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Ankle pump exercises do not produce clinically meaningful benefits in oedema, pain, functionality or mobility after
Guilherme S Nunes1, Bruna Batista Da Cas2, Andreza Evaldt de Lima2
1Department of Physiotherapy and Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil; Postgraduate Program in Movement Sciences and Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil.
Background:
Inadequate resolution of inflammation following ankle sprain may contribute to persistent pain and chronic instability. However, the effectiveness of active interventions, such as ankle pump exercises, during the acute phase remains uncertain.
Objective:
To investigate whether ankle pump exercises provide additional benefit when added to usual care in the management of acute ankle sprain.
Methods:
This randomised controlled trial included 88 individuals with acute ankle sprain. Both groups received usual care based on the protection, optimal load, ice, compression, and elevation protocol. Participants in the experimental group additionally performed ankle pump exercises. Primary outcomes were oedema, assessed using the figure-of-eight ankle perimetry method; pain, assessed using a visual analog scale; and function, assessed using the Foot and Ankle Ability Measure (daily living and sports subscales). Outcomes were assessed at baseline, 5 days post-intervention, and 15 days post-intervention.
Results:
After 5 days of intervention, the experimental group demonstrated a greater reduction in ankle oedema than the control group (mean difference -1.2 cm, 95% CI -2.2; -0.2). This between-group difference was not evident at 15-day follow-up (mean difference -0.9 cm, 95% CI -1.9; 0.1). No between-group differences were observed for pain, ankle range of motion, or function at any time point.
Conclusion:
Our findings indicate that adding ankle pump exercises to usual care produced a statistically significant but small short-term reduction in oedema compared to usual care alone, unlikely to be clinically meaningful. No benefits were observed in pain, mobility, or function, and no between-group differences were observed at the 15-day follow-up.
