title: Initial changes in posterior talar glide and dorsiflexion of the ankle after mobilization with movement in individuals with recurrent ankle sprain.
abstract: METHODS
  A double-blind randomized crossover experimental study with repeated measures, including a no-treatment control condition.
  
  
  OBJECTIVE
  To evaluate the initial effect of 2 mobilization with movement (MWM) treatment techniques performed in weight bearing and non-weight bearing on posterior talar glide and talocrural dorsiflexion in individuals with recurrent lateral ankle sprain.
  
  
  BACKGROUND
  MWM treatment techniques are commonly used in the treatment of musculoskeletal pain, such as lateral ankle sprain. Recent evidence indicates that a lack of posterior talar glide and weight-bearing ankle dorsiflexion are common physical impairments in individuals with recurrent ankle sprains. MWM of the ankle joint involves the application of a combined posterior talar glide mobilization and active dorsiflexion movement. The recurrent ankle sprain injury and the MWM treatment techniques for the ankle seemingly provide an appropriate model to further evaluate the effects and mechanism(s) of action of the MWM treatment techniques in a way that they have not been tested to date.
  
  
  METHODS
  Sixteen subjects (mean +/- SD age, 19.8 +/- 2.3 years) with a history of recurrent lateral ankle sprain and deficits in posterior talar glide (71%) and weight-bearing dorsiflexion (34%) were studied. A within-subjects study design was used to evaluate the effect of 2 independent variables: treatment conditions (weight-bearing MWM, non-weight-bearing MWM, and a no-treatment control group) and time (pretreatment and posttreatment) on the dependent variables of posterior talar glide and weight-bearing dorsiflexion.
  
  
  RESULTS
  Both the weight-bearing and non-weight-bearing MWM treatment techniques significantly improved posterior talar glide by 55% and 50% of the preapplication deficit between affected and unaffected sides, respectively, which was significantly greater than that of the control group (P<.001). The weight-bearing and non-weight-bearing MWM treatment techniques improved weight-bearing dorsiflexion by 26% (P<.017), compared to 9% for the control condition. The change in posterior talar glide, expressed as a proportion of pretreatment deficit, was correlated to the change in weight-bearing dorsiflexion (r = .88, P<.001), but only after the weight-bearing MWM technique.
  
  
  CONCLUSIONS
  This preliminary study demonstrated an initial ameliorative effect of MWM treatment techniques on posterior talar glide and dorsiflexion range of motion in individuals with recurrent lateral ankle sprain. These results suggest that this technique should be considered in rehabilitation programs following lateral ankle sprain. This study provides justification for follow-up research of the long-term effects of MWM on lateral ankle sprain and proposes further work be conducted on the posterior talar glide test.
authors.affiliation: Department of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia. b.vicenzino@uq.edu.au
authors.forename: Bill
authors.initials: B
authors.lastname: Vicenzino
authors.forename: Michelle
authors.initials: M
authors.lastname: Branjerdporn
authors.forename: Pam
authors.initials: P
authors.lastname: Teys
authors.forename: Kate
authors.initials: K
authors.lastname: Jordan
mesh_terms: D000328:Adult; D016512:Ankle Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D000843:Ankle Joint / Q000502:physiology*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D017844:Lateral Ligament, Ankle / Q000293:injuries; D008297:Male; D009068:Movement; D016059:Range of Motion, Articular; D012008:Recurrence; D013180:Sprains and Strains / Q000503:physiopathology / Q000534:rehabilitation*; D013628:Talus / Q000502:physiology*; D016474:Weight-Bearing