especially when stepping down, is landing on a plantiflexed and inverted foot. This action causes the anterior talofibular and calcaneofibular ligaments to be most at risk due to the force that the whole body weight exerts upon them. A ‘Grade 2’ sprain of the anterior talofibular and/or the calcaneofibular ligament (partial tear) follows the normal tissue healing pattern – bleeding, inflammation, proliferation, remodelling. Since the patient only recently suffered the injury, she is likely to be in the inflammation stage, showing pain, redness, heat and edema. As part of the patient’s rehabilitation, a progressive exercise programme may be used in order to aid the healing process and restore function in the ankle joint.
Bleakly et al (2010) carried out a study investigating the early application of therapeutic exercises following an acute ankle sprain. 101 participants with grade 1 or 2 ankle sprains were split into two groups, using randomised control trial techniques. One group received an accelerated exercise programme and the other group received standard PRICE (Protection, Rest, Ice, Compression, Elevation) treatment – the popular method used in “most cases” by 70% of respondants (Cooke et al 2003).
The outcome measures were
A 35 year-old mother of two pre-school children sustained a grade 2 sprain of the lateral ankle ligaments of her right leg whilst stepping off an escalator 2 days ago. She is currently mobilising independently using 2 elbow crutches. By critically appraising relevant evidence discuss how a progressive exercise programme might be used to promote tissue healing and restore function.
Lateral ankle sprains, like the one this 35 year old mother suffered, are among the most common orthopaedic conditions treated by healthcare professionals (Stanley 1991). The mechanism of injury associated with ankle sprains, especially when stepping down, is landing on a plantiflexed and inverted foot. This action causes the anterior talofibular and calcaneofibular ligaments to be most at risk due to the force that the whole body weight exerts upon them. A ‘Grade 2’ sprain of the anterior talofibular and/or the calcaneofibular ligament (partial tear) follows the normal tissue healing pattern – bleeding, inflammation, proliferation, remodelling. Since the patient only recently suffered the injury, she is likely to be in the inflammation stage, showing pain, redness, heat and edema. As part of the patient’s rehabilitation, a progressive exercise programme may be used in order to aid the healing process and restore function in the ankle joint.
Bleakly et al (2010) carried out a study investigating the early application of therapeutic exercises following an acute ankle sprain. 101 participants with grade 1 or 2 ankle sprains were split into two groups, using randomised control trial techniques. One group received an accelerated exercise programme and the other group received standard PRICE (Protection, Rest, Ice, Compression, Elevation) treatment – the popular method used in “most cases” by 70% of respondants (Cooke et al 2003).
The outcome measures were
References: Han K, Ricard MD, Fellingham GW. Effects of a 4-week exercise program on balancing using elastic tubing as a perturbation force for individuals with a history of ankle sprains. Journal of Orthopedic & Sports Physical Therapy. 2009;39(4):246–255. Hertel J, Buckley WE, Denegar CR. Serial testing of postural control after acute lateral ankle sprain. J Athl Train. 2001;36:363-368.