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Subacute lateral ankle sprains respond well to Mulligan concept in dorsiflexion range of motion recuperation: a placebo-controlled randomized trial

Machiels, Sylvie ; Ledoux, Hélène
(2020)

Files

Ledoux_Hélène_37501400Machiels_Sylvie_39651500.pdf
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Details

Supervisors
Nguyen, Anh Phong ; Hidalgo, Benjamin
Faculty
Faculté des sciences de la motricité
Degree label
Master [120] en sciences de la motricité, orientation générale
Abstract
BACKGROUND: Majority of lateral ankle sprains (LAS) will suffer from a reinjury or developed functional instability. Dorsiflexion range of motion (ROM) deficit is usually found after LAS and impact daily life activities. Mulligan mobilization with movement (MWM) is a manual therapy concept that combines active functional movement with manual adjustments. The goals are to improve ROM, pain or function in a pain free manner. DESIGN: Single blinded placebo-controlled randomized trial. METHODS: Fifty-one subacute LAS participants were recruited. A mulligan screening was used to assess responders. Then, responders were randomized in a MWM (intervention group) or Placebo group (fake treatement group). The MWM group received either lower tibiofibular MWM, talocrural MWM or cubometatarsal MWM. The most suitable technique for the patient according to Mulligan's concept was performed. The Placebo group executed active dorsiflexion mobilization with only pressure on the skin. The treatment was administered during three sessions, with four days apart. RESULTS: Forty-three participants were considered responders after the mulligan screening. Two-way ANOVA showed a significant improvement between session (p<0.001) in dorsiflexion ROM: +2.7 cm for the MWM group and +1.6 cm for Placebo group. Both groups improved between session similarly in pain (p=0.002), stiffness (p<0.001) and Y-Balanced-Test (p<0.001). Effect size (Cohen d) between T1-T6 for WBLT was higher in the Mulligan treatment than the placebo treatment (1.04 versus 0.56). CONCLUSION: More than 80% of LAS responded to the mulligan concept. Three sessions of Mulligan's treatment provided a significant clinical benefit on dorsiflexion ROM compared to a sham treatment.