Lateral Ayak Bileği Yaralanmasının Rehabilitasyonunda Kullanılan Ortez Yaklaşımlarının Etkinliği

Lateral ayak bileği bağ yaralanmaları en sık karşılaşılan alt ekstremite yaralanmalarındandır. Genellikle çabuk iyileşen yaralanmalar olarak kabul edilse de etkin tedavi ve korunma stratejileri ile takip edilmeyen hastalar kronik ağrı, tekrarlayan ayak bileği yaralanmaları, talusun osteokondral lezyonları, erken osteoartrit gibi bir takım ilişkili problemler yaşayabilirler. Ayak bileği yaralanmalarının yetersiz tedavisi, işe veya spora dönüş süresini uzatır, fiziksel aktif bireylerin günlük yaşam rollerine katılımını engelleyerek yaşam kalitelerini düşürebilir. Ortezleme, lateral ayak bileği yaralanmasının hem akut evresinde doku iyileşmesine izin vermek ve immobilizasyonu sağlamak, hem de fonksiyonel iyileşme evresinde sıklıkla kullanılmaktadır. Lateral ayak bileği bağ yaralanmalarının rehabilitasyonunda kullanılmak üzere tasarlanmış çok sayıda farklı ayak bileği ortezi vardır. Rehabilitasyonda kanıta dayalı tedavi seçeneklerinin etkinliğinin sağlık profesyonellerince bilinmesi yüksek insidans ve prevalansı ile sağlık sistemi üzerine önemli maliyet oluşturan bu yaralanmaların önlenmesinde büyük önem arz etmektedir. Bu çalışmanın amacı lateral ayak bileği bağ yaralanmasının rehabilitasyonunda sıklıkla kullanılan ortez yaklaşımlarının etkinliğinin derlenmesidir.

Anahtar Kelimeler:

Ayak Bileği Yaralanması, Tedavi Etkinliği, Ortez

Effectiveness of Orthotic Approaches Used in Rehabilitation of Lateral Ankle Sprain

Lateral ankle sprains are among the most common lower extremity injuries. Although lateral ankle sprain is generally considered to be injuries that heal quickly, patients who are not followed up with effective treatment and prevention strategies may experience several related problems such as chronic pain, recurrent sprains, and osteochondral lesions of the talus, and early osteoarthritis. Inadequate treatment of ankle injuries prolongs the time to return to work or sports and may reduce the quality of life of physically active individuals by preventing them from participating in daily life roles. Orthoses are frequently used to allow tissue healing and immobilization in the acute phase of a lateral ankle sprain, as well as in the functional recovery phase. There are many different ankle orthoses designed for use in the rehabilitation of lateral ankle ligament sprains. Knowing the effectiveness of evidence-based treatment options in the rehabilitation of lateral ankle sprain by health professionals is of great importance in the prevention of these sprains, which pose a significant cost to the health system with their high incidence and prevalence. This study aims to review the effectiveness of orthotic approaches that are frequently used in the rehabilitation of lateral ankle ligament sprain.

Keywords:

