MOBILIZATION WITH MOVEMENT FOR ASSESSMENT AND TREATMENT IN SUBACUTE ANKLE SPRAINS PATIENTS : A RANDOMISED AND PLACEBO CONTROLLED TRIAL.

Nguyen, Anh Phong [UCL] Mahaudens, Philippe [UCL] Detrembleur, Christine [UCL] Yuval David Hidalgo, Benjamin [UCL]

BACKGROUND AND AIMS: Lateral ankles sprains (LAS) are one the most common musculoskeletal injury. However, their impact if often underestimated and a significant number of patients with LAS develop chronic ankle instability (CAI). Limitations of dorsiflexion range of motion (DROM) is a common impairment after LAS which could lead to CAI. Mulligan mobilization with movement (MWMs) are a group of manual therapy techniques that combine active functional movement with manual adjustments, the goals being to improve ROM, pain or function. Aim of this study was to assess how many patients with DROM limitation following LAS responded to MWMs and their efficiency compared to sham treatment. METHODS: Patients with LAS grade I/II were included. MWMs approach was used to assess the responding patient. Assessment included inferior tibiofibular, talocrural or cubometatarsal MWMs. Patients who did not responded to any of the three MWMs techniques were excluded. Responding patients were then randomised into MWM groups, i.e. 3 sessions of real MWMs, or sham group, i.e. 3 sessions of sham MWMs, i.e. without any pression applied. Two-way repeated measure ANOVA was used to assess the effect of interventions for DROM (with Wall-Toe-test and inclinometer), Pain, rigidity sensation, Y-Balance- Test (YBT), Forward-Step-Down test (FSD), Balance-Error-System-Scoring (BESS) and the FAAM questionnaire. RESULTS: 30 patients were assessed (16 female, 23.56 ± 4.042 years). three were non- respondent and 2 dropped out. 10 patients were included in MWM group and 15 into the sham group. Both groups improved in DROM: +2.5cm for MWM group and +1,2cm for sham. Both groups evolved similarly in pain, scale rigidity, YBT, FSD, BESS and FAAM. CONCLUSIONS: Patients with LAS respond positively to MWMs. MWM treatment seems to significantly improve DROM limitations with real clinical improvement (over the MCID of 1,9 cm) and should be considered during the treatment of LAS.