Grant: Randomized Controlled Trials

Soft tissue injuries to the ankle (ankle sprains) are common injuries treated in Canadian emergency departments. An important proportion (up to 40%) of these injuries result in chronic functional limitations that may affect work and leisure activities. However, there is little evidence surrounding the optimal care of these injuries. While evidence exists from studying athletes that physical therapy can be effective in the treatment of ankle injuries, similar treatments have yet to be tested in more general populations, such as those treated in emergency departments. We propose to conduct a randomized controlled trial in order to assess the efficacy of a physical therapy based intervention among adult patients presenting to a hospital-based emergency department with acute ankle sprains. We will recruit approximately 500 patients for study, randomize them to one of two treatment areas (usual emergency care plus physical therapy vs. usual emergency care alone), then follow both groups and compare patient experiences with functional limitations up to six months post-injury. This trial is important because: 1) despite being common, there is little evidence surrounding the optimal treatment of ankle sprains in emergency department settings; 2) existing research from other clinical settings (e.g. sports injury management) suggests that physical therapy is beneficial; 3) there is a paucity of published randomized clinical trials of physical therapy interventions for the acute treatment of ankle sprains in the general population; 4) we expect that the findings will inform clinical practice for both emergency physicians and allied health professionals including physical therapists; 5) we believe the potential to reduce the burden of disability from this injury exists and this may be accomplished with early intervention