Digital Rehabilitation for Acute Ankle Sprains: Prospective Longitudinal Cohort Study.
Fernando D Correia, Maria Molinos, Carlos Neves and 6 others
PMID 34499038WHAT IT FOUND
Patients with acute ankle sprains who completed a fully remote digital rehabilitation program reported significant reductions in pain and improvements in function over six months.
Because this study had no control group, these results describe what happened to patients using the app, not proof that the app works better than standard care.
Key findings
01Participants reported clinically meaningful improvements in pain and function from baseline to the 6-month follow-up.
02Most patients were discharged with no residual disability, and the rate of reinjury at follow-up was low.
03Patients who required more than four weeks of treatment had worse functional outcomes and pain scores at the six-month mark compared to those discharged earlier.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
There was no control group, so it is impossible to determine if the digital program was more or less effective than usual care or no treatment. Patients were referred by surgeons to a specific commercial provider, which may have introduced selection bias toward patients more comfortable with digital care. The study was conducted during the pandemic, which may have affected baseline health behaviors and access to other care. Attrition occurred: 11 patients dropped out, and only 79 were available for 6-month follow-up. The authors compare their results to historical data from other studies, but differences in patient populations and measurement methods make these comparisons uncertain.
Declared interests
The study was conducted by SWORD Health, a commercial digital health provider. The patients were recruited from health plans that had entered into a commercial agreement with SWORD Health. The authors state that the study was aimed at assessing the clinical outcomes of programs provided by SWORD Health.
The easy way to misread this
Do not conclude that digital rehabilitation is superior to in-person physical therapy. This study had no control group, so the observed improvements could have occurred with standard care or even natural recovery. The results show what happened to patients using this specific app, not how it compares to other treatments.