Abstract
Intoduction:
Lateral ankle sprains are common soft tissue injuries. The peroneal
nerves are also at risk from ankle sprains. However there is no
evidence to suggest which intervention best augments functional
treatment in the presence of soft tissue and neural dysfunctions. The
purpose of this study was to examine and describe the use and efficacy
of neurodynamic techniques in management of patients with lateral ankle
sprain.
Material
and methods: Thirty athletes with clinical diagnosis
distortion of the talocrural articulation, after inversion sprains were
treated for the period of three years. Patients were randomly divided
into two groups. Group B underwent a traditional physiotherapy
management of these injuries that include ice, active exercises,
strapping and proprioceptive retraining in varying amounts and forms.
Group A underwent a traditional PT program, added with neurodynamic
techniques – ankle plantarflexion/inversion (PFI) and
straight leg raising (SLR). Outcome measures used were the: visual
analogue scale (VAS) scores for ankle pain, ankle range of motion, and
the modified Lower Extremity Functional Scale (LEFS); these were
recorded at baseline, discharge, and 3 months post-discharge. All
patients were treated in physical therapy twice weekly for 4 weeks for
a total of 8 visits.
Results:
Data
recorded from the primary outcome measures, VAS scores and percentage
overall improvement were considered interval level and analyzed with
parametric statistics: repeated measures ANOVA (within group changes)
and the independent t-test (between group changes). No baseline
differences existed between the groups (P>0.05). In a baseline,
we found that, compared to healthy leg, the injured leg showed a
decrease in the painfree range of PFI/SLR in 26 patients (86,7%). It
seems inevitable that with inversion sprains, the peroneal
nerves will be affected either directly or indirectly by pressure from
blood, oedema and compressive taping or plaster casts. Data analysis
showed a significant improvement in pain and disability from baseline
to all follow up points for both group. At discharge, patients who
received neurodynamic techniques demonstrated significantly greater
improvements in disability (32.6 points on the LEFS, P < 0.001),
pain (3.4 points on the VAS, P =0.001), and range of motion (P <
0.01) than patients who did not. These benefits are maintained at a 3
months follow-up.
Conclusions:
The
results demonstrated that both
groups improved with treatment but that additional benefit was achieved
with the addition of neurodynamic techniques to the physiotherapy
programme. 
