injuries, it is paramount that intervention strategies are developed to restore functional ranges of DFROM. There are various interventions that have been used to increase DFROM at the ankle, such as mobilizations, stretching, foam rolling, etc. One specific manual therapy technique is Mulligan’s
Jennifer E. Meyer, Matthew J. Rivera and Cameron J. Powden
James May, Ryan Krzyzanowicz, Alan Nasypany, Russell Baker and Jeffrey Seegmiller
Although randomized controlled trials indicate that the Mulligan Concept (MC) of mobilization with movement can improve pain-free grip strength and pressure pain threshold in patients with lateral epicondylalgia of the elbow, improve ankle dorsiflexion in patients with subacute ankle sprains, and decrease the signs and symptoms of patients with cervicogenic headache, little is known about the clinical application, use, and profile of certified Mulligan practitioners (CMPs) in America.
To better understand the use and value of applying the MC philosophy in clinical-care environments from the perspective of American CMPs while establishing a clinical profile of a CMP.
Quantitative descriptive design. Setting: Online survey instrument.
Data Collection and Analysis:
Online survey instrument.
CMPs use the MC to treat a broad spectrum of spinal and peripheral clinical pathologies in primarily outpatient clinics with an active and athletic population. American CMPs also find value in the MC.
American CMPs continue to use and find value in the MC intervention strategy to treat a broad spectrum of spinal and peripheral conditions in their clinical practices.
Alex J. Rhinehart and Caroline C. Guindon
A 21-year-old female NCAA Division III soccer player presented with an insidious onset of posterior ankle pain. Lateral radiographs revealed a Stieda process, leading to a physician diagnosis of posterior ankle impingement (PAI). Mulligan Concept mobilizations with movement (MWM) were used to ameliorate patient complaints. The MWM glide was maintained during activity using a tape application. Return to play and patient improvement occurred dramatically faster while utilizing the MWM technique than other traditional methods used to treat this condition. This case report demonstrates a novel approach to treating Stieda process-related PAI that warrants further clinical inquiry.
Marjan Someeh, Ali Asghar Norasteh, Hassan Daneshmandi and Abbas Asadi
Ankle sprains or chronic ankle instability (CAI) is common in athletes and a common method for decreasing the effects of ankle instable is using tape.
To determine whether Mulligan ankle taping (MAT) influenced the functional performance (FP) tests in athletes with and without CAI.
A cross-sectional study using a within-subject experimental design between four ankle conditions (taped and untaped, athletes with and without CAI).
Sixteen professional athletes with unilateral CAI (10 men and 6 women; age 23.2 ± 3 years, height 175.4 ± 10.3 cm, weight 73 ± 14.5 kg, and body mass index 23.8 ± 3.6%) and 16 uninjured professional athletes (10 men and 6 women; age 22.8 ± 1.7 years, height 173.6 ± 12.2 cm, weight 66.4 ± 11.4 kg, and body mass index 22.2 ± 3.3%) volunteered to participant in this study.
Mulligan ankle taping.
Main Outcome Measures:
FP tests including single leg hopping course, Figure-of-8 hop and side hop were measured for both the groups in two conditions: taped and untaped.
There were significant differences between injured and uninjured athletes in all FP tests (P < .05). MAT significantly improved FP tests in both groups (P < .05).
We found that MAT can improve FP tests in athletes with CAI and uninjured athletes. Therefore, it seems that MAT can be an effective method for enhancing athletes’ performance in sports that require lateral movements.
James M. May, Alan Nasypany, Julie Paolino, Russell Baker and Jeffrey Seegmiller
While the incidence and reinjury rates of lateral ankle sprain (LAS) continue to persist at high rates across many sporting activities, further exploration of assessment and treatment beyond the traditional ligamentous and strength/proprioceptive model is warranted. Further, assessing and treating both arthrokinematic and osteokinematic changes associated with LAS can provide insight into a more diverse approach to treating ankle pathology.
To examine the clinical use of the Mulligan Concept mobilization with movement (MWM) while treating patients diagnosed with an acute grade I or II LAS through authentic patient care.
An a priori case series.
Intercollegiate athletic training clinic.
Intercollegiate patients diagnosed with an acute grade I or II LAS.
The Mulligan Concept distal fibular anterior to posterior MWM.
Main Outcome Measures:
Pain-Intensity Numeric Rating Scale (NRS) with Non-Weight Bearing (NRS-NWB) and Weight Bearing (NRS-WB), Disablement of the Physically Active Scale (DPAscale), Foot and Ankle Ability Measure (FAAM) with Activity of Daily living (FAMM-ADL) and Sport (FAAM-Sport), Client Specific Impairment Measure (CSIM), Y-Balance Composite (YBC), and Weight Bearing Measure for Dorsiflexion (WBDF).
Patients who are diagnosed with an acute grade I or II LAS and are treated with the Mulligan Concept report immediate and long-lasting minimal clinically important differences in patient outcome measures.
Clinicians who examine and use the Mulligan Concept MWM to treat acute LAS can expect immediate positive results that are progressively retained over time specific to patient-centered outcome measures as well as functional clinicianbased measures. Based on the immediate and positive results, clinicians should examine associated osteokinematic and arthrokinematic changes beyond that of the traditional ligamentous model.
Russell T. Baker, Alan Nasypany, Jeff G. Seegmiller and Jayme G. Baker
Kari Brody, Russell T. Baker, Alan Nasypany and Jeff Seegmiller
Jessica Mulligan and David J. Leonard
Stephen Jarrell and Robert F. Mulligan
College athletic directors face the difficulty of setting a price for goods and services they provide to the public. One complementary good provided as a part of major college sports events is game-day programs. This paper estimates a demand function for football programs using 11 years of data for an NCAA Division I-AA college. Least median of squares (LMS), a new outlier-resistant estimation technique, is used to refine the model and provide a more useful estimate of the demand function. The revenue- and profit-maximizing program price is found and compared with prices actually charged throughout the sample period.
Murat Tomruk, Melda Soysal Tomruk, Emrullah Alkan and Nihal Gelecek
weight-bearing (WB) and daily living activities. 3 Joint mobilization techniques have widely been used to restore normal arthrokinematics of ankle joint. 4 , 5 Mulligan’s mobilization with movement (MWM) technique is a different theoretical approach compared with other joint mobilization systems, as it