Physiotherapy’s influence to foot's range of motion and function after lateral malleolus fracture

Research objects: ankle’s and calf’s size, foot’s range of motion, pain, foot‘s and ankle‘s function, dynamic balance. Ankle fracture is the second most common ankle injury after the ankle sprain (Fong et al., 2007 from Beckenkamp et al., 2011). In Sweden ankle fracture occurs in 71 of 10,000 people and every year it increases by 0.2 percent. The most common reason for ankle fracture is falling of the flat surface (Thur et al., 2012). Usually ankle fracture is treated by immobilizing it for 6 weeks therefore, there is a loss of movement function that is shown in swelling, stiffness and the lack of muscle strength. Rehabilitation starts immediately after fracture stabilization or after when the cast is removed (Lin et al., 2010). After ankle fracture two thirds of patients recovers good or excellent function, but the one third has the acceptable or poor results (Nilsson et al., 2003). The aim of rehabilitation is to restore function and come back to work as soon as possible. To make proper physiotherapy program you need to know the mechanism of injury and applying anatomy and kinesiology knowledge apply the most effective treatment method (Birrer and O‘Connor, 2004). The aim of physiotherapy is to improve patients’ quality of life and daily activity (Harvey, 2008 from Pääbo and Pill, 2012), despite aging, injury or disease, or environmental effect (Giura and Nagel, 2010). Physiotherapy as distinct from operation or injection, is less risky, cheaper and after it patient can go back to work earlier (Paavola et al., 2000 from Hutchison et al., 2011). Physiotherapists often apply joint mobilization for treating muscularskeletal injuries and pain (Martins et al., 2013). During joint mobilization there is an activation of seratonin and norepinephrin receptors in spinal cord and that reduces pain (Skyba et al., 2003 from Martins et al., 2013) and increases joint’s range of motion (Prentice, 2005 from Kahanov and Kato, 2007). In addition, mobilization is used to reduce hipomobility and maintain joint mobility, while full range of motion is still impossible (Maitland, 2006). Hypothesis. We presume that by applying physiotherapy with passive joint mobilization there will be an increase in foot‘s range of motion and function. The aim of the research: To asses physiotherapy’s and joint mobilization’s influence for foot range of motion and function after ankle fracture. Objectives: 1.To determine the alternation of ankle‘s and calf‘s size, and pain before and after physiotherapy and in physiotherapy with joint mobilization; 2.To determine the alternation of foot’s range of motion before and after physiotherapy and in physiotherapy with joint mobilization; 3.To determine the alteration of foot‘s function and dynamic balance before and after physiotherapy and in physiotherapy with joint mobilization. The results of the research: 1.Physiotherapy did not influences ankle‘s, although there was a significant decrease in calf‘s size, and physiotherapy and joint mobilization, significantly reduced pain; 2.Physiotherapy and joint mobilization, significantly increased foot’s dorsiflexion, although it did not reached range of motion of non-injured leg; 3.Physiotherapy improved foot’s and ankle’s function and physiotherapy and joint mobilization, significantly improved dynamic balance