Clinical trial NCT05393310: Effects of MET vs Mulligan MWM on Pain, Disability & Balance in Athletes With Ankle Sprain
Official title: Effects of Post Isometric Relaxation Versus Mulligan Mobilization With Movement on Pain, Disability and Dynamic Balance in Athletes With Chronic Ankle Sprain
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Chronic Ankle Sprain
Keywords: ankle sprain, mulligan MWM, METs
Lead sponsor: Riphah International University
Sponsor class: OTHER
First posted: 2022-05-26
Enrollment: 30
Sex: MALE
Minimum age (years): 20
Maximum age (years): 35
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Ankle Sprains are the most common injury in Athletes and have a high rate of recurrence, pain, dynamic balance and disability is the leading cause of season break in athletes with chronic ankle sprain so as we see post isometric relaxation and Mulligan MWM are the useful techniques used to minimize pain, improve dynamic balance and to restrain athlete from disability due to chronic ankle sprain.

This study will be a randomized clinical trial,non probability convenience sampling technique will be used to collect the data. The sample size of athletes will be taken in this study to find the effect of post isometric relaxation and mulligan mobilization with movement in athletes.

Detailed description: Ankle Sprains are the most common injury in Athletes and have a high rate of recurrence, pain, dynamic balance and disability is the leading cause of season break in athletes with chronic ankle sprain so as we see post isometric relaxation and Mulligan MWM are the useful techniques used to minimize pain, improve dynamic balance and to restrain athlete from disability due to chronic ankle sprain. As the effect of post isometric relaxation in comparison with Mulligan MWM has never been investigated in Athletes, the aim of this study is to investigate and compare the effect of these two techniques on athletes with chronic ankle sprain presented with pain, dynamic imbalance that leads to disability.

This study will be a randomized clinical trial and will be conducted in Pakistan sports board and Multan sports complex. The study will be completed within the time duration of six months. Non probability convenience sampling technique will be used to collect the data. The sample size of athletes will be taken in this study to find the effect of post isometric relaxation and mulligan mobilization with movement in athletes of PSB and MSC, aged 20-35 years, were allocated to both intervention group. The participants will be divided into two groups i-e, MET group and MWM group. MET group will receive post-isometric relaxation technique for gastrocnemius and soleus muscle. Patient will be in prone lying with the ankle out of the bed. 30% of the available strength will applied by the patient against unyielding resistance towards plantarflexion. The therapist will ensure that foot will not actually move and only a static muscle contraction apply and held for 20 seconds. This will be followed by 2-3 second of relaxation, and then the foot passively stretched to dorsiflexion up to the palpated barrier and/or tolerance to stretch. This will continue until no further gains achieved 2 sets of 5 repetitions a day for 3 days a week for 4 weeks. MWM group will receive inferior tibiofibular, talocrural, or cubometatarsal MWM 2-8 treatment sessions over 4 weeks.

Eligibility criteria: Inclusion Criteria:

* Diagnosed cases of chronic ankle sprain (grade I or II) (3-4 months)
* Players have spent at least one year in sports

Exclusion Criteria:

* • Players undergone surgery or had an accident.

  * Any malignant or chronic disease
  * Players with the history of fracture in the same ankle

Primary outcomes:
measure: Numeric pain rating scale
timeFrame: 4th week
measure: Dorsiflexion lunge test
timeFrame: 4th week
measure: star excursion balance test
timeFrame: 4th week
measure: Foot and Ankle outcome score
timeFrame: 4th week
Secondary outcomes:
Other outcomes:
Locations:
city: Lahore
country: Pakistan
facility: Pakistan sports board
state: Punjab
city: Lahore
country: Pakistan
facility: PSB
state: Punjab
Study officials:
affiliation: Riphah International University
name: Amna Shahid
role: PRINCIPAL_INVESTIGATOR
References:
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citation: Mohd Salim NS, Umar MA, Shaharudin S. Effects of the standard physiotherapy programme on pain and isokinetic ankle strength in individuals with grade I ankle sprain. J Taibah Univ Med Sci. 2018 Nov 30;13(6):576-581. doi: 10.1016/j.jtumed.2018.10.007. eCollection 2018 Dec.
citation: Doherty C, Bleakley C, Hertel J, Caulfield B, Ryan J, Delahunt E. Dynamic balance deficits in individuals with chronic ankle instability compared to ankle sprain copers 1 year after a first-time lateral ankle sprain injury. Knee Surg Sports Traumatol Arthrosc. 2016 Apr;24(4):1086-95. doi: 10.1007/s00167-015-3744-z. Epub 2015 Aug 8.
citation: Golightly YM, Devellis RF, Nelson AE, Hannan MT, Lohmander LS, Renner JB, Jordan JM. Psychometric properties of the foot and ankle outcome score in a community-based study of adults with and without osteoarthritis. Arthritis Care Res (Hoboken). 2014 Mar;66(3):395-403. doi: 10.1002/acr.22162.