Optimizing Ankle Sprain Management in Primary Care: A Randomized Trial of Telerehabilitation Added to Usual Care

Ankle sprains (AS) are among the most common musculoskeletal injuries, with physical rehabilitation being a cornerstone of treatment. Telerehabilitation has emerged as an effective alternative for managing various musculoskeletal conditions; however, evidence supporting its use specifically for AS remains limited. This study aimed to evaluate whether the addition of structured telerehabilitation to usual care (UC) improves functional recovery in patients with grade I-II AS more effectively than UC alone in a primary care setting.

Eighty-two participants were randomized into two groups (41 each): 1) Intervention group (IG): UC (standard primary care management) plus a four-week telerehabilitation program (30-minute daily exercises, five days/week) delivered via a digital platform with pre-recorded videos; Control group (CG): UC only. The primary outcome was ankle functionality measured using the Foot and Ankle Ability Measure (FAAM), including subscales for activities of daily living (FAAM-ADL) and sports (FAAM-Sports). Secondary outcomes included pain perception and work disability days.

At four weeks, the IG demonstrated superior outcomes; at functionality, mean between-group differences favored the IG (FAAM-ADL: +8.3 points [95% CI 3.8-12.7]; FAAM-Sports: +13.4 points (6.7-20)). Pain: Significant reduction in VAS scores for grade II AS only (-0.9 points (-1.5 to -0.4)). Subgroup analysis: Clinically meaningful improvements in functionality were observed for both grades, but pain reduction was significant only in grade II AS. Grade I AS showed improvement limited to FAAM-Sports.

Telerehabilitation, as an adjunct to UC, significantly enhances functional recovery in AS, with particularly pronounced effects in grade II (moderate) sprains. However, pain reduction exhibits grade-dependent variability. These findings support incorporating telerehabilitation into primary care management protocols for AS.