Table 3.
Effect Size With 95% Confidence Interval for Improved Ankle Dorsiflexion After 1 Dose or Multiple Doses of Therapeutic Interventions
| Study |
Intervention |
Effect of 1 Dose (95% Confidence Interval) |
Effect of Multiple Doses (95% Confidence Interval) |
| Acute ankle sprain | |||
| Green et al31,a | Passive joint mobilization | Session 1: 0.45 (−0.20, 1.08) | 2 Sessions: 1.28 (0.55, 1.96)b,c |
| Session 2: 0.19 (−0.47, 0.84) | 3 Sessions: 1.63 (0.81, 2.36)b,c | ||
| Session 3: 0.11 (−0.61, 0.83) | 4 Sessions: 1.49 (0.44, 2.44)b,c | ||
| Session 4: 0.37 (−0.80, 1.48) | 5 Sessions: 1.71 (0.47, 2.83)b,c | ||
| Session 5: 0.09 (−1.31, 1.46) | |||
| Control (rest, ice, compression, and elevation) | Session 1: 0.09 (−0.55, 0.73) | 2 Sessions: 0.76 (0.09, 1.40)c | |
| Session 2: 0.21 (−0.43, 0.84) | 3 Sessions: 0.95 (0.26, 1.60)b,c | ||
| Session 3: −0.13 (−0.76, 0.51) | 4 Sessions: 1.11 (0.37, 1.80)b,c | ||
| Session 4: −0.17 (−0.86, 0.53) | 5 Sessions: 1.65 (0.76, 2.45)b,c | ||
| Session 5: 0.27 (−0.58, 1.10) | |||
| Sandoval et al32 | High-voltage pulsed-current electrical stimulation (+) and conventional treatmentd | NA | 0.35 (−0.66, 1.31) |
| High-voltage pulsed-current electrical stimulation (−) and conventional treatmentd | NA | 0.94 (−0.02, 1.82) | |
| Conventional treatmentd only | NA | 0.81 (−0.13, 1.69) | |
| Borromeo et al33 | Hyperbaric oxygen therapy and standardized treatmentse | 0.46 (−0.26, 1.15) | 1.32 (0.53, 2.05)b |
| Air and standardized treatmentse | 0.50 (−0.21, 1.19) | 1.22 (0.44, 1.94)b | |
| Peer et al36 | Biomechanical muscle stimulation | 0.52 (−0.79, 1.72) | NA |
| Rest, ice, compression, and elevation | −0.05 (−1.28, 1.20) | NA | |
| Youdas et al34 | Static stretching for 30 s and home exercise programf | NA | 1.36 (0.12, 2.42)b |
| Static stretching for 1 min and home exercise programf | NA | 1.86 (0.60, 2.91)b | |
| Static stretching for 2 min and home exercise programf | NA | 1.99 (0.60, 3.10)b | |
| Christakou et al35 | Relaxation and imagery program and physiotherapy programg | NA | 1.22 (0.16, 2.16)b |
| Physiotherapy programg only | NA | 1.27 (0.20, 2.21)b | |
| Subacute ankle sprain | |||
| Collins et al30 | Weight-bearing movement with mobilization | 0.38 (−0.32, 1.07) | NA |
| Placebo | 0.05 (−0.65, 0.74) | NA | |
| Control | −0.06 (−0.75, 0.64) | NA | |
| Recurrent ankle sprain | |||
| Reid et al28 | Weight-bearing movement with mobilization | 0.15 (−0.44, 0.72) | NA |
| Sham mobilization | 0.05 (−0.53, 0.62) | NA | |
| Vicenzino et al29 | Weight-bearing movement with mobilization | 0.39 (−0.32, 1.08) | NA |
| Nonweight-bearing movement with mobilization | 0.29 (−0.41, 0.98) | NA | |
| Control | 0.13 (−0.57, 0.82) | NA | |
Abbreviation: NA indicates not applicable.
The authors performed 6 sessions of the interventions for each group; however, only 1 patient received passive oscillatory joint mobilization in the last session. Therefore, we could not calculate the effect size and 95% confidence interval because of the lack of mean and standard deviation.
Indicates large effect size with 95% confidence interval that did not cross zero.
Indicates effect size was calculated from baseline measurement before the first session to measurement immediately after each session.
Conventional treatment included crushed ice bag for 20 min with elevation and isometric and resisted active exercises in all degrees of freedom at the ankle joint until the limits of pain without weight bearing.
Standardized treatment programs included naproxen; rest, ice, compression, and elevation; range-of-motion and strength exercises; and proprioceptive training.
The home exercise program included active ankle range of motion; active resistive exercise to the affected ankle in all planes; proprioceptive training; and rest, ice, compression, and elevation.
Physiotherapy program included hydromassage, ultrasound, a laser device, range-of-motion exercises, strengthening exercises, proprioceptive training, cycling on a stationary bicycle, forward lunges against a wall, step-ups and step-downs, diagonal hops, and stretching exercises.