Ankle sprain treatment at home with RICE therapy trumps physio, study suggests
People with sprained ankles may not benefit from physiotherapy, researchers have said.
Some ankle sprains are better dealt with at home with basic self management, a new study suggests.
The research, published in The BMJ, found that for simple sprains physiotherapy did not lead to "clinically important improvements" after six months compared to self care.
A group of Canadian researchers assessed 503 patients, aged 16-79 years, presenting to emergency departments with mild or moderate ankle sprain injuries between 2009 and 2013.
They were either given physiotherapy and home care or just home care with instruction for basic management of the injury at home.
This included information on ankle protection, rest, ice, application of compression bandage, elevation, use of painkillers, graduated weight bearing activities and information about expected recovery.
They found that 43 per cent of participants in the physiotherapy group and 38 per cent in the control group had not reached "excellent recovery" by six months.
The authors concluded: "In the acute management of patients with grade 1 and 2 ankle sprains presenting to an emergency department within 72 hours of injury, a standard intervention of early supervised physiotherapy plus usual care does not lead to clinically important improvements in functional recovery up to six months after injury compared with usual care alone."
Dr Brenda Brouwer, of Queen's University in Kingston, said: "While there was not a clinically important effect with the standardised physiotherapy regimen provided to our participants, there is potential for the investigation of alternative interventions that would reduce morbidity in patients with these injuries."
Dr Chris Bleakley, of Ulster University, reviewed the study for The BMJ and said the randomised controlled study was "an important addition to the evidence base."
He also called for patients, practitioners and researchers to consider other rehabilitative exercises that could influence treatment success.
Clinical benefit of rehabilitative exercises might depend on the nature, intensity, and duration of treatment, he said.
The maximum of seven lots of 30 minutes of supervised physiotherapy in the latest study might be a "lower dose" when compared to other studies.
He also said there was an "urgent need to diversify the exercise content of treatments beyond the ankle," such as the knee, hip, and in the torso, which can be implicated in long term problems.