Advanced

Effects of a training program after surgically treated ankle fracture: a prospective randomised controlled trial

Nilsson, Gertrud LU ; Jonsson, Kjell LU ; Ekdahl, Charlotte LU and Eneroth, Magnus LU (2009) In BMC Musculoskeletal Disorders 10.
Abstract
Background: Despite conflicting results after surgically treated ankle fractures few studies have evaluated the effects of different types of training programs performed after plaster removal. The aim of this study was to evaluate the effects of a 12-week standardised but individually suited training program ( training group) versus usual care ( control group) after plaster removal in adults with surgically treated ankle fractures. Methods: In total, 110 men and women, 18-64 years of age, with surgically treated ankle fracture were included and randomised to either a 12-week training program or to a control group. Six and twelve months after the injury the subjects were examined by the same physiotherapist who was blinded to the treatment... (More)
Background: Despite conflicting results after surgically treated ankle fractures few studies have evaluated the effects of different types of training programs performed after plaster removal. The aim of this study was to evaluate the effects of a 12-week standardised but individually suited training program ( training group) versus usual care ( control group) after plaster removal in adults with surgically treated ankle fractures. Methods: In total, 110 men and women, 18-64 years of age, with surgically treated ankle fracture were included and randomised to either a 12-week training program or to a control group. Six and twelve months after the injury the subjects were examined by the same physiotherapist who was blinded to the treatment group. The main outcome measure was the Olerud-Molander Ankle Score (OMAS) which rates symptoms and subjectively scored function. Secondary outcome measures were: quality of life (SF-36), timed walking tests, ankle mobility tests, muscle strength tests and radiological status. Results: 52 patients were randomised to the training group and 58 to the control group. Five patients dropped out before the six-month follow-up resulting in 50 patients in the training group and 55 in the control group. Nine patients dropped out between the six- and twelve-month follow-up resulting in 48 patients in both groups. When analysing the results in a mixed model analysis on repeated measures including interaction between age-group and treatment effect the training group demonstrated significantly improved results compared to the control group in subjects younger than 40 years of age regarding OMAS (p = 0.028), muscle strength in the plantar flexors ( p = 0.029) and dorsiflexors ( p = 0.030). Conclusion: The results of this study suggest that when adjusting for interaction between age-group and treatment effect the training model employed in this study was superior to usual care in patients under the age of 40. However, as only three out of nine outcome measures showed a difference, the beneficial effect from an additional standardised individually suited training program can be expected to be limited. There is need for further studies to elucidate how a training program should be designed to increase and optimise function in patients middle-aged or older. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMC Musculoskeletal Disorders
volume
10
publisher
BioMed Central
external identifiers
  • wos:000271310100001
  • scopus:70350022410
ISSN
1471-2474
DOI
10.1186/1471-2474-10-118
language
English
LU publication?
yes
id
f2e764f0-581f-4bea-8de7-f28822377df5 (old id 1505189)
date added to LUP
2009-11-24 16:16:45
date last changed
2017-03-05 03:47:23
@article{f2e764f0-581f-4bea-8de7-f28822377df5,
  abstract     = {Background: Despite conflicting results after surgically treated ankle fractures few studies have evaluated the effects of different types of training programs performed after plaster removal. The aim of this study was to evaluate the effects of a 12-week standardised but individually suited training program ( training group) versus usual care ( control group) after plaster removal in adults with surgically treated ankle fractures. Methods: In total, 110 men and women, 18-64 years of age, with surgically treated ankle fracture were included and randomised to either a 12-week training program or to a control group. Six and twelve months after the injury the subjects were examined by the same physiotherapist who was blinded to the treatment group. The main outcome measure was the Olerud-Molander Ankle Score (OMAS) which rates symptoms and subjectively scored function. Secondary outcome measures were: quality of life (SF-36), timed walking tests, ankle mobility tests, muscle strength tests and radiological status. Results: 52 patients were randomised to the training group and 58 to the control group. Five patients dropped out before the six-month follow-up resulting in 50 patients in the training group and 55 in the control group. Nine patients dropped out between the six- and twelve-month follow-up resulting in 48 patients in both groups. When analysing the results in a mixed model analysis on repeated measures including interaction between age-group and treatment effect the training group demonstrated significantly improved results compared to the control group in subjects younger than 40 years of age regarding OMAS (p = 0.028), muscle strength in the plantar flexors ( p = 0.029) and dorsiflexors ( p = 0.030). Conclusion: The results of this study suggest that when adjusting for interaction between age-group and treatment effect the training model employed in this study was superior to usual care in patients under the age of 40. However, as only three out of nine outcome measures showed a difference, the beneficial effect from an additional standardised individually suited training program can be expected to be limited. There is need for further studies to elucidate how a training program should be designed to increase and optimise function in patients middle-aged or older.},
  author       = {Nilsson, Gertrud and Jonsson, Kjell and Ekdahl, Charlotte and Eneroth, Magnus},
  issn         = {1471-2474},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {BMC Musculoskeletal Disorders},
  title        = {Effects of a training program after surgically treated ankle fracture: a prospective randomised controlled trial},
  url          = {http://dx.doi.org/10.1186/1471-2474-10-118},
  volume       = {10},
  year         = {2009},
}