OBJECTIVE:To compare the changes in gait parameters before and after the treatment of lateral ankle sprain using the rotating-pulling-poking manipulation, and explore the potential bio-mechanical mechanism of this man...OBJECTIVE:To compare the changes in gait parameters before and after the treatment of lateral ankle sprain using the rotating-pulling-poking manipulation, and explore the potential bio-mechanical mechanism of this manipulation. METHODS:Forty patients with lateral ankle sprains were randomly divided into two groups in a 1∶1 ratio using a random number table. The experimental group were treated by rotating-pulling-poking manipulation and elastic bandage external fixation, while the control group were treated by ice compress and elastic bandage external fixation. The treatment courses of the two groups were both 2 weeks. We used a three-dimensional motion capture system for kinematic measurements and a Bertec gait analysis force measurement system for mechanical measurements, and compared the changes in gait parameters between the two groups of patients before and after treatment. RESULTS:Intragroup comparison showed that the support time, swing time, peak of back extension, peak of plantar flexion, peak of toe pedal force, and peak of heel landing force of the affected feet in the experimental group were significantly improved compared to those before treatment(P < 0.05). The swing time of the affected feet in the control group was significantly improved compared to that before treatment(P < 0.05). The inter group comparison showed that the gait speed, stride length, peak of back extension, peak of plantar flexion, peak of toe pedal force, and peak of heel landing force of the affected feet in the experimental group were significantly better than those in the control group(P < 0.05). CONCLUSIONS:The rotating-pulling-poking manipulation can effectively improve the patient's gait and range of motion of the affected ankle joint, and enhance the negative gravity in the vertical direction of the affected foot, and the braking and driving forces in the front and back directions. This may be the potential biomechanical mechanism of the rotating-pulling-poking manipulation for treating lateral ankle sprain.展开更多
BACKGROUND Lateral ankle sprains are the most common traumatic musculoskeletal injuries of the lower extremity,with an incidence rate of 15%-20%.The high incidence and prevalence highlights the economic impact of this...BACKGROUND Lateral ankle sprains are the most common traumatic musculoskeletal injuries of the lower extremity,with an incidence rate of 15%-20%.The high incidence and prevalence highlights the economic impact of this injury.Ankle sprains lead to a high socioeconomic burden due to the combination of the high injury incidence and high medical expenses.Up to 40%of patients who suffer from an ankle sprain develop chronic ankle instability.Chronic instability can lead to prolonged periods of pain,immobility and injury recurrence.Identification of factors that influence return to work(RTW)and return to sports(RTS)after a lateral ankle sprain(LAS)may help seriously reduce healthcare costs.AIM To explore which factors may potentially affect RTW and RTS after sustaining an LAS.METHODS EMBASE and PubMed were systematically searched for relevant studies published until June 2023.Inclusion criteria were as follows:(1)Injury including LAS or chronic ankle instability;(2)Described any form of treatment;(3)Assessment of RTW or RTS;(4)Studies published in English;and(5)Study designs including randomized controlled clinical trials,clinical trials or cohort studies.Exclusion criteria were:(1)Studies involving children(age<16 year);or(2)Patients with concomitant ankle injury besides lateral ankle ligament damage.A quality assessment was performed for each of the included studies using established risk of bias tools.Additionally quality of evidence was assessed using the GRADEpro tool in cases where outcomes were included in the quantitative analysis.A best evidence synthesis was performed in cases of qualitative outcome analysis.For all studied outcomes suitable for quantitative analysis a forest plot was created to calculate the effect on RTW and RTS.RESULTS A total of 8904 patients were included in 21 studies,10 randomized controlled trials,7 retrospective cohort studies and 4 prospective cohort studies.Fifteen studies were eligible for meta-analysis.The overall RTS rate ranged were 80%and 83%in the all treatments pool and surgical treatments pool,respectively.The pooled mean days to RTS ranged from 23-93 d.The overall RTW rate was 89%.The pooled mean time to RTW ranged from 5.8-8.1 d.For patients with chronic ankle instability,higher preoperative motivation was the sole factor significantly and independently(P=0.001)associated with the rate of and time to RTS following ligament repair or reconstruction.Higher body mass index was identified as a significant factor(P=0.04)linked to not resuming sports or returning at a lower level(median 24,range 20-37),compared to those who resumed at the same or higher level(median 23,range 17-38).Patients with a history of psychological illness or brain injury,experienced a delay in their rehabilitation process for sprains with fractures and unspecified sprains.The extent of the delayed rehabilitation was directly proportional to the increased likelihood of experiencing a recurrence of the ankle sprain and the number of ankle-related medical visits.We also observed that 10%of athletes who did return to sport after lateral ankle sprain without fractures described non-ankle-related reasons for not returning.CONCLUSION All treatments yielded comparable results,with each treatment potentially offering unique advantages or benefits.Preoperative motivation may influence rehabilitation after LAS.Grading which factor had a greater impact was not possible due to the lack of comparability among the included patients.展开更多
Objective To observe the clinical effect of acupuncture on the obsolete lateral malleolus joint sprain. Methods Thirty-one cases of patients with obsolete lateral malleolus joint sprain were selected. Jiexi （解溪 ST...Objective To observe the clinical effect of acupuncture on the obsolete lateral malleolus joint sprain. Methods Thirty-one cases of patients with obsolete lateral malleolus joint sprain were selected. Jiexi （解溪 ST 41） were penetrated to Shenmei （申脉 BL 61）, and Yanglingquan （阳陵泉 GB 34） was applied. The needles were retained for 30 min, and the treatment was performed only once, with follow-up visit after 1 month. Results All the patients were cured after treatment, and without relapse on the follow-up visit after 1 month. Conclusion The clinical effect of acupuncture on the obsolete lateral malleolus joint sprain is remarkable.展开更多
