| Objective: Acute ankle sprains are a common and frequent clinical condition with a high recurrence rate.For the management of post-sprain injuries,the use of new injury medicine is beneficial for promoting blood circulation and reducing swelling and pain.;the Mulligan technique aims to improve joint position,adjust fascial tension,and alleviate pain and functional impairment through dynamic joint mobilization.This study aimed to investigate the clinical efficacy of combining new injury medicine and Mulligan technique in the treatment of acute ankle sprain,the improvement in clinical outcomes(local skin temperature,pain,swelling,ROM and function of the ankle joint)in the two groups was observed through multiple time points of assessment and to explore whether there is a synergistic effect of this combination therapy on clinical outcomes.The ultimate goal is to optimize the treatment of acute ankle sprain and provide a theoretical basis for its clinical application.Methods: The 24 patients were randomly divided into two groups: new wound drug external application combined with Mulligan group(experimental group)and Mulligan group(control group),with 12 patients in each group.Both groups received POLICE principle within 72 hours after sprain.And both groups received Mulligan technique treatment once every other day in the first week,and then three times a week for three weeks.The experimental group also received new injury medicine externally applied every other day for 5days,until swelling and pain significantly reduced.At the treatment day(before treatment),and at day 3,5,7,10,14,and 28 after treatment,the temperature difference between the injured and healthy sides,visual analog scale(VAS)score,degree of swelling,range of motion(ROM)of the ankle joint in various directions,and the Ankle-Hindfoot Assessment Tool(AOFAS)score were measured.After one week and one month of treatment,the balance ability and proprioception of the ankle joint were evaluated.The data were analyzed using SPSS 22.0 statistical software,and P<0.05 was considered statistically significant.Result:The results of the repeated measures ANOVA showed that there was a significant time effect(P<0.05)for each indicator in both groups,i.e.each indicator improved significantly with time;there was a significant interaction effect(P<0.05)for skin temperature difference,VAS score,swelling,dorsal extension,inversion,ectropion ROM and AOFAS score in both groups,i.e.the fluctuations in the trend of change were not identical in both groups.A simple effects analysis yielded:1.skin temperature difference: the skin temperature difference on the healthy side of the experimental group was significantly lower than that of the control group on days 3,5 and 7 after the start of treatment(P<0.05);the magnitude of change in skin temperature difference on the healthy side of the two groups decreased significantly at all time points within 7 days after treatment(P<0.05),and there was no significant difference in the changes at the next time points(P>0.05).2.VAS score: VAS score was significantly lower in the experimental group than in the control group on days 3 and 5 after starting treatment(P<0.05);there was no significant decrease in the change in VAS score in both groups on day 10 compared to day 7 after treatment(P>0.05),and a significant decrease in the change at all other time points(P<0.05).3.Swelling: the swelling in the experimental group was significantly lower than that in the control group on days 3,5,7 and 10 after treatment(P<0.05);the change in swelling in both groups was significantly lower in the experimental group at all time points up to 10 days after treatment(P<0.05)and in the control group at all time points up to 2 weeks after treatment(P<0.05),with the two groups next There was no significant difference in the changes at each time point between the two groups(P>0.05).4.ROM: Dorsal extension ROM was significantly higher in the experimental group than in the control group on day 7 after treatment(P<0.05),internal rotation ROM was significantly higher in the experimental group than in the control group on days 7 and 10 after treatment(P<0.05),and plantar flexion and external rotation ROM were not significantly different at any time point after treatment(P>0.05).In the control group,there was a significant increase in the change in ROM in all directions at all time points up to 7 days after treatment(P<0.05),and no significant increase in the change at the next time points(P>0.05);in the control group,there was a significant increase in the change in ROM in plantarflexion,dorsiflexion and valgus at all time points up to 10 days after treatment(P<0.05),and inversion ROM in the control group at all time points up to 2 weeks after treatment(P< 0.05),with no significant increase in change at each subsequent time point(P>0.05).5.AOFAS scores: AOFAS scores were significantly higher in the experimental group than in the control group at day 10 and 2 weeks post-treatment(P<0.05);there was a significant increase in the change in AOFAS scores at all time points post-treatment in both groups(P<0.05).In addition,balance and proprioceptive abilities improved significantly in both groups at the end of 4 weeks of treatment compared to pre-treatment(P<0.05),but there was no significant difference between the two groups after 4 weeks of treatment(P>0.05).After 2 weeks of treatment,the total effective rate was 100% in the experimental group and 83.3% in the control group;after 4 weeks of treatment,the total clinical effective rate was 100% in both groups,and there was no statistically significant difference between the clinical efficacy of the two groups after 4 weeks and 2 weeks of treatment(P>0.05).Conclusion:1.Topical application of new injury medicine combined with the Mulligan technique for the treatment of acute ankle sprains has a certain superimposed effect,showing significant clearing and anti-inflammatory,swelling and pain relief in the early and middle stages(around 0-7d)after the sprain;significant improvement in ROM takes an average of 7 days;significant recovery of the overall function of the ankle joint takes about 10 days.2.After 4 weeks of intervention,both the new injury medicine topical application combined with the Mulligan technique and the Mulligan technique had good therapeutic effects on patients with acute ankle sprains.The new injury medicine topical application combined with the Mulligan technique group had a better overall efficiency than the Mulligan technique group after 2 weeks of treatment,and the overall efficiency of the two groups was the same after 4 weeks of treatment. |
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