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Early osteopathic treatment delivered to patients with an acute lateral ankle sprain improves recovery: an investigative study

Journal: Journal of Osteopathic Medicine Date: 2026/01, (online 2026/01/22):. doi: Subito , type of study: randomized controlled trial

Free full text   (https://www.degruyterbrill.com/document/doi/10.1515/jom-2025-0096/html)

Keywords:

ankle sprain [8]
injury [107]
OMT [3746]
osteopathic manipulative treatment [3766]
randomized controlled trial [889]

Abstract:

Context Acute lateral ankle sprain (ALAS) is responsible for short-term disability, increased risk for future acute ankle sprain, and chronic ankle instability. Several studies highlighted that manipulative therapy may reduce pain and increase the range of motion (ROM) of the injured ankle, but not all of them targeted acute injuries. Some studies focused their interest on a specific manipulative technique or utilized either physiotherapy or chiropractic techniques. Objectives The objectives of this study were to evaluate the effectiveness of osteopathic care in ALAS, to assess pain, edema, and functional stability of the injured ankle, and to assess and comparing mobility between the injured and noninjured ankle. Methods We conducted an interventional randomized controlled trial (RCT) in the emergency department (ED) of a French University Hospital. Fifty patients were enrolled in this study. They had to be ≥18 years old, consulting in the ED for a single ALAS (<72 h) stage 1 or 2, and must have had preliminary consultation with an emergency physician. Patients with an ALAS stage 3 or fractured, or with history of homolateral ankle surgery, were excluded. Patients were randomized either in the medical treatment (MT) group or in the medical and osteopathic treatment (MOT) group and had a 3-week follow-up. In the MOT group, the intervention consisted of a single osteopathic treatment (manual intervention) at Day 0, depending on the tissue affected and on the intensity of the tissular tension found, and individualized advice provided at Days 0, 7, and 21. Comparisons between groups were investigated utilizing the chi-square or Fisher’s exact test, or Student’s t-test or Mann Whitney U-test, as appropriate. Results Forty-five patients completed the study. The patients’ median age was 29.5 years old (23–40 years). At Day 21, 95.7 % of patients in the MOT group had equivalent capacity of unloaded dorsal flexion between the injured and noninjured ankle, vs. 50.0 % of patients in the MT group (p=0.0005). Between Day 0 and Day 21, the pain with the injured ankle loaded and unloaded decreased more significantly in the MOT group (p=0.001 and p=0.0007, respectively), while the loaded and unloaded dorsal flexion, and the unloaded plantar flexion, increased (p=0.003, p<0.0001 and p=0.02, respectively). Between Day 0 and Day 0 postosteopathic treatment, all judgment criteria showed improvement in the MOT group. At Day 7, all the functional stability tests were performed better by patients in the MOT group. Conclusions Early osteopathic treatment associated with usual MT, delivered to patients with an ALAS, may improve mobility and functional stability, and may reduce pain and edema, in the 3 weeks postintervention. These promising findings require confirmation in a larger controlled trial.


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