Chiropractic Care and a Specific Regimen of Nutritional Supplementation for Patients With Acute Ankle Sprain

Specific Aim 1: to compare the short-term (6 week) effect of chiropractic care combined with
a specific nutritional supplement regimen to chiropractic care with a placebo nutritional
supplement for patients with ankle sprains, in terms of speed and amount of improvement in
physical function and pain. Our hypothesis is that chiropractic care plus nutritional
supplements designed to supply necessary nutrients for ligament healing will have improved
outcomes in pain and disability, compared to chiropractic care plus placebo. We will use the
Foot and Ankle Ability Measure Activities of Daily Living Subscale (FAAM ADLS) to measure
outcomes.

Specific aim 2: to compare the long-term (6 month) effect of chiropractic care combined with
a specific nutritional supplement regimen to chiropractic care with a placebo nutritional
supplement for patients with ankle sprains, in terms of speed and amount of improvement in
physical function and pain. Our hypothesis is that chiropractic care plus nutritional
supplements designed to supply necessary nutrients for ligament healing will have improved
outcomes as measured by the FAAM ADLS, compared to chiropractic care plus placebo.

Specific aim 3: to explore any changes in the attitude, knowledge and behavior of
chiropractic interns and practitioners of the role of nutrition in treating musculoskeletal
injuries, pre- and post-intervention. We will also compare their responses to those of a
population of students and practitioners who did not participate in the project, as a
comparison group.

Inclusion Criteria:

- Acute ankle sprain, defined as ankle sprain within the past 7 days, by patient
report. Treating clinician will verify diagnosis via clinical examination.

- Ages 18-50; ankle sprains are more common in this age group.

Exclusion Criteria:

- Diagnosis of grade III ankle sprain, fracture or dislocation; fracture will be
diagnosed using the Ottawa ankle rules11,12

- Contraindications to chiropractic care, such as fracture or other abnormalities found
by history, examination, or x-rays, as determined by the treating or supervising
clinician.

- Pregnancy: although it is unlikely that the nutritional supplements would have
adverse effects on the fetus, we are excluding pregnant women as a safeguard.

- Unwilling or unable to regularly take the supplements (e.g., vegetarians; known
sensitivity by self-report; patients will be shown the ingredient list prior to
signing the informed consent).

- Litigation for a health-related claim (in process or pending).

- History of ankle surgery or presence of ankle hardware (pins, screws, etc.), by
patient report.

- History of diabetic or other peripheral neuropathy, by patient report.

- Current use of prescription or nonprescription medications that may interact with
experimental or placebo supplements, by patient report.