Immediate Effects of Anterior-to-Posterior Talocrural Joint Mobilization after Prolonged Ankle Immobilization: A Preliminary Study

Abstract

ABSTRACT:Ankle dorsifl exion range of motion (ROM) typically decreases aft er prolonged immobilization. Anterior-to-posterior talocrural joint mobilizations are purported to increase dorsifl exion ROM and decrease joint stiff ness aft er immobilization. Th e purpose of this study was to determine if a single bout of Grade III anterior-to-posterior talocrural joint mobilizations immediately aff ected measures of dorsifl exion ROM, posterior ankle joint stiff ness, and posterior talar translation in ankles of patients who had been immobilized at least 14 days. Ten physically active patients (5 males, 5 females; age=21.4+3.3 years) participated. Each had the ankle immobilized following a lower extremity injury for at least 14 days and presented with at least a 5° dorsifl exion ROM defi cit compared to the contralateral ankle. A crossover design was employed so that half of the subjects received joint mobilizations fi rst and half of the subjects received the control intervention (no treatment) fi rst. All subjects ultimately received both treatments. Active dorsifl exion ROM was assessed with a bubble inclinometer, and posterior ankle stiff ness and talar translation were assessed with an instrumented ankle arthrometer. Aft er a single application of grade III anterior-to-posterior talocrural joint mobilization, dorsifl exion ROM and posterior ankle joint stiff ness were signifi cantly increased. Th ere was also a trend toward less posterior talar translation immediately aft er mobilization. Th e trend toward decreased posterior talar translation and increased posterior ankle joint stiff ness supports the positional fault theory. Correction of an anterior talar positional fault off ers a possible explanation for these results.

Increased treatment durations lead to greater improvements in non-weight bearing dorsiflexion range of motion for asymptomatic individuals immediately following an anteroposterior grade IV mobilisation of the talus

“…The talus was then glided posteriorly with downward force applied by the mobilising hand (AP) (Houglum, 2010). The joint mobilisation was operationally defined as a grade IV, 1 second rhythmic oscillation with translation taken to tissue resistance (Landrum et al, 2008). The oscillatory technique was chosen in order to load and unload the tissue in a similar way to that which would occur functionally (Banks & Hengeveld, 2010).…”

“…Research has also shown that significant increases in DF-ROM can be gained from low dose AP mobilisation treatments. Venturini et al (2007) concluded that a treatment prescription of two, 30 second bouts elicited a 2 0 improvement in DF-ROM, whilst Landrum et al (2008) recorded an increase of 4.4 0 following a single 30 second mobilisation. These studies highlight how minimal treatment doses can produce clinically significant outcomes.…”

Effects of a Proximal or Distal Tibiofibular Joint Manipulation on Ankle Range of Motion and Functional Outcomes in Individuals With Chronic Ankle Instability

“…11,23,25,43,44,46,[59][60][61][62] Mobilization or manipulation of the talocrural joint has been shown to result in improvements in dorsiflexion ROM and function. 11,13,25,33,38,44,46,59 Specifically, individuals with CAI have been shown to demonstrate increased ankle dorsiflexion ROM and improved balance following talocrural joint mobilization. 33 Because a positional fault of the fibula 35,36 may also contribute to limitations in dorsiflexion ROM following lateral ankle sprains, it is logical that manual interventions directed at the proximal or distal tibiofibular joints may also improve motion and function.…”

Normal sensory and range of motion (ROM) responses during Thoracic Slump Test (ST) in asymptomatic subjects

“…28,29 This might be due to greater available ROM for CF compared to AD. 30 The changes in ROM were comparable to ROM changes recommended as normal response described for other NDTs.…”