Joint mobilization and static stretching for individuals with chronic ankle instability – A pilot study

Objective: To complete preliminary analysis regarding the effects joint mobilization timing during a 4-week calf stretching intervention on clinician-oriented and patient-oriented outcomes in individuals with chronic ankle instability (CAI). Additionally, a secondary objective was to examine the combined effect of joint mobilization and calf stretching. Design: Randomized two-group pretest posttest design. Setting: Laboratory. Participants: Ten adults (age = 24.4 ± 4.7years; height = 172.1 ± 11.3 cm; weight = 76.2 ± 17.1 kg) with self-reported CAI participated. Interventions: Participants completed outcome measures at three collection sessions (baseline, pre-intervention, and post-intervention). Participants were randomized into either into an early-mobilization or late-mobilization group in which they completed a joint mobilization intervention during the first or last 2 weeks of a 4-week calf stretching intervention. Main outcome measures: Outcome measures included: dorsiflexion ROM, dynamic postural control, single-limb postural control, Disablement in the Physically Active Scale (DPA), Foot and Ankle Ability Measure (FAAM), and Fear-Avoidance Beliefs Questionnaire (FABQ). Wilcoxon Sign Rank Tests examined pre-intervention to post-intervention differences for each dependent variable. Mann-Whitney U tests examined differences between early-mobilization and late-mobilization groups. Alpha was set a priori at p <.05. Results: No significant differences were identified between early-mobilization and late-mobilization groups at post intervention (p >.095). FAAM-Activities of Daily Living, DPA, FABQ-Physical Activity, and dorsiflexion ROM were significantly improved at post-intervention compared to pre-intervention (p <.047). No other significant differences were identified between pre-intervention and post-intervention (p >.057). Conclusion: Preliminarily results suggest the timing of joint mobilization when used in conjunction with calf stretching does not effect treatment efficacy. However, the combination of joint mobilization and calf stretching can improve dorsiflexion ROM and self-reported function in individuals with CAI. Improvements from the combined intervention are similar to previously reported effects of isolated joint mobilization or stretching.