Clinical trial NCT01438905: Effect of Joint Mobilization in the Treatment of Chronic Ankle Instability
Official title: Effect of Joint Mobilization on Muscle Activation and Function in Individuals With Chronic Ankle Instability
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Ankle Sprain
Keywords: Ankle Sprain
Chronic Ankle Instability
Ankle Mobilization
Talocrural Joint Mobilization
Cortical Muscle Activation
Spinal Muscle Activation
Lead sponsor: Creighton University
Sponsor class: OTHER
Collaborators: name: Nebraska Foundation for Physical Therapy
First posted: 2011-09-22
Enrollment: 30
Sex: MALE
Minimum age (years): 19
Maximum age (years): 45
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to examine the effects of a gentle pressure movement performed at the ankle by a physical therapist on muscle function and ankle motion in individuals who frequently twist (sprain) their ankle.

Detailed description: Novel rehabilitation methods, that specifically target decreased muscle activation due to joint pathology prior to strength training, have elicited greater improvements in muscle function and self-reported disability compared to traditional therapies. Preliminary evidence suggests ankle joint mobilization can improve contributions of spinal influences on ankle muscle activation in individuals with ankle joint pathology, but there is a considerable gap in understanding cortical contributions to muscle activation following joint injury. It is unknown how joint mobilization concurrently affects cortical and spinal neural motor pathways, as well as clinical measures of patient function. The overall aim of this grant is to determine the immediate effects of talocrural joint mobilization on cortical and spinal muscle activation of the fibularis longus (peroneus) and soleus muscles in individuals with chronic ankle instability (CAI). The secondary aims of this study will examine changes in ankle dorsiflexion range of motion (ROM) and dynamic balance. This innovate approach will provide the necessary scientific knowledge regarding the potential mechanism and efficacy of joint mobilization.

Eligibility criteria: Inclusion Criteria:

* Age 16-45 years
* History of one or more ankle sprains
* Scoring at least an 85% on the Foot and Ankle Ability Measure (FAAM) Sport or at least 3 on the Modified Ankle Instability Instrument (AII).
* At least 5° ankle dorsiflexion asymmetry compared to the contralateral limb OR ankle dorsiflexion ROM less than 21°

Exclusion Criteria:

* Lower extremity injury or surgery within the past 6 months (including lateral ankle sprain)
* Diagnosed ankle osteoarthritis
* History of ankle surgery that involves intra-articular fixation
* Medical conditions which would be contraindications to mobilization/manipulation and/or transcranial magnetic stimulation, including cardiac pacemaker, metal implants in the head, current pregnancy, neurological disorders, recent use of stimulants or medications known to lower seizure threshold, and personal or family history of seizures

Primary outcomes:
measure: Changes in Muscle activation
timeFrame: Baseline and immediately after each manual therapy intervention; 1 week study
measure: Changes in Ankle dorsiflexion ROM
timeFrame: Baseline and immediately after each manual therapy intervention; 1 week study
measure: Changes in Dynamic Balance
timeFrame: Baseline and immediately after each manual therapy intervention; 1 week study
Secondary outcomes:
Other outcomes:
Locations:
city: Omaha
country: United States
facility: Creighton University
state: Nebraska
Study officials:
affiliation: Creighton University
name: Terry L Grindstaff, PhD, PT, ATC
role: PRINCIPAL_INVESTIGATOR
References:
citation: Grindstaff TL, Dolan N, Morton SK. Ankle dorsiflexion range of motion influences Lateral Step Down Test scores in individuals with chronic ankle instability. Phys Ther Sport. 2017 Jan;23:75-81. doi: 10.1016/j.ptsp.2016.07.008. Epub 2016 Jul 29.