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The efficacy of adjusting the ankle in the treatment of subacute and chronic grade I and grade II ankle inversion sprains
Pellow JE, Brantingham JW
Journal of Manipulative and Physiological Therapeutics 2001 Jan;24(1):17-24
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: The purpose of this study was to determine the efficacy of adjusting the ankle in the treatment of subacute and chronic grade I and grade II ankle inversion sprains. DESIGN: A single-blind, comparative, controlled pilot study. SETTING: Technikon Natal Chiropractic Day Clinic. PARTICIPANTS: Thirty patients with subacute and chronic grade I and grade II ankle inversion sprains. Patients were recruited from the public; they responded to advertisements placed in newspapers and on notice boards around the campus and local sports clubs. INTERVENTION: Each of the 15 patients in the treatment group received the ankle mortise separation adjustment. Each of the 15 patients in the placebo group received 5 minutes of detuned ultrasound treatment. Each participant received a maximum of 8 treatment sessions spread over a period of 4 weeks. MAIN OUTCOME MEASURE: Patients were evaluated at the first treatment, at the final treatment, and at a 1-month follow-up consultation. Subjective scores were obtained by means of the short-form McGill Pain Questionnaire and the Numerical Pain Rating Scale 101. Objective measurements were obtained from goniometer readings measuring ankle dorsiflexion range of motion and algometer readings measuring pain threshold over the ankle lateral ligaments. A functional evaluation of ankle function was also used. RESULTS: Although both groups showed improvement, statistically significant differences in favor of the adjustment group were noted with respect to reduction in pain, increased ankle range of motion, and ankle function. CONCLUSIONS: This study appears to indicate that the mortise separation adjustment may be superior to detuned ultrasound therapy in the management of subacute and chronic grade I and grade II inversion ankle sprains.
Reprinted from the Journal of Manipulative and Physiological Therapeutics with copyright permission from the National University of Health Sciences.

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