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Functional management of ankle sprains: what volume and intensity of walking is undertaken in the first week postinjury
  1. Mark A Tully1,2,
  2. Chris M Bleakley1,
  3. Sean R O'Connor1,
  4. Suzanne M McDonough1
  1. 1Health and Rehabilitation Sciences Research Institute, School of Health Sciences, University of Ulster, Jordanstown, UK
  2. 2UKCRC Centre of Excellence for Public Health (NI), Queen's University Belfast, Belfast, UK
  1. Correspondence to Mark A Tully, UKCRC Centre of Excellence for Public Health (NI), Queen's University Belfast, Room 02020, Institute of Clinical Science B Royal Victoria Hospital, Belfast BT12 6BJ, UK; m.tully{at}


Background Acute ankle sprains are usually managed functionally, with advice to undertake progressive weight-bearing and walking. Mechanical loading is an important modular of tissue repair; therefore, the clinical effectiveness of walking after ankle sprain may be dose dependent. The intensity, magnitude and duration of load associated with current functional treatments for ankle sprain are unclear.

Aim To describe physical activity (PA) in the first week after ankle sprain and to compare results with a healthy control group.

Methods Participants (16–65 years) with an acute ankle sprain were randomised into two groups (standard or exercise). Both groups were advised to apply ice and compression, and walk within the limits of pain. The exercise group undertook additional therapeutic exercises. PA was measured using an activPAL accelerometer, worn for 7 days after injury. Comparisons were made with a non-injured control group.

Results The standard group were significantly less active (1.2±0.4 h activity/day; 5621±2294 steps/day) than the exercise (1.7±0.7 h/day, p=0.04; 7886±3075 steps/day, p=0.03) and non-injured control groups (1.7±0.4 h/day, p=0.02; 8844±2185 steps/day, p=0.002). Also, compared with the non-injured control group, the standard and exercise groups spent less time in moderate (38.3±12.7 min/day vs 14.5±11.4 min/day, p=0.001 and 22.5±15.9 min/day, p=0.003) and high-intensity activity (4.1±6.9 min/day vs 0.1±0.1 min/day, p=0.001 and 0.62±1.0 min/day p=0.005).

Conclusion PA patterns are reduced in the first week after ankle sprain, which is partly ameliorated with addition of therapeutic exercises. This study represents the first step towards developing evidence-based walking prescription after acute ankle sprain.

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  • Funding This trial was funded by grants from the Physiotherapy Research Foundation and Strategic Priority Fund (Department of Employment and Learning, Northern Ireland). Dr Tully is currently funded by the Centre of Excellence for Public Health (Northern Ireland), a UKCRC Public Health Research Centre of Excellence.

  • Competing interests None.

  • Ethics approval Office for Research Ethics Committees (Northern Ireland).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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