Telerehabilitation in Patients With Ankle Fracture

February 4, 2026 updated by: Daniel Martínez Barro, Instituto Mexicano del Seguro Social

Effectiveness in Functional Recovery and Quality of Life After a Telerehabilitation Program for Patients With Ankle Fracture, Controlled Clinical Trial

The objective of this clinical trial is to determine the effectiveness of a telerehabilitation program in the recovery of functionality and quality of life in patients recovering from ankle fracture. The main questions to be answered are:

What is the effectiveness of a telerehabilitation program in the recovery of functionality in patients with ankle fracture?

What is the effectiveness of a telerehabilitation program in the recovery of quality of life in patients with ankle fracture?

The researchers will compare the telerehabilitation program against the usual hospital rehabilitation procedure to see if there are differences in functional recovery and quality of life.

Participants will take a telerehabilitation program at home with the help of smartphones or will be sent to the usual hospital procedure for in-person rehabilitation.

They will have monthly in-person follow-up until 3 months, and by telephone at 6 months for the evaluation of their functionality and quality of life.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Patients will be selected from the pelvic limb consultation, they will be invited to go to the tele-rehabilitation module where they will be taught the rehabilitation program that they must carry out, as well as written information about the program. Once the teaching is finished, they will be asked if they have any questions to clarify them. Once the teaching is finished, they will be followed up through the Moodle platform to see their clinical evolution and identify the date of their discharge from work. Later, this group will be compared with the patients who carried out their rehabilitation treatment in the usual way.

Randomization Randomization will be carried out through a software-based randomization program. The assignment will be done by balanced random blocks, block size 8, with an assignment ratio of 1:1. The recruitment of participants, the assignment of participants to the interventions and the evaluations will be carried out by medical evaluators.

Blinding of subjects, therapists and evaluators: Due to the nature of the intervention, it is not possible to blind participants and therapists. However, the initial and final evaluators will not be aware of the treatment group to which the study subject belongs, and the statistical analysis will be performed in a blinded manner, only the treatment will be mentioned as Group A or Group B

Data quality: Several strategies will be implemented to ensure data quality. All procedures will be adjusted with the standard operating procedures of the North Physical Medicine and Rehabilitation Unit. Evaluators and treating physiotherapists will receive appropriate training before working. Compliance with the intervention follow-up will be closely monitored by a research associate in the Physical Medicine and Rehabilitation Unit and on the platform. Forms and data processing will be periodically reviewed for accuracy. All data entry will be double-checked for accuracy.

Intervention Experimental group: Tele-Rehabilitation Group (Online Exercise and Counseling) Conceptual definition: Rehabilitation service that is provided remotely through information and communication technologies. In this case it will be carried out online through the Moodle platform.

Operational definition: The Moodle application will be installed on their mobile phone to access the online content that will be integrated into three modules: 1) Information module on the disease and self-care, 2) Exercise module (stretching, strengthening and proprioception), 3) Phased walking module. These will be integrated with video and text. Patients must log in at least 5 days a week to perform their exercises. The exercise program is based on the recommendations of national and international clinical practice guidelines, which lasts 4 weeks.

Participants will also be provided with written exercise material and a physical activity diary to assess adherence to treatment.

Control Group: Exercise supervised by the physiotherapist and advice Conceptual definition: Rehabilitation program that is carried out in person. Operational Definition: Rehabilitation program that will be carried out in person at the North Physical Medicine and Rehabilitation Unit. The program will be carried out by a physiotherapist and the patient will be taught: Information about the disease and self-care, Exercise module (stretching, strengthening and proprioception), gait re-education in phases. During the rehabilitation program, the physiotherapist can use physical means such as ultrasound, laser or interferential currents. The rehabilitation program is similar to the telerehabilitation program with a duration of 4 weeks.

Likewise, written exercise material will be provided to participants and a physical activity diary to evaluate adherence to treatment.

Statistical analysis

Descriptive statistics: qualitative variables will be summarized in absolute and relative frequencies, quantitative variables will be summarized in measures of central tendency and dispersion, if they meet the normality criterion, mean and standard deviation will be used. If they do not meet the assumption, median and interquartile ranges will be used.

Inferential statistics: For the comparison of the dependent variables between the telerehabilitation group and the traditional rehabilitation group, at the end of the study, the Student t test will be used for independent samples.

Likewise, to assess the evolution of the dependent variables in the same group, the Kruskal Wallis test will be used.