Ankle Sprains, Treatment Effectiveness, Orthosis,

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1. Hertel J. Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. Vol. 37, Journal of Athletic Training. National Athletic Trainers’ Association Inc.; 2002. p. 364–75.
2. Gribble PA, Bleakley CM, Caulfield BM, Docherty CL, Fourchet F, Fong DTP, et al. Evidence review for the 2016 International Ankle Consortium consensus statement on the prevalence, impact and long-term consequences of lateral ankle sprains. Vol. 50, British Journal of Sports Medicine. BMJ Publishing Group; 2016. p. 1496–505.
3. Fong DTP, Hong Y, Chan LK, Yung PSH, Chan KM. A systematic review on ankle injury and ankle sprain in sports. Vol. 37, Sports Medicine. Adis International Ltd; 2007. p. 73–94.
4. Fong DT, Chan Y-Y, Mok K-M, Yung PS, Chan K-M. Understanding acute ankle ligamentous sprain injury in sports. Sports Med Arthrosc Rehabil Ther Technol. 2009 Dec;1(1).
5. Wright IC, Neptune RR, Van Den Bogert AJ, Nigg BM. The influence of foot positioning on ankle sprains. J Biomech. 2000;33(5):513–9. 6. Van Den Bekerom MPJ, Oostra RJ, Alvarez PG, Van Dijk CN. The anatomy in relation to injury of the lateral collateral ligaments of the ankle: A current concepts review. Vol. 21, Clinical Anatomy. Wiley-Liss Inc.; 2008. p. 619–26.
7. Melanson SW, Shuman VL. Acute Ankle Sprain. Eur J Emerg Med. 2021 Jul 29;18(4):225–30.
8. P. Kannus. Current concepts review. Treatment for acute tears of the lateral ligaments of the ankle. J Bone Jt Surg. 1991;73:305–12.
9. Beynnon BD, Murphy DF, Alosa DM. Predictive factors for lateral ankle sprains: A literature review. J Athl Train. 2002;37(4):376.
10. Herzog MM, Kerr ZY, Marshall SW, Wikstrom EA. Epidemiology of Ankle Sprains and Chronic Ankle Instability. J Athl Train. 2019;54(6):603.
11. Hirose K, Murakami G, Minowa T, Kura H, Yamashita T. Lateral ligament injury of the ankle and associated articular cartilage degeneration in the talocrural joint: anatomic study using elderly cadavers. J Orthop Sci. 2004;9(1):37–43.
12. McCriskin BJ, Cameron KL, Orr JD, Waterman BR. Management and prevention of acute and chronic lateral ankle instability in athletic patient populations. World J Orthop.2015;6(2):161–71. 13. Kobayashi T, Gamada K. Lateral Ankle Sprain and Chronic Ankle Instability: A Critical Review. 2014 Jun 24;7(4):298–326.
14. Renström PAFH, Lynch SA. Ankle ligament injuries. Rev Bras Med do Esporte. 1998 Jun;4(3):71–80.
15. Dubin JC, Comeau D, McClelland RI, Dubin RA, Ferrel E. Lateral and syndesmotic ankle sprain injuries: a narrative literature review. J Chiropr Med. 2011 Sep;10(3):204–19.
16. Miller-Spears, Erica; Kleiber B. Ankle. In: J.M. Daniels, editor. Common Musculoskeletal Problems: A Handbook, Second Edition. Springer; 2015.
17. Czajka CM, Tran E, Cai AN, DiPreta JA. Ankle sprains and instability. Med Clin North Am. 2014 Mar;98(2):313–29.
18. Abdulhameed A, Shaju K. Rehabilitation, Back to Sports and Competition. In: Valderrabano V, Easley ME, editors. Foot and Ankle Sports Orthopaedics. Springer International Publishing; 2016. p. 147–83.
19. Mattacola CG, Dwyer MK. Rehabilitation of the Ankle After Acute Sprain or Chronic Instability. J Athl Train. 2002;37(4):413.
20. Kemler E, Van De Port I, Backx F, Van Dijk CN. A systematic review on the treatment of acute ankle sprain: Brace versus other functional treatment types. Sport Med. 2011 Oct 7;41(3):185–97.
21. Kerkhoffs GM, Rowe BH, Assendelft WJ, Kelly KD, Struijs PA, van Dijk CN. Immobilisation and functional treatment for acute lateral ankle ligament injuries in adults. Cochrane database Syst Rev. 2002 Jul 22;(3).
22. Tiemstra JD. Update on Acute Ankle Sprains. Am Fam Physician.;85(12):1170-6.