OBJECTIVE： Several studies have reported that acupuncture is effective for treatment of acute lumbar sprain, but they neglected to consider that acupuncture cannot remarkably improve lumbar activity. We performed a r...OBJECTIVE： Several studies have reported that acupuncture is effective for treatment of acute lumbar sprain, but they neglected to consider that acupuncture cannot remarkably improve lumbar activity. We performed a randomized controlled trial to evaluate the effect of acupuncture-movement therapy versus conventional acupuncture in the trea ment of acute lumbar sprain. METHODS： Sixty patients were randomized into four groups： the acupuncture-movement （AM） group, sham acupuncture-movement （SAM） group, conventional acupuncture （CA） group, and physical therapy （PT） group. Patients in the AM group were treated with acupuncture at Yintang （EX-HN 3） and exercise of the lumbar region during acupuncture. Patients in the SAM group were treated with sham acupuncture at Yintang （EX-HN 3） and exercise of the lumbar region during sham acupuncture. Con- ventional acupuncture was performed in the CA group, and physical therapy was applied in the PT group. Each treatment lasted for 20 min. Patients were assessed before and after treatment using a visual analogue scale （VAS） and the Roland Morris Questionnaire （RMQ）. RESULTS： The VAS and RMQ scores in the AM group were significantly lower after than before treatment （P 〈 0.01）. The AM group reported lower RMQ scores in after-treatment and 24 h after treatment and lower VAS score in 24 h after treatment in comparison with those of the CA, SAM, and PT groups （P 〈 0.05）. CONCULSlON： Acupuncture-movement therapy is effective for treating acute lumbar sprain with a persistent pain-relief and remarkable improvement of lumbar activity. Movement, that is, lumbar exercise during acupuncture, enhances the effect of acupuncture.展开更多
Background:Chronic ankle instability(CAI) is a common sequela following an acute lateral ankle sprain(LAS).To treat an acture LAS more effectively and efficiently,it is important to identify patients at substantial ri...Background:Chronic ankle instability(CAI) is a common sequela following an acute lateral ankle sprain(LAS).To treat an acture LAS more effectively and efficiently,it is important to identify patients at substantial risk for developing CAI.This study identifies magnetic resonance imaging(MRI) manifestations for predicting CAI development after a first episode of LAS and explores appropriate clinical indications for ordering MRI scans for these patients.Methods:All patients with a first-episode LAS who received plain radiograph and MRI scanning within the first 2 weeks after LAS from December 1,2017 to December 1,2019 were identified.Data were collected using the Cumberland Ankle Instability Tool at final follow-up.Demographic and other related clinical variables,including age,sex,body mass index,and treatment were also recorded.Univariable and multivariable analyses were performed successively to identify risk factors for CAI after first-episode LAS.Results:A total 131 out of 362 patients with a mean follow-up of 3.0± 0.6 years(mean ± SD;2.0—4.1 years) developed CAI after first-episode LAS.According to multivariable regression,development of CAI after first-episode LAS was associated with 5 prognostic factors:age(odds ratio(OR)=0.96,95% confidence interval(95%CI):0.93-1.00,p=0.032);body mass index(OR=1.09,95%CI:1.02-1.17,p=0.009);posterior talofibular ligament injury(OR=2.17,95%CI:1.05-4.48,p=0.035);large bone marrow lesion of the talus(OR=2.69,95%CI:1.30-5.58,p=0.008),and Grade 2 effusion of the tibiotalar joint(OR=2.61,95%CI:1.39-4.89,p=0.003).When patients had at least 1 positive clinical finding in the 10-m walk test,anterior drawer test,or inversion tilt test,they had a 90.2% sensitivity and 77.4% specificity in terms of detecting at least 1 prognostic factor by MRI.Conclusion:MRI scanning is valuable in predicting CAI after first-episode LAS for those patients with at least 1 positive clinical finding in the10-m walk test,anterior drawer test,and inversion tilt test.Further prospective and large-scale studies are necessary for validation.展开更多
Acute ankle sprain is the most common lower limb injury in athletes and accounts for 16%-40%of all sports-related injuries.It is especially common in basketball,American football,and soccer.The majority of sprains aff...Acute ankle sprain is the most common lower limb injury in athletes and accounts for 16%-40%of all sports-related injuries.It is especially common in basketball,American football,and soccer.The majority of sprains affect the lateral ligaments,particularly the anterior talofibular ligament.Despite its high prevalence,a high proportion of patients experience persistent residual symptoms and injury recurrence.A detailed history and proper physical examination are diagnostic cornerstones.Imaging is not indicated for the majority of ankle sprain cases and should be requested according to the Ottawa ankle rules.Several interventions have been recommended in the management of acute ankle sprains including rest,ice,compression,and elevation,analgesic and anti-inflammatory medications,bracing and immobilization,early weight-bearing and walking aids,foot orthoses,manual therapy,exercise therapy,electrophysical modalities and surgery(only in selected refractory cases).Among these interventions,exercise and bracing have been recommended with a higher level of evidence and should be incorporated in the rehabilitation process.An exercise program should be comprehensive and progressive including the range of motion,stretching,strengthening,neuromuscular,proprioceptive,and sport-specific exercises.Decision-making regarding return to the sport in athletes may be challenging and a sports physician should determine this based on the self-reported variables,manual tests for stability,and functional performance testing.There are some common myths and mistakes in the management of ankle sprains,which all clinicians should be aware of and avoid.These include excessive imaging,unwarranted non-weightbearing,unjustified immobilization,delay in functional movements,and inadequate rehabilitation.The application of an evidence-based algorithmic approach considering the individual characteristics is helpful and should be recommended.展开更多
OBJECTIVE:To observe the effect of electroacupuncture(EA) on force-displacement value(FDV)of muscle state and the temperature index of infrared thermogram in patients with acute lumbar muscle sprain.METHODS:Patients w...OBJECTIVE:To observe the effect of electroacupuncture(EA) on force-displacement value(FDV)of muscle state and the temperature index of infrared thermogram in patients with acute lumbar muscle sprain.METHODS:Patients with acute lumbar muscle sprain were randomly divided into a medication group and an EA group.The medication group(n-60) were treated with diclofenac sodium dual release enteric-coated capsules,75 mg per day for 7days.The EA group(n = 60) received EA at bilateral Houxi(SI 3),Jiaji(EX-B2),and Ashi points,at 20-30 mm depth and 10-25 Hz frequency for 20 min daily for 7 days.Muscle states were determined by measuring FDVs of the bilateral lumbar muscle with a Myotonometer fast muscle state detector.The temperature index of the lumbar skin was measured before and after treatment with a Fluke Ti30 non-refrigerated focal plane infrared thermal imaging detector.RESULTS:There were no significant pre-treatment differences between the medication group and the EA group in mean FDV(P = 0.052) or temperature index of the lumbar skin(P = 0.25).The cure rate was 63.3%in the EA group and 53.3%in the medication group.The total efficacy in the EA group(93.3%) was not significantly different from that in the medication group(86.6%,P = 0.204).After treatment,the mean FDV of the lumbar muscle significantly increased in both groups(P < 0.05 for both groups);the FDV increase in the EA group was significantly higher than in the medication group(P = 0.015).The temperature index was also significantly increased in both groups(P < 0.05 for both groups);the infrared thermogram in the EA group indicated significantly greater recovery compared to the medication group(P = 0.026).CONCLUSION:Both EA and diclofenac sodium markedly improved acute lumbar sprain,but EA better improved the rehabilitation and regeneration of FDVs and temperature index of infrared thermogram of the muscle.展开更多
