The AFTER Study

The AFTER Study is trying to find out if attending physiotherapy after an ankle fracture really does help improve recovery

In the UK, one in ten people that go to hospital with a broken bone or fracture have injured their ankle. Treatment may or may not involve an operation, but most people will have the lower leg placed in a cast or boot for a few weeks to allow the bone to heal. When this cast or boot is removed healthcare professionals give patients advice on how to gradually get back to their usual activities.

In some hospitals, patients are asked to attend physiotherapy sessions. In other hospitals, patients just receive advice. There is currently no scientific evidence that shows that seeing a physiotherapist after an ankle fracture improves recovery.

As physiotherapy appointments aren’t always convenient for patients, and because it’s important to make the best use of NHS time and resources, we want to find out if attending physiotherapy after an ankle fracture improves recovery.

In the AFTER study, half the participants will receive high quality information to guide their recovery. The other half of the participants will be asked to attend 4-6 physiotherapy sessions, as well as receiving the high quality information to guide their recovery.

A process called randomisation is used to decide which treatment a participant receives. Participants will have an equal chance of being entered into either treatment group. This process means that the two groups of people are similar and we can make a fair comparison between the treatments.

To measure recovery, we will ask participants questions about any pain they might be experiencing, how well their ankle is working and how they are feeling in general.

We will ask participants to complete this questionnaire at 2, 4 and 6 months after their cast or boot has been removed. We will send a link to the questionnaire in a text message or e-mail so that participants can enter their answers on a secure website, or, if preferred, we can send the questionnaire by post.

The answers from all of the people taking part will be combined to find out whether having physiotherapy after an ankle fracture helps to improve recovery.

The doctors, nurses, physiotherapists and research team are happy to answer any questions that you may have about joining the AFTER study.

AFTER Participant Information Animation

This study is comparing the impact of physiotherapy vs self-directed rehabilitation following ankle fracture.

More information

We have successfully met our recruitment target, thank you to all the sites for your hard work in recruiting to AFTER. Please continue to support AFTER by ensuring that follow-up is completed.

Background

After a broken ankle, the lower leg is usually placed in a cast or boot for a number of weeks so the broken bone can heal. When the cast or boot is removed the ankle initially feels stiff and sore. At this time, patients are given advice by health professionals on how to gradually get back to their usual activities and are given exercises to do at home.

In some hospitals, patients are asked to attend physiotherapy sessions, whilst in other hospitals, patients will just receive advice. There is currently no scientific evidence showing that seeing a physiotherapist after an ankle fracture improves recovery. As physiotherapy appointments aren’t always convenient for patients, and because it’s important to make the best use of NHS time and resources, we want to find out if attending physiotherapy after an ankle fracture really does help improve recovery.

About the Study

In the AFTER study, all participants will receive high quality information that will guide them with their recovery, with half of the participants also being asked to attend 4-6 physiotherapy sessions. Information on how quickly and how well patients are able to return to the majority of their usual activities will be used to make a comparison between the two treatments.

The AFTER study has been developed by patients and healthcare professionals, including physiotherapists and doctors. Their experience and knowledge have been used to plan this study which could provide an answer as to what type of rehabilitation is best.

The Ankle Fracture Treatment Enhancing Rehabilitation Study

Study Participants

All patients aged 50 years or over who have been treated for a broken ankle with a cast or orthotic boot for non-weight bearing ankle movement for at least four weeks, are eligible to be included in this study