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Immediate effects of manipulation of the talocrural joint on stabilometry and baropodometry in patients with ankle sprain.
Lopez-Rodriguez S, de-Las-Penas CF, Alburquerque-Sendin F, Rodriguez-Blanco C, Palomeque-del-Cerro L. J Manipulative Physiol Ther. 2007 Mar-Apr;30(3):186-92
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OBJECTIVE: This study assessed the immediate effects of talocrural joint manipulation on stabilometric and baropodometric outcomes in patients with grade II ankle sprain.
METHODS: Fifty-two field hockey players (35 men and 17 women) between 18 and 40 years old (mean = 22.5 years, SD = 3.6 years) were included in this study. A simple blind, intrapatient, placebo-controlled, and repeated-measures study was carried out. All the patients underwent a baropodometric study performed with a Foot Work force platform (4 times; pre-post placebo group and pre-post intervention group). The sample was subjected to two techniques of manipulative treatment: (a) talocrural joint manipulation and (b) posterior gliding manipulation over the talus. In a second instance, placebo manipulation was applied. Unilateral analysis of variance and multivariate analysis of variance were used for statistical analysis.
RESULTS: The results in the intervention group revealed significant differences in the percentage of posterior load on the foot (P = .015) and the percentage of bilateral anterior load (P = .02) before and after the manipulation. The placebo group did not show any change in any of the variables except for area (P = .045). Intergroup comparison revealed statistically significant differences in the increase in percentage of posterior load on the manipulated foot, percentage of bilateral posterior load, percentage of anterior load on the manipulated foot, and percentage of bilateral anterior load (with the exception of the total load on the foot).
CONCLUSIONS: The application of caudal talocrural joint manipulation, as compared with placebo manipulation, in athletic patients with grade II ankle sprain redistributed the load supports at the level of the foot.
Immediate Effects of Anterior-to-Posterior Talocrural Joint Mobilization after Prolonged Ankle Immobilization: A Preliminary Study.
Landrum EL, Kelln CB, Parente WR, Ingersoll CD, Hertel J.
J Man Manip Ther. 2008;16(2):100-5.
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Ankle dorsiflexion range of motion (ROM) typically decreases after prolonged immobilization. Anterior-to-posterior talocrural joint mobilizations are purported to increase dorsiflexion ROM and decrease joint stiffness after immobilization. The purpose of this study was to determine if a single bout of Grade III anterior-to-posterior talocrural joint mobilizations immediately affected measures of dorsiflexion ROM, posterior ankle joint stiffness, 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 degrees dorsiflexion ROM deficit compared to the contralateral ankle. A crossover design was employed so that half of the subjects received joint mobilizations first and half of the subjects received the control intervention (no treatment) first. All subjects ultimately received both treatments. Active dorsiflexion ROM was assessed with a bubble inclinometer, and posterior ankle stiffness and talar translation were assessed with an instrumented ankle arthrometer. After a single application of grade III anterior-to-posterior talocrural joint mobilization, dorsiflexion ROM and posterior ankle joint stiffness were significantly increased. There was also a trend toward less posterior talar translation immediately after mobilization. The trend toward decreased posterior talar translation and increased posterior ankle joint stiffness supports the positional fault theory. Correction of an anterior talar positional fault offers a possible explanation for these results.
Immediate manipulation for ankle sprain
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