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Faculty Advisor(s)

Joaquin Barrios, PT, PhD

Description

Purpose/Hypothesis: Restricted ankle dorsiflexion (DF) mobility is a common musculoskeletal impairment. For intervention, ankle joint mobilizations are often utilized to address restricted DF. Interestingly, no studies have investigated the short-term effect duration of a joint mobilization intervention on restricted DF. Therefore, the purpose of this study was to observe the initial effectiveness and effect duration of a DF mobilization treatment. DF measures included both a static inclinometer-based weight-bearing lunge test (WBLT) as well as dynamic 3D motion capture-based peak ankle DF during a forward step down (FSD) task. We hypothesized that both measures would increase post-mobilization and fade to baseline within 1 hour.

Number of Subjects: 76 individuals responded to recruitment efforts seeking individuals with DF restriction, of which 26 (15 female, 22.3 ± 2.2 years old, body mass index 25.2 ± 2.9 kg/m2) qualified with a WBLT of ≤ 35° on at least one limb, provided informed consent and completed all testing.

Materials and Methods: Reflective markers were placed on the pelvis and qualifying test leg. If both limbs qualified, the limb with the greatest restriction was tested. A baseline WBLT measure and 3D motion capture of 5 consecutive FSD repetitions on a 6-inch box were obtained. Participants then viewed an instructional video of a talocrural joint self-mobilization using an elastic band. Participants were monitored during the mobilization. WBLT and FSD were collected again immediately post-mobilization and at 5-minute intervals for 60 minutes or until the WBLT returned to baseline for 2 consecutive measures. Repeated measures general linear models with Bonferroni adjustments were performed with the last observation carried forward for both DF measures.

Results: WBLT DF showed a mean increase of 6.5 degrees (p<0.001) post-mobilization. The effect faded over time and no longer differed from baseline 25 minutes post-mobilization (p=0.964). Dynamic peak ankle DF showed no changes post-mobilization at any time point (p≥0.546).

Conclusions: Partially consistent with our hypotheses, the self-applied joint mobilization increased static DF per the WBLT for a 20-25 minute period with fading effectiveness. The data suggest that restricted DF can be improved short-term with mobilization. However, increased dynamic ankle DF was not observed post-mobilization during the FSD functional task. Further research is warranted to investigate how increased DF mobility after mobilization can translate to improved dynamic joint function in those with restriction.

Clinical Relevance: DF mobilization was effective in increasing mobility for 20-25 minutes, on average. Effective utilization of this short time period of enhanced mobility is important.

However, improved mobility alone does not appear to change movement patterns. Clinicians should be aware of both fading effectiveness and the potential need for movement pattern retraining after a single DF mobilization.

Publication Date

5-2024

Disciplines

Physical Therapy | Rehabilitation and Therapy

Effectiveness of a Talocrural Joint Mobilization on Restricted Dorsiflexion: A Time Series Intervention Analysis

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