Electroacupuncture Combined with Surround Needling for Acute Lateral Ankle Sprain in Adults: A Randomized Controlled Trial
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Qimiao Hu1, Qingzi Cai2, Bonuo Qi2
1Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China.
Objective:
Acute lateral ankle sprain (ALAS) has a high incidence in adults. Improper acute-stage intervention causes prolonged pain, swelling and impaired functional recovery. Conventional ice plus brake rest has limited rehabilitation efficacy. This study investigated the clinical efficacy and safety of electroacupuncture (EA) combined with surround needling for adult ALAS.
Methods:
In this single-center randomized controlled trial, 95 patients aged 18-60 years with ALAS were 1:1:1 randomized to EA+surround needling (n=34), sham EA (n=32) or control (ice+brake rest, n=29) groups. Outcomes were the Kofoed score and musculoskeletal ultrasound, assessed at baseline and weeks 1, 2, 3 and 9. Adverse events were monitored throughout.
Results:
EA improved Kofoed scores more than control or sham EA from week 2 to week 9 (adjusted mean differences 7.8-11.4, 95% CI excluding zero). Kofoed AUC (baseline to week 9, points × week) was greater with EA (675.5, 95% CI 658.3-692.8). AUC differences were 39.51 vs control (95% CI 19.32-59.70) and 24.76 vs sham EA (95% CI 6.05-43.47). EA reduced anterior talofibular ligament thickness more than both groups and calcaneofibular ligament thickness more than control.
Conclusion:
EA combined with surround needling was superior to sham EA and ice plus brake rest in improving ankle function assessed by the Kofoed score and reducing anterior talofibular ligament thickness, and superior to ice plus brake rest in reducing calcaneofibular ligament thickness. However, larger, longer-term trials are needed to verify these findings.