Compared to conventional physiotherapy, does the use of an ankle trainer device after Weber B ankle fracture operation improve outcome and shorten hospital stay? A randomized controlled trial.
Marius Molund, Jan Hellesnes, Gøran Berdal and 2 others
PMID 32526153WHAT IT FOUND
Ankle function scores were higher with a spring-loaded trainer at three weeks after operated ankle fracture, but not at 52 weeks.
Hospital stay averaged 2.6 days versus 3.2 days. Pain and ankle motion did not differ.
Key findings
01The main ankle function score, OMAS, was higher in the ankle trainer group at three weeks (40.9 versus 35.3, P = 0.021), but not at 52 weeks (91.4 versus 93.5, P = 0.386).
02Hospital stay was shorter in the ankle trainer group, mean 2.6 days versus 3.2 days (P = 0.026).
03Pain, analgesic use and passive dorsiflexion did not differ between groups at any follow-up.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was done at one level 1 trauma centre, so its results may not apply elsewhere. The 3-week assessor was not blinded, and the physiotherapist who randomized patients knew group; only the 6, 12, and 52 week assessor was blinded. Four patients dropped out from the ankle trainer group and eight from the conventional group, and eleven patients were absent to follow-up. The three-week OMAS difference did not reach the predefined minimal clinical important difference of 12 points. Only patients considered to have good compliance and able to follow the protocol were included, and only operated Weber B fractures were studied, so results may not apply to conservative treatment or less compliant patients. Follow-up was 52 weeks, which may be too short for final function.
Declared interests
The study was funded by Oslo University Hospital, which was also responsible for the study. The authors declared no potential conflicts of interest.
The easy way to misread this
Do not conclude that the ankle trainer produces a clinically important 52-week improvement. The three-week OMAS advantage did not reach the predefined minimal clinical important difference of 12 points, and OMAS was not different at 52 weeks.