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Contact the study team using the details below to take part. If there are no contact details below please ask your doctor in the first instance.

Contact Information:

Dr David Keene
+44 1865223126
after@ndorms.ox.ac.uk


More information about this study, what is involved and how to take part can be found on the study website.

Study Location:

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Be Part of Research - Trial Details - AFTER – Ankle fracture treatment: enhancing rehabilitation trial

AFTER – Ankle fracture treatment: enhancing rehabilitation trial

Medical Conditions

Ankle fracture


This information is provided directly by researchers, and we recognise that it isn't always easy to understand. We are working with researchers to improve the accessibility of this information. In some summaries, you may come across links to external websites. These websites will have more information to help you better understand the study.


After a broken ankle, the lower leg is usually placed in a cast or boot for a number of weeks so the broken bone can heal. When the cast or boot is removed the ankle initially feels stiff and sore. At this time, patients are given advice by health professionals on how to gradually get back to their usual activities and are given exercises to do at home.
In some hospitals, patients are asked to attend physiotherapy sessions, whilst in other hospitals, patients will just receive advice. There is currently no scientific evidence showing that seeing a physiotherapist after an ankle fracture improves recovery. As physiotherapy appointments aren’t always convenient for patients, and because it’s important to make the best use of NHS time and resources, we want to find out if attending physiotherapy after an ankle fracture really does help improve recovery. This study aims to find out the best way to provide rehabilitation for people aged 50 and over who have a broken ankle.

Start dates may differ between countries and research sites. The research team are responsible for keeping the information up-to-date.  

The recruitment start and end dates are as follows:

15 Sep 2022 15 Nov 2023

Publications

2025 Other publications in https://pubmed.ncbi.nlm.nih.gov/40250162/ design and delivery of the interventions (added 23/04/2025)

If patients are happy to take part in this study, a researcher will help them to complete a short online questionnaire that asks about the patient's health and level of activity, and ankle. This questionnaire should take no more than 10 minutes to complete.
Researchers will then use a computer program to allocate patients to one of the treatment groups. Patients will be randomised to either self-directed or supervised rehabilitation.
Self-directed rehabilitation involves the doctor, physiotherapist or nurse at the hospital providing advice and exercises to be followed at home. Patients will be provided with a detailed advice workbook and/or access to a website. The workbook and website contain a set of exercises that can be progressed independently over the next few months.
If patients are randomised to supervised rehabilitation they will receive the same advice and a workbook/access to a website. In addition, they will also attend 4-6 sessions with a physiotherapist to receive advise on exercises and progression. Sessions may be face-to-face or remotely by telephone/video call. The physiotherapy sessions will take place over three months.
All patients will then be asked to complete a further questionnaire at two, four and six months post randomisation.


People aged 50 and over who have a broken ankle.

You can take part if:



You may not be able to take part if:


1. Patient is deemed unable to adhere to trial procedures or complete questionnaires2. Patient was not ambulatory before the injury3. Patient has contraindications to participation in an exercise programme


Below are the locations for where you can take part in the trial. Please note that not all sites may be open.

  • North Bristol NHS Trust
    Southmead Hospital Southmead Road Westbury-on-trym
    Bristol
    BS10 5NB
  • Oxford University Hospitals NHS Foundation Trust
    John Radcliffe Hospital Headley Way Headington
    Oxford
    OX3 9DU
  • Hampshire Hospitals NHS Foundation Trust
    Basingstoke and North Hampshire Hos Aldermaston Road
    Basingstoke
    RG24 9NA
  • North West Anglia NHS Foundation Trust
    Peterborough City Hospital Bretton Gate Bretton
    Peterborough
    PE3 9GZ
  • University Hospitals of Leicester NHS Trust
    Leicester Royal Infirmary Infirmary Square
    Leicester
    LE1 5WW
  • Royal United Hospitals Bath NHS Foundation Trust
    Combe Park
    Bath
    BA1 3NG
  • Northern General Hospital
    Herries Road
    Sheffield
    S5 7AU
  • Luton and Dunstable University Hospital
    Lewsey Road
    Luton
    LU4 0DZ
  • Royal Berkshire Hospital
    Royal Berkshire Hospital London Road
    Reading
    RG1 5AN
  • Royal Cornwall Hospitals NHS Trust
    Royal Cornwall Hospital Treliske
    Truro
    TR1 3LJ
  • William Harvey Hospital
    Kennington Road Willesborough
    Ashford
    TN24 0LZ
  • Victoria Hospital
    Hayfield Road
    Kirkcaldy
    KY2 5AH
  • Royal Devon University Healthcare NHS Foundation Trust
    Royal Devon University NHS Ft Barrack Road
    Exeter
    EX2 5DW
  • Nottingham University Hospitals NHS Trust - City Campus
    Nottingham City Hospital Hucknall Road
    Nottingham
    NG5 1PB
  • Airedale General Hospital
    Skipton Road Steeton
    Keighley
    BD20 6TD
  • Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust
    Doncaster Royal Infirmary Armthorpe Road
    Doncaster
    DN2 5LT
  • King’s College Hospital NHS Foundation Trust
    Denmark Hill
    London
    SE5 9RS
  • South Tyneside and Sunderland NHS Foundation Trust
    Sunderland Royal Hospital Kayll Road
    Sunderland
    SR4 7TP
  • Surrey and Sussex Healthcare NHS Trust
    Trust Headquarters East Surrey Hospital Canada Avenue
    Redhill
    RH1 5RH
  • Milton Keynes General Hospital
    Milton Keynes Hospital Standing Way Eaglestone
    Milton Keynes
    MK6 5LD
  • Pinderfields Hospitals NHS Trust
    Trust Hq, Rowan House Pinderfields General Hospital Aberford Road
    Wakefield
    WF1 4EE
  • Somerset NHS Foundation Trust
    Trust Management Lydeard House Musgrove Park Hospital
    Taunton
    TA1 5DA
  • The Princess Alexandra Hospital
    Hamstel Road
    Harlow
    CM20 1QX
  • Betsi Cadwaladr University Lhb Anglesey Office
    17 High Street
    Llangefni
    LL77 7LT
  • Northumbria Healthcare NHS Foundation Trust (headquarters)
    Rake Lane
    North Shields
    NE29 8NH
  • Eastbourne Hospitals NHS Trust
    Eastbourne District Gen Hospital Kings Drive
    Eastbourne
    BN21 2UD
  • West Suffolk NHS Foundation Trust
    West Suffolk Hospital Hardwick Lane
    Bury St. Edmunds
    IP33 2QZ
  • Wrightington, Wigan and Leigh NHS Foundation Trust
    Royal Albert Edward Infirmary Wigan lane
    Wigan
    WN1 2NN

Fully qualified, registered health professionals will provide treatment. They will use widely recognised treatments in the NHS. We hope the information from this study will be used to help treat people with broken ankles more effectively.
Patients are unlikely to be harmed by this treatment. They may experience soreness after completing some of the exercises. This is normal, and patients will be given advice on how to manage this soreness. We are not able to pay travel expenses for attendance at physiotherapy sessions as this part of patients treatment.

Dr David Keene
+44 1865223126
after@ndorms.ox.ac.uk



More information about this study, what is involved and how to take part can be found on the study website.


The study is sponsored by University of Oxford and funded by National Institute for Health Research.




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Read full details for Trial ID: ISRCTN11830323

Or CPMS 52704

Last updated 23 April 2025

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