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.
BACKGROUND
Altered neuromuscular function and decreased dorsiflexion range of motion (DFROM) have been observed in patients with chronic ankle instability (CAI). Joint mobilizations are indicated for restoring DFROM and dynamic postural control, yet it remains unknown if a mobilization can alter neuromuscular excitability in muscles surrounding the ankle.


OBJECTIVE
To determine the immediate effects of a Maitland grade III anterior-to-posterior joint mobilization on spinal-reflex and corticospinal excitability in the fibularis longus (FL) and soleus (SOL), DFROM, and dynamic postural control.


METHODS
Single-blinded randomized control trial.


METHODS
Research laboratory.


METHODS
30 patients with CAI randomized into a mobilization (n = 15) or control (n = 15) group.


METHODS
Maitland grade III anterior-to-posterior joint mobilization.


METHODS
Spinal-reflex excitability was measured with the Hoffmann reflex, while corticospinal excitability was evaluated with transcranial magnetic stimulation. DFROM was measured seated with the knee extended, and dynamic postural control was quantified with the Star Excursion Balance Test. Separate 2 × 2 repeated-measures ANOVAs were performed for each outcome measure. Dependent t tests were used to evaluate individual differences within groups in the presence of significance.


RESULTS
Spinal-reflex and corticospinal excitability of the SOL and FL were not altered in the mobilization or control group (P > .05). DFROM increased immediately after the mobilization (P = .05) but not in the control group, while dynamic postural control was unchanged in both groups (P > .05).


CONCLUSIONS
A single joint-mobilization treatment was efficacious at restoring DFROM in participants with CAI; however, excitability of spinal reflex and corticospinal pathways at the ankle and dynamic postural control were unaffected.
Dept of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Matthew
M
Harkey
Michelle
M
McLeod
Ashley
A
Van Scoit
Masafumi
M
Terada
Michael
M
Tevald
Phillip
P
Gribble
Brian
B
Pietrosimone
D000843:Ankle Joint / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D017063:Outcome Assessment, Health Care; D004856:Postural Balance / Q000502:physiology*; D016059:Range of Motion, Articular / Q000502:physiology*; D013628:Talus / Q000502:physiology*; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D055815:Young Adult