The effect of supervised rehabilitation on strength, postural sway, position sense and re-injury risk after acute ankle ligament sprain

The effect of an early rehabilitation program, including postural training, on ankle joint function after an ankle ligament sprain was investigated pr ospectively. Ninety-two subjects, matched for age, sex, and level of sports activity, were randomized to a control or training group. All subject rece ived the same standard information regarding early ankle mobilization. In a ddition, the training group participated in supervised physical therapy reh abilitation (1 h, twice weekly) with emphasis on balance training. Postural sway, position sense and isometric ankle strength were measured 6 weeks an d 4 months after the injury, and at 12 months re-injury data were obtained. In the training group, there was a significant difference between the inju red and uninjured side for plantar flexion (P<0.01), eversion (P<0.01) and inversion (P<0.05), but not for dorsiflexion at 6 weeks. In the control gro up, there was a significant difference between the injured and uninjured si de for plantar flexion (P<0.01), eversion (P<0.01), inversion (P<0.01), and dorsiflexion (P<0.05) at 6 weeks. Postural sway, but not position sense, d iffered between the injured and uninjured side in both groups (P<0.01) at 6 weeks. The side-to-side percent differences were similar in both groups fo r all variables (P>0.05) at 6 weeks, and there were no side-to-side differe nces at 4 months in either group. In the control group, 11/38 (29%) suffere d a re-injury while this number was only 2/29 (7%) in the training group (P <0.05). These data showed that an ankle injury resulted in reduced ankle st rength and postural control at 6 weeks, but that these variables had normal ized at 4 months, independent of the supervised rehabilitation. However, th e findings also demonstrated that supervised rehabilitation may reduce the number of re-injuries, and therefore may play a role in injury prevention.