Functional and Kinetic Treatment With Rehabilitation Combined With Cryotherapy Compared to Cryotherapy Alone in the Treatment of Acute Grade I or II Inversion Ankle Sprains: A Randomized Clinical Trial

The purpose of this study was to compare Functional and Kinetic Treatment with Rehabilitation (FAKTR) combined with cryotherapy to cryotherapy alone in the treatment of acute grade I or II inversion ankle sprains. This prospective, randomized clinical trial of adult (18-40 years of age) participants (n = 40) with acute grade I or II inversion ankle sprain of less than 3 weeks, who were randomly allocated into a FAKTR and cryotherapy group (n = 20) or a cryotherapy only group (n = 20). The participants had 3 treatments (inclusive of the initial consultation), with a fourth as a measurement follow-up (2 weeks after the third treatment). Measurement procedures were completed at the outset of the first to third consultations and the fourth measurement only consultation. Clinical measures taken by a blinded research assistant included the Numerical Pain Rating Scale, Foot function index, algometer, digital inclinometer for ankle dorsiflexion range of motion measures, the figure-of-8 maneuver measured swelling, and the Stork-Balance-Stand Test. Significant intergroup differences were observed for pain rating (P ≤ .01; 95% confidence interval [CI] –4.74 to 0.86), pain pressure threshold (P ≤ .05; 95% CI –1.06 to 1.52), balance and proprioception (P ≤ .01; 95% CI –5.28 to –1.39), and foot function index (P ≤ .01; 95% CI –30.12 to 4.83). No significant intergroup differences were observed in ankle dorsiflexion range of motion (P = .242; 95% CI –3.17 to 1.20) and edema measurements (P = .602; 95% CI 0.41-1.46). The FAKTR instrument assisted soft tissue mobilization treatment combined with cryotherapy indicated a trend toward greater clinical effectiveness than cryotherapy for measures of pain, pain pressure threshold, balance and proprioception, and foot function index; however, these outcomes were not reflected for ankle dorsiflexion range of motion and edema measurements.