Closed Versus Open Chain Exercises in Management of Chondromalacia Patellae

Abstract

Background and purpose: Acute lateral ankle ligament injuries (ankle sprains) are common problems in acute medical care. The treatment variation observed for the acutely injured lateral ankle ligament complex suggests a lack of evidence-based management strategies for this problem. Subjects and methods: The study included fourty patients, age ranged from 18 to 25 year and divided into two groups. The first group with mean age 21.4±2.65 years followed a physical therapy program of exercises in the form of strengthening exercises for dorsiflexors, planterflexors, evertors, and invertors muscles, stretching exercise of planterflexors, using of ankle support (elastic bandage), and partial weight bearing, three sessions per week for 3 weeks. The second group with mean age 22.1±3.21 years, submitted to a physical therapy program of exercises in the form of strengthening exercises for dorsiflexors, planterflexors, evertors, and invertors muscles, stretching exercise of planterflexors, using of ankle support (elastic bandage), and complete weight bearing, three sessions per week for 3 weeks. Outcome measures were rating score system of the japanese orthopaedic association for measuring daily living activities (walking), universal goniometer to detect range of motion of ankle dorsiflexion and planterflexion, and visual analogue scale to measure the pain severity. Results: There was a significant difference in the first group (t of pain=0.0007, t of ROM of dorsiflexion=0.009, t of ROM of planterflexion=0.007, t of ADL (walking) =0.035) than in the second group, there was a significant difference (t of pain=0.0009, t of ROM of dorsiflexion=0.007, t of ROM of planterflexion=0.0008, t of ADL (walking)=0.025). In comparison, there was a significant difference in ADL (walking) only. Discussion and Conclusion: This study showed that patients rehabilitated according to the complete weight bearing is better than partial weight bearing in pain and ROM, and specially ADL (walking) in management of ankle sprain patients