Immediate Effects of Ankle Joint Mobilization With Movement on Postural Control, Range of Motion, and Muscle Strength in Healthy Individuals: A Randomized, Sham-Controlled Trial

Abstract

Context: Ankle proprioception is one of the crucial components contributing to postural control. Although the effects of Mulligan’s mobilization with movement (MWM) on postural control, ankle dorsiflexion range of motion (DFROM), and muscle strength in people with ankle disorders have previously been investigated, it is still unclear whether ankle MWM had ability to change postural control, DFROM, and muscle strength. Objectives: To reveal pure effects of MWM on postural control, ankle DFROM, and muscle strength in healthy individuals. Design: A prospective, randomized, double-blinded, sham-controlled study. Setting: Musculoskeletal laboratory, Dokuz Eylul University, Turkey. Participants: Forty students in good health recruited from a local university. Interventions: Mulligan’s MWM or sham application over ankle joint. Main Outcome Measures: The primary outcome was postural control and measured using limits of stability (LOS) test. The secondary outcomes were tibialis anterior muscle strength and ankle DFROM, which were measured using handheld dynamometer and weight-bearing lunge test, respectively. All outcomes were assessed before and immediately after intervention. Results: Left and right ankle DFROM and LOS overall score showed a statistically significant improvement compared with first measurement in both groups (P < .05). However, LOS time was significantly improved only in the MWM group (P < .05). Statistical analyses of between-group mean differences showed that Mulligan’s MWM provided significant improvement in the LOS in forward–right direction compared with sham application (P = .03). Conclusions: The results of this study suggest that the application of Mulligan’s MWM on ankle joint might be beneficial to improve postural control in forward right direction in individuals with healthy ankles. On the other hand, both MWM and sham application were able to increase overall postural control and DFROM, and MWM had no superiority over sham application for increasing these 2 variables.