23. Vuurberg G, Hoorntje A, Wink LM, Van Der Doelen BFW, Van Den Bekerom MP, Dekker R, et al. Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. Br J Sports Med. 2018 Aug 1;52(15):956.
24. Rome K, Handoll HH, Ashford RL. Interventions for preventing and treating stress fractures and stress reactions of bone of the lower limbs in young adults. Cochrane database Syst Rev. 2005 Apr 20;2005(2).
25. Cordova ML, Ingersoll CD, Palmieri RM. Efficacy of prophylactic ankle support: An experimental perspective. J Athl Train. 2002;37(4):446–57.
26. Dizon JMR, Reyes JJB. A systematic review on the effectiveness of external ankle supports in the prevention of inversion ankle sprains among elite and recreational players. J Sci Med Sport. 2010 May;13(3):309–17.
27. Hume PA, Gerrard DF. Effectiveness of external ankle support. Bracing and taping in rugby union. Sports Med. 1998;25(5):285–312.
28. Simon J, Donahue M. Effect of Ankle Taping or Bracing on Creating an Increased Sense of Confidence, Stability, and Reassurance When Performing a Dynamic-Balance Task. J Sport Rehabil. 2013 Aug 1;22(3):229–33.
29. Hume PA, Gerrard DF. Effectiveness of External Ankle Support. Sport Med 1998 255. 2012 Sep 23;25(5):285–312. 30. Cordova ML, Ingersoll CD, LeBlanc MJ. Influence of ankle support on joint range of motion before and after exercise: a meta-analysis. J Orthop Sports Phys Ther. 2000;30(4):170–82.
31. Nishikawa T, Kurosaka M, Mizuno K, Grabiner M. Protection and performance effects of ankle bracing. Int Orthop. 2000 Jan 1;24(5):285–8.
32. Luu Kyaw S, Moore IS, Oo ML. A Systematic Review on the Effectiveness of Different Functional Treatments for Acute Ankle Sprains. J Sport Med Doping Stud . 2019;9:213.
33. DiStefano LJ, Padua DA, Brown CN, Guskiewicz KM. Lower extremity kinematics and ground reaction forces after prophylactic lace-up ankle bracing. J Athl Train. 2008;43(3):234–41.
34. Sefton JM, Hicks-Little CA, Koceja DM, Cordova ML. Effect of inversion and ankle bracing on peroneus longus Hoffmann reflex. Scand J Med Sci Sports. 2007 Oct 1;17(5):539–46.
35. Kerkhoffs GM, Struijs PA, Marti RK, Assendelft WJ, Blankevoort L, van Dijk CN. Different functional treatment strategies for acute lateral ankle ligament injuries in adults. Cochrane database Syst Rev. 2002 Jul 22;(3).
36. Boyce SH, Quigley MA, Campbell S. Management of ankle sprains: A randomised controlled trial of the treatment of inversion injuries using an elastic support bandage or an aircast ankle brace. Br J Sports Med. 2005 Feb;39(2):91–6.
37. Lamb SE, Marsh JL, Hutton JL, Nakash R, Cooke MW. Mechanical supports for acute, severe ankle sprain: a pragmatic, multicentre, randomised controlled trial. Lancet. 2009;373(9663):575–81.
38. Beynnon BD, Renström PA, Haugh L, Uh BS, Barker H. A prospective, randomized clinical investigation of the treatment of first-time ankle sprains. Am J Sports Med. 2006 Sep ;34(9):1401–12.
39. Tropp H, Askling C, Gillquist J. Prevention of ankle sprains. Am J Sports Med. 1985;13(4):259–62.
40. Guskiewicz KM, Perrin DH. Effect of orthotics on postural sway following inversion ankle sprain. J Orthop Sports Phys Ther. 1996;23(5):326–31.
41. O’Connor SR, Bleakley CM, Tully MA, McDonough SM. Predicting Functional Recovery after Acute Ankle Sprain. PLoS One. 2013 Aug 5;8(8).
42. Janssen KW, Van Mechelen W, Verhagen EALM. Bracing superior to neuromuscular training for the prevention of self-reported recurrent ankle sprains: a three-arm randomised controlled trial. Br J Sports Med. 2014;48(16):1235–9.
43. Barelds I, van den Broek AG, Huisstede BMA. Ankle Bracing is Effective for Primary and Secondary Prevention of Acute Ankle Injuries in Athletes: A Systematic Review and Meta-Analyses. Sports Med. 2018 Dec 1;48(12):2775–84.