Date of Graduation
College of Physical Activity and Sport Sciences
Sport and Exercise Psychology
Michelle A. Sandrey
Context: The use of manual therapy in the athletic training setting is becoming more common place. While there is information on joint mobilizations, there are few systematic reviews that examine the use of joint mobilizations on mechanical deficits in chronic ankle instability and lateral ankle sprain. Objective: To understand the benefits of joint mobilization in the lateral ankle sprain (chronic and acute) and determine common parameters/techniques used in practice. Data Sources: Pub Med (1950-2013), CINAHL with full text (1982-2013), MEDLINE (1950-2013), SPORTDiscus with full text (1800- 2013), Science Direct(1950-2013), Google Scholar (1950-2013), and PEDro (1929-2013) were searched using the terms lateral ankle sprain, chronic ankle instability (CAI), and joint mobilization. Next lateral ankle sprain and CAI were searched with the following: Maitland mobilization, Mulligan's mobilization, mobilization with movement, manual therapy, and treatment. Lastly citations were searched for possible references not previously found. Study Selection: Studies were included if they are: 1) Written or translated into the English language, 2) Lateral Ankle sprain, chronic ankle instability, or joint mobilizations were included in the title or subject of the study, 3) Lateral ankle sprain, chronic ankle instability, or joint mobilizations were included in the abstract, 4) The main focus of the study must be joint mobilizations, 5) The study must be an experimental study. Data Extraction: All studies that met the inclusion criteria were examined using the PEDro Scale and a comparison of effect sizes. Each study was read without the use of the PEDro Scale and then again with the use of the PEDro Scale. Scores were then compared between investigators. If differences in scores occurred, it was discussed until an agreement of final score was reached. Data Synthesis: There was a total of 16 studies that were analyzed for this review. They varied with subject populations, mobilization type, exclusion and inclusion criteria, methodological quality, and effect sizes. The PEDro scores ranged from 1 to 8 with an average score of 5.81. Effect sizes were calculated in 11 of the 16 studies. Only 4 of these studies had effect sizes that did not cross 0 and were large. Conclusion: Overall, the studies evaluated had poor methodological quality. While most studies did show an improvement in dorsiflexion ROM, posterior talar glide, pain levels, and H/M ratios, recommendations for the clinician cannot be based off of these studies due to poor methodological quality and effect sizes that encompass 0. More studies should be conducted to improve statistical significance and methodological quality to improve the current evidence.
Kerecman, Kathleen M., "The use of joint mobilization on mechanical instability deficits for a lateral ankle sprain: A Systematic Review" (2014). Graduate Theses, Dissertations, and Problem Reports. 554.