October 2021

Isometric Exercise During Immobilization Reduces Return-to-play Time After Las

  • Increased side-to-side difference in ankle ROM leads to a longer time to RTP after a lateral ankle sprain.
  • Isometric exercise combined with EMS during immobilization increased the total ankle ROM at the time of cast removal.
  • Less side-to-side difference after ankle immobilization due to active isometric exercise and EMS intervention led to a shorter time to RTP.

Researchers from Japan reported that immobilization reduces symptoms after lateral ankle sprain (LAS) but may worsen the range of motion (ROM) of the ankle and delay return to play (RTP). They sought to understand the correlation between ankle ROM and time to RTP following immobilization for LAS and studied whether isometric exercise during immobilization would increase ROM and shorten the time to RTP. Their study looked at 82 patients with acute LAS who were treated by a short-leg cast with or without isometric exercise and electrical muscle stimulation (EMS); intervention group or control group, respectively. The correlation between ankle ROM at cast removal and time to RTP was analyzed. The total and side-to-side ankle ROM and the time to RTP were compared between the two groups. Their results show side-to-side difference in total ankle ROM was significantly correlated with time to RTP (r = 0.38, P = 0.02). The intervention reduced the side-to-side difference in total ROM (20º versus 31º, P = 0.01) and time to RTP (46 vs 65 days, P = 0.01) compared to the control group. They concluded that increased deficiency in ankle ROM led to a longer time to RTP, and that isometric exercise combined with EMS during immobilization increased the total ankle ROM and shortened the time to RTP.

Source: Toyoshima Y, Akagi R, Nabeshima K. Isometric exercise during immobilization reduces the time to return to play after lateral ankle sprain. Phys Ther Sport. 2021;52:168-172.

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