Acute lumbar sprain is commonly encountered among the young and middle-aged. It often occurs at the lower part of the back, which seriously hinders the daily life and work of the patients because of the severe pain. T...Acute lumbar sprain is commonly encountered among the young and middle-aged. It often occurs at the lower part of the back, which seriously hinders the daily life and work of the patients because of the severe pain. The author has treated 43 cases of acute lumbar sprain by needling Weizhong (BL 40), Houxi (SI 3) and Yaotongdian (EX-UE7) plus kinesitherapy and obtained satisfactory therapeutic results. A report follows.展开更多
In recent years, the authors have treated 30 cases of acute lumbar sprain by acupuncture combined with point medicinal injection at Tianzhu (BL 10), and obtained quite good therapeutic results, as is reported in the f...In recent years, the authors have treated 30 cases of acute lumbar sprain by acupuncture combined with point medicinal injection at Tianzhu (BL 10), and obtained quite good therapeutic results, as is reported in the following.展开更多
Objective: To observe clinical therapeutic effects of electroacupuncture plus point-penetration for chronic ankle joint sprain. Methods: 76 patients were randomly divided into treatment group (n=43) and control group ...Objective: To observe clinical therapeutic effects of electroacupuncture plus point-penetration for chronic ankle joint sprain. Methods: 76 patients were randomly divided into treatment group (n=43) and control group (n=33).In teatment group, penetration needling from Qiuxu (丘墟 GB 40) to Zhaohai (照海 KI 6) was performed, combined with electrical stimulation for 30 min. Patients of control group were ordered to take Antinfan (50 mg,b.i.d.),supplemented with local external application of Votalin cream (b.i.d.).After 14 treatments (two courses), the therapeutic effect was assessed. Results: Following two courses of treatment, of the 43 cases and 33 cases in treatment and control groups,33 (76.7%) and 15 (45.5%) were cured, 4 (9.3%) and 7 (21.2%) had marked improvement in their symptoms, 3 (7.0%) and 2 (6.1%) had improvement, and 3 (7.0%) and 9(27.3%) failed, with the effective rates being 93.0% and 72.7% respectively. The therapeutic effect of treatment group was significantly superior to that of control group (P<0.05). Conclusion: Penetrative needling plus EA is significantly superior to medication in relieving chronic ankle spain patient’s clinical symptoms and signs.展开更多
In the present paper,70 cases of acute sprain of soft tissue were treated withacupuncture at pressure pain points on the lateral of the second metacarpal bone.Results showedthat the cure rate was 58.6％ and the total ...In the present paper,70 cases of acute sprain of soft tissue were treated withacupuncture at pressure pain points on the lateral of the second metacarpal bone.Results showedthat the cure rate was 58.6％ and the total effective rate was 94.3％.Also,its mechanisms werestudied preliminarily.The present therapy is simple,convenient,easy to operate and it producesrapidly desired effects with a higher cure rate,so it is suited to be popularized clinically.展开更多
In the present paper,30 cases of acute lumbar sprain are treated with finger pressuretherapy and moxibustion therapy.Results show that 21 cases are cured,4 markedly effective and 5effctive.This combined treatment has ...In the present paper,30 cases of acute lumbar sprain are treated with finger pressuretherapy and moxibustion therapy.Results show that 21 cases are cured,4 markedly effective and 5effctive.This combined treatment has no sufferings to the patient,is safe,simple and easy to be ac-cepted by patients.展开更多
Background:Lateral ankle sprain is the most common musculoskeletal injury.Although clinical research in this field is growing,there is a broader concern that clinical trial outcomes are often false and fail to transla...Background:Lateral ankle sprain is the most common musculoskeletal injury.Although clinical research in this field is growing,there is a broader concern that clinical trial outcomes are often false and fail to translate into patient benefits.Methods:We audited 30 years of experimental research related to lateral ankle sprain management(n=74 randomized controlled trials)to determine if reports of treatment effectiveness could be validated beyond statistical certainty.Results:A total of 77%of trials reported positive treatment effects,but there was a high risk of false discovery.Most trials were unregistered and relied solely on statistical significance,or lack of statistical significance,rather than on interpreting key measures of minimum clinical importance(e.g.,minimal detectable change,minimal clinically important difference).Conclusion:Future clinical trials must adopt higher standards of reporting and data interpretation.This includes consideration of the ethical responsibility to preregister their research and interpretation of clinical outcomes beyond statistical significance.展开更多
Objective To observe the clinical effect of relaxing needling combined with paired needling in the treatment of acute lumbar sprain.Methods Fifty cases with acute lumbar sprain were treated with relaxing needling in c...Objective To observe the clinical effect of relaxing needling combined with paired needling in the treatment of acute lumbar sprain.Methods Fifty cases with acute lumbar sprain were treated with relaxing needling in combination with paired needling for 30 min each time and once everyday,7 times made one course.The clinical effect was observed after one course.Results Thirty-two cases were cured,15 cases were improved,and 3 cases were ineffective.The total effective rate was 94.0%.Conclusion Relaxing needling in combination with paired needling has remarkable effect in the treatment of acute lumbar sprain as the treatment can obviously alleviate pain and restore the functional movement of lumbar region.展开更多
