Effects of Talocrural Joint Mobilizations in the Treatment of Subacute Lateral Ankle Sprains

The goal is to determine if standard therapy including joint mobilizations of the ankle performed 3 times per week for 2 weeks will increase self-reported function and decrease pain in patients with mild lateral ankle sprains.

Study Overview

• Status: Unknown
• Conditions: Ankle Sprain
• Intervention / Treatment: Other: Sham intervention; Other: Mobilization therapy in addition to standard therapy

Detailed Description

The purpose of this protocol is to assess the effects of grade IV anterior to posterior joint mobilization on self-reported function, dorsiflexion range of motion and talar glide on subjects suffering from lateral ankle sprain in the past 2-10 days and exhibit 5 degree dorsiflexion deficit in range of motion or a restriction in posterior glide of the talus.

• Study Type: Interventional
• Enrollment (Anticipated): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Virginia
    • Charlottesville, Virginia, United States, 22908
      • Recruiting
      • University of Virginia
      • Contact: Terry Grindstaff, PhD, DPT; Phone Number: 434-243-2430; Email: tlg6q@virginia.edu
      • Contact: Nicole Cosby, MS, ATC; Phone Number: 434-924-6184; Email: nlb4v@virginia.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 50 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Incomplete tear of lateral ligaments with mild laxity as measured by anterior drawer test and talar tilt
• Slight reduction in function
• Anterolateral ankle tenderness
• Dorsiflexion ROM asymmetry greater than 5° compared to uninvolved limb
• Posterior talar glide restriction greater than 5° compared to uninvolved limb; or
• Posterior talar glide less than 19°, which is one standard deviation (7°) from our previously established normative values (26°)9, 10
• Suffered from grade 1 or 2 lateral ankle sprain within the last 48hr - 8 days

Exclusion Criteria:

• A history of ankle surgery that involves intra-articular fixation,
• Syndesmotic ankle sprain (to be ruled out based on clinical examination),
• History or signs of reflex sympathetic dystrophy,
• Have received manual therapy for the ankle sprain prior to enrollment
• Grade III ankle sprain.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Sham Comparator: "Laying of hands" plus standard therapy; Subjects will lie on their back as if they were receiving the joint mobilization treatment and the therapist will place their hands in a position as if to perform the mobilization but no movement will occur. Standard therapy will consist of ankle strengthening exercises with elastic bands, balance, active ROM, and 20 minutes of ice bag application, elevation and compression	Other: Sham intervention; Physical therapist will lay hands as if to perform the joint mobilization but no movement will occur.
Experimental: Standard therapy with joint mobilization; This group will receive three 60-second bouts of posterior joint mobilizations applied to the ankle joint during each treatment session, in addition to standard therapy. Standard therapy will consist of ankle strengthening exercises with elastic bands, balance, active ROM, and 20 minutes of ice bag application, elevation and compression	Other: Mobilization therapy in addition to standard therapy; Subject will receive three 60-second bouts of posterior joint mobilizations applied to the ankle joint during each treatment session. Standard therapy will consist of ankle strengthening exercises with elastic bands, balance, active ROM, and 20 minutes of ice bag application, elevation and compression.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in self-reported function	We hypothesize that the group that receives joint mobilization in addition to standard therapy will show greater improvements in Functional Ankle and Ability Measure (FAAM) and FAAM-Sport (FAAM-S) scores than those who receive standard therapy alone.	Baseline and four weeks
Change in self-reported pain	We hypothesize visual analog scale (VAS) scores for pain will have a greater improvement in those who received joint mobilization in addition to standard therapy when compared to standard therapy alone.	Baseline and 4 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in ankle dorsiflexion range of motion	We hypothesize that mobilization when applied to the talocrural joint in addition to standard therapy will result in a greater increase of ankle dorsiflexion ROM than just standard therapy alone.	Baseline and 4 weeks
Change in ligamentous laxity	We hypothesize that ligamentous laxity in both groups will be reduced.	Baseline and 4 weeks

Collaborators and Investigators

• Sponsor: University of Virginia
• Collaborators: American Physical Therapy Association
• Investigators: Principal Investigator: Terry Grindstaff, PhD, DPT, University of Virginia

Study record dates

Study Major Dates

• Study Start: April 1, 2010
• Primary Completion (Anticipated): December 1, 2011
• Study Completion (Anticipated): December 1, 2011

Study Registration Dates

• First Submitted: May 4, 2010
• First Submitted That Met QC Criteria: May 5, 2010
• First Posted (Estimate): May 6, 2010

Study Record Updates

• Last Update Posted (Estimate): May 30, 2011
• Last Update Submitted That Met QC Criteria: May 26, 2011
• Last Verified: May 1, 2011

More Information

Terms related to this study

• Keywords: ankle sprain; arthritis; athletic injury
• Additional Relevant MeSH Terms: Wounds and Injuries; Leg Injuries; Sprains and Strains; Ankle Injuries
• Other Study ID Numbers: 14919