KNGF – Guideline for Physical Therapy in patients with acute ankle sprain
This KNGF guideline replaces the KNGF guidelines on ‘Acute Ankle Sprain’ (1998) and ‘Chronic Ankle Sprain’ (2003) and concerns the physical therapist’s diagnostic and therapeutic process for patients with an inversion trauma of the lateral capsular ligamentous complex or for patients with functional instability of the ankle, including measures to prevent recurrence of the injury. In addition, the guideline offers recommendations for sports-specifi c treatment and rehabilitation after acute ankle sprain or functional instability among athletes. The choices underlying the guideline are explained in a separate document called ‘Verantwoording en toelichting’ (review of the evidence), which is available only in Dutch.
The recommendations for the treatment of ankle sprain have been adjusted on the basis of recent literature studies, which yielded stronger evidence for functional treatment (as opposed to immobilization) and for the effectiveness of exercise therapy for athletes to prevent recurrent ankle sprain. These studies have also yielded more evidence that the use of passive modalities like ultrasound, laser therapy or electrotherapy is not effective for the treatment of acute ankle sprains.
The present guideline no longer uses the term ‘chronic ankle sprain’, as the treatment of chronic complaints in this guideline specifi cally focuses on functional instability, and the recommendations for this problem are essentially unchanged. On the other hand, new research fi ndings have been taken into account in formulating the recommendations adopted from the former guideline on chronic ankle sprain.
As regards acute ankle sprain, the present guideline can be regarded as a specifi cation for physical therapists of the consensus statement on the diagnostics and treatment of acute ankle sprain, which was developed by a committee of medical specialists, family physicians, and physical therapists under the auspices of the Dutch Institute for Health Care Improvement (CBO, 1999). By and large, the guideline follows those on ankle distortion developed by the Dutch College of General Practitioners (NHG, 2000).