The Evaluation of Joint Mobilization Dosage on Ankle Range of Motion in Individuals With Decreased Dorsiflexion and a History of Ankle Sprain

in Journal of Sport Rehabilitation
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Context: Mulligan’s Mobilization with Movement (MWM) is a common intervention used to address dorsiflexion range of motion (DFROM) impairments. However, the treatment dosage of MWMs varies within the literature. Objective: The aim of this study was to examine the effect of serial MWM application on DFROM. Design: Repeated-measures cohort. Setting: A Midwestern University and the surrounding community. Participants: A total of 18 adults (13 females; age = 29 [12.87] y; DFROM = 30.26° [4.60°]) with decrease dorsiflexion (<40°) participated. Inclusion criteria consisted of a history of ≥1 ankle sprain, ≥18 years old, no lower-extremity injury in the last 6 months, and no history of foot/ankle surgery. Intervention: Participants completed a single data collection session consisting of 10 individual sets of MWMs. Main Outcome Measures: DFROM was taken at baseline and immediately after each intervention set (post 1, post 2, … post 10). DFROM was measured with a digital inclinometer on the anterior aspect of the tibia during the weight-bearing lunge test with the knee straight and knee bent. Analysis of variances examined DFROM changes over time. Post hoc analysis evaluated sequential pairwise comparisons and changes from baseline at each time point. Results: Analysis of variance results indicated a significant time main effect for weight-bearing lunge test with knee bent (P < .001) and a nonsignificant effect for weight-bearing lunge test with knee straight (P < .924). Post hoc analysis indicated improvements in the weight-bearing lunge test with knee bent at each timepoint compared with baseline (P < .005). Post 2 improved compared with post 1 (P = .027). No other pairwise sequential comparisons were significant (P > .417). Conclusions: MWMs significantly improved acute knee bent DFROM and indicated that after 2 sets of MWMs, no further DFROM improvements were identified. Future research should investigate the lasting effects of DFROM improvements with variable MWM dosages.

Meyer is with Indiana State University, Terre Haute, IN, USA. Rivera is with the Doctorate in Athletic Training Program, Indiana State University, Terre Haute, IN, USA. Powden is with the Masters of Science in Athletic Training Program, University of Indianapolis, Indianapolis, IN, USA.

Powden (powdenc@uindy.edu) is corresponding author.
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