Does Neuromuscular Electrical Stimulation Improve Recovery Following Acute Ankle Sprain? A Pilot Randomised Controlled Trial

Abstract

Aim: Following soft tissue ankle injury, patients are often referred for out-patient physiotherapy and present symptoms including pain, reduced range of movement and function, and oedema. In this study, we assess the use of a neuromuscular electrical stimulation (NMES) device as an adjunctive therapy to reduce oedema in patients recovering from grade I and II ankle sprains. Methods: This was a single-centre, pilot randomised controlled study, recruiting patients referred to physiotherapy following an ankle sprain. Participants presenting with oedema were randomised to one of two treatment groups: (1) the current standard of care and (2) the current standard of care plus NMES use. Participants were identified in an emergency department and referred to a physiotherapy department for treatment 1 to 5 days following the injury and returned to clinic 7 days later. Results: Twenty-two participants completed the study and had full data sets for analysis (11 in each group). Mean volumetric displacement was reduced in the intervention group in comparison to the standard care group ( P = .011); however, there were no between-group differences in figure of eight measurements, function or pain scores. The device was well tolerated, with no device-related adverse events recorded. Conclusions: In this pilot, randomised controlled trial, NMES was well tolerated by patients following ankle sprain and demonstrated statistically significant improvements in oedema reduction as measured by fluid displacement. No other changes were observed. Further work will need to confirm the clinical significance and effect on longer term recovery post-ankle sprain.

The comparison of the effects of neuromuscular electrical stimulation and Kinesio Taping on ankle swelling in athletes with lateral ankle sprain

“…This mechanism can be considered the main factor in reducing swelling due to increased venous pressure and its ineffectiveness in swelling due to increased capillary permeability. Our results also contrast with those of the study by Wainwright et al [ 24 ], in which edema (as measured by fluid displacement) was statistically significantly reduced in patients with ankle sprains who received the current standard of care plus NMES use compared with the current standard of care only. However, consistent with our results, they showed no differences in ankle perimetry (recording figure of eight values) between groups.…”

A Comprehensive Injury Review: Lateral Ankle Sprain

“…In the acute phases of ankle injuries, electrical stimulation, cryotherapy, and Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) are common adjuncts to POLICE. Electrical stimulation can control edema because it reduces capillary permeability and inhibits edema formation, thereby affecting the rate of normal function recovery [18]. Cryotherapy can reduce nerve conduction velocity, resulting in cutaneous analgesia, the elimination of edema formation, and a decrease in metabolic activity and secondary injury [19].…”

Measures of Foot Pain, Foot Function, and General Foot Health

“…The FAAM has been used as an outcome measure in clinical trials of ankle injuries , plantar heel pain , taping for exercise‐related leg pain , and edema in patients with ankle/hindfoot fractures .…”