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Ankle injury rehabilitation and place of immersive virtual reality as digital health solutions in rehabilitation: A clinical randomized controlled trial

Chin J Traumatol. 2026 Jun 29:S1008-1275(26)00128-8. doi: 10.1016/j.cjtee.2025.10.008. Online ahead of print.

ABSTRACT

PURPOSE: The ankle is the main interface between the ground and body during ambulation, standing, and any sports exercise. Ankles should be able to absorb impact-loading forces from body weight and exercise pressure, adapt to uneven ground, and allow efficient propulsion. The estimated lifetime incidence of ankle injuries is 1 out of every 10 people. Most ankle injuries occur during sports activities. The epidemiologic trends associated with chronic ankle instability suggest that current rehabilitation approaches may be inadequate. Therefore, it is uttermost important to seek alternative rehabilitation modalities, as the current conventional rehabilitation is not effective.

METHODS: This retrospective study utilized a single-blinded 3-arm parallel-randomized controlled clinical trial to assess the efficacy of various rehabilitation modalities for ankle injuries. Seventy-five participants with ankle injuries were randomly assigned to 1 of 3 groups: a control group receiving standard rehabilitation, a virtual reality (VR) group utilizing VR technology, and a mixed group combining VR with kinesiotape interventions. Each group included 25 participants who underwent 2 weeks of rehabilitation activities specific to their assigned treatment. The single-blinded design ensured that participants were unaware of their treatment assignment, minimizing bias in their responses. This methodology facilitates a comparative analysis of rehabilitation strategies, offering insights into the effectiveness of innovative approaches such as VR and kinesiotaping for ankle injury recovery. The R statistical software was used to complete the analysis. One-way ANOVA analysis was utilized to compare the statistical differences between the 3 groups.

RESULTS: Seventy-five ankle injury patients were recruited, and 96% of them finished the study. The ANOVA results show that ankle injury rehabilitation via VR and/or kinesiotape application had significant effects on reducing ankle pain, ankle edema, and anthropometric measurements compared with the control group. The VR treatment modality has positive effects on reducing the distal edema limb circumference compared to both control and mixed groups at p < 0.05.

CONCLUSION: Physical rehabilitation via immersive VR and/or kinesiotape application is considered the main rehabilitation modality for ankle injury compared to conventional physical rehabilitation.

PMID:42595598 | DOI:10.1016/j.cjtee.2025.10.008

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