Ankle Sprains and Corticospinal Excitability
Condition: Ankle Sprain
MeSH terms: Sprains and Strains; Ankle Injuries
Study type: Interventional
Phase: Phase 1/Phase 2

Summary: 
      The purpose of this study is to determine changes in the brain associated with improvement in
      ankle range of motion following ankle manual therapy procedures in individuals with
      post-acute ankle sprains
    

Detailed description: 
      Physical therapists use many ways to treat joints that do not move well. One way takes 1-2
      seconds. Another way may take up to 1 minute. Both stretches seem to work, but we do not know
      how. Certain changes in the brain and spinal cord may cause joints to become more flexible
      after these kinds of stretches. Right now, we do not have very much information about how
      these might work in people who have injured their ankle. This study will find out if changes
      in the brain cause better flexibility in the ankle joint after different kinds of stretches.
      In this study, subjects with a certain kind of ankle sprains and limited ankle joint
      flexibility will be assigned to 1 out of 3 groups. Subjects will not get to choose their
      groups. The first group will have an ankle stretch that lasts 1-2 seconds. The second group
      will have a stretch that last 1 minute. The third group will have their foot held without any
      stretching. We will use a machine to stimulate the brain and spinal cord to find out how
      these stretches affect the brain and spinal cord. The machine sends a magnetic signal to the
      brain, and we will measure how much signal gets through to the leg muscles using electrodes
      on the skin. We also will use 3 flexibility tests to find out how well each stretch worked.
      One test is with the subject lying on their stomach, and the others are with the subject
      standing up. To start the study, subjects will get their brain stimulated. They will then get
      their brain stimulated again one hour later. After the second stimulation, subjects will have
      their flexibility tested and then get 1 of the 3 treatments. After the treatment, subjects
      will get a last brain stimulation test and flexibility tests. We think subjects that get a
      fast stretch will have better brain function and flexibility than subjects that get the slow
      stretch or no stretch. To test our idea, we will compare how each group did with the brain
      stimulation and flexibility tests. We will also look at the relationship between brain
      function and flexibility.
    

Intervention name(s): High velocity, low amplitude stretch; Slow, mobilization stretch; Passive Positioning
Intervention type(s): Other; Other; Other
Intervention description(s): This group (n=9) will receive talocrural traction manipulation. With the subject in a seated position on a treatment table and the lower extremity of interest stabilized to the table with a belt, a single standardized treating investigator will grasp the foot of interested with the thenar eminences on the foot's plantar surface. A thrust will be delivered parallel to the long axis of the subject's lower leg after the treating therapist induces passive ankle dorsiflexion to end range.; This group (n=9) will receive talocrural traction mobilization. With the subject in a seated position on a treatment table and the lower extremity of interest stabilized to the table with a belt, a single standardized treating investigator will grasp the foot of interested with the thenar eminences on the foot's plantar surface. Traction will be delivered to the talocrural joint at the treating investigator's second perception of tissue resistance in 3 bouts of 30-second holds, separated by 10 seconds of rest.; This group (n=9) will receive the manual therapy control intervention. This will consist of the same patient and clinician preparation for the mobilization/manipulation techniques. However, a single standardized treating investigator will simply maintain passive ankle positioning for the duration of 1 deep inhalation and exhalation by the subject rather than induce an iatrogenic force characteristic of the intervention received by the other 2 comparison groups.
Other intervention name(s): Manipulation; GPM-V; Articulation; Mobilization; Traction; Passive Range of Motion; Placebo
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Basic Science
Keywords: Ankle Sprain