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应用弹性绷带和IPC对急性踝扭伤的治疗.doc

1、应用弹性绷带和 IPC 对急性踝扭伤的治疗Elastic Bandages and Intermittent PneumaticCompression for Treatment of Acute Ankle SprainsOlavi Airaksinen, MD, Pertti J. Kolari, MSc, Hannu Miettinen, MDABSTRACT. Airaksinen O, Kolari P J, Miettinen It: Elastic bandages and intermittent pneumatic compression for treatment of a

2、cute ankle sprains. Arch Phys Med Rehabil 71:380-383, 1990. The efficacy of elastic bandage alone and with intermittent pneumatic compression (IPC) treatments in the rehabilitation of 44 acute ankle sprains was studied. Lower-leg dysfunction was assessed by measurements of edema, degree of ankle mot

3、ion, pain, and limb dysfunction when the patient was first included in the study, after treatment for one week, and after a four-week follow-up. For all the parameters studied, elastic bandage with IPC treatment resulted in highly significantly (p0.001) faster rehabilitation during the four-week fol

4、low-up than did elastic bandage treatment alone. The limb dysfunction improved significantly (p0.01) during the follow-up on the study group receiving IPC with elastic bandage compared to elastic bandage alone. The results suggest that IPC treatment is effective in acute posttraumatic therapy.KEY WO

5、RDS: Ankle; Edema; PainInversion ankle sprains are among the most common injuries seen in physically active people, and typically occur when the foot is stressed in a plantar-flexed and inverted position.1-3 Early mobilization is recognized as an effective method of treatment for lateral ankle ligam

6、ent tears.4-6 Therapy often includes use of elastic bandages together with early mobilization.Intermittent pneumatic compression (IPC) has been used to treat lymphatic and vascular disorders for more than 40 years. In previous studies we have found that IPC was effective in reducing chronic posttrau

7、matic edema and in relieving pain after removal of a cast. Starkey successfully used IPC and cold packs to treat acute ankle sprains; however, the efficacy of IPC in such therapy has not been well studied. The aim of this study was to evaluate conservative elastic bandage treatment alone and with IP

8、C therapy for the rehabilitation of acute ankle sprains. A novel pulsatile IPC system was used for therapy? Measurements of lower-leg edema, the degree of ankle motion, subjective assessments of pain, and limb function were used as evaluation criteria.MATERIAL AND METHODSAnkle sprain was defined as

9、a lesion resulting from an inverting injury, with edema and pain at the lateral ankle joint but with no fractures apart from small avulsions. The patients were examined by a surgeon, and x-ray pictures were taken to evaluate for talar tilt and ligament stability. The criteria for acceptance into the

10、 control or study group were (1) injury that had occurred not more than 24 hours earlier; (2) no other acute or chronic immobilizing lesion; (3) no combined clinical adduction instability; (4) age 15 to 50 years; (5) consent to come for the follow-up examination; and (6) no other treatment. All subj

11、ects in our study had a stable ankle sprain involving marked edema and dysfunction.From the Department of PM Kuopio, Finland. This study was sponsored by the Research and Science Foundatopn of Farmos, Turku, Finland.Submitted for publication November11, 1988. Accepted in revised form July 15, 1989.T

12、he authors have chosen not to select a disclosure statement.Reprint requests to Dr. Airaksinen, Department of PM 1:3-12.2. Balduini FC, Vegso JJ, Torg JS, Torg E. Management and re-habilitation Of ligamentous injuries to the ankle. Sports Med 1987;4:364-80.3. Jackson DW, Ashley RL, Powell JW. Ankle

13、sprains in young athletes. Clin Ortop 1974;101:201-15.4. Brooks SC, Potter BT, Rainey JB. Treatment for partial tears of the lateral ligament of the ankle. A prospective trial. Br Med J 1981 ;282:606-7.5. Nilsson S. Sprains of the lateral ankle ligaments. Part II. A ACUTE ANKLE SPRAINS, Airaksinen c

14、ontrolled trial of different forms of conservative treatment. J aslo City ltosp 1983;33:13-36.Prins JG. Diagnosis and treatment of injury to the lateral ligaments of the ankle. A comparative clinical study. Acta Chir Scand 1978;Supply486:3-149.7. Linde F, Hvass l, Jurgensen U, Madsen F. Compression

15、bandage in the treatment of ankle sprains. Scand J Rehabil Med 1984;16:177-9.8. Linde F, Hvass l, Jurgensen U, Madsen F. Early mobilizing treatment in lateral ankle sprains. Scand J Rehabil Med 1986;18:17-21.9. Airaksinen O, Kolari P J, Herve R, Holopainen R. Treatment of post-traumatic oedema in lo

16、wer legs using intermittent pneumatic compression. Scand J Rehabil Meal 1988;20:25-8.10. Dillon RS. Treatment of resistant venous stasis ulcers and dermatitis with the end:diastolic pneumatic compression boot. Angiology 1986;37:47-56.11. Godal R, Swedborg I. A correction for the natural asymmetry of

17、 the arms in the determination of the volume of oedema. Scand J Rehabil Med 1982;14:193-5.12. Airaksinen O. Changes in posttraumatic ankle joint mobility, pain, and oedema following intermittent pneumatic compression therapy. Arch Phys Med Rehabil 1989;70:341-.4.13. Starkey JA. Treatment of ankle sp

18、rains by simultaneous use of intermittent compression and ice packs. Am J Sports Med 1976;4:142-4.14. Pekanmaki K, Kolari PJ. Sequential and graded intermittent pneumatic compression device for treatment of swollen limbs. Biomed Tech (Berlin) 1987;32:50-4.15. Price DD, McGrath PA, Rafii A, Buckingha

19、m B. The validation of visual analogue scale as ratio scale measures for chronic and expcrimental pain. Pain 1983;17:45-56.16. Lentner C, cd. Gcigy Scientific Tables. 8th ed. Basic, Switz-erland: Ciba-Geigy, 1982;2.17. Badger CMA, Mortimer PS, Regnard CFB, Twycross RG. Pain in the chronically swolle

20、n limbs. In: Partsch H, ed. Progress in lymphology -Xl. Amsterdam: Elsevier Science Publishers,1988:243-6.18. Matsen FA, Krugmire RB. The effect of externally applied pres-sure on post-fracture swelling. J Bone Joint Surg 1974;56A: 1586-91.19. Airaksinen O, Kolari PJ, Ahonen E. Effect of intermitten

21、t pneu-matic compression (vcntipress) on post-traumatic oedema and venous outflow, In: Partsch H, ed. Progress in lymphology-Xl. Amsterdam: Elsevier Science Publishers, 1988:579-82.20. Morey KR, Watson AH. Team approach to treatment of post-traumatic stiff hand. A case report. Phys Ther 1986;66:225-

22、8.21. Zoltan JD. Treatment of ankle sprains with joint aspiration, xy-locaine infiltration and early mobilization. J Trauma 1977;17:93-5.22. kester AA. Management of sprained ankles. A double blind study.Practitioner 1981;225:935-36.23. Kolari PJ, Pekanmaki K. Effects of intermittent compression tre

23、atment on skin perfusion and oxygenation in lower legs with venous ulcers. VASA 1987;16:312-7. Suppliersa. Beiersdorf AG, Aliothstrasse 40, 4142 Munchenstein, Hamburg, West Germany. b. Ventipress Ltd, Norokatu 5, PL 5, 15211 Lahti, Lahti, Finland.c. Rehab Producter AB, Svctsarv Y, 17183 Solna Stockholm, Sweden.

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