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Elevation: Retarding edema formation in the acute lateral ankle sprain

Abstract

Purpose of the Study: Ankle sprains are among the most common musculoskeletal injuries among athletes and are associated with all five signs of acute inflammation: redness, warmth, pain, edema, and loss of function. In the acute management of ankle sprains the current standard of care is to apply a treatment often referred to as R.I.C.E.(rest, ice, compression, and elevation). The elevation portion of this treatment is used in an attempt to retard edema formation. However, the efficacy of elevation in retarding edema formation following acute injury is unknown. It is unclear whether elevation plays any therapeutic role in acute injury management. Therefore, the purpose of this study is to determine whether elevation retards the formation of edema following the acute lateral ankle sprain. Research Method: Subjects are male and female varsity athletes from The Ohio State University who are within one hour of sustaining a lateral ankle sprain that will result in a loss of participation time. Subjects are randomly assigned to either the experimental group (standard care but elevation not used) or the control group (standard care including elevation). A figure-of-eight girth measurement of the injured ankle is used to assess ankle size and serve as a representation of ankle edema. The initial post-injury measurement will serve as a baseline for measurements repeated at twenty-four, forty-eight, and seventy-two hours post injury. This clinical trial was approved by the OSU Biomedical Sciences IRB, and subjects provide written informed consent prior to participating. Findings: No subjects were admitted to this clinical trial. Discussion: The following factors contributed to the inability to obtain subjects and data: specific population, short time period, rigorous inclusion criteria of injury, and possible cultural hesitance of practitioners to enroll their patients. Conclusions: Clinical research trials, such as this study, are critical to the development of the athletic training profession and to serve the best interests of the patient. Despite the difficulty in conducting clinical research trials, it is important that athletic trainers continue to attempt these studies aimed at obtaining valuable clinical evidence on the day-to-day practice of patient care. Advisor: Mark A. Merric

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