SOURCE: Moseley AM, et al. Rehabilitation after immobilization for ankle fracture: The EXACT Randomized Clinical Trial. JAMA 2015;314:1376-1385.
Ankle fracture is a very common injury afflicting persons of all ages and degrees of athleticism. After initial healing, some persons have availed themselves of a program of physical therapy (PT), anticipating improved functional outcome as a result. In the face of remarkably limited data confirming the efficacy of PT after healed ankle fracture, Moseley et al performed a randomized, controlled trial of an intensive program of PT vs simple advice alone for adults who had had immobilization casts removed subsequent to healed ankle fracture. Researchers followed up with study subjects at 1, 3, and 6 months after engagement into treatment arms.
Participants randomized to a supervised exercise program administered by physical therapists did not enjoy any greater degree of improved mobility or quality of life than subjects simply given a single session discussion of education about return to activity and a brochure with pictures describing some exercise activities they might perform.
Quality of life and functional activity outcomes did not differ between the two groups at the conclusion of the trial. The lack of efficacy of PT was similar across subgroups, including gender, age, and fracture severity. After successful healing of an ankle fracture, a program of supervised PT does not appear to improve outcomes.
After successful healing of an ankle fracture, a program of supervised physical therapy does not appear to improve outcomes.
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