Search

Context: Manual therapy (MT ) is reported to increase range of motion (ROM ), improve balance, and decrease pain in individuals with chronic ankle instability (CAI). Additional literature is needed to examine the effectiveness of the addition of MT to a therapeutic exercise regimen in individuals with CAL Objective : To examine the combined effects of thrust joint manipulation ( TJM ) and exercise on function in participants reporting CAI . Design . Randomized controlled trial. Sening: Research laboratory. Participants: A convenience sample of 30 participants (mean age 23 . 7 [ 3 .651 y ; mean height 169 . 50 [9 . 50 ] cm ; mean mass 66 . 48 [ 10.64]1 kg). Intervention: Participants were randomly allocated to the exercise (n = 15 ) or exercise + TJM group (n = 20) and completed an exercise program. The exercise + TJM group also received MT at the talocrural proximal, and distal tibiofibular joints in the first 3 sessions. Main Outcome Measures. Self-reported outcomes were recorded at baseline and follow - up using the Foot and Ankle Ability Measure (FAAM), the FAAM-Sport (FAAM-S) subscale, and the Ankle Joint Functional Assessment Tool (AJFAT). The side-hop test, figure-of-8 hop test, 3 directions of the Star Excursion Balance Test. and dorsifiexion ROM were also assessed at baseline and follow -up . Results : Only the exercise + TJM group demonstrated an improvement in weightbearing dorsiflexion with the knee flexed following treatment (P = .02). For all outcome measures, except ROM, subjects improved significantly at follow - up regardless of group assignment (P 5 . 01 ). Conclusions : Our data suggest that rehabilitation of patients with CAI is related to improved ROM, function, and self-reported outcomes. This provides evidence that the addition of MT to exercise may enhance improvements in ROM as compared with exercise alone. Additional research is needed to identify optimal parameters to maximize therapeutic benefit. [ABSTRACT FROM AUTHOR]

Context: Bilateral improvements in postural control have been reported among individuals with acute lateral ankle sprains and individuals with chronic ankle instability (CAI) when only the unstable ankle is rehabilitated. We do not know if training the stable ankle will improve function on the unstable side. Objective: To explore the effects of a unilateral balance-training program on bilateral lower extremity balance and function in individuals with CAI when only the stable limb is trained. Design: Cohort study. Setting: University clinical research laboratory. Patients or Other Participants: A total of 34 volunteers (8 men, 26 women; age = 24.32 ± 4.95 years, height = 167.01 ± 9.45 cm, mass = 77.54 ± 23.76 kg) with CAI were assigned to the rehabilitation (n = 17) or control (n = 17) group. Of those, 27 (13 rehabilitation group, 14 control group) completed the study. Intervention(s): Balance training twice weekly for 4 weeks. Main Outcome Measure(s): Foot and Ankle Disability Index (FADI), FADI Sport (FADI-S), Star Excursion Balance Test, and Balance Error Scoring System. Results: The rehabilitation and control groups differed in changes in FADI-S and Star Excursion Balance Test scores over time. Only the rehabilitation group improved in the FADI-S and in the posteromedial and anterior reaches of the Star Excursion Balance Test. Both groups demonstrated improvements in posterolateral reach; however, the rehabilitation group demonstrated greater improvement than the control group. When the groups were combined, participants reported improvements in FADI and FADI-S scores for the unstable ankle but not the stable ankle. Conclusions: Our data suggest training the stable ankle may result in improvements in balance and lower extremity function in the unstable ankle. This further supports the existence of a centrally mediated mechanism in the development of postural-control deficits after injury, as well as improved postural control after rehabilitation. [ABSTRACT FROM AUTHOR]