Dose-response of Anteroposterior Mobilizations in Weight Bearing Talus Dorsiflexion

Study Overview
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Brief Summary
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Ankle mobility limitations are common in older adults. A possible treatment to restore joint mobility is manual therapy based on mobilization techniques, in this case, applied on the ankle joint. Previous research had proposed different treatment volumes (one to twelve sessions), but shown a different and non-consistent degree of effectiveness according to such factor. Therefore, this work aims to determine the dose-response relationship of manual therapy (talus mobilizations) on ankle range of motion in the older adult.

Official Title
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Dose-response of Anteroposterior Mobilizations in Weight Bearing Talus Dorsiflexion in the Older Adult: Allegorized Clinical Trial

Conditions
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Aging Problems

Intervention / Treatment
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* Procedure: Posteriorization of the talus.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Community-dwelling older adults. Limited ankle mobility (< 35 degrees). Over 60 years. Exclusion Criteria: Not willing to participate or signing a consent form Lower limb injury in the three months prior to the study (ex. sprain) Diagnosed condition that may influence mobility assessments (i.e. stroke)

Ages Eligible for Study
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Minimum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

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


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: One session<br>One session of talus posteriorization. | Procedure: Posteriorization of the talus.<br>* Three sets of a 30-s grade IV anteroposterior mobilization.<br>|
| Experimental: Two sessions<br>Two sessions of talus posteriorization. | Procedure: Posteriorization of the talus.<br>* Three sets of a 30-s grade IV anteroposterior mobilization.<br>|
| Experimental: Three sessions<br>Three sessions of talus posteriorization. | Procedure: Posteriorization of the talus.<br>* Three sets of a 30-s grade IV anteroposterior mobilization.<br>|
| Experimental: Four sessions<br>Four sessions of talus posteriorization. | Procedure: Posteriorization of the talus.<br>* Three sets of a 30-s grade IV anteroposterior mobilization.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Treatment dose | Number of sessions of experimental intervention needed to induce a clinically important gain in ankle mobility after the intervention. A baseline progression over 4.6º in the Lunge test will be considered clinically important (Powden, 2015), so that the number of sessions will be established when this threshold is exceeded (see secondary outcome) . | Change from baseline to end of intervention (2 weeks) and follow-up (10 weeks) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Lunge test | Weight bearing ankle dorsiflexion range of motion. This test will measure the maximum tilt of the tibia that a subject can perform while standing and bearing the weight on the limb without lifting the heel from the floor. A Baseline® Digital Inclinometer (Fabrication Enterprises Inc) will be used to assessed this outcome. Values below 35º indicate limited mobility. A baseline progression over 4.6º will be considered clinically important (Powden, 2015). This mobility gain will be used to determine the dose-response relationship: number of sessions of talus mobilizations needed to induce a clinically important gain in ankle mobility after the intervention (see primary outcome measure) | Change from baseline, to end of intervention (2 weeks) and follow-up (10 weeks) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Weight Bearing Dorsiflexion, Manual Therapy, Ankle, Dose-response