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Man Ther. 2015 Oct;20(5):633-45. doi: 10.1016/j.math.2015.03.012. Epub 2015 Mar 28.

The effectiveness of exercise on recovery and clinical outcomes of soft tissue injuries of the leg, ankle, and foot: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration.

Author information

1
Division of Graduate Studies, Canadian Memorial Chiropractic College, 6100 Leslie St., Toronto, Ontario M2H 3J1, Canada.
2
UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario M2H 3J1, Canada; Division of Clinical Education, Canadian Memorial Chiropractic College, 6100 Leslie St., Toronto, Ontario M2H 3J1, Canada. Electronic address: cjacobs@cmcc.ca.
3
UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario M2H 3J1, Canada; Division of Undergraduate Education, Canadian Memorial Chiropractic College, 6100 Leslie St., Toronto, Ontario M2H 3J1, Canada.
4
Canada Research Chair in Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe Street North, Oshawa, Ontario L1H 7K4, Canada; Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000 Simcoe Street North, Oshawa, Ontario L1H 7K4, Canada; UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, 6100 Leslie St., Toronto, Ontario M2H 3J1, Canada.
5
Division of Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario M2H 3J1, Canada; UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario M2H 3J1, Canada.
6
UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario M2H 3J1, Canada; Division of Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario M2H 3J1, Canada.
7
Department of Emergency Medicine, Queen's University at Kingston, Kingston General Hospital and Hotel Dieu Hospital, c/o 76 Stuart St., Kingston, Ontario K7L 2V7, Canada.
8
Toronto Health Economics and Technology Assessment (THETA) Collaborative, Leslie Dan Pharmacy Building, University of Toronto, 6th Floor, Room 658, 144 College Street, Toronto, Ontario M5S 3M2, Canada; Faculty of Pharmacy, University of Toronto, Leslie Dan Pharmacy Building, University of Toronto, 144 College Street, Toronto, Ontario M5S 3M2, Canada; Institute for Work and Health, 481 University Ave., Toronto, Ontario M5G 2E9, Canada.
9
Division of Graduate Studies, Canadian Memorial Chiropractic College, 6100 Leslie St., Toronto, Ontario M2H 3J1, Canada; Division of Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario M2H 3J1, Canada.
10
UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario M2H 3J1, Canada.
11
Division of Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario M2H 3J1, Canada; Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000 Simcoe Street North, Oshawa, Ontario L1H 7K4, Canada.
12
School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405-87 Ave., Edmonton, Alberta T6G 1C9, Canada.

Abstract

INTRODUCTION:

Soft tissue injuries of the leg, ankle, or foot are common and often treated by exercise. The purpose of this study was to determine the effectiveness of exercise for the management of soft tissue injuries of the leg, ankle, or foot.

METHODS:

A systematic review of the literature was conducted. We searched five databases from 1990 to 2015. Relevant articles were critically appraised using Scottish Intercollegiate Guidelines Network (SIGN) criteria. The evidence from studies with low risk of bias was synthesized using the best-evidence synthesis methodology.

RESULTS:

We screened 7946 articles. We critically appraised ten randomized trials and six had a low risk of bias. The evidence suggests that for recent lateral ankle sprain: 1) rehabilitation exercises initiated immediately post-injury are as effective as a similar program initiated one week post-injury; and 2) supervised progressive exercise plus education/advice and home exercise lead to similar outcomes as education/advice and home exercise. Eccentric exercises may be more effective than an AirHeel brace but less effective than acupuncture for Achilles tendinopathy of more than two months duration. Finally, for plantar heel pain, static stretching of the calf muscles and sham ultrasound lead to similar outcomes, while static plantar fascia stretching provides short-term benefits compared to shockwave therapy.

CONCLUSIONS:

We found little evidence to support the use of early or supervised exercise interventions for lateral ankle sprains. Eccentric exercises may provide short-term benefits over a brace for persistent Achilles tendinopathy and plantar fascia stretching provides short-term benefits for plantar heel pain.

KEYWORDS:

Achilles tendinopathy; Ankle sprain; Exercise; Plantar fasciitis; Systematic review

PMID:
25892707
DOI:
10.1016/j.math.2015.03.012
[Indexed for MEDLINE]

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