title: Some benefit from physiotherapy intervention in the subgroup of patients with severe ankle sprain as determined by the ankle function score: a randomised trial.
abstract: OBJECTIVE
  Do patients with a severe ankle injury (baseline ankle function score < or = 40) do worse in the short-term than patients with a mild injury (score > 40)? Does physiotherapy intervention have more effect on patients with a severe injury compared with a mild injury in the short- or long-term? Is self-reported recovery related to ankle function score over time?
  
  
  METHODS
  Subgroup analysis of a randomised trial.
  
  
  METHODS
  102 adults with an acute lateral ankle sprain.
  
  
  METHODS
  The experimental group received physiotherapist-supervised exercises in addition to conventional intervention.
  
  
  METHODS
  Outcomes were self-reported recovery, pain, and instability all measured on a 10-point visual analogue scale, and incidence of re-sprain. Measurements were collected at baseline, 4 and 8 weeks, 3 and 12 months.
  
  
  RESULTS
  Participants with a severe injury did worse in 3 out of 7 outcomes than those with a mild injury at 4 weeks but not at 8 weeks. There was no difference in effect of physiotherapy intervention in those with a severe injury compared with a mild injury, at 8 weeks or 12 months. However, there was an effect of physiotherapy intervention in those with a severe injury in 3 out of 7 outcomes at 8 weeks. Self-reported recovery was related to ankle function score at all points in time (r = 0.48 to 0.79).
  
  
  CONCLUSIONS
  The results of this study only partially support the recommendations regarding the use of the ankle function score in the 'Acute Ankle Injury' guideline of the Royal Dutch Society of Physiotherapists.
authors.affiliation: Department of General Practice, Erasmus MC, Rotterdam, The Netherlands. r.vanrijn@erasmusms.nl
authors.forename: Rogier M
authors.initials: RM
authors.lastname: van Rijn
authors.forename: Jos A C
authors.initials: JA
authors.lastname: van Heest
authors.forename: Philip
authors.initials: P
authors.lastname: van der Wees
authors.forename: Bart W
authors.initials: BW
authors.lastname: Koes
authors.forename: Sita M A
authors.initials: SM
authors.lastname: Bierma-Zeinstra
mesh_terms: D000328:Adult; D016512:Ankle Injuries / Q000628:therapy*; D000843:Ankle Joint / Q000503:physiopathology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D012720:Severity of Illness Index; D013180:Sprains and Strains / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome