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Study: MalleoTrain in early functional treatment  Stability is crucial

Issue 02/2021

Which benefits do the supports of the MalleoTrain series have when treating ankle problems in patients with acute, unilateral supination trauma? Laura Niklaus, Movement Scientist, looked for answers to this question in a scientific study conducted by Chemnitz Technical University. Her findings: balance, gait and patient satisfaction are improved significantly.

Laura Niklaus, Movement Scientist and Sports Therapist, at Chemnitz Technical University, Germany.

The high case numbers for ankle trauma and, at times, lengthy course of the condition highlight the importance of evidence-based findings for the effectiveness of supports as part of non-surgical treatment. This subject is also relevant from the patients’ perspective because effective and quick treatment is crucial to allow them to return to unrestricted everyday mobility soon.
Joint stability, balance and fine coordination define the successful recovery of sprains treated non-surgically. Laura Niklaus, Movement Scientist and Sports Therapist, used these aspects to formulate the research questions for a scientific study conducted by Chemnitz Technical University, Germany, under the leadership of Professor Dr. Thomas Milani: what acute effects does the MalleoTrain have on balance, coordination and gait? How do patients assess their joint stability, pain perception and the support’s wearing comfort?
Even when compiling the group of subjects, it became very clear to Laura Niklaus and her research partners how widespread recurring supination trauma is. Only ten percent of patients at Chemnitz Hospital, Germany, fulfilled the inclusion criterion of an acute initial injury. The rest had chronic instabilities, recurring problems, or they had twisted their ankle once or several times over a period of twelve months. This also points to the fact that ankle treatment does not always exhaust all options. Another problem is the often lengthy duration of the condition. Laura Niklaus, Study Director, summarizes her impressions: “We were surprised by the number of patients with initial injuries who reported having severe problems even seven weeks after the injury occurred. This clearly shows that a seemingly simple sprain is a diagnosis that mustn’t be ignored.” 

Benefits of supports in the early stage of recovery

Existing studies relating to supports have often been conducted with patients suffering from chronic ankle instability. The research at Chemnitz Technical University focused on patients with an initial injury. “These findings provide valuable information about the benefits of a support in the early stage of recovering from ankle sprains,” Movement Scientist Niklaus explains. “The study showed that starting to wear the MalleoTrain early makes a huge difference – and these differences are statistically significant. We were also surprised how clear the results were.”

Visualization of the Center of Pressure (CoP) test with pressure plate to show static balance.

The research group led by Laura Niklaus put the puzzle together piece-by-piece: clinical characteristics like pain, hematoma and swelling were recorded, and movement tests were carried out to obtain meaningful data relating to balance, gait, stability and fine coordination. In addition, the subjects were asked about their own perception. “Subjectively, patients largely rated the MalleoTrain as very good,” doctoral candidate Niklaus explains. “Patients feel that the product provides them with stability and protection and that they did better in all movement tests when wearing the support on the injured joint, compared with not wearing it. The feeling of instability decreased drastically.” This feeling is evident from the patients’ questionnaires: an impressive 86 percent of patients taking part rated their balance as “better” or “much better”, and 70 percent felt that their joint stability had improved. Overall, 81 percent were “happy” to “very happy” with their MalleoTrain support after two weeks of wearing it.

A quick return to mobility

From a medical point of view, it is important that patients quickly trust in the stability of their foot again. That is the only way they will return to their usual mobility. An impaired gait is asymmetrical, for example with noticeable differences in step length, step duration and joint angles in foot, knee or pelvis. “In our study, starting to wear the MalleoTrain early significantly improved gait symmetry,” Laura Niklaus says, “and patients were able to stand on the injured leg for longer when walking with the support.”
This provides us with clear conclusions for ankle treatment, says the Movement Scientist: “In order to appropriately treat patients with persistent problems, the follow-up treatment regimen for sprains has to be revised in a way that firmly integrates therapeutic measures, such as proprioceptive training, in the recovery process. Here, supports can be highly beneficial.” This result also has a direct impact on patients’ everyday life, Laura Niklaus reports: “The support normalizes gait and significantly improves patients’ balance. This provides the majority of patients with a secure feeling of stability. There were no negative effects from wearing the support for longer periods. From the perspective of movement science, we therefore see no reason why the support shouldn’t be used long-term.” ?

 

 

Gait analysis, using a pressure plate and inertial sensors, measures pressure distribution and hindfoot movement.

 

More information about the study?

Bauerfeind offers a free summary of selected findings upon request: in the white paper “Effect of a compression support on gait, balance, fine coordination and subjective perception of patients with recent ankle sprains”.
The PDF files are available in German and English, so please state which language you would like.

Simply send a brief email to  medical.affairs@bauerfeind.com

Images: Frank Steinhorst


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