The Immediate Effect of Mobilisation With Movement in Amateur Futsal Athletes With Chronic Ankle Instability

Study Overview
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Brief Summary
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Chronic ankle instability (CAI) is an increasingly prevalent condition among futsal athletes. Mobilization with Movement (MWM) is a conservative rehabilitation strategy commonly used in this condition. Even so, the effects of two MWM dorsiflexion techniques on sports performance are not known. The aim is to analyze the immediate effect of two MWM techniques on the dorsiflexion range of motion, the dynamic balance and the performance variables in futsal athletes with CAI. Also, to analyze the impact of performing them in a different order.

Official Title
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The Immediate Effect of Two Mobilization With Movement Techniques on Dorsiflexion, Dynamic Balance and Performance Variables, in Futsal Athletes With Chronic Ankle Instability: A Randomized Controlled Trial

Conditions
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Ankle Injuries and Disorders

Intervention / Treatment
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* Procedure: Mobilisation With Movement 1
* Procedure: Mobilisation With Movement 2
* Other: Placebo


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: A history of at least one significative ankle sprain: Initial sprain must have occurred at least 12 months prior to study enrolment; Was associated with inflammatory symptoms; Created at least one interrupted day of desired physical activity; The most recent injury must have occurred more than 3 months prior to study enrolment. A history of the previously injured ankle joint giving way and/or recurrent sprain and/or feelings of instability: Participants should report at least two episodes of giving way in the 12 months prior to study enrolment, to account for the seasonal nature of futsal; Recurrent sprain was defined as two or more sprains to the same ankle. Self-reported ankle instability should be confirmed with the Ankle Instability Instrument: answer yes to at least 5 yes/no questions. Exclusion Criteria: A history of previous surgeries to the musculoskeletal structures (i.e., bones, joint structures, nerves) in either lower extremity. A history of bilateral ankle sprain. A history of a fracture in either lower extremity requiring realignment. Acute injury to musculoskeletal structures of other joints of the lower extremity in the previous 3 months that impacted joint integrity and function (i.e., sprains, fractures), resulting in at least one interrupted day of desired physical activity. Have conditions for which manual therapy is generally contraindicated (such as the presence of a tumour, fracture, rheumatoid arthritis, osteoporosis, prolonged history of steroid use, or severe vascular disease). Receiving concurrent physiotherapy treatment in the last 3 months. Inability to read Portuguese.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 35 Years

Sexes Eligible for Study
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Male

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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Mobilisation with Movement 1 (MWM1)<br>Participants received two ankle dorsiflexion MWM techniques, with glides applied at fibula and talus. Three sets of 10 repetitions of each techniques, were administrated. | Procedure: Mobilisation With Movement 1<br>* Application of a sustained passive accessory movement to a joint (talus or fibula) while the patient actively performs a forward lean/lunge that was previously limited. 3 sets of 10 repetitions of a glide applied to the talus were performed, followed by 3 sets of 10 repetitions of a glide applied to the fibula.<br>* Other names: Mulligan;|
| Experimental: Mobilisation with Movement 2 (MWM2)<br>Participants received two ankle dorsiflexion MWM techniques, with glides applied at talus and fibula (order of application inverted). Three sets of 10 repetitions of each techniques, were administrated. | Procedure: Mobilisation With Movement 2<br>* Application of a sustained passive accessory movement to a joint (talus or fibula) while the patient actively performs a forward lean/lunge that was previously limited. 3 sets of 10 repetitions of a glide applied to the fibula were performed, followed by 3 sets of 10 repetitions of a glide applied to the talus.<br>* Other names: Mulligan;|
| Placebo Comparator: Placebo<br>The Placebo group participants performed the same number of sets and repetitions of lean/lunge forward into dorsiflexion, without any glide application, in the same position | Other: Placebo<br>* The Placebo group participants performed the same number of sets and repetitions (6 sets of 20 repetitions) of lean/lunge forward into dorsiflexion, without any glide application.<br>|
| Experimental: Intervention<br>The experimental groups (MWM1 and MWM2), were later merged into a single Intervention group. | Procedure: Mobilisation With Movement 1<br>* Application of a sustained passive accessory movement to a joint (talus or fibula) while the patient actively performs a forward lean/lunge that was previously limited. 3 sets of 10 repetitions of a glide applied to the talus were performed, followed by 3 sets of 10 repetitions of a glide applied to the fibula.<br>* Other names: Mulligan;Procedure: Mobilisation With Movement 2<br>* Application of a sustained passive accessory movement to a joint (talus or fibula) while the patient actively performs a forward lean/lunge that was previously limited. 3 sets of 10 repetitions of a glide applied to the fibula were performed, followed by 3 sets of 10 repetitions of a glide applied to the talus.<br>* Other names: Mulligan;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dorsiflexion range of motion | The dorsiflexion range of motion (DFROM) of the ankle joint was measured by the Weight-Bearing Lunge Test (WBLT) | Immediate after procedure | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dynamic balance | The dynamic balance was measured by the anterior (ANT), posteromedial (PM) and posterolateral (PL) reach directions of the Star Excursion Balance Test (SEBT) | Immediate after procedure | 
| Performance variables | The performance variables were measured by the time needed to complete the Side Hop Test and the Sprint Test | Immediate after procedure |