Ankle Fracture: No Added Value With Supervised Exercise Rehab
Written by Editor   
Tuesday, November 10, 2015 09:26 AM

For patients with isolated and uncomplicated ankle fracture, a supervised exercise-based rehabilitation program confers no additional benefits in activity limitation or quality of life compared with advice alone, according to data from the randomized Exercise or Advice After Ankle Fracture (EXACT) trial.

"We have previously shown that recovery of activity limitation after ankle fracture is rapid in the first 6 months and that adding passive stretch or manual therapy to a supervised exercise program did not enhance the benefits of exercise alone," the authors write. "It is possible that the lack of treatment effect we observed in this trial is attributable to the fact that rehabilitation cannot accelerate this rapid recovery. These findings and the findings of the present trial suggest that routine care for patients after isolated ankle fracture should include self-management advice at the time of removal of immobilization but not a supervised exercise program."

Ankle fractures are common, and their postsurgical management involves a period of immobilization to allow fracture healing, followed by rehabilitation to reduce swelling, pain, stiffness, and weakness. However, studies evaluating rehabilitation after the removal of immobilization have reported conflicting results, and the benefits of the different components of a rehabilitation program remain unclear.

This study concluded that "A supervised exercise program did not confer additional benefits in activity limitation or quality of life compared with advice alone for patients with isolated and uncomplicated ankle fracture.  These findings do not support the routine use of supervised exercise programs after removal of immobilization for patients with isolated and uncomplicated ankle fracture."


Source: http://www.medscape.com/viewarticle/852345