Effects of Talocrural Joint Mobilizations in the Treatment of Subacute Lateral Ankle Sprains

Study Overview
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Brief Summary
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The goal is to determine if standard therapy including joint mobilizations of the ankle performed 3 times per week for 2 weeks will increase self-reported function and decrease pain in patients with mild lateral ankle sprains.

Detailed Description
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The purpose of this protocol is to assess the effects of grade IV anterior to posterior joint mobilization on self-reported function, dorsiflexion range of motion and talar glide on subjects suffering from lateral ankle sprain in the past 2-10 days and exhibit 5 degree dorsiflexion deficit in range of motion or a restriction in posterior glide of the talus.

Official Title
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Effects of Talocrural Joint Mobilizations in the Treatment of Subacute Lateral Ankle Sprains

Conditions
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Ankle Sprain

Intervention / Treatment
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* Other: Mobilization therapy in addition to standard therapy
* Other: Sham intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Incomplete tear of lateral ligaments with mild laxity as measured by anterior drawer test and talar tilt Slight reduction in function Anterolateral ankle tenderness Dorsiflexion ROM asymmetry greater than 5° compared to uninvolved limb Posterior talar glide restriction greater than 5° compared to uninvolved limb; or Posterior talar glide less than 19°, which is one standard deviation (7°) from our previously established normative values (26°)9, 10 Suffered from grade 1 or 2 lateral ankle sprain within the last 48hr - 8 days Exclusion Criteria: A history of ankle surgery that involves intra-articular fixation, Syndesmotic ankle sprain (to be ruled out based on clinical examination), History or signs of reflex sympathetic dystrophy, Have received manual therapy for the ankle sprain prior to enrollment Grade III ankle sprain.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Sham Comparator: Laying of hands plus standard therapy<br>Subjects will lie on their back as if they were receiving the joint mobilization treatment and the therapist will place their hands in a position as if to perform the mobilization but no movement will occur. Standard therapy will consist of ankle strengthening exercises with elastic bands, balance, active ROM, and 20 minutes of ice bag application, elevation and compression | Other: Sham intervention<br>* Physical therapist will lay hands as if to perform the joint mobilization but no movement will occur.<br>|
| Experimental: Standard therapy with joint mobilization<br>This group will receive three 60-second bouts of posterior joint mobilizations applied to the ankle joint during each treatment session, in addition to standard therapy. Standard therapy will consist of ankle strengthening exercises with elastic bands, balance, active ROM, and 20 minutes of ice bag application, elevation and compression | Other: Mobilization therapy in addition to standard therapy<br>* Subject will receive three 60-second bouts of posterior joint mobilizations applied to the ankle joint during each treatment session. Standard therapy will consist of ankle strengthening exercises with elastic bands, balance, active ROM, and 20 minutes of ice bag application, elevation and compression.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in self-reported function | We hypothesize that the group that receives joint mobilization in addition to standard therapy will show greater improvements in Functional Ankle and Ability Measure (FAAM) and FAAM-Sport (FAAM-S) scores than those who receive standard therapy alone. | Baseline and four weeks | 
| Change in self-reported pain | We hypothesize visual analog scale (VAS) scores for pain will have a greater improvement in those who received joint mobilization in addition to standard therapy when compared to standard therapy alone. | Baseline and 4 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in ankle dorsiflexion range of motion | We hypothesize that mobilization when applied to the talocrural joint in addition to standard therapy will result in a greater increase of ankle dorsiflexion ROM than just standard therapy alone. | Baseline and 4 weeks | 
| Change in ligamentous laxity | We hypothesize that ligamentous laxity in both groups will be reduced. | Baseline and 4 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ankle sprain, athletic injury, arthritis