Effects of MET vs Mulligan MWM on Pain, Disability & Balance in Athletes With Ankle Sprain

Effects of Post Isometric Relaxation Versus Mulligan Mobilization With Movement on Pain, Disability and Dynamic Balance in Athletes With Chronic Ankle Sprain

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.

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.

effects of post-isometric relaxation on pain, disability and dynamic balance in athletes with chronic ankle sprain

effects of mulligan mobilization with movement on pain, disability and dynamic balance in athletes with chronic ankle sprain

The therapist will apply Post isometric relaxation 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.

Changes from baseline numeric pain rating scale for pain from 0-10 (0 means no pain and 10 means worst pain)

Participants are instructed to lunge forward until their knee touches the wall (vertical line). The heel is required to remain in contact with the floor at all times. The foot is moved away from the wall to the point where the knee can only make slight contact with the wall, while the heel remains in contact with the floor. This puts the ankle joint in maximal dorsiflexion. The leg not being tested can rest on the the floor and participants are allowed to hold onto the wall for support. The maximum distance from the wall to the tip of the big toe is recorded. The distance is measured in centimeters (cm) with each centimeter corresponding to approximately 3.6° of ankle dorsiflexion

The Star Excursion Balance Test is a dynamic test that requires strength, flexibility, and proprioception.

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

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