Immediate Effects of Ankle Mobilization on Dorsiflexion Range of Motion in Women With Patellofemoral Pain.
Condition: Patellofemoral Pain Syndrome
MeSH terms: Patellofemoral Pain Syndrome
Study type: Interventional

Summary: 
      Anterior Knee Pain or Patellofemoral Pain (PFP) is one of the most common disorders that
      affecting knee in the physically active population, being a condition that typically presents
      as diffuse knee pain in the anterior region and retro- or peri-patellar area, mainly in
      activities that increase compression force in patellofemoral joint, such as squatting,
      running, stair ascent and descent. The overall prevalence of PFP has been reported as between
      15-45% of the population, and its incidence is higher among women. The literature cites as
      etiology of PFP the ocorrence of dysfunctions in the local (knee), proximal (trunk, pelvis
      and hip complex) and distal (ankle and foot regions) factores. Actually, there is a lack of
      studies that investigate the interventions influences on distal factors in outcomes clinical
      in persons with PFP. Thus, the aim of this study is analyze the effect of ankle mobilization
      techiniques in ankle dorsiflexion range of motion closed kinetic chain in women with
      patellofemoral pain and with dorsoflexion restriction.
    

Detailed description: 
      The sample of this study will be formed by 117 lower limbs of women with PFP who have ankle
      dorsoflexion restriction, divided into three groups. Each group will contain 39 lower limbs
      and receive an ankle mobilization technique with a specific sense of mobilization. The group
      nominated GAP will receive an mobilization technique with slip sense from anterior to
      posterior. The group nominated GPA will receive an mobilization technique with slip sense
      from posterior to anterior. The group nominated GPA-AP will receive an mobilization technique
      with slip sense both from posterior to anterior and from anterior to posterior.

      Each group will receive a single intervention, which will consist of four sets of five
      repetitions of the ankle mobilization technique (according to the specific slip direction of
      each group), with rest time between series of one minute. In the group GPA-AP, to
      standardized the sequence of mobilization, the first two sets will be performed with slip
      sense from anterior to posterior, and the last two sets will be performede with slip sense
      from posterior to anterior. There will be randomisation allocation of individuals in the
      groups and because of the nature of the interventions only the evaluator may be blind.

      The Kolmogorov - Smirnov test is used to verify the data distribution normality. The
      characterization of the participants is performed by means of descriptive statistical
      analysis. Parametric or non-parametric tests will be used according to the data distribution
      normality for comparison between groups at baseline. The evaluator blinding will be tested
      using the chi -square test by comparing the randomization code with the evaluator opinion.
      The difference between the groups and their respective confidence intervals will be
      calculated by linear mixed models using interaction term of "time versus group".
    

Intervention name(s): Manual Therapy
Intervention type(s): Other
Intervention description(s): The manual therapy intervention, through the technique of mobilization with movement in the ankle joint (following the specific sense direction of the group), will be performed in a protocol that consists of four sets of five repetitions, with rest time between series of one minute.
Other intervention name(s): Manual Physical Therapy
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment