Korean J Sports Med.  2020 Mar;38(1):20-27. 10.5763/kjsm.2020.38.1.20.

Effect of Postoperative Intensive Rehabilitation on Ankle Function Recovery in Patients with Chronic Ankle Instability

• Lee GS
• Lee SH
• Park SH
• Joo MC
• Kim HJ
• Kim MS

• KMID: 2502513
• DOI: http://doi.org/10.5763/kjsm.2020.38.1.20

Abstract

Purpose
This study aimed to investigate the effect of hospital-based intensive rehabilitation program after ankle ligament operation.
Methods
A total of 35 patients were included in this randomized controlled trial. Fifty-minute sessions of hospital-based rehabilitation were performed three times weekly for 12 weeks in the intervention group. Home-based exercise was conducted in the control group. Outcomes were evaluated at baseline, 12 weeks, and 16 weeks. The primary outcome was measured using the Foot and Ankle Outcome Score (FAOS). Secondary outcomes included the American Orthopedic Foot and Ankle Society (AOFAS) score, ankle strength measured using an isokinetic device, fall index measured using a Tetrax posturography device, and the Berg Balance Scale.
Results
Significant improvements in FAOS, AOFAS, ankle strength, and fall index were found in the intervention group after performing the hospital-based rehabilitation (all p＜0.05) and these improvements were sustained at T2 (all p＜0.05). Between-group comparisons demonstrated significantly greater improvements in FAOS, AOFAS, ankle strength, and fall index in the intervention group than those in the control group at both T1 (all p＜0.05), and T2 (all p＜0.05).
Conclusion
The rehabilitation program in this study improved postoperative pain, sports function, quality of life, and strength and balance of the ankle significantly better than home-based self-care. Therefore, we recommend hospital-based systematic rehabilitation programs after surgical treatment for chronic ankle instability.

Keyword

Ankle; Hospital-based; Ligament; Operation; Rehabilitation

Figure

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  Fig. 1. Early stage of the rehabilitation program. (A) Passive range of motion (ROM). (B) Ankle pump. (C) Weight shifting. (D) Active ROM of ankle dorsi/plantarflexion. (E) Leg raise. (F) Bridge exercise.

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  Fig. 2. Middle stage of the rehabilitation program. (A) Stationary bicycle exercise. (B) Active range of motion of ankle in-version/eversion. (C) Calf raise. (D) One leg lunge. (E) One leg standing. (F) One leg standing on a balance ball.

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  Fig. 3. Late stage of rehabilitation program. (A) Treadmill exercise. (B) Lunge exercise. (C) Squat. (D) Hop on one foot.

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  Fig. 4. Patient selection flowchart.

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  Fig. 5. Changes in the Foot and Ankle Outcome Score (FAOS) across the three time points (at baseline [T0], after intervation [T1], 4 weeks of follow-up [T2]). All five subscales of the FAOS significantly improved in the intervention group over time, and a between-group comparison showed a significant difference between groups after intervention and at 4 weeks of follow-up. ∗p＜0.05.

Reference

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