In order to identify possible confounding variables, the clinical and demographic characteristics of both groups will be compared. The Student t test will be used to compare quantitative variables and the CHi2 test will be used to compare qualitative variables. If there is a difference in any of the variables, a multivariate model will be entered to adjust the effectiveness of the intervention. A value of p< 0.05 will be considered statistically significant. All analyses will be performed on an intention-to-treat basis using the SPSS statistical program version 20.

Blind analysis Statistical analysis will be performed by a statistician who will be blinded to group assignment by dummy coding the group names. Results will be unblinded to the rest of the team once the final statistical report has been completed.

Dealing with missing data It is anticipated that missing data will be 'random'. After considering the amount and distribution of data, the likely approach will be to use multiple imputation to impute missing data for the primary outcomes. The data will be used for imputation. We did not plan to impute missing data for any of the secondary outcomes or endpoints

Sample size calculation

For the calculation of the sample size, a clinically important minimum difference of 10 points on the Ankle Functionality Scale was considered, considering a SD of 19.5, significance level of 5% and power of 80%, an estimated loss of 20% was considered, an estimated sample size of 86 subjects per group.

Study Type

Interventional

Enrollment (Actual)

200

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Mexico
    • GUSTAVO A MADERO
      • México, GUSTAVO A MADERO, Mexico, 07760
        • Unidad Médica de Alta Especialidad (UMAE) de Traumatología, Ortopedia y Rehabilitación "Dr. Victorio de la Fuente Narváez",

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • IMSS beneficiaries treated at HTVFN for ankle fractures, over 18 years of age, discharged and referred to Rehabilitation
  • WEBER A, B, and C fractures, conservative or surgical management
  • Removal of immobilization
  • Partial weight bearing indicated
  • Access to telephone with internet (independent or with family support)

Exclusion Criteria:

Inability to complete a quality of life/functionality questionnaire Disability that limits compliance with instructions for completing a rehabilitation program at home or in an institutional setting

Elimination Criteria Loss to follow-up or individuals who wish to withdraw from the clinical study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Hospital rehabilitation
Rehabilitation program that will be carried out in person at the North Physical Medicine and Rehabilitation Unit. The program will be carried out by a physiotherapist and the patient will be taught: Information about the disease and self-care, Exercise module (stretching, strengthening and proprioception), gait re-education in phases.
Other: Hospital rehabilitation
Rehabilitation program that will be carried out in person at the North Physical Medicine and Rehabilitation Unit. The program will be carried out by a physiotherapist and the patient will be taught: Information about the disease and self-care, Exercise module (Stretching, strengthening and proprioception), and phased gait re-education.
Experimental: Tele-rehabilitation
The Moodle application will be installed on your mobile phone to access the online content that will be integrated into three modules: 1) Information module on the disease and self-care, 2) Exercise module (stretching, strengthening and proprioception), 3) Phased walking module. Which will be integrated with video and text.
Other: Tele-rehabilitation
Rehabilitation service provided remotely through information and communication technologies.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
functionality
Time Frame: From admission, and with evaluations at the first, second and third month
Rating obtained through the functional foot index. The participant rates the degree of difficulty in performing 23 different functional activities on a 10-point scale ranging from 0 ('no difficulty') to 10 ('extreme difficulty or inability to perform activity')
From admission, and with evaluations at the first, second and third month
Quality of Life - SF-12 health questionnaire
Time Frame: From admission, and with evaluations at the first, second and third month

The score obtained by the SF12 survey, which is designed to measure health-related quality of life and be the descriptive system for a multi-attribute utility instrument.

The SF-12 response options are based on Likert-type scales that assess intensity or frequency. Each question is assigned a score, which is transformed into a scale from 0 to 100. The scores have a mean of 50 with a standard deviation of 10, so scores above or below 50 indicate better or worse health, respectively, than the reference population.
From admission, and with evaluations at the first, second and third month

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Instituto Mexicano del Seguro Social

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

February 18, 2025

Primary Completion (Actual)

December 30, 2025

Study Completion (Actual)

December 30, 2025

Study Registration Dates

First Submitted

January 31, 2025

First Submitted That Met QC Criteria

January 31, 2025

First Posted (Actual)

February 6, 2025

Study Record Updates

Last Update Posted (Actual)

February 6, 2026

Last Update Submitted That Met QC Criteria

February 4, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • R-2020-3401-024

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

IPD Plan Description

out of respect for patient privacy

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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