Comparison of Two Manual Therapy Techniques on Ankle Dorsiflexion

2016-01-13 12:53:22 | BioPortfolio


Ankle rigidity is a common musculoskeletal disorder affecting the talocrural joint, which can impair weight-bearing ankle dorsiflexion (WBADF). The objective was to compare the efficacy of Mulligan Mobilization with Movement (MWM) and Osteopathic Mobilization (OM) for improving ankle dorsiflexion range of motion (ROM) and musculoarticular stiffness (MAS).


Increased musculoarticular stiffness (MAS) of the talocrural joint is a frequently encountered problem, identified during evaluation of weight bearing ankle dorsiflexion (WBADF). Such stiffness may follow ankle injury such as ankle sprain. In such a situation, MAS could be increased and might leads to a lack of joint flexibility as well as decreased dorsiflexion range-of-motion (ROM), however asymmetric rigidity does not necessarily always follow ankle sprain. Nevertheless, MAS is an important and necessary component of normal stability of the talocrural joint and could help to prevent abnormal ankle joint movement and ankle sprains.

Measurement of MAS can be determined by a technique known as free-oscillation, which is a comprehensive measure of joint stiffness comprising the stiffness of the muscle-tendon unit, skin, ligaments and joint capsule, along with a number of other mechanical and neuromuscular factors. The assessment of MAS is important when evaluating muscular performance, injury prevention and gender differences in flexibility. For example, men, as well as older people, are known to present with greater MAS than women and young people.

MAS of the talocrural joint can be objectively measured using an electromechanical device that imparts a passive oscillatory dorsiflexion movement, but also by means of clinical tests such as toe-wall distance and angular goniometric measurement during the weight bearing lunge test. Electromechanical measurement of ankle MAS has been used in several previous studies of asymptomatic participants and in patients with fibromyalgia syndrome, and spasticity after a stroke.

In orthopaedic manual therapy, different methods have been proposed to treat MAS associated with loss of dorsiflexion ROM at the talocrural joint. These include single session of Mulligan's Mobilization with Movement (MWM), anteroposterior mobilization of the talus, high velocity thrust, and Osteopathic Mobilization (OM). These methods have been described in clinical practice manuals, with greater proportion of studies reporting on the effects of MWM in comparison to high velocity thrust for improving ankle dorsiflexion ROM in chronic ankle instability or to study MWM efficacy in isolation for subacute or recurrent ankle sprains and for chronic ankle instability. With the exception of one study the results are generally in favor of MWM.

Generally MWM is an increasingly popular form of manual therapy for musculoskeletal disorders, concerning the ankle MWM try to improve talocrural ROM. MWM is a combination of accessory joint glide of the talus combined with active ankle dorsiflexion movement. The patient performs active WBADF while the therapist simultaneously applies an anteroposterior glide of the talus with respective posteroanterior tibial glide with the aid of a manual therapy belt. OM is a purely passive anteroposterior mobilization of the talus with respect to tibia, performed in a non weight-bearing position. To date, there have been no studies comparing the effectiveness of each technique with respect to electromechanically determined ankle MAS or ankle joint ROM determined by the WBADF lunge test.

Therefore, the aim of the study was to investigate the relative efficacy of MWM and OM on MAS as the primary outcome measurement and joint ROM during the WBADF lunge test as the secondary outcome measurement. The hypothesis was that MWM would produce significantly greater reduction in MAS and increased ankle joint ROM when compared to OM.

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment


Ankle Stiffness


mobilization with movement, osteopathic mobilization


IREC/CARS - Tour Pasteur - Saint-Luc Hospital




Université Catholique de Louvain

Results (where available)

View Results


Published on BioPortfolio: 2016-01-13T12:53:22-0500

Clinical Trials [1148 Associated Clinical Trials listed on BioPortfolio]

Ankle Kinesio Taping vs Mulligan Mobilization With Movement

The aim of the study is to compare the effects of Kinesio taping and Mulligan's mobilization with movement technique on balance, muscle strength and flexibility in healthy ankles . Patient...

Ankle Instability Treatment in Patients With Chronic Ankle Instability

Ankle joint self mobilization.

Comparison Between Two Mobilization Techniques of Ankle on Balance in Patients With Chronic Ankle Instability

The ankle joint is often affected by injuries, especially lateral sprains, often leading to chronic instability. Joint mobilization techniques seem to influence the sense of joint position...

Effects of Feet and Ankle Mobilization on Balance of Older Adults: a Preliminary Randomized Clinical Trial

This study aims to assess whether mobilization of the ankle and foot produces significant improvements in the balance of the elderly. To this end, a randomized study was designed with a c...

Effects of Mobilization in Conjunction With Therapeutic Exercise in Participants With a History of Ankle Sprain

Our purpose was to examine the combined effects of thrust mobilization of the proximal and distal ankle joints in conjunction with a six-week rehabilitation program on ankle function in su...

PubMed Articles [3057 Associated PubMed Articles listed on BioPortfolio]

The effect of spinal mobilization with leg movement in patients with lumbar radiculopathy - A double blind randomized controlled trial.

To evaluate the effect of spinal mobilization with leg movement (SMWLM) on low back and leg pain intensity, disability, pain centralization and patient satisfaction in subjects with lumbar radiculopat...

Photoreductive dissolution of schwertmannite induced by oxalate and the mobilization of adsorbed As(V).

Schwertmannite (Sch), a poorly crystalline iron mineral, shows high sorption capacity to As(V). In this study, the effects of UV irradiation and oxalate on the dissolution of pure Sch, Sch with adsorb...

Comparative Effects of Tensioning and Sliding Neural Mobilization on Static Postural Control and Lower Limb Hop Testing in Football Players.

Context Sliding and tensioning neural mobilization are used to restore normal function of the nervous system, but impose different stresses to it. Particularly, sliding induces greater nerve excursion...

Mobilization of Hematopoietic Progenitor Cells for Autologous Transplantation Using Pegfilgrastim and Plerixafor: Efficacy and Cost Implications.

Filgrastim (FIL) is the most common growth factor combined with plerixafor for autologous hematopoietic progenitor cell mobilization, but requires daily, multi-injection administration. We adopted a s...

Comparison of high, medium and low mobilization forces for increasing range of motion in patients with hip osteoarthritis: A randomized controlled trial.

Manual therapy has been shown to increase range of motion (ROM) in hip osteoarthritis (OA). However, the optimal intensity of force during joint mobilization is not known.

Medical and Biotech [MESH] Definitions

The release of stem cells from the bone marrow into the peripheral blood circulation for the purpose of leukapheresis, prior to stem cell transplantation. Hematopoietic growth factors or chemotherapeutic agents often are used to stimulate the mobilization.

LIPOLYSIS of stored LIPIDS in the ADIPOSE TISSUE to release FREE FATTY ACIDS. Mobilization of stored lipids is under the regulation of lipolytic signals (CATECHOLAMINES) or anti-lipolytic signals (INSULIN) via their actions on the hormone-sensitive LIPASE. This concept does not include lipid transport.

Licensed physicians trained in OSTEOPATHIC MEDICINE. An osteopathic physician, also known as D.O. (Doctor of Osteopathy), is able to perform surgery and prescribe medications.

Mobilization of human, financial, capital, physical and or natural resources to generate goods and services.

The mobilization of EMERGENCY CARE to the locations and people that need them.

More From BioPortfolio on "Comparison of Two Manual Therapy Techniques on Ankle Dorsiflexion"

Quick Search


Relevant Topics

Arthritis Fibromyalgia Gout Lupus Rheumatic Rheumatology is the medical specialty concerned with the diagnosis and management of disease involving joints, tendons, muscles, ligaments and associated structures (Oxford Medical Diction...

Wound management
Anything that breaks the skin is a wound because when the skin is broken, there's a risk of germs getting into the body and causing an infection. Follow and track Wound Care News on BioPortfolio: Wound Car...

Women's Health
Women's Health - key topics include breast cancer, pregnancy, menopause, stroke Follow and track Women's Health News on BioPortfolio: Women's Health News RSS Women'...

Searches Linking to this Trial