Home-Based Physical Therapy Intervention With Adherence-Enhancing Strategies Versus Clinic-Based Management for Patients With Ankle Sprains

Background and Purpose: To some extent, favorable treatment outcomes for physical therapy intervention programs depend on patients attending their clinic appointments and adhering to the program requirements. Previous studies have found less-than-optimal levels of clinic attendance, and a viable option might be physical therapy intervention programs with a large component of home treatment. This study investigated the effects of a standard physical therapy intervention program—delivered primarily at either the clinic or home—on ankle function, rehabilitation adherence, and motivation in patients with ankle sprains. Subjects: Forty-seven people with acute ankle sprains who were about to start a course of physical therapy intervention participated in the study. Methods: Using a prospective design, subjects were randomly assigned to either a clinic intervention group or a home intervention group. Ankle function and motivation were measured before and after rehabilitation, and adherence to the clinic- and home-based programs was measured throughout the study. Results: The groups had similar scores for post-treatment ankle function, adherence, and motivation. The home intervention group had a significantly higher percentage of attendance at clinic appointments and better physical therapy intervention program completion rate. Discussion and Conclusion: Home-based physical therapy intervention appears to be a viable option for patients with sprained ankles.

[1]  R. Gonzalez.  Applied Multivariate Statistics for the Social Sciences , 2003 .

[2]  P. Little,et al.  Should We Give Detailed Advice and Information Booklets to Patients With Back Pain?: A Randomized Controlled Factorial Trial of a Self-Management Booklet and Doctor Advice to Take Exercise for Back Pain , 2001, Spine.

[3]  Hugh Coolican.  Research Methods and Statistics , 1999 .

[4]  Ellen L. Lewis,et al.  Facilitating Treatment Adherence: A Practitioner’s Guidebook , 1989 .

[5]  Linda M Vasey.  DNAs and DNCTs — Why Do Patients Fail to Begin or to Complete a Course of Physiotherapy Treatment? , 1990 .

[6]  Albert J. Petitpas,et al.  Psychological factors, rehabilitation adherence, and rehabilitation outcome after anterior cruciate ligament reconstruction. , 2000 .

[7]  J Bennett,et al.  Communicating with patients. , 1992, BMJ.

[8]  J. Duda,et al.  Predictors of Adherence in the Rehabilitation of Athletic Injuries: An Application of Personal Investment Theory , 1989 .

[9]  M. Callaghan,et al.  An evaluation of exercise regimes for patients with osteoarthritis of the knee: a single-blind randomized controlled trial , 1995 .

[10]  R. Vallerand,et al.  On the Assessment of Situational Intrinsic and Extrinsic Motivation: The Situational Motivation Scale (SIMS) , 2000 .

[11]  K. Cook,et al.  A randomized controlled trial comparing 2 instructional approaches to home exercise instruction following arthroscopic full-thickness rotator cuff repair surgery. , 2002, The Journal of orthopaedic and sports physical therapy.

[12]  D. Perrin,et al.  Reliability and responsiveness of disablement measures following acute ankle sprains among athletes. , 1998, The Journal of orthopaedic and sports physical therapy.

[13]  B. Pozehl,et al.  Staying on course: the effects of an adherence facilitation intervention on home exercise participation. , 2002, Progress in cardiovascular nursing.

[14]  J E Kapsos,et al.  Communicating with patients. , 1977, Canadian Medical Association journal.

[15]  J. Donovan,et al.  Why don't patients do their exercises? Understanding non-compliance with physiotherapy in patients with osteoarthritis of the knee , 2001, Journal of epidemiology and community health.

[16]  F. Bassett.  Treatment of Injuries to Athletes—3rd edition , 1978 .

[17]  D. H. O'donoghue,et al.  Treatment of Injuries to Athletes , 1979, Northwest medicine.

[18]  Jacob Cohen,et al.  A power primer. , 1992, Psychological bulletin.

[19]  Hugh Coolican.  Research methods and statistics in psychology, 2nd ed. , 1994 .

[20]  Fisher Ac,et al.  Adherence to Sports-Injury Rehabilitation Programs , 1988 .

[21]  J. Dias,et al.  Hospital versus home management of children with buckle fractures of the distal radius. A prospective, randomised trial. , 2001, The Journal of bone and joint surgery. British volume.

[22]  M. Roebroeck,et al.  Physiotherapy for Patients with Lateral Ankle Sprains A prospective survey of practice patterns in Dutch primary health care , 1998 .

[23]  J. Corsetti,et al.  Rehabilitation adherence and anterior cruciate ligament reconstruction outcome , 2004 .

[24]  B. Brewer,et al.  Effects of relaxation and guided imagery on knee strength, reinjury anxiety, and pain following anterior cruciate ligament reconstruction. , 2001 .

[25]  Adrian H. Taylor,et al.  Threat and coping appraisal as determinants of compliance with sports injury rehabilitation: an application of Protection Motivation Theory. , 1996, Journal of sports sciences.

[26]  K. E. Sell,et al.  The effects of the number and frequency of physical therapy treatments on selected outcomes of treatment in patients with anterior cruciate ligament reconstruction. , 1997, The Journal of orthopaedic and sports physical therapy.

[27]  M. Shapiro,et al.  Persistent pain after ankle sprain: targeting the causes. , 1997, The Physician and sportsmedicine.

[28]  D. Ogilvie-Harris,et al.  Treatment Modalities for Soft Tissue Injuries of the Ankle: A Critical Review , 1995, Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine.

[29]  Rumana Z Omar,et al.  Effectiveness of supervised physical therapy in the early period after arthroscopic partial meniscectomy. , 2003, Physical therapy.

[30]  S. Symons,et al.  Hospital versus home management of children with buckle fractures of the distal radius , 2001 .

[31]  Keith J Petrie,et al.  The Effect of Treatment Goals on Patient Compliance with Physiotherapy Exercise Programmes , 1999 .

[32]  Dinesh Kumbhare MSc Md Frcp,et al.  Decision Making and Outcomes in Sports Rehabilitation , 2000 .

[33]  M. Safran,et al.  Lateral ankle sprains: a comprehensive review: part 1: etiology, pathoanatomy, histopathogenesis, and diagnosis. , 1999, Medicine and science in sports and exercise.

[34]  P. Ley,et al.  Communicating with Patients: Improving Communication, Satisfaction and Compliance , 1988 .

[35]  G. Kok,et al.  Correlates of exercise compliance in physical therapy. , 1993, Physical therapy.

[36]  S. Bull.  Adherence Issues in Sport And Exercise , 2001 .

[37]  A. Fisher,et al.  Adherence to Sports-Injury Rehabilitation Programs. , 1988, The Physician and sportsmedicine.

[38]  A. Calin,et al.  The effect of a home based exercise intervention package on outcome in ankylosing spondylitis: a randomized controlled trial. , 2002, The Journal of rheumatology.

[39]  K. Lorig,et al.  A randomized trial of a cognitive-behavioral program for enhancing back pain self care in a primary care setting , 2000, Pain.

[40]  Hugh Coolican.  Research Methods and Statistics in Psychology , 1993 .

[41]  M. Safran,et al.  Lateral ankle sprains: a comprehensive review part 2: treatment and rehabilitation with an emphasis on the athlete. , 1999, Medicine and science in sports and exercise.

[42]  M. Horodyski,et al.  Factors Associated with Adherence to Sport Injury Rehabilitation in College-Age Recreational Athletes , 1995 .