Predicting short-term response to thrust and nonthrust manipulation and exercise in patients post inversion ankle sprain.

Whitman JM, Cleland JA, Mintken PE, Keirns MA, Bieniek ML, Albin SR, Magel JS, McPoil TG

The objective of this study was to develop a clinical prediction rule (CPR) to identify patients who had sustained an inversion ankle sprain who would likely benefit from manual therapy and exercise. Consecutive patients with a status of post inversion ankle sprain underwent a standardized examination followed by manual therapy (both thrust and nonthrust manipulation) and general mobility exercises. Patients were classified as having experienced a successful outcome at the second and third sessions based on their perceived recovery. Eighty-five patients were included in the data analysis, of which 64 had a successful outcome (75%). A CPR with 4 variables was identified. If 3 of the 4 variables were present the accuracy of the rule was maximized and the posttest probability of success increased to 95%.

The CPR presented provides the ability to a priori identify patients with an inversion ankle sprain who are likely to exhibit rapid and dramatic short-term success with a treatment approach, including manual therapy and general mobility exercises.

J Orthop Sports Phys Ther. 2009, 39(3), 188-200

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