BACKGROUND Orthopedic physicians typically apply a cast to immobilize a body part that has been injured.There have been no significant structural changes or advances in synthetic casts since the development of the mod...BACKGROUND Orthopedic physicians typically apply a cast to immobilize a body part that has been injured.There have been no significant structural changes or advances in synthetic casts since the development of the modern cast.The Opencast®is a recently developed type of cast that allows ventilation and direct visual inspection of the skin to avoid cast-related complications.Although this novel cast appears to have more benefits than the conventional synthetic cast,its clinical efficacy and advantages have not been established.AIM To investigate the clinical efficacy and advantages of the newly developed Opencast®based on patients’perspectives in those with ankle inversion injury.METHODS A specifically designed questionnaire consisting of 19 items was used to compare patients’opinions and concerns of the Opencast®and the conventional synthetic cast.The items were focused on subjective patient satisfaction,discomfort,and adverse effects while wearing the cast.Patients with an ankle inversion injury diagnosed as a high-grade ankle sprain were enrolled.The subjects were randomized and instructed to fill the questionnaire after wearing a synthetic cast or an Opencast®for 2 wk.They were then required to fill the questionnaire again,after switching to the alternative type of cast for 2 more weeks.RESULTS A total of 22 subjects participated in the study.The synthetic cast appeared to be more rigid and stable than the Opencast®,but there was no significant difference in the amount of pain relief.The likelihood of adverse effects when wearing the synthetic cast was significantly higher.Patient satisfaction tended to be rated higher after wearing the Opencast®.Opencast®showed more subjective vulnerability than the synthetic cast,but there was no significant difference in the redo rate.Patients were more anxious about removal of the synthetic cast than of the Opencast®.CONCLUSION The results indicate that the Opencast®could replace the conventional synthetic cast as it offers increased patient satisfaction,which would in turn increase compliance to treatment.展开更多
Acute waist sprain is a local injury of themuscle, fascia and ligament in the waist due tosudden overstretch by external force beyond thenormal physiological limit. Acute waist spraincan lead to cicatrix adhesion, los...Acute waist sprain is a local injury of themuscle, fascia and ligament in the waist due tosudden overstretch by external force beyond thenormal physiological limit. Acute waist spraincan lead to cicatrix adhesion, loss of normal tis-sue function and chronic waist pathologicalchanges without timely and effecthe treatment.Long time treatment without cure will affectboth work and daily life.展开更多
Objective: this experiment briefly analyzes the understanding and treatment of ankle sprain in the department of orthopedics and traumatology of traditional Chinese medicine. Methods: five years from May 2020 to May 2...Objective: this experiment briefly analyzes the understanding and treatment of ankle sprain in the department of orthopedics and traumatology of traditional Chinese medicine. Methods: five years from May 2020 to May 2021 were selected as the time points, and the years from 2020 to 2021 were recent years. Therefore, the research results are more time-sensitive and referential. From the patients received in the hospital during this period of time, 68 cases of study subjects with medication standard were selected and randomly divided into the control group and the experimental group with 34 patients in each group. The patients in the control group were treated with traditional Chinese medicine, while the patients in the experimental group were treated with massage. After the experiment, the therapeutic effect, recovery time of ankle sprain and patients' satisfaction with the treatment were compared between the two groups. Results: the effective rate of treatment in the experimental group was as high as 94.1%, while that in the control group was only 82.3%, the difference was statistically significant (p < 0.05). In addition, the patients in the experimental group were 94.1% satisfied with the treatment, while the patients in the control group were 79.4% satisfied with the treatment. The patients in the experimental group were more satisfied with the treatment. Conclusion: according to the results of the experiment, it can be seen that the therapeutic effect of the traditional Chinese medicine massage combined with traditional Chinese medicine application is better than the conventional treatment, which can not only shorten the treatment time, speed up the recovery of the patients, but also increase the satisfaction of the patients.展开更多
Objective: to explore the clinical application value of new cattle horn can in the treatment of acute lumbar sprain. Methods: From May 2020 to August 2020, 62 patients with acute lumbar sprain received treatment in ou...Objective: to explore the clinical application value of new cattle horn can in the treatment of acute lumbar sprain. Methods: From May 2020 to August 2020, 62 patients with acute lumbar sprain received treatment in our hospital were collected as study subjects and divided into two groups. The patients in the control group were treated with orthopedic routine treatment. While the patients in the observation group were treated with new cattle horn can to compare the clinical effect of the two groups. Results: The scores of VAS (2.25±0.74) in observation group were significantly lower than those in control group (4.32±1.63). The score of Barthel index (82.33±6.59) in the observation group was significantly higher than that in the control group (64.26±7.54). The effective rate of clinical treatment in the observation group (88.10%) was significantly higher than that in the control group (67.74%). The difference was statistically significant (P<0.05). Conclusion: The clinical effect of new cattle horn can in the treatment of acute lumbar sprain is accurate, which can significantly improve the effective rate of clinical treatment, and improve the VAS score and Barthel index score of patients at the same time, which is worthy of clinical promotion.展开更多
