The immediate effects of an anterior-to-posterior talar mobilization on neural excitability, dorsiflexion range of motion, and dynamic balance in patients with chronic ankle instability

Matthew Harkey, Michelle McLeod, Ashley Van Scoit, Masafumi Terada, Michael Tevald, Phillip Gribble, Brian Pietrosimone

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

Abstract

Context: Altered neuromuscular function and decreased dorsiflexion range of motion (DFROM) have been observed in patients with chronic ankle instability (CAI). Joint mobilizations are indicated for restoring DFROM and dynamic postural control, yet it remains unknown if a mobilization can alter neuromuscular excitability in muscles surrounding the ankle. Objective: To determine the immediate effects of a Maitland grade III anterior-to-posterior joint mobilization on spinal-reflex and corticospinal excitability in the fibularis longus (FL) and soleus (SOL), DFROM, and dynamic postural control. Design: Single-blinded randomized control trial. Setting: Research laboratory. Patients: 30 patients with CAI randomized into a mobilization (n = 15) or control (n = 15) group. Intervention: Maitland grade III anterior-to-posterior joint mobilization. Main Outcome Measures: Spinal-reflex excitability was measured with the Hoffmann reflex, while corticospinal excitability was evaluated with transcranial magnetic stimulation. DFROM was measured seated with the knee extended, and dynamic postural control was quantified with the Star Excursion Balance Test. Separate 2 × 2 repeated-measures ANOVAs were performed for each outcome measure. Dependent t tests were used to evaluate individual differences within groups in the presence of significance. Results: Spinal-reflex and corticospinal excitability of the SOL and FL were not altered in the mobilization or control group (P >.05). DFROM increased immediately after the mobilization (P =.05) but not in the control group, while dynamic postural control was unchanged in both groups (P >.05). Conclusion: A single joint-mobilization treatment was efficacious at restoring DFROM in participants with CAI; however, excitability of spinal reflex and corticospinal pathways at the ankle and dynamic postural control were unaffected.

Original languageEnglish
Pages (from-to)351-359
Number of pages9
JournalJournal of Sport Rehabilitation
Volume23
Issue number4
DOIs
StatePublished - 2014

Bibliographical note

Publisher Copyright:
© 2014 Human Kinetics, Inc.

Keywords

  • Corticospinal excitability
  • Disinhibitory intervention
  • Spinal-reflex excitability
  • Star Excursion Balance Test

ASJC Scopus subject areas

  • Biophysics
  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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