Ankle Fracture Rehabilitation
Sean is a 36 year old male who sustained a syndesmotic high ankle fracture and is rehabilitating through a standard physiotherapy program after a button suture surgery. He is using Plantiga insoles to track his progress and return to his pre-injury strength and fitness levels.
Walk Test
As soon as he is able to bear weight on his injured ankle without a walking boot, Sean begins to collect walking data every day to assess his speed and asymmetry.
On his first walk without a boot, Sean’s average speed is 0.29 m/s. His speed increases to 1.60 m/s over two months, as he uses the same indoor route every day. On April 2, he begins outdoor walking on uneven surfaces, so his average speed drops to 1.02 m/s. As he continues his rehabilitation, his outdoor walking speed increases to 1.51 m/s over the span of a month.
For his first bootless walk test, Sean exhibits a load asymmetry of 70.62% L. Within 4 weeks his asymmetry decreases to be within 10%. As he continues to strengthen his right side, he begins to overcompensate and develops a slight right asymmetry for 8 weeks. After moving to outdoor walking, he goes back to a left asymmetry, but is still within a normal range of < 10%.
Cyclic Jump Test
Around 8 weeks after his first walk test, Sean has developed enough strength in his ankle to begin cyclic jumping.
Sean’s cyclic jump RSI increases from 1 to 2.7 over 9 weeks. The improvement here is an indication of his strength progression, as the cyclic jump primarily engages the calf-ankle complex.
When he begins to do cyclic jumps, Sean’s hesitation about jumping on his injured right foot causes him to use a jumping strategy where he leans away from the injured foot. On each jump, he takes off with his right foot first and lands with his right foot last. This is visible in the raw data, where the grey bars show when each foot was off the ground. The result of this jumping strategy is a greater asymmetry toward his right foot, as visible in the asymmetry graph. As his subconscious fear begins to fade, his jumping strategy becomes more balanced.
Single Leg Jump for Distance Test
11 weeks after he begins to walk, Sean is able to conduct single leg jumps.
Over 5 months, Sean is able to increase his single leg jump distance on both legs and decrease the discrepancy between his legs from 55% to 11%.
Summary
After 5 months of rehabilitation, Sean is showing good progress in returning to his baselines and he can continue to gradually increase the intensity of his activities. With Plantiga’s objective measurements and a tailored rehabilitation program, Sean is confident in his own progress and can better understand his own limits in terms of over-activity and strength building.