Objective: To present a case of a rodeo cowboy who suffered a seemingly routine 1st degree acromioclavicular (AC) sprain. The AC sprain was exacerbated by an elevated 1st rib. Background: Saddle bronc riding is one of...Objective: To present a case of a rodeo cowboy who suffered a seemingly routine 1st degree acromioclavicular (AC) sprain. The AC sprain was exacerbated by an elevated 1st rib. Background: Saddle bronc riding is one of three rough stock events in North American rodeo and the least common event for injury relative to bull riding and bareback riding. Shoulder injury in rodeo rough stock events make up 9.3% of all injuries. Approximately 28% of injuries in rodeo are considered minor sprains. The professional cowboy was thrown from his horse landing on the tip of his shoulder. The cowboy presented with a routine 1st degree AC sprain based on the Tossey and Rockwood definitions. Differential Diagnosis: Due to the mechanism of injury and forces produced with the cowboy being thrown to the ground, elimination of serious neck injury was critical. A scanning examination revealed some neck dysfunction. A cervical rotation, lateral flexion special test confirmed the additional elevated 1st rib in addition to the 1st degree AC sprain. Treatment: A chiropractic adjustment of the 1st rib reduced pain in the AC joint from a 6/10 to 1/10 immediately. Subsequently, the patient iced and was treated with one other 1st rib adjustment at a later date. Uniqueness: There were no cases of 1st degree AC sprains with an associated elevated first rib in the literature. It was very unique to relieve to the patient’s shoulder symptoms so dramatically in a short period of time with manual therapy to the first rib. Conclusions: It is important to follow a thorough history and physical examination of patients who suffer from a 1st degree AC sprain. The use of a scanning examination will help identify the primary source of pain (i.e. neck and/or shoulder). Manual therapy of the 1st rib may be useful in the treatment.展开更多
基金the National Traditional Chinese Medicine Inheritance and Innovation Team Project:Traditional Chinese Medicine Innovation Team for Prevention and Treatment of Bone and Joint Degenerative Diseases (No. ZYYCXTD-C-202003)National Natural Science Foundation of China:the study on the Quantification and Mechanism of the rotating-pulling-poking manipulation in the Treatment of Lateral Ankle Sprain (No. 81473694)China Academy of Chinese Medical Sciences Science and Technology Innovation Project:Establishment and Promotion of a Simulation Operation Evaluation System for Rotating-pulling-poking Manipulation (CI2021A02015)。
文摘OBJECTIVE:To compare the changes in gait parameters before and after the treatment of lateral ankle sprain using the rotating-pulling-poking manipulation, and explore the potential bio-mechanical mechanism of this manipulation. METHODS:Forty patients with lateral ankle sprains were randomly divided into two groups in a 1∶1 ratio using a random number table. The experimental group were treated by rotating-pulling-poking manipulation and elastic bandage external fixation, while the control group were treated by ice compress and elastic bandage external fixation. The treatment courses of the two groups were both 2 weeks. We used a three-dimensional motion capture system for kinematic measurements and a Bertec gait analysis force measurement system for mechanical measurements, and compared the changes in gait parameters between the two groups of patients before and after treatment. RESULTS:Intragroup comparison showed that the support time, swing time, peak of back extension, peak of plantar flexion, peak of toe pedal force, and peak of heel landing force of the affected feet in the experimental group were significantly improved compared to those before treatment(P < 0.05). The swing time of the affected feet in the control group was significantly improved compared to that before treatment(P < 0.05). The inter group comparison showed that the gait speed, stride length, peak of back extension, peak of plantar flexion, peak of toe pedal force, and peak of heel landing force of the affected feet in the experimental group were significantly better than those in the control group(P < 0.05). CONCLUSIONS:The rotating-pulling-poking manipulation can effectively improve the patient's gait and range of motion of the affected ankle joint, and enhance the negative gravity in the vertical direction of the affected foot, and the braking and driving forces in the front and back directions. This may be the potential biomechanical mechanism of the rotating-pulling-poking manipulation for treating lateral ankle sprain.
文摘BACKGROUND Lateral ankle sprains are the most common traumatic musculoskeletal injuries of the lower extremity,with an incidence rate of 15%-20%.The high incidence and prevalence highlights the economic impact of this injury.Ankle sprains lead to a high socioeconomic burden due to the combination of the high injury incidence and high medical expenses.Up to 40%of patients who suffer from an ankle sprain develop chronic ankle instability.Chronic instability can lead to prolonged periods of pain,immobility and injury recurrence.Identification of factors that influence return to work(RTW)and return to sports(RTS)after a lateral ankle sprain(LAS)may help seriously reduce healthcare costs.AIM To explore which factors may potentially affect RTW and RTS after sustaining an LAS.METHODS EMBASE and PubMed were systematically searched for relevant studies published until June 2023.Inclusion criteria were as follows:(1)Injury including LAS or chronic ankle instability;(2)Described any form of treatment;(3)Assessment of RTW or RTS;(4)Studies published in English;and(5)Study designs including randomized controlled clinical trials,clinical trials or cohort studies.Exclusion criteria were:(1)Studies involving children(age<16 year);or(2)Patients with concomitant ankle injury besides lateral ankle ligament damage.A quality assessment was performed for each of the included studies using established risk of bias tools.Additionally quality of evidence was assessed using the GRADEpro tool in cases where outcomes were included in the quantitative analysis.A best evidence synthesis was performed in cases of qualitative outcome analysis.For all studied outcomes suitable for quantitative analysis a forest plot was created to calculate the effect on RTW and RTS.RESULTS A total of 8904 patients were included in 21 studies,10 randomized controlled trials,7 retrospective cohort studies and 4 prospective cohort studies.Fifteen studies were eligible for meta-analysis.The overall RTS rate ranged were 80%and 83%in the all treatments pool and surgical treatments pool,respectively.The pooled mean days to RTS ranged from 23-93 d.The overall RTW rate was 89%.The pooled mean time to RTW ranged from 5.8-8.1 d.For patients with chronic ankle instability,higher preoperative motivation was the sole factor significantly and independently(P=0.001)associated with the rate of and time to RTS following ligament repair or reconstruction.Higher body mass index was identified as a significant factor(P=0.04)linked to not resuming sports or returning at a lower level(median 24,range 20-37),compared to those who resumed at the same or higher level(median 23,range 17-38).Patients with a history of psychological illness or brain injury,experienced a delay in their rehabilitation process for sprains with fractures and unspecified sprains.The extent of the delayed rehabilitation was directly proportional to the increased likelihood of experiencing a recurrence of the ankle sprain and the number of ankle-related medical visits.We also observed that 10%of athletes who did return to sport after lateral ankle sprain without fractures described non-ankle-related reasons for not returning.CONCLUSION All treatments yielded comparable results,with each treatment potentially offering unique advantages or benefits.Preoperative motivation may influence rehabilitation after LAS.Grading which factor had a greater impact was not possible due to the lack of comparability among the included patients.
