A typical patient journey with Vitrue EVVA

One of the biggest benefits Vitrue assessments bring is showing the entire recovery pathway in detail to both the clinician and crucially the patient themselves. So let’s take a look at a typical patient’s recovery while using the Vitrue system with one of our customers.

Issue: Lateral Ankle Sprain

Lateral ankle sprains are among one of the most common injuries sustained during sport and exercise. Athletes typically return to sport within 3 weeks of injury, well before the normal healing time frame and can sometimes go on to become a recurrent injury leading to chronic ankle instability and eventually osteoarthritis if not treated correctly. Prognosis and degree of injury are strongly linked, specificity on the grade of sprain allows may assist in injury management.

Patient case study

Stephanie, a 36 year old female runner sustained a grade 2 ankle sprain on her left leg. 3 days after treatment. She was assessed by a physiotherapist with the addition of the EVVA system at 3 days, 3 weeks and 6 weeks post injury.

Below you can see Stephanie’s results from her Vitrue assisted assessments.

Balance:

In the first assessment Stephanie was unable to stay balanced for the full 10 seconds during her left leg test with significant sway. You can see this steadily improve to an excellent result by week 6.

Sit to Stand:

Similarly in sit to stand you can clearly see how Stephanie protected her left ankle during the transition with this almost completely fixed by week 3 and perfect by week 6.

Squat:

Stephanie was able to complete a full squat in all three assessments however you can see how her center of mass became more central in the movement as her left ankle recovered. You can also see her overall depth improve as her conditioning was developed during rehab.

Single Leg Squat:

In her first assessment Stephanie was almost unable to complete any single leg squat on her left. You can see after 3 weeks her left ankle had recovered enough to equal her right on this test.

Star Excursion:

For this test, although Stephanie's results improved significantly from unable to complete to 68% on her left leg, there is still a substantial imbalance between her performance on her injured left leg and her right.

Pistol Squat:

Similar to the above test, Stephanie has not managed to recover on her left to the point that she performs a pistol squat as well as her right. This indicates some more work to be done.

As seen in the results Stephanie improves over a 6-week period with an assessment at the start of her injury midway through rehab and at the end. She achieved this recovery through a carefully planned rehabilitation program designed with the input of the baseline Vitrue assessment data.

From the 3 assessment points Stephanie could clearly see her hard work was paying off. After six weeks although she’s back running you can clearly see she still has differences between left and right performance particularly in the more advanced tests (pistol squat and star excursion) showing she still has a little work to go.

In her own words:

“This isn’t my first injury like this. I do a lot of hiking and I’m no stranger to the frustration of not being able to exercise the way I want, and the painful journey back to fitness. This is the first time I can honestly say I knew where I was throughout my recovery. After three weeks I’d have said recovery was not progressing, but the data I was given showed otherwise. It was so motivating. After 6 weeks I feel totally recovered, but I can see in the data I still need to keep working at it! Easily my least frustrating recovery”

Rehabilitation journey planned using Vitrue EVVA results

• Day 3-2 weeks: Treatment focuses on swelling management, regaining range of movement and gentle balance exercises.

• Weeks 2-3: Focus is on static and dynamic balance as well as lower limb strengthening. Aerobic fitness can be maintained by static bike.

• Weeks 3-6: Progress in assessment is encouraging, it's time for functional rehab and return to sport, running on treadmill.

• 6 weeks+: Assessment still shows small imbalance in left and right results (14% overall performance difference) however progress sufficient to start to run on outdoor terrain

How Vitrue EVVA is helping in Stephanie’s journey to recovery

EVVA is an extremely beneficial adjunct to the physiotherapist’ assessment giving figures thaare clinically meaningful. These minor variances and improvements are very hard to detect and extremely difficult to quantify by eye. They’re also equally difficult to communicate to the patient who is often very frustrated.

Using Vitrue EVVA allows the physiotherapist to have specific objective values and set quantitative goals for the patient which is fantastic for patient engagement and to track progress.

At 6 weeks post injury some would assume Stephanie is back to full strength but from these results we can see she still needs some ankle stability and lower limb conditioning before she is back to full fitness.