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Trial registered on ANZCTR
Registration number
ACTRN12609000327280
Ethics application status
Approved
Date submitted
5/05/2009
Date registered
22/05/2009
Date last updated
22/05/2009
Type of registration
Retrospectively registered
Titles & IDs
Public title
Effects of a neuromuscular training program on pain and function after surgically treated ankle fracture. A prospective randomised controlled trial
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Scientific title
Effects of a neuromuscular training program on pain and function after surgically treated ankle fracture. A prospective randomised controlled trial
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Surgically treated ankle fractures
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Condition category
Condition code
Injuries and Accidents
237048
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0
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Fractures
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Musculoskeletal
237077
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A neuromuscular training program, that started within one week after plaster removal and continued for 8-12 weeks. The patient trained at the nearby physiotherapist in the primary care two times per week. The duration of each session was one hour and between the sessions home exercises relevant at the moment had to be performed. The home exercises had to be performed every day except the day when training was performed at the phyiotherapist. The type of exercises varied during the rehabilitation process and the phyiotherapist had to determine what type, number that should be perofmred and frequence during tha day. For example strengt training could be 15 x 3 while stretching could be performed 30 sec x 3. That is the home exercises varied on case by case. Mobility exercises, strengt training, stretching and functional execises like different type of walking exercises, jumping and so on were peroformed. The physiotherapists were carefully informed that the training had to be on a level that not increased swelling or pain.
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Intervention code [1]
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Rehabilitation
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Comparator / control treatment
Usual care: Patients followed the principles that are normally applied at the orthopaedic clinic from where the patients were recruited. That is after 6-8 weeks when plaster cast is removed the doctor examined the ankle and depending on the status and doctor's opinion the patient could be referred to a physiotherapist or encourraged to start walking and resume function on their own as soon as possible. The neuromuscular training program applied in the intervention group was kept apart from other physiothrapists than those included in the intervention study. The physiotherapists in the "usual care" group had to apply the methods that normally are used. The duration, methods used and choice of exercises varied on case by case and was determined by the physiotherapist. Also the time after plaster removal when the training started varied on case by case.
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Control group
Active
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Outcomes
Primary outcome [1]
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Olerud Molander Ankle Score (OMAS). Nine items are included measuring 1) ankle pain, 2)ankle stiffness, 3) ankle swelling; 4) stair-climbing, 5) running, 6) squatting 7) jumping, 8) need of walking aid, 8) working ability
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Assessment method [1]
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Timepoint [1]
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6 and 12 months after surgery
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Primary outcome [2]
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Olerud Molander Ankle Score (OMAS).
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Assessment method [2]
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Timepoint [2]
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6 and 12 months after surgery
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Secondary outcome [1]
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Muscle strength: number of heel rises
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Assessment method [1]
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Timepoint [1]
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6 and 12 months after surgery
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Secondary outcome [2]
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Ankle mobility in plantar flexion and dorsiflexion using a goniometer
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Assessment method [2]
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Timepoint [2]
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6 and 12 months after surgery
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Secondary outcome [3]
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Timed walking speed 30 m using a stop watch
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Assessment method [3]
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Timepoint [3]
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6 and 12 months after surgery
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Secondary outcome [4]
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Health Related Quality of Life (HQoL): Short Form 36 (SF-)36
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Assessment method [4]
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Timepoint [4]
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6 and 12 months after surgery
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Eligibility
Key inclusion criteria
Surgically treated ankle fracture
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Minimum age
18
Years
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Maximum age
64
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
co-existing fractures, psychiatric diagnosis, drug abuse, symptom giving osteoarthritis in the lower extremity, systemic diseases, delayed surgery due to complications
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/01/2003
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
100
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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Sweden
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State/province [1]
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Skane
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Skane County Council, Primary Health Care
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Address [1]
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Baravagen 1, SE 221 00 Lund
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Country [1]
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Sweden
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Funding source category [2]
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Charities/Societies/Foundations
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Name [2]
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Skane County Council
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Address [2]
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Region Skane, Baravagen 1, SE 221 00 Lund
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Country [2]
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Sweden
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Primary sponsor type
Charities/Societies/Foundations
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Name
Skane County Council, Primary Health Care
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Address
Baravagen 1, SE 221 00 Lund
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Country
Sweden
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Secondary sponsor category [1]
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University
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Name [1]
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Lund University
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Address [1]
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Baravagen 3, SE 221 00 Lund
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Country [1]
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Sweden
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Secondary sponsor category [2]
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University
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Name [2]
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Lund University
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Address [2]
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Baravagen 3, SE 221 00 Lund
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Country [2]
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Sweden
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Ethics Committee of Lund University
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Ethics committee address [1]
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Barngatan 2, SE 221 85 Lund
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Ethics committee country [1]
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Sweden
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Date submitted for ethics approval [1]
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Approval date [1]
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Ethics approval number [1]
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Summary
Brief summary
Purpose The aim of this study was to determinate the effects of a 12- week standardised but individually suited training program (training group) versus usual care (control group) after plaster removal in adults with surgically treated ankle fractures. Methods In total, 110 men and women, 18-64 years of age, with surgically treated ankle fracture were included and randomised to either a 12-week training program or to a control group. Six and twelve months after the injury the subjects were examined by the same physiotherapist Gertrud Nilsson (GN), blinded to the treatment group. The main outcome measure was the Olerud-Molander Ankle Score (OMAS) measuring symptoms and subjectively scored function. Secondary outcome measures were: quality of life (SF-36), timed walking tests, ankle mobility tests, muscle strength tests and radiological status. Results 52 patients were randomised to the training group and 58 to the control group. Five patients dropped out before the six-month follow-up resulting in 50 patients in the training group and 55 in the control group. Nine patients dropped out between the six- and twelve-month follow-up resulting in 48 patients in both groups. When analysing the results in a mixed model analysis on repeated measures including interaction between age-group and treatment effect the training group demonstrated significantly improved results compared to the control group in subjects less than 40 years of age regarding OMAS (p=0.028), muscle strength in the plantar flexors (p=0.029) and dorsiflexors (p=0.030). Conclusion The results of this study suggest that when adjusting for interaction between age-group and treatment effect the training model employed in this study based on neuromuscular training principles was superior to usual care in patients under the age of 40. There is need for further studies to elucidate how a training program should be composed to increase and optimise function in patients middle-aged or older.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Gertrud Nilsson
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Address
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Ouvertyrvagen 2, SE 245 42 Staffanstorp
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Country
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Sweden
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Phone
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+ 46 70 673 52 94
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Gertrud Nilsson
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Address
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Ouvertyrvagen 2, SE 245 42 Staffanstorp
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Country
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Sweden
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Phone
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+ 46 70 673 52 94
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Dimensions AI
Effects of a training program after surgically treated ankle fracture: a prospective randomised controlled trial
2009
https://doi.org/10.1186/1471-2474-10-118
N.B. These documents automatically identified may not have been verified by the study sponsor.
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