文摘Objective To observe the clinical effect of acupuncture on the obsolete lateral malleolus joint sprain. Methods Thirty-one cases of patients with obsolete lateral malleolus joint sprain were selected. Jiexi （解溪 ST 41） were penetrated to Shenmei （申脉 BL 61）, and Yanglingquan （阳陵泉 GB 34） was applied. The needles were retained for 30 min, and the treatment was performed only once, with follow-up visit after 1 month. Results All the patients were cured after treatment, and without relapse on the follow-up visit after 1 month. Conclusion The clinical effect of acupuncture on the obsolete lateral malleolus joint sprain is remarkable.
基金Supported by Study the mechanism based on the p38MAPK signal pathway mediated by Cautery moxibustion therapy of Hui medicine treatment IDD(The National Natural Science Foundation of China,No.81360567)Evaluation of different moxibustion doses for low back pain:a randomized controlled clinical trial of moxibustion therapy on CV4(Ningxia Natural Science Foundation,No.NZ11208)
文摘OBJECTIVE： Several studies have reported that acupuncture is effective for treatment of acute lumbar sprain, but they neglected to consider that acupuncture cannot remarkably improve lumbar activity. We performed a randomized controlled trial to evaluate the effect of acupuncture-movement therapy versus conventional acupuncture in the trea ment of acute lumbar sprain. METHODS： Sixty patients were randomized into four groups： the acupuncture-movement （AM） group, sham acupuncture-movement （SAM） group, conventional acupuncture （CA） group, and physical therapy （PT） group. Patients in the AM group were treated with acupuncture at Yintang （EX-HN 3） and exercise of the lumbar region during acupuncture. Patients in the SAM group were treated with sham acupuncture at Yintang （EX-HN 3） and exercise of the lumbar region during sham acupuncture. Con- ventional acupuncture was performed in the CA group, and physical therapy was applied in the PT group. Each treatment lasted for 20 min. Patients were assessed before and after treatment using a visual analogue scale （VAS） and the Roland Morris Questionnaire （RMQ）. RESULTS： The VAS and RMQ scores in the AM group were significantly lower after than before treatment （P 〈 0.01）. The AM group reported lower RMQ scores in after-treatment and 24 h after treatment and lower VAS score in 24 h after treatment in comparison with those of the CA, SAM, and PT groups （P 〈 0.05）. CONCULSlON： Acupuncture-movement therapy is effective for treating acute lumbar sprain with a persistent pain-relief and remarkable improvement of lumbar activity. Movement, that is, lumbar exercise during acupuncture, enhances the effect of acupuncture.
基金supported by the Biomedicine Supporting Program of Shanghai "Science and Technology Innovation Plan" (19441902400)the Ningxia Hui Autonomous Region Key R&D program (2020BCH01001)+1 种基金the Shanghai "Science and Technology Innovation Action Plan" Domestic Science and Technology Cooperation Project (20025800200)the Clinical Research Program of Shanghai Municipal Health Commission (201940367)。
文摘Background:Chronic ankle instability(CAI) is a common sequela following an acute lateral ankle sprain(LAS).To treat an acture LAS more effectively and efficiently,it is important to identify patients at substantial risk for developing CAI.This study identifies magnetic resonance imaging(MRI) manifestations for predicting CAI development after a first episode of LAS and explores appropriate clinical indications for ordering MRI scans for these patients.Methods:All patients with a first-episode LAS who received plain radiograph and MRI scanning within the first 2 weeks after LAS from December 1,2017 to December 1,2019 were identified.Data were collected using the Cumberland Ankle Instability Tool at final follow-up.Demographic and other related clinical variables,including age,sex,body mass index,and treatment were also recorded.Univariable and multivariable analyses were performed successively to identify risk factors for CAI after first-episode LAS.Results:A total 131 out of 362 patients with a mean follow-up of 3.0± 0.6 years(mean ± SD;2.0—4.1 years) developed CAI after first-episode LAS.According to multivariable regression,development of CAI after first-episode LAS was associated with 5 prognostic factors:age(odds ratio(OR)=0.96,95% confidence interval(95%CI):0.93-1.00,p=0.032);body mass index(OR=1.09,95%CI:1.02-1.17,p=0.009);posterior talofibular ligament injury(OR=2.17,95%CI:1.05-4.48,p=0.035);large bone marrow lesion of the talus(OR=2.69,95%CI:1.30-5.58,p=0.008),and Grade 2 effusion of the tibiotalar joint(OR=2.61,95%CI:1.39-4.89,p=0.003).When patients had at least 1 positive clinical finding in the 10-m walk test,anterior drawer test,or inversion tilt test,they had a 90.2% sensitivity and 77.4% specificity in terms of detecting at least 1 prognostic factor by MRI.Conclusion:MRI scanning is valuable in predicting CAI after first-episode LAS for those patients with at least 1 positive clinical finding in the10-m walk test,anterior drawer test,and inversion tilt test.Further prospective and large-scale studies are necessary for validation.
文摘Acute ankle sprain is the most common lower limb injury in athletes and accounts for 16%-40%of all sports-related injuries.It is especially common in basketball,American football,and soccer.The majority of sprains affect the lateral ligaments,particularly the anterior talofibular ligament.Despite its high prevalence,a high proportion of patients experience persistent residual symptoms and injury recurrence.A detailed history and proper physical examination are diagnostic cornerstones.Imaging is not indicated for the majority of ankle sprain cases and should be requested according to the Ottawa ankle rules.Several interventions have been recommended in the management of acute ankle sprains including rest,ice,compression,and elevation,analgesic and anti-inflammatory medications,bracing and immobilization,early weight-bearing and walking aids,foot orthoses,manual therapy,exercise therapy,electrophysical modalities and surgery(only in selected refractory cases).Among these interventions,exercise and bracing have been recommended with a higher level of evidence and should be incorporated in the rehabilitation process.An exercise program should be comprehensive and progressive including the range of motion,stretching,strengthening,neuromuscular,proprioceptive,and sport-specific exercises.Decision-making regarding return to the sport in athletes may be challenging and a sports physician should determine this based on the self-reported variables,manual tests for stability,and functional performance testing.There are some common myths and mistakes in the management of ankle sprains,which all clinicians should be aware of and avoid.These include excessive imaging,unwarranted non-weightbearing,unjustified immobilization,delay in functional movements,and inadequate rehabilitation.The application of an evidence-based algorithmic approach considering the individual characteristics is helpful and should be recommended.
