TY  - JOUR
AU  - Correia, Fernando D
AU  - Molinos, Maria
AU  - Neves, Carlos
AU  - Janela, Dora
AU  - Carvalho, Diana
AU  - Luis, Sara
AU  - Francisco, Gerard E
AU  - Lains, Jorge
AU  - Bento, Virgilio
PY  - 2021
DA  - 2021/9/30
TI  - Digital Rehabilitation for Acute Ankle Sprains: Prospective Longitudinal Cohort Study
JO  - JMIR Rehabil Assist Technol
SP  - e31247
VL  - 8
IS  - 3
KW  - acute ankle sprains
KW  - physical rehabilitation
KW  - home-based digital rehabilitation
KW  - digital therapy
KW  - rehabilitation
KW  - sprain
KW  - digital health
KW  - therapy
KW  - prospective
KW  - longitudinal
KW  - cohort
KW  - ankle
KW  - soft tissue
KW  - physical therapy
KW  - pain
KW  - outcome
KW  - fatigue
AB  - Background: Ankle sprains are one of the most prevalent soft-tissue injuries worldwide. Physical therapy, especially progressive exercise, has proven effective in improving function, while preventing recurrence. Objective: We aim to present the results of a fully remote and digitally guided rehabilitation program for acute ankle sprains. Methods: We performed a prospective longitudinal cohort study of individuals eligible for workers’ compensation, who were referred for digital rehabilitation therapy for a sprained ankle. Therapeutic exercise sessions were to be performed independently by the patient at home using the biofeedback device provided by SWORD Health. Primary endpoints were the change in self-reported Numerical Pain Rating Scale (NPRS) and Foot and Ankle Ability Measure–activities of daily living (FAAM–ADL) and FAAM–Sports scores. Participants were assessed at baseline, end of the program, and 6 months after program completion. Secondary outcomes included digital therapy dosage, pain and fatigue during sessions, and satisfaction. Results: In total, 93 (89.4%) patients completed the program and 79 (76.0%) were available for follow-up. Changes in the primary outcomes between baseline and the 6-month follow-up were both significant (P<.001) and clinically meaningful: mean difference of –2.72 points (95% CI –3.31 to –2.13) on the NPRS (49.8% reduction), 21.7 points (95% CI 17.13-26.27) on the FAAM–ADL (41.1% increase), and 37.8 points (95% CI 30.45-45.15) on the FAAM-Sports (151.8% increase). Longer waiting periods between the accident date and treatment initiation were found to negatively impact functional status at baseline and at the end of the program, triggering an extension in the program duration. The total training volume (12.5 hours, SD 10.5 hours) was similar to that of other interventions for ankle sprains, but the dosage per week was much higher (2.4 hours per week, SD 0.87 hours per week). The mean patient satisfaction score was 8.8 (SD 1.57) out of 10. Among program completers, 83.9% attained full recovery and were discharged with no residual disability. Conclusions: Being far less demanding in terms of human resources, the digital program presented constituted a viable, clinically effective, and convenient solution for ankle sprain rehabilitation, particularly during the pandemic. This is the first study presenting a fully remote home-based rehabilitation program for acute ankle sprains, with patients achieving sustained long-term results.  This was a prospective cohort study and, as such, did not include a control group, but the results appear comparable to those published for face-to-face interventions. Trial Registration: ClinicalTrials.gov NCT04819022; https://clinicaltrials.gov/ct2/show/NCT04819022 
SN  - 2369-2529
UR  - https://rehab.jmir.org/2021/3/e31247
UR  - https://doi.org/10.2196/31247
UR  - http://www.ncbi.nlm.nih.gov/pubmed/34499038
DO  - 10.2196/31247
ID  - info:doi/10.2196/31247
ER  -