OBJECTIVE: To examine the effectiveness of an unsupervised e-health-supported neuromuscular training programme in combination with usual care compared with usual care alone in patients with acute lateral ankle sprains in general practice.
METHODS: Randomised controlled trial with 1-year follow-up among patients (14-65 years) who visited the GP with an acute lateral ankle sprain within 3 weeks of injury.
METHODS: The intervention group received, in addition to usual care, an unsupervised e-health-supported neuromuscular training programme and the control group received usual care alone. The primary outcome was self-reported re-sprains during 52 weeks of follow-up. Secondary outcomes were ankle function, pain in rest and during activity, subjective recovery, and return to the same type and level of sport.
RESULTS: In total, 165 participants (mean age 38.3 years and 69 [41.8%] male) were included. No statistically significant difference in the occurrence of a re-sprain were found between the intervention 20.7% (17/82) and control group 24.1% (20/83) (hazard ratio 1.14, 95% confidence interval = 0.59 to 2.21). Also, no statistically significant differences in secondary outcomes were found between groups. The adherence rate to the programme was low (6.1%, 5/82).
CONCLUSIONS: The rate of re-sprains was relatively high and an unsupervised e-health-supported neuromuscular training programme does not yield meaningful effects and does not encourage adherence in preventing re-sprains in patients in general practice. More research is necessary to indicate the best treatment modality and way of delivery for these patients.
目的:在一般实践中,对急性踝关节外侧扭伤患者进行无监督电子健康支持的神经肌肉训练计划联合常规护理与单纯常规护理的有效性比较。
方法:在受伤后3周内因急性踝关节外侧扭伤就诊的患者(14-65年)中进行1年随访的随机对照试验。
方法:干预组接受,除了常规护理,无监督的电子健康支持的神经肌肉训练计划和对照组仅接受常规护理.主要结果是52周随访期间自我报告的扭伤。次要结果是踝关节功能,休息和活动时疼痛,主观恢复,回到相同的运动类型和水平。
结果:总计,165名参与者(平均年龄38.3岁,男性69[41.8%])被纳入。干预组20.7%(17/82)和对照组24.1%(20/83)之间的再扭伤发生率无统计学差异(风险比1.14,95%置信区间=0.59至2.21)。此外,两组间次要结局无统计学差异.该计划的遵守率很低(6.1%,5/82).
结论:再扭伤率相对较高,无监督的电子健康支持的神经肌肉训练计划不能产生有意义的效果,也不能鼓励患者坚持预防一般实践中的再扭伤。需要更多的研究来指出这些患者的最佳治疗方式和分娩方式。