Physical Therapy Does Not Benefit Simple Ankle Sprains

BMJ 2016 Nov 16;355:i5650

Most ankle sprains are simple grade 1 (stable) or 2 (mild joint laxity) sprains, but often result in some persistent impairment.  Physical therapy’s role in improving recovery is unclear.

n= 504 (ages 16-79) presenting with grade 1 or 2 presenting within 72 hours of injury

Randomized to usual care (evaluation, home mgmt (RICE)) or to usual care + PT (up to seven half-hour sessions + home exercise plan).

Intention-to-treat analysis (yeah!).

Percentage reporting “excellent recovery” at 3 mos was 37% in usual care group and 43% in PT group, not a statistically significant difference.  Similarly, no difference at 1 mo or at 6 mos.  Subgroup analyses (boo!) also did not show differences.

Take-home point:  Don’t refer mild ankle sprains to PT.  PT makes no difference in these injuries.

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