DOI QR코드

DOI QR Code

Short-term effects of joint mobilization with versus without voluntary movement in patients with chronic ankle instability: A single-blind randomized controlled trial

  • Kim, Hyunjoong (Sports Rehabilitation Center, The Better Hospital) ;
  • Song, Seonghyeok (Department of Physical Therapy, Graduate School of Sahmyook University) ;
  • Lee, Sangbong (Department of Physical Therapy, Graduate School of Sahmyook University) ;
  • Lee, Seungwon (Department of Physical Therapy, College of Health Science and Social Welfare, Sahmyook University)
  • Received : 2021.03.03
  • Accepted : 2021.03.15
  • Published : 2021.03.31

Abstract

Objective: Joint mobilization for arthrokinematics altered by the positional fault of chronic ankle instability (CAI) is an effective intervention for stabilization. In this study, we compared the effects of ankle dorsi flexion range of motion (DFROM) and dynamic balance ability (DBA) in CAI patients via passive joint mobilization (PJM), a method traditionally performed in previous studies, and active joint mobilization (AJM), a method that can have a greater effect on cortical excitability with spontaneous movements. Design: Single-blind two-arm randomized controlled trial Methods: A total of 30 participants were registered: 15 each to the PJM and AJM groups. Each participant received a total of 10 intervention sessions, 10 minutes per session, 5 times a week for 2 weeks. PJM used Maitland's mobilization method to apply joint mobilization with talus in the posterior direction and AJM used an angular joint motion to induce patient's voluntary motion of medial malleolus anterior gliding and lateral malleolus posterior gliding, respectively. DFROM of the ankle was measured by using tape and DBA was evaluated by using the balance system. Results: Significant improvement was observed after intervention in both the PJM and AJM groups except for the DBA-anterior and DBA-right variables of the PJM group. There were statistically significant differences between the AJM and PJM groups in the DFROM, DBA-anterior, DBA-posterior, and DBA-right variables. Conclusions: The overall improvement of DFROM and DBA was found to be more effective in joint mobilization including voluntary movement. When it is accompanied by voluntary movement, it further affects the neuromuscular system of the ankle.