基金Supported by the Study on the Clinical Curative Effect and Standardization of Acupuncture and Tuina Treatment of Acute Lumbar Sprain from the Projects of Science and Technology Commission of Shanghai Municipality(No.10DZ1974700)the Clinical Research on Acupuncture and Tuina Treatment of Acute Lumbar Sprain Scheme Optimization and Rehabilitation Evaluation from Shanghai Municipal Health Bureau(No.2010QL035A)+2 种基金the Research on the Spreading Appropriate Technology of TCM in Shanghai(No.2010G007A)the Study on the Inheritance of Lushi Acupuncture about Shanghai Traditional Chinese Medicine Schools(No.ZYSNXD-CC-HPGC-JD-004)the Program of TCM Personnel Training in Shanghai(No.ZY3-RCPY-2-2034)
文摘OBJECTIVE:To observe the effect of electroacupuncture(EA) on force-displacement value(FDV)of muscle state and the temperature index of infrared thermogram in patients with acute lumbar muscle sprain.METHODS:Patients with acute lumbar muscle sprain were randomly divided into a medication group and an EA group.The medication group(n-60) were treated with diclofenac sodium dual release enteric-coated capsules,75 mg per day for 7days.The EA group(n = 60) received EA at bilateral Houxi(SI 3),Jiaji(EX-B2),and Ashi points,at 20-30 mm depth and 10-25 Hz frequency for 20 min daily for 7 days.Muscle states were determined by measuring FDVs of the bilateral lumbar muscle with a Myotonometer fast muscle state detector.The temperature index of the lumbar skin was measured before and after treatment with a Fluke Ti30 non-refrigerated focal plane infrared thermal imaging detector.RESULTS:There were no significant pre-treatment differences between the medication group and the EA group in mean FDV(P = 0.052) or temperature index of the lumbar skin(P = 0.25).The cure rate was 63.3%in the EA group and 53.3%in the medication group.The total efficacy in the EA group(93.3%) was not significantly different from that in the medication group(86.6%,P = 0.204).After treatment,the mean FDV of the lumbar muscle significantly increased in both groups(P < 0.05 for both groups);the FDV increase in the EA group was significantly higher than in the medication group(P = 0.015).The temperature index was also significantly increased in both groups(P < 0.05 for both groups);the infrared thermogram in the EA group indicated significantly greater recovery compared to the medication group(P = 0.026).CONCLUSION:Both EA and diclofenac sodium markedly improved acute lumbar sprain,but EA better improved the rehabilitation and regeneration of FDVs and temperature index of infrared thermogram of the muscle.
文摘Acute lumbar sprain is commonly encountered among the young and middle-aged. It often occurs at the lower part of the back, which seriously hinders the daily life and work of the patients because of the severe pain. The author has treated 43 cases of acute lumbar sprain by needling Weizhong (BL 40), Houxi (SI 3) and Yaotongdian (EX-UE7) plus kinesitherapy and obtained satisfactory therapeutic results. A report follows.
文摘In recent years, the authors have treated 30 cases of acute lumbar sprain by acupuncture combined with point medicinal injection at Tianzhu (BL 10), and obtained quite good therapeutic results, as is reported in the following.
文摘Objective: To observe clinical therapeutic effects of electroacupuncture plus point-penetration for chronic ankle joint sprain. Methods: 76 patients were randomly divided into treatment group (n=43) and control group (n=33).In teatment group, penetration needling from Qiuxu (丘墟 GB 40) to Zhaohai (照海 KI 6) was performed, combined with electrical stimulation for 30 min. Patients of control group were ordered to take Antinfan (50 mg,b.i.d.),supplemented with local external application of Votalin cream (b.i.d.).After 14 treatments (two courses), the therapeutic effect was assessed. Results: Following two courses of treatment, of the 43 cases and 33 cases in treatment and control groups,33 (76.7%) and 15 (45.5%) were cured, 4 (9.3%) and 7 (21.2%) had marked improvement in their symptoms, 3 (7.0%) and 2 (6.1%) had improvement, and 3 (7.0%) and 9(27.3%) failed, with the effective rates being 93.0% and 72.7% respectively. The therapeutic effect of treatment group was significantly superior to that of control group (P<0.05). Conclusion: Penetrative needling plus EA is significantly superior to medication in relieving chronic ankle spain patient’s clinical symptoms and signs.
文摘In the present paper,70 cases of acute sprain of soft tissue were treated withacupuncture at pressure pain points on the lateral of the second metacarpal bone.Results showedthat the cure rate was 58.6％ and the total effective rate was 94.3％.Also,its mechanisms werestudied preliminarily.The present therapy is simple,convenient,easy to operate and it producesrapidly desired effects with a higher cure rate,so it is suited to be popularized clinically.
文摘In the present paper,30 cases of acute lumbar sprain are treated with finger pressuretherapy and moxibustion therapy.Results show that 21 cases are cured,4 markedly effective and 5effctive.This combined treatment has no sufferings to the patient,is safe,simple and easy to be ac-cepted by patients.
文摘Background:Lateral ankle sprain is the most common musculoskeletal injury.Although clinical research in this field is growing,there is a broader concern that clinical trial outcomes are often false and fail to translate into patient benefits.Methods:We audited 30 years of experimental research related to lateral ankle sprain management(n=74 randomized controlled trials)to determine if reports of treatment effectiveness could be validated beyond statistical certainty.Results:A total of 77%of trials reported positive treatment effects,but there was a high risk of false discovery.Most trials were unregistered and relied solely on statistical significance,or lack of statistical significance,rather than on interpreting key measures of minimum clinical importance(e.g.,minimal detectable change,minimal clinically important difference).Conclusion:Future clinical trials must adopt higher standards of reporting and data interpretation.This includes consideration of the ethical responsibility to preregister their research and interpretation of clinical outcomes beyond statistical significance.
文摘Objective To observe the clinical effect of relaxing needling combined with paired needling in the treatment of acute lumbar sprain.Methods Fifty cases with acute lumbar sprain were treated with relaxing needling in combination with paired needling for 30 min each time and once everyday,7 times made one course.The clinical effect was observed after one course.Results Thirty-two cases were cured,15 cases were improved,and 3 cases were ineffective.The total effective rate was 94.0%.Conclusion Relaxing needling in combination with paired needling has remarkable effect in the treatment of acute lumbar sprain as the treatment can obviously alleviate pain and restore the functional movement of lumbar region.
