Effects of Mobilization in Conjunction With Therapeutic Exercise in Participants With a History of Ankle Sprain
Condition: Functional Deficits; Manipulation; Rehabilitation
Study type: Interventional

Summary: 
      Our purpose was to examine the combined effects of thrust mobilization of the proximal and
      distal ankle joints in conjunction with a six-week rehabilitation program on ankle function
      in subjects reporting chronic ankle instability (CAI).
    

Detailed description: 
      Joint mobilizations are reported to increase range of motion (ROM), postural control and
      proprioception, and decrease pain in individuals with CAI. There is no research supporting
      the combined effects of thrust mobilization and exercise on function in this population.

      Inclusion and exclusion criterion were established and a convenience sample was performed. 19
      subjects were randomized into the exercise only or mobilization (experimental) and exercise
      group. Both groups underwent 12 supervised training sessions across a six-week period. The
      mobilization (experimental) group also received high-velocity-low-amplitude (HVLA) thrust
      mobilizations at the talocrural, proximal, and distal tibiofibular joints prior to the first
      three treatment sessions.

      An examiner blinded to involved limb and group allocation performed a baseline and six-week
      follow-up examination of muscle strength, joint mobility, range of motion, and/or functional
      performance. The participants completed subjective outcome measures at baseline, 2 weeks, 4
      weeks, and finally at 6 weeks including the Functional Ankle Disability Index (FADI),
      FADI-Sport, and the Ankle Joint Functional Assessment Tool (AJFAT). Participants also
      completed baseline and a six-week follow up assessments of the figure-of-8 hop test, side hop
      test, and three directions of the Star Excursion Balance test (SEBT).

      The exercise protocol is a modified version of the balance training program described by
      McKeon et al. Participants completed this protocol twice a week, for six weeks. Treatment
      sessions lasted approximately 30 minutes. Participants were individually progressed on
      particular exercises if zero errors were observed. In addition, all participants were given a
      home exercise program (HEP) to complete every day of the week excluding treatment days.

      The mobilization (experimental) group received HVLA thrust mobilizations at the three joints
      stated above for the first three sessions prior to completing the exercise protocol. Each
      mobilization was performed one time at each joint. The order of joint mobilizations was
      randomized prior to administering.

      Data analysis was performed using International Business Machines Statistical Package for the
      Social Sciences (SPSS) version (22). Alpha level was set p<0.05. Separate 2 x 2 repeated
      measures analysis of variance (ANOVA) were used to assess changes in the FADI, FADI-Sport,
      figure-of-8 hop test, side hop test, and three directions of the SEBT.
    

Intervention name(s): High Velocity Low Amplitude mobilization; Exercise Protocol
Intervention type(s): Other; Other
Intervention description(s): Mobilizations were performed one time at each joint, prior to completing the exercise protocol during the first three treatment sessions.; This exercise regimen is a modified version of the balance training program described by McKeon et al.
Other intervention name(s): HVLA; thrust mobilization; Control
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment