Publication Date

Spring 2015

Document Type

Project Summary

Degree Name

Doctor of Physical Therapy


Physical Therapy

First Advisor

Roberta O'Shea, PT, DPT, Ph.D.

Second Advisor

Mary K. Jones, PT, MPT, CLT, NCS

Third Advisor

Russell E. Carter, PT, Ed.D.


Background and purpose: Recent literature has shown that neuromuscular re-education and lower extremity muscle strengthening are important therapeutic components of preventing re-injury in patients with lateral ankle sprains (LAS). There is very literature however on the effectiveness of this treatment on a person with a LAS as well as overall balance issues secondary to a medical diagnosis such as multiple sclerosis (MS). The purpose of this retrospective case study is to describe the outcomes of using neuromuscular re-education as well as lower extremity muscle strengthening in a 44-year-old female patient with a LAS and a medical diagnosis of MS.

Case description: The subject was a 44-year-old female that presented to outpatient physical therapy with a diagnosis of a left LAS. She also reported a history of MS, which had caused overall balance issues throughout her life prior to the injury. Impairments included decreased strength in her left lower extremity, increased pain, decreased balance, and decreased functional abilities. The patient was seen for 12 treatment sessions over 4 weeks.

Outcomes: The patient demonstrated improvements on the following outcome measures: Lower Extremity Functional Scale, Manual Muscle Testing, Numerical Pain Rating Scale, Modified Romberg Test, and Single Leg Stance Test. All Physical Therapy goals were met.

Discussion: Rapid improvements in pain, function, strength and balance were seen in this patient following physical therapy with neuromuscular re-education and lower extremity muscle strengthening. These results are consistent with the findings in the current literature on the use of neuromuscular re-education to treat LAS. The relationship between the interventions and the results cannot be considered causative due to the single subject in this case report. More research is needed in order to study the effects of neuromuscular re-education and lower extremity muscle strengthening in a larger population of patients with LAS.