Volume 10, Issue 1, Pages (January 2018)

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Volume 10, Issue 1, Pages 36-44 (January 2018) Acupressure Therapy for Acute Ankle Sprains: A Randomized Clinical Trial  Mingxing Zhao, MD, Wei Gao, MD, MS, Long Zhang, MD, Wei Huang, MD, Sihua Zheng, MD, Guanliang Wang, MD, PhD, Brian Y. Hong, MD, Baoyong Tang, MD, MS  PM&R  Volume 10, Issue 1, Pages 36-44 (January 2018) DOI: 10.1016/j.pmrj.2017.06.009 Copyright © 2018 American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Figure 1 Depiction of acupressure therapy. Yongquan point, an acupuncture point, also called Gushing Spring, on the sole, in depression with foot in plantar flexion, at the junction of the anterior one third and posterior two thirds of line connecting base of the second and third toes with the heel. Thenar, the fleshy mass on the palm of the hand at the base of the thumb. PM&R 2018 10, 36-44DOI: (10.1016/j.pmrj.2017.06.009) Copyright © 2018 American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Figure 2 Ankle injury trial flow diagram. PM&R 2018 10, 36-44DOI: (10.1016/j.pmrj.2017.06.009) Copyright © 2018 American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Figure 3 (A) At day 3, APG reduced the mean volumetric measurement of the foot, ankle, and lower leg to 62.14 (95% CI 44.03-80.25) compared with 119.00 (95% CI 89.14-148.86) and 118.18 (95% CI 83.99-152.37) in the STG and mock APG groups, respectively (P < .01). (B) The ROAM improved gradually in all 3 groups at every visit, with the improvement being significantly greater in APG, in which the ROAM improved by the first, third, and 28th day to 31.67 (95% CI 27.78-35.55), 57.67 (95% CI 50.40-64.93), and 83.95 (95% CI 80.24-87.67) compared with the STG and mock APG groups (P < .001). (C) The improvement in pain scores with APG was significantly greater, to 3.33 (2.97-3.70), 1.33 (0.70-1.97), and 0.10 (0.04-0.23) at the first, third, and 28th day (P < .001). (D) The mean (95% CI) AOFAS scores at the first, third, and 28th day for the STG and mock APG groups were significantly worse than those achieved with acupressure (P = .001). AOFAS scores for APG at first, third, and 28th were 55.86 (95% CI 50.03-61.69), 70.95 (95% CI 64.94-76.96), and 93.24 (95% CI 90.86-95.61), respectively. AOFAS = American Orthopedic Foot and Ankle Score; APG = standard treatment plus acupressure; CI = confidence interval; mock APG = standard treatment plus mock acupressure; STG = standard treatment for soft tissue injuries includes rest, ice compression and elevation (RICE); VAPS = visual analog pain scores. * Statistical significance as described above. PM&R 2018 10, 36-44DOI: (10.1016/j.pmrj.2017.06.009) Copyright © 2018 American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Figure 4 The SF12v2 scores for the physical component and mental component were all improved with APG, achieving a total SF12v2 of 109.95 (95% CI 107.29-112.62) at 4 weeks and 119.67 (95% CI 119.27-120.05) at 8 weeks, both significantly better than STG and mock APG at equivalent time points (P < .01). APG, standard treatment plus acupressure; CI, confidence interval; mock APG, standard treatment plus mock acupressure; STG, standard treatment for soft tissue injuries includes rest, ice compression and elevation (RICE). * Statistical significance as described above. PM&R 2018 10, 36-44DOI: (10.1016/j.pmrj.2017.06.009) Copyright © 2018 American Academy of Physical Medicine and Rehabilitation Terms and Conditions