Accumulative Effects of Talus Mobilization

Effects of Anteroposterior Talus Mobilization on Range of Motion, Pain, and Functional Capacity in Participants With Sub-acute and Chronic Ankle Injuries: A Randomized Controlled Trial

The purpose of this study is to verify the effect of anteroposterior talus mobilization on range of motion, pain, and functional capacity in participants with sub-acute and chronic ankle injuries.

The purpose of this study was to verify the acute effect (one session) and chronic (six sessions) and follow-up of the anteroposterior talus mobilization Maitland's grade III on range of motion, pain, and functional capacity in participants with sub-acute and chronic ankle injuries. Thirty eight volunteers subjects (male and female) participated of this study with minimum 18 and maximum 59 years old. The volunteers were allocated in two groups: experimental and control. The variables related to range of motion, pain and functional capacity were measured by biplane goniometer, Visual Analog Scale and Foot and Ankle Ability Measure respectively in four moments: 1- baseline; 2- after the first intervention; 3- after the sixth intervention (two weeks); 4- follow-up (one month). The experimental group received anteroposterior articular mobilization of the talus and the control group received manual contact.

The experimental group received joint mobilization (anteroposterior mobilization of the talus - Maitland grade III). During the mobilization cyclic movements were applied in an anteroposterior direction from the first tissue resistance barrier until the end of the accessory range of motion without any pain or discomfort. This mobilization maneuver was performed in 30-second duration sets with a 30-second interval between each set. The interventions lasted two weeks with three sessions each, completing six sessions.

The placebo group received only manual contact. This maneuver was performed in 30-second duration sets with a 30-second interval between each set. The interventions lasted two weeks with three sessions each, completing six sessions.

Inclusion Criteria: unilateral traumatic injury of the ankle with at least two weeks and maximum eight months at least a 5º limitation of passive dorsiflexion in comparison to the contralateral side do not be under another physical therapy treatment for the lesion able to unload partial or total body weight do not be in use of analgesic provided informed consent after receiving and explanation of all procedures and pertinent information regarding the study Exclusion Criteria: joint blockage by surgical fixation or ankylosis presence of vascular, rheumatic, neurological and neoplastic disease in the lower limb open or contagious lesion in the ankle region pain during palpation in the region anterior of the ankle

Hoch MC, Andreatta RD, Mullineaux DR, English RA, Medina McKeon JM, Mattacola CG, McKeon PO. 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 Nov;30(11):1798-804. doi: 10.1002/jor.22150. Epub 2012 May 18.

Landrum EL, Kelln CB, Parente WR, Ingersoll CD, Hertel J. Immediate Effects of Anterior-to-Posterior Talocrural Joint Mobilization after Prolonged Ankle Immobilization: A Preliminary Study. J Man Manip Ther. 2008;16(2):100-5. doi: 10.1179/106698108790818413.

Teixeira LM, Pires T, Silva RD, de Resende MA. Immediate effect of a single anteroposterior talus mobilization on dorsiflexion range of motion in participants with orthopedic dysfunction of the ankle and foot. J Manipulative Physiol Ther. 2013 Jul-Aug;36(6):369-75. doi: 10.1016/j.jmpt.2013.06.003. Epub 2013 Jul 11.

Hoch MC, McKeon PO. Joint mobilization improves spatiotemporal postural control and range of motion in those with chronic ankle instability. J Orthop Res. 2011 Mar;29(3):326-32. doi: 10.1002/jor.21256. Epub 2010 Sep 30.

Harkey M, McLeod M, Van Scoit A, Terada M, Tevald M, Gribble P, Pietrosimone B. The immediate effects of an anterior-to-posterior talar mobilization on neural excitability, dorsiflexion range of motion, and dynamic balance in patients with chronic ankle instability. J Sport Rehabil. 2014 Nov;23(4):351-9. doi: 10.1123/jsr.2013-0085. Epub 2014 Apr 3. Erratum In: J Sport Rehabil. 2015 May;24(2):197.