The Effect of Different Talocrural Joint Mobilization Techniques in Lateral Ankle Sprain

August 5, 2024 updated by: Pelin Pişirici, Bahçeşehir University

Investigation of the Effects of Different Talocrural Mobilization Techniques on Jumping Performance and Kinesiophobia in Professional Basketball Players With Lateral Ankle Sprain -Randomized Single-Blind Study

Decreased ankle dorsiflexion range of motion (DFROM) has been identified among the factors that increase the risk of lateral ankle sprain (LAS) in basketball players. Restoring the DFROM is important in restoring reduced functional abilities and reducing the risk of re-injury. There is evidence that talocrural joint mobilization improves DFROM, but studies investigating the effectiveness of different mobilization techniques are needed. Our study aims to investigate the effects of single-session Mulligan and Maitland talocrural joint mobilization methods on dorsiflexion joint range of motion, jumping performance, and kinesiophobia in elite basketball players.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Lateral ankle sprain (LAS) accounts for 80% of all ankle injuries. LAS injuries have high recurrence rates and are the most common injury type in basketball players with a rate of 41.1%. Many LAS injuries; It occurs in situations such as falling to the ground after jumping, at the end of the swing phase, during contact of the foot with the ground, in hard turns, collision, falling and sudden stopping. Decreased ankle dorsiflexion range of motion has been identified among the factors that increase the risk of LAS in basketball players. Dorsiflexion range of motion (DFROM) of the ankle is important in restoring reduced functional abilities and reducing the risk of re-injury. Among the talocrural antero-posterior mobilization techniques, Maitland 3rd degree talocrural anterior-posterior mobilization and Mulligan talocrural mobilization with movement are frequently preferred mobilization methods. Ankle DFROM limitation reduces the ability to absorb force through the lower extremity during jumping and landing, resulting in a decrease in vertical jumping ability. Fear of movement, called kinesiophobia, is a primary psychosocial construct in the fear-avoidance model. The development of chronic pain to sports injury appears to be a common psychological response. Because fear of re-injury can impact recovery as a barrier to return to sport, it is important to recognize fear of movement/re-injury to facilitate athletes' return to sport. Although kinesiophobia is associated with chronic orthopedic symptoms, there are no studies on athletes with LAS. There is little evidence regarding the association of kinesiophobia in athletes with chronic ankle instability, the advanced version of which presents with symptoms for 12 months or more. Although the effects of different treatment methods on kinesiophobia have been investigated in the literature, to our knowledge, the effect of talocrural joint mobilization on kinesiophobia has not been investigated. The study aimed to investigate the effects of different talocrural joint mobilization techniques on jumping performance and kinesiophobia in elite basketball players with LAS.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
72

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

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Study Contact

Study Contact

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Study Contact Backup

Study Locations

  • Turkey
    • Istanbul
      • Besiktas, Istanbul, Turkey, 34353
        • Bahçeşehir University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

18-35 years old Being a professional basketball player Clinical diagnosis of lateral ankle sprain in the last 12 months Having a Cumberland Ankle Instability Test score <24 >2.5 cm symmetry between the two extremities in the lunge test Not to participate in any ankle treatment program in the last three months, Being Volunteer

Exclusion Criteria:

History of lower extremity surgery History of disease that may affect sensorimotor function in the lower extremity Musculoskeletal disorders that may affect balance Having any musculoskeletal and orthopedic problems Having a history of previous ankle fracture or ankle surgery Presence of any visual impairment, metabolic, neurological or rheumatological disease

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Mulligan Group
Participants in the Mulligan group stood in front of the physical therapist at the end of the treatment table and placed their affected lower extremity forward and the other slightly backward. The physical therapist placed both hands on top of each other on the patient's talus to stabilize the talus. The athlete was asked to move until he reached the end of his pain-free ankle dorsiflexion range. Meanwhile, the physiotherapist gave posterior pushing with both hands. The Mulligan mobilization technique was performed 10 times by each athlete.
Other: Single lep drop jump test
All evaluations will be repeated before and after the treatment.
Other Names:
  • Weight-bearing lunge test
  • Tampa kinesiophobia scale
  • Fear Avoidance Belief Questionnaire
Experimental: Maitland Group
Maitland group, III. degree talus mobilization technique was applied. In this mobilization technique, 120 seconds of application, 60 seconds of rest, and then 120 seconds of application were performed. Maitland III, which takes 5 minutes in total. For the 10-degree mobilization technique, the participant was placed on his back with the foot pointing forward, the ankle was placed in 20° plantar flexion, and the talocrural ligament was in a relaxed position. The hand stabilizing the foot was placed proximal to the malleolus to stabilize the leg. The other hand performing the mobilization grasped the anterior talus using the first web space. The talus was then shifted posteriorly downwards with force.
Other: Single lep drop jump test
All evaluations will be repeated before and after the treatment.
Other Names:
  • Weight-bearing lunge test
  • Tampa kinesiophobia scale
  • Fear Avoidance Belief Questionnaire

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Single-leg drop jump test
Time Frame: baseline, immediately after the intervention
Upon instruction, participants will aim to fall to the ground with the leg to be tested from the 30 cm high step, with their hands on their hips, and then immediately jump as high as possible. Specific instructions are given as "minimizing ground contact time and maximizing bounce height," in line with previous research. A one-minute rest is allowed between attempts.
baseline, immediately after the intervention

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Weight-bearing lunge test
Time Frame: baseline, immediately after the intervention
Weight-bearing lunge test (WBLT) is frequently used in individuals with ankle instability in order to determine dorsiflexion normal joint movement. During WBLT the participant puts their hands on the wall and takes one leg forward and the other leg helps balance behind. The maximum distance that the knee touches the wall is recorded without allowing the heel of the front foot to lose contact with the ground.
baseline, immediately after the intervention
Tampa kinesiophobia scale
Time Frame: baseline, immediately after the intervention
The Tampa kinesiophobia (TKS) scale is often used in musculoskeletal injuries. TKS has a checklist of 17 questions. A 4-point Likert scoring (1= I strongly disagree, 4= I totally agree) is used in the scale. After reversing items 4, 8, 12 and 16, a total score is calculated. The person gets a total score between 17-68. A high score on the scale indicates a high level of kinesiophobia.
baseline, immediately after the intervention
Fear Avoidance Belief Questionnaire
Time Frame: baseline, immediately after the intervention
The Fear Avoidance Questionnaire is a 10-item instrument designed to measure fear avoidance related to injury in sports. All items have a Likert type scale (1-5) from "strongly disagree" to "strongly agree" to be scored. The FAQ score ranges from 10 to 50. A higher score indicates a higher level of fear related to sports injury.
baseline, immediately after the intervention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Bahçeşehir University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Study Director: Pelin Pişirici, PT, PhD, Bahcesehir University, Faculty of Health Sciences, Department of Physiotherapy
  • Principal Investigator: Arif Ozan Yıldırım, PT, MSc, Bahcesehir University, Graduate Education Institute

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
July 30, 2023

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
May 30, 2024

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
June 30, 2024

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
February 6, 2024

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 3, 2024

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
March 6, 2024

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
August 6, 2024

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 5, 2024

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
August 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • OPMM-Ankle Instability

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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