Mulligan mobilisation with movement concept in the assessment and treatment of subacute ankle sprain: a randomised and placebo trial.

BACKGROUND&OBJECTIVES: Lateral ankles sprains (11) are the most common injury in musculoskeletal field. However, and significant number of LAS develop chronic ankle instability (CAI). Mulligan mobilization with movement (MWM) is a manual therapy concept that combine active functional movement with manual adjustments, the goals are to improve ROM, pain or function in a pain free manner. The aim of this study is to assess how many patients with DROM limitation following LAS could respond to the MWM and if it is more effective than a sham treatment. METHODS: Patients with LAS grade I/II were included. MWM approach were used to assess the respondent patient. Assessment included Inferior Tibiofibular MWM or Talocrural MWM or Cubometatarsal MWM. If patient did not respond they were excluded. Respondent patients were then randomized into MWM or SHAM group, i.e. 3 sessions MWM. Two-way repeated measure ANOVA was used to assess the efficiency of group and session for DROM, Pain, Scale rigidity sensation, Y-Balance-Test (YBT), Forward Step-Down test (FSD), Balance Error System Scoring (BESS), FAAM questionnaire. RESULTS: Both groups improved in dorsiflexion ROM: +2.5cm for MWM group and +1,2cm for sham group. Both groups improved similarly in pain, scale rigidity, YBT, FSD, BESS and FAAM. CONCLUSION: Patients with LAS seems to respond positively to MWM treatment. MWM treatment seems to improve significantly DROM limitations with real clinical improvement (over the MCID of 1,9 cm).