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- Title
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.
- Authors
Harkey, Matthew; McLeod, Michelle; Van Scoit, Ashley; Terada, Masafumi; Tevald, Michael; Gribble, Phillip; Pietrosimone, Brian
- Abstract
CONTEXT: 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. DESIGN: Single-blinded randomized control trial. SETTING: Research laboratory. PATIENTS: 30 patients with CAI randomized into a mobilization (n = 15) or control (n = 15) group. INTERVENTION: Maitland grade III anterior-to-posterior joint mobilization. MAIN OUTCOME MEASURES: 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). CONCLUSION: 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.
- Subjects
ANKLE physiology; CALF muscle physiology; ANALYSIS of variance; ANKLE; ANKLE injuries; ANTHROPOMETRY; ATHLETIC trainers; CONFIDENCE intervals; POSTURAL balance; JOINT hypermobility; RANGE of motion of joints; NEUROPHYSIOLOGY; PHYSICAL therapy; PROBABILITY theory; REFLEXES; RESEARCH evaluation; STATISTICAL sampling; SPRAINS; STATISTICS; T-test (Statistics); TRANSCRANIAL magnetic stimulation; DATA analysis; EFFECT sizes (Statistics); RANDOMIZED controlled trials; PRE-tests &; post-tests; REPEATED measures design; BLIND experiment; DATA analysis software; DESCRIPTIVE statistics; H-reflex; DISEASE complications
- Publication
Journal of Sport Rehabilitation, 2014, Vol 23, Issue 4, p351
- ISSN
1056-6716
- Publication type
Article
- DOI
10.1123/JSR.2013-0085