A prospective study of physiotherapy with pilates machines, following operative treatment of ankle fractures.
ESSKA Academy. Hristova D. 11/08/19; 284347; epAFAS-07 Topic: Ankle
Ms. Deyana Hristova
Ms. Deyana Hristova
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A prospective study of physiotherapy with pilates machines, following operative treatment of ankle fractures.

ePoster - epAFAS-07

Topic: Hindfoot Arthritis

Hristova D.1, Hristov H.2
1Physioflex Ltd, Sofia, Bulgaria, 2Pirogov Emergency Hospital, First Clinic of Orthopedic Trauma Surgery, Sofia, Bulgaria

Background: Ankle fractures can range from simple malleolar fractures to complex ones with severe soft tissue injury, involving disruption of the tibiofibular syndesmosis. The main problems after surgical treatment of ankle fractures are stiffness, swelling and muscle hypotrophy not only of the lower leg, but the whole extremity.
Objectives: Rehabilitation with pilates machines is not simply an exercise; but a holistic approach towards the optimization of function. Physiotherapy with Pilates Machines can be adapted according the current clinical and functional issues after ankle trauma treated surgically.
Aims: The aim of this study is to assess prospectively the effectiveness of rehabilitation with pilates machines during the recovery phase in patients with ankle fractures, treated with open reduction and internal fixation.
Methods: Sixteen patients with mean age 47 years were followed prospectively for 2 months. Eleven had trimalleolar fractures with subluxation of the talocrural joint, 3 had bimalleolar fractures, and 2 had fractures of the fibular malleolus. Eight had syndesmotic disruption. All were treated with open reduction and internal fixation.The patients without syndesmotic injuries started physiotherapy after removal of the stitches. The ones with syndesmotic disruption started physiotherapy after removal of the syndesmotic screw. Range of motion by goniometry and functional assessment by the American Foot and Ankle Score (AFAS) were taken on days 1, 30 and 60 of the rehabilitation. The physiotherapy program included: pilates machines exercises, manual lymph drainage, cryotherapy and kinesiotapig.
Results: On day 1 the average ROM was 25⁰ (21⁰-0⁰-4⁰), AFAS was 52. On day 30 the average ROM was 40⁰ (30⁰-0⁰-10⁰), the mean AFAS was 70. On day 60 the average ROM was 60⁰ (45⁰-0⁰-15⁰), and AFAS was 86.
Conclusion: Rehabilitation with Pilates Machies reduces the stiffness and increases the elasticity of the soft tissue envelope of the ankle joint. It improves the neuromuscular control and the balance between mobility and stability not only of the ankle, but of the whole lower extremity, which reduces the risk of gait abnormalities when full weight bearing is started.
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