Keywords

References

  1. Doherty C, Delahunt E, Caulfield B, Hertel J, Ryan J, Bleakley C. The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies. Sports Med. 2014;44:123-40. https://doi.org/10.1007/s40279-013-0102-5
  2. Roos KG, Kerr ZY, Mauntel TC, Djoko A, Dompier TP, Wikstrom EA. The epidemiology of lateral ligament complex ankle sprains in National Collegiate Athletic Association sports. Am J Sports Med. 2017;45:201-9. https://doi.org/10.1177/0363546516660980
  3. Al-Mohrej OA, Al-Kenani NS. Chronic ankle instability: Current perspectives. Avicenna J Med. 2016;6:103. https://doi.org/10.4103/2231-0770.191446
  4. Hertel J. Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. J Athl Train. 2002;37:364.
  5. Hertel J. Sensorimotor deficits with ankle sprains and chronic ankle instability. Clin Sports Med. 2008;27: 353-70, vii. https://doi.org/10.1016/j.csm.2008.03.006
  6. Pietrosimone BG, Gribble PA. Chronic ankle instability and corticomotor excitability of the fibularis longus muscle. J Athl Train. 2012;47:621-6. https://doi.org/10.4085/1062-6050-47.6.11
  7. Needle AR, Palmer JA, Kesar TM, Binder-Macleod SA, Swanik CB. Brain regulation of muscle tone in healthy and functionally unstable ankles. J Sport Rehabil. 2013;22:202-11. https://doi.org/10.1123/jsr.22.3.202
  8. Zech A, Hubscher M, Vogt L, Banzer W, Hansel F, Pfeifer K. Neuromuscular training for rehabilitation of sports injuries: a systematic review. Med Sci Sports Exerc. 2009;41:1831-41. https://doi.org/10.1249/MSS.0b013e3181a3cf0d
  9. Nitz AJ, Dobner JJ, Kersey D. Nerve injury and grades II and III ankle sprains. Am J Sports Med. 1985;13:177-82 https://doi.org/10.1177/036354658501300306
  10. Konradsen L, Magnusson P. Increased inversion angle replication error in functional ankle instability. Knee Surg Sports Traumatol Arthrosc. 2000;8:246-51. https://doi.org/10.1007/s001670000124
  11. Cain MS, Kyeongtak S, Blackburn JT, Kimmery M, Erik AW. The Immediate Effects of Ankle Joint Mobilization on Ankle Musculotendinous Stiffness in Individuals With Chronic Ankle Instability. International Journal of Athletic Therapy and Training. 2021;26:106-10. https://doi.org/10.1123/ijatt.2019-0122
  12. Hing W, Bigelow R, Bremner T. Mulligan's Mobilization with Movement: A Systematic Review. J Man Manip Ther. 2009;17:E39-E66. https://doi.org/10.1179/jmt.2009.17.2.39E
  13. Hing W. The Mulligan concept of manual therapy. Sydney: Churchill Livingstone; 2015.
  14. Myers KM, Davis M. Behavioral and neural analysis of extinction. Neuron. 2002;36:567-84. https://doi.org/10.1016/S0896-6273(02)01064-4
  15. Zusman M. Mechanisms of musculoskeletal physiotherapy. Physical Therapy Reviews. 2004;9:39-49. https://doi.org/10.1179/108331904225003973
  16. Cruz-Diaz D, Lomas Vega R, Osuna-Perez MC, Hita-Contreras F, Martinez-Amat A. Effects of joint mobilization on chronic ankle instability: a randomized controlled trial. Disabil Rehabil. 2015;37:601-10. https://doi.org/10.3109/09638288.2014.935877
  17. LeClaire JE, Wikstrom EA. Massage for Postural Control in Individuals With Chronic Ankle Instability. Athletic training & sports health care. 2012;4:213-9. https://doi.org/10.3928/19425864-20120731-02
  18. Hoch MC, Andreatta RD, Mullineaux DR, English RA, Medina McKeon JM, Mattacola CG, et al. Two-week joint mobilization intervention improves self-reported function, range of motion, and dynamic balance in those with chronic ankle instability. J Orthop Res. 2012;30:1798-804. https://doi.org/10.1002/jor.22150
  19. Vicenzino B, Branjerdporn M, Teys P, Jordan K. Initial changes in posterior talar glide and dorsiflexion of the ankle after mobilization with movement in individuals with recurrent ankle sprain. J Orthop Sports Phys Ther. 2006;36:464-71. https://doi.org/10.2519/jospt.2006.2265
  20. Hoch MC, McKeon PO. The effectiveness of mobilization with movement at improving dorsiflexion after ankle sprain. J Sport Rehabil. 2010;19:226-32. https://doi.org/10.1123/jsr.19.2.226
  21. Kim Y, Lee G. Immediate Effects of Angular Joint Mobilization (a New Concept of Joint Mobilization) on Pain, Range of Motion, and Disability in a Patient with Shoulder Adhesive Capsulitis: A Case Report. Am J Case Rep. 2017;18:148-56. https://doi.org/10.12659/AJCR.900858
  22. Hoch MC, McKeon PO. Normative range of weight-bearing lunge test performance asymmetry in healthy adults. Man Ther. 2011;16:516-9. https://doi.org/10.1016/j.math.2011.02.012
  23. Bennell KL, Talbot RC, Wajswelner H, Techovanich W, Kelly DH, Hall AJ. Intra-rater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion. Aust J Physiother. 1998;44:175-80. https://doi.org/10.1016/S0004-9514(14)60377-9
  24. Konor MM, Morton S, Eckerson JM, Grindstaff TL. Reliability of three measures of ankle dorsiflexion range of motion. Int J Sports Phys Ther. 2012;7:279-87.
  25. Kim KJ, Heo M. Effects of virtual reality programs on balance in functional ankle instability. J Phys Ther Sci. 2015;27:3097-101. https://doi.org/10.1589/jpts.27.3097
  26. Perron M, Hebert LJ, McFadyen BJ, Belzile S, Regniere M. The ability of the Biodex Stability System to distinguish level of function in subjects with a second-degree ankle sprain. Clin Rehabil. 2007;21:73-81. https://doi.org/10.1177/0269215506071288
  27. Cohen J. Eta-Squared and Partial Eta-Squared in Fixed Factor Anova Designs. Educational and Psychological Measurement. 1973;33:107-12. https://doi.org/10.1177/001316447303300111
  28. Cohen J. Statistical power analysis for the behavioral sciences 2nd edn. Erbaum Press ,NJ, USA
  29. Hoch MC, McKeon PO. Joint mobilization improves spatiotemporal postural control and range of motion in those with chronic ankle instability. J Orthop Res. 2011;29:326-32. https://doi.org/10.1002/jor.21256
  30. Marron-Gomez D, Rodriguez-Fernandez AL, Martin-Urrialde JA. The effect of two mobilization techniques on dorsiflexion in people with chronic ankle instability. Phys Ther Sport. 2015;16:10-5. https://doi.org/10.1016/j.ptsp.2014.02.001
  31. Powden CJ, Hogan KK, Wikstrom EA, Hoch MC. The effect of 2 forms of talocrural joint traction on dorsiflexion range of motion and postural control in those with chronic ankle instability. J Sport Rehabil. 2017;26:239-44. https://doi.org/10.1123/jsr.2015-0152
  32. McKeon PO, Wikstrom EA. Sensory-targeted ankle rehabilitation strategies for chronic ankle instability. Med Sci Sports Exerc. 2016;48:776-84. https://doi.org/10.1249/MSS.0000000000000859
  33. Denegar CR, Hertel J, Fonseca J. The effect of lateral ankle sprain on dorsiflexion range of motion, posterior talar glide, and joint laxity. J Orthop Sports Phys Ther. 2002;32:166-73. https://doi.org/10.2519/jospt.2002.32.4.166
  34. Tomruk M, Soysal Tomruk M, Alkan E, Gelecek N. Immediate Effects of Ankle Joint Mobilization With Movement on Postural Control, Range of Motion, and Muscle Strength in Healthy Individuals: A Randomized, Sham-Controlled Trial. J Sport Rehabil. 2020;29:1060-8.. https://doi.org/10.1123/jsr.2019-0198
  35. Someeh M, Norasteh AA, Daneshmandi H, Asadi A. Immediate effects of Mulligan's fibular repositioning taping on postural control in athletes with and without chronic ankle instability. Phys Ther Sport. 2015;16:135-9. https://doi.org/10.1016/j.ptsp.2014.08.003
  36. Shi X, Han J, Witchalls J, Waddington G, Adams R. Does treatment duration of manual therapy influence functional outcomes for individuals with chronic ankle instability: A systematic review with meta-analysis? Musculoskelet Sci Pract. 2019;40:87-95. https://doi.org/10.1016/j.msksp.2019.01.015
  37. Rosen AB, Yentes JM, McGrath ML, Maerlender AC, Myers SA, Mukherjee M. Alterations in Cortical Activation Among Individuals With Chronic Ankle Instability During Single-Limb Postural Control. J Athl Train. 2019;54:718-26. https://doi.org/10.4085/1062-6050-448-17