文摘BACKGROUND Orthopedic physicians typically apply a cast to immobilize a body part that has been injured.There have been no significant structural changes or advances in synthetic casts since the development of the modern cast.The Opencast®is a recently developed type of cast that allows ventilation and direct visual inspection of the skin to avoid cast-related complications.Although this novel cast appears to have more benefits than the conventional synthetic cast,its clinical efficacy and advantages have not been established.AIM To investigate the clinical efficacy and advantages of the newly developed Opencast®based on patients’perspectives in those with ankle inversion injury.METHODS A specifically designed questionnaire consisting of 19 items was used to compare patients’opinions and concerns of the Opencast®and the conventional synthetic cast.The items were focused on subjective patient satisfaction,discomfort,and adverse effects while wearing the cast.Patients with an ankle inversion injury diagnosed as a high-grade ankle sprain were enrolled.The subjects were randomized and instructed to fill the questionnaire after wearing a synthetic cast or an Opencast®for 2 wk.They were then required to fill the questionnaire again,after switching to the alternative type of cast for 2 more weeks.RESULTS A total of 22 subjects participated in the study.The synthetic cast appeared to be more rigid and stable than the Opencast®,but there was no significant difference in the amount of pain relief.The likelihood of adverse effects when wearing the synthetic cast was significantly higher.Patient satisfaction tended to be rated higher after wearing the Opencast®.Opencast®showed more subjective vulnerability than the synthetic cast,but there was no significant difference in the redo rate.Patients were more anxious about removal of the synthetic cast than of the Opencast®.CONCLUSION The results indicate that the Opencast®could replace the conventional synthetic cast as it offers increased patient satisfaction,which would in turn increase compliance to treatment.
文摘Acute waist sprain is a local injury of themuscle, fascia and ligament in the waist due tosudden overstretch by external force beyond thenormal physiological limit. Acute waist spraincan lead to cicatrix adhesion, loss of normal tis-sue function and chronic waist pathologicalchanges without timely and effecthe treatment.Long time treatment without cure will affectboth work and daily life.
文摘Objective: this experiment briefly analyzes the understanding and treatment of ankle sprain in the department of orthopedics and traumatology of traditional Chinese medicine. Methods: five years from May 2020 to May 2021 were selected as the time points, and the years from 2020 to 2021 were recent years. Therefore, the research results are more time-sensitive and referential. From the patients received in the hospital during this period of time, 68 cases of study subjects with medication standard were selected and randomly divided into the control group and the experimental group with 34 patients in each group. The patients in the control group were treated with traditional Chinese medicine, while the patients in the experimental group were treated with massage. After the experiment, the therapeutic effect, recovery time of ankle sprain and patients' satisfaction with the treatment were compared between the two groups. Results: the effective rate of treatment in the experimental group was as high as 94.1%, while that in the control group was only 82.3%, the difference was statistically significant (p < 0.05). In addition, the patients in the experimental group were 94.1% satisfied with the treatment, while the patients in the control group were 79.4% satisfied with the treatment. The patients in the experimental group were more satisfied with the treatment. Conclusion: according to the results of the experiment, it can be seen that the therapeutic effect of the traditional Chinese medicine massage combined with traditional Chinese medicine application is better than the conventional treatment, which can not only shorten the treatment time, speed up the recovery of the patients, but also increase the satisfaction of the patients.
文摘Objective: to explore the clinical application value of new cattle horn can in the treatment of acute lumbar sprain. Methods: From May 2020 to August 2020, 62 patients with acute lumbar sprain received treatment in our hospital were collected as study subjects and divided into two groups. The patients in the control group were treated with orthopedic routine treatment. While the patients in the observation group were treated with new cattle horn can to compare the clinical effect of the two groups. Results: The scores of VAS (2.25±0.74) in observation group were significantly lower than those in control group (4.32±1.63). The score of Barthel index (82.33±6.59) in the observation group was significantly higher than that in the control group (64.26±7.54). The effective rate of clinical treatment in the observation group (88.10%) was significantly higher than that in the control group (67.74%). The difference was statistically significant (P<0.05). Conclusion: The clinical effect of new cattle horn can in the treatment of acute lumbar sprain is accurate, which can significantly improve the effective rate of clinical treatment, and improve the VAS score and Barthel index score of patients at the same time, which is worthy of clinical promotion.
文摘Objective: To present a case of a rodeo cowboy who suffered a seemingly routine 1st degree acromioclavicular (AC) sprain. The AC sprain was exacerbated by an elevated 1st rib. Background: Saddle bronc riding is one of three rough stock events in North American rodeo and the least common event for injury relative to bull riding and bareback riding. Shoulder injury in rodeo rough stock events make up 9.3% of all injuries. Approximately 28% of injuries in rodeo are considered minor sprains. The professional cowboy was thrown from his horse landing on the tip of his shoulder. The cowboy presented with a routine 1st degree AC sprain based on the Tossey and Rockwood definitions. Differential Diagnosis: Due to the mechanism of injury and forces produced with the cowboy being thrown to the ground, elimination of serious neck injury was critical. A scanning examination revealed some neck dysfunction. A cervical rotation, lateral flexion special test confirmed the additional elevated 1st rib in addition to the 1st degree AC sprain. Treatment: A chiropractic adjustment of the 1st rib reduced pain in the AC joint from a 6/10 to 1/10 immediately. Subsequently, the patient iced and was treated with one other 1st rib adjustment at a later date. Uniqueness: There were no cases of 1st degree AC sprains with an associated elevated first rib in the literature. It was very unique to relieve to the patient’s shoulder symptoms so dramatically in a short period of time with manual therapy to the first rib. Conclusions: It is important to follow a thorough history and physical examination of patients who suffer from a 1st degree AC sprain. The use of a scanning examination will help identify the primary source of pain (i.e. neck and/or shoulder). Manual therapy of the 1st rib may be useful in the treatment.
