Manual therapy in addition to physiotherapy does not improve clinical or economic outcomes after ankle fracture

Lin, CWC; Moseley, AM; Haas, M; Refshauge, KM; Herbert, RD

Manual therapy in addition to physiotherapy does not improve clinical or economic outcomes after ankle fracture

Lin, CWC Moseley, AM Haas, M

Refshauge, KM Herbert, RD

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Publication Type:: Journal Article
Citation:: Journal of Rehabilitation Medicine, 2008, 40 (6), pp. 433 - 439
Issue Date:: 2008-06-01

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Field	Value	Language
dc.contributor.author	Lin, CWC	en_US
dc.contributor.author	Moseley, AM	en_US
dc.contributor.author	Haas, M https://orcid.org/0000-0002-9726-3063	en_US
dc.contributor.author	Refshauge, KM	en_US
dc.contributor.author	Herbert, RD	en_US
dc.date.issued	2008-06-01	en_US
dc.identifier.citation	Journal of Rehabilitation Medicine, 2008, 40 (6), pp. 433 - 439	en_US
dc.identifier.issn	1650-1977	en_US
dc.identifier.uri	http://hdl.handle.net/10453/9576
dc.description.abstract	Objective: The primary aim of this study was to determine the effectiveness and cost-effectiveness of adding manual therapy to a physiotherapy programme for ankle fracture. Design: Assessor-blinded randomized controlled trial. Participants: Ninety-four adults were recruited within one week of cast removal for isolated ankle fracture. Inclusion criteria were: they were able to weight-bear as tolerated or partial weight-bear, were referred for physiotherapy, and experienced pain. Ninety-one participants completed the study. Methods: Participants were randomly allocated to receive manual therapy (anterior-posterior joint mobilization over the talus) plus a standard physiotherapy programme (experimental), or the standard physiotherapy programme only (control). They were assessed by a blinded assessor at baseline, and at 4, 12 and 24 weeks. The main outcomes were activity limitation and quality of life. Information on costs and healthcare utilization was collected every 4 weeks up to 24 weeks. Results: There were no clinically worthwhile differences in activity limitation or quality of life between groups at any time-point. There was also no between-group difference in quality-adjusted life-years, but the experimental group incurred higher out-of-pocket costs (mean between-group difference = AU$200, 95% confidence interval 26-432). Conclusion: When provided in addition to a physiotherapy programme, manual therapy did not enhance outcome in adults after ankle fracture. © 2008 Foundation of Rehabilitation Information.	en_US
dc.relation.ispartof	Journal of Rehabilitation Medicine	en_US
dc.relation.isbasedon	10.2340/16501977-0187	en_US
dc.subject.classification	Rehabilitation	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Ankle Injuries	en_US
dc.subject.mesh	Pain Measurement	en_US
dc.subject.mesh	Treatment Outcome	en_US
dc.subject.mesh	Musculoskeletal Manipulations	en_US
dc.subject.mesh	Follow-Up Studies	en_US
dc.subject.mesh	Recovery of Function	en_US
dc.subject.mesh	Time Factors	en_US
dc.subject.mesh	Cost of Illness	en_US
dc.subject.mesh	Quality of Life	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Cost-Benefit Analysis	en_US
dc.subject.mesh	Health Care Costs	en_US
dc.subject.mesh	Outcome Assessment (Health Care)	en_US
dc.subject.mesh	Physical Therapy Modalities	en_US
dc.subject.mesh	Fractures, Bone	en_US
dc.subject.mesh	Outcome Assessment, Health Care	en_US
dc.title	Manual therapy in addition to physiotherapy does not improve clinical or economic outcomes after ankle fracture	en_US
dc.type	Journal Article
utslib.citation.volume	6	en_US
utslib.citation.volume	40	en_US
utslib.for	110317 Physiotherapy	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1106 Human Movement and Sports Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
utslib.copyright.status	open_access
pubs.issue	6	en_US
pubs.publication-status	Published	en_US
pubs.volume	40	en_US

Abstract:

Objective: The primary aim of this study was to determine the effectiveness and cost-effectiveness of adding manual therapy to a physiotherapy programme for ankle fracture. Design: Assessor-blinded randomized controlled trial. Participants: Ninety-four adults were recruited within one week of cast removal for isolated ankle fracture. Inclusion criteria were: they were able to weight-bear as tolerated or partial weight-bear, were referred for physiotherapy, and experienced pain. Ninety-one participants completed the study. Methods: Participants were randomly allocated to receive manual therapy (anterior-posterior joint mobilization over the talus) plus a standard physiotherapy programme (experimental), or the standard physiotherapy programme only (control). They were assessed by a blinded assessor at baseline, and at 4, 12 and 24 weeks. The main outcomes were activity limitation and quality of life. Information on costs and healthcare utilization was collected every 4 weeks up to 24 weeks. Results: There were no clinically worthwhile differences in activity limitation or quality of life between groups at any time-point. There was also no between-group difference in quality-adjusted life-years, but the experimental group incurred higher out-of-pocket costs (mean between-group difference = AU$200, 95% confidence interval 26-432). Conclusion: When provided in addition to a physiotherapy programme, manual therapy did not enhance outcome in adults after ankle fracture. © 2008 Foundation of Rehabilitation Information.

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http://hdl.handle.net/10453/9576