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J.-M. Blasco Igual1, D. Hernández-Guillén1, S. Roig-Casasús1, Y. Alakhdar1, C. Tolsada-Velasco1
1Universitat de València, Physiotherapy, Valencia, Spain
Background: Range of motion in elderly women decreases with age, which is a normal physiological fact due to different causes. However, in the case of the ankle, this can produce negative effects on balance and postural control, increasing the risk of falling.
Purpose: The objective of this study was to investigate the effects of a talus mobilization-based intervention among healthy community-dwelling older adult women, with limited weight-bearing ankle dorsiflexion range of motion.
Methods:This was a 2-arm randomized pilot study. The design of the study complied with the Declaration of Helsinki principles. This study was conducted in an outpatient clinic. Spanish community-dwelling older adult women over 60 years of age who had limited ankle mobility (less than 35 degrees of weight-bearing ankle dorsiflexion) participated in this study. The intervention consisted of 6 sessions spread over two weeks. The experimental group received a manual therapy treatment, where three grade 4 anterior-to-posterior mobilizations of 30 seconds duration were carried out in each foot. The control group received a sham intervention, which consisted of the same protocol but without applying force. The main outcome was the weight-bearing ankle dorsiflexion range of motion measured using the lunge test. Data from both feet were analyzed separately. There were two measurement points: baseline and immediately after finishing the last session.
Results: 28 participants were randomized between control and experimental group. A total of 27 participants completed the intervention, 13 in the control group (age: 70.7 (6.2) years; height: 155.8 (4.6) cm; weight: 69.5 (9.8) Kg), and 14 in the experimental group (age: 77.6 (8.4) years; height: 155.8 (8.2) cm; weight: 70.8 (6.9) Kg). No differences were detected between both groups at baseline in none of the variables. After the intervention, only the experimental group improved the weight-bearing joint range significantly in both feet (right: 12.1 (4.1), p<0.001; left: 12.1 (3.9), p<0.001), with significant differences in the results between groups (right: p<0.001; left: p<0.001).
Conclusions: Six sessions of a talus posterization mobilization intervention are effective to improve significantly the ankle weight-bearing range of motion dorsiflexion in healthy community-dwelling older adult women. However, is necessary to continue investigating in order to check if these positive effects on the ankle joint range have the capacity to be maintained in the medium term. Additionally, it would be interesting to repeat this same study in the male population in order to check whether the results are the same or differ from those of the present study.
Implications: Manual therapy is an effective tool to improve the limited ankle weight-bearing range of movement in the elderly women. This will have a positive effect on the balance and postural control of the older adult women. It is necessary to investigate the different therapies considering gender differences, because they can have different effects in women and men.
Funding acknowledgements: This project PID2020-115825RA-I00, is supported MCIN/ AEI/10.13039/501100011033, convocatoria Proyectos I+D+i 2020 - Modalidades “Retos Investigación” y “Generación de Conocimiento”
Keywords:
elderly women
ankle
manual therapy
elderly women
ankle
manual therapy
Topics:
Musculoskeletal: lower limb
Older people
Musculoskeletal: lower limb
Older people
Did this work require ethics approval? Yes
Institution: University of Valencia
Committee: Ethics Committee of Human Investigation
Ethics number: H1528343276571
All authors, affiliations and abstracts have been published as submitted.
