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Rogan S.1,2, Zuber S.1, Jost K.3, Stuker N.1, Zimmerli T.1, Eichelberger P.1
1Bern University of Applied Sciences, Health, Bern, Switzerland, 2Academy of Physiotherapy and Training Education, Grenzach-Wyhlen, Germany, 3Bern University of Applied Sciences, Health, Bern, Switzerland, Bern, Switzerland
Background: Acute ankle distorsion traumas are common sport injuries and 20 to 40% of them lead to chronic ankle instability. The literature described for patients with CAI a reduced postural control and reduced muscle activity. Treatment recommendation includes sensorimotor training and strength training. Recently, manual therapy techniques were used to improve range of motion and to stimulate receptors in the joint capsule and muscle-tendon complex to increase proprioception with the aim to enhance postural control and muscle activity. However, this hypothesis shows a heuristic nature. Empiric investigation should be implemented, to formulate first hypothesis and subsequently these hypotheses should be verified and falsified, respectively. For this reason, a single case study was carried out.
Purpose: The aim of this single case study was to evaluate the influence of an ankle joint mobilization on the time-to-stabilization (TTS; postural control) and on the neuromuscular activity of the peroneus longus muscle (PL) during the landing and stabilization phase after a single leg drop jump.
Methods: A single case study was used in the preliminary stage of an investigation to generate hypotheses, which are subsequently planned to be systematically tested with a larger number of participants. A 32-year-old female with chronic ankle instability on the right foot was included. Based on the physical examination, different manual mobilization techniques were applied during ten minutes. Ten single leg jumps were performed on a force plate. TTS was measured based on stability criteria extracted from ground reaction forces in vertical, anterior/posterior and medial/lateral direction at standardized threshold value and individual threshold value. PL neuromuscular activity was analyzed from surface electromyography signals in a time windows relative to the landing time point of -30 to 0, 0 to 30, 30 to 60, 60 to 90, 90 to 120 and 120 to 150 ms.
Results: The TTS after joint mobilization were significantly reduced (p 0.05) in vertical direction at standardized threshold value and individual threshold value and anterior/posterior direction at standardized threshold value. A trend towards increased activity was determined for PL activity at 90 to 120 ms (Baseline: 32.53 mV, post: 40.23 mV; p = 0.049).
Conclusion(s): Beneficial effects of manual ankle joint mobilization on a reduced TTS and improved PL muscle activity could be identified due to a possible optimal reflex outflow from the proprioceptors and alpha-moto-neurons. Further studies have to elaborate this hypothesis. The functional approach of ankle joint mobilization appears to be promising.
Implications: The results indicate potential to reduced TTS and altered neuromuscular activity after manual ankle joint mobilization.
Funding acknowledgements: None
Topic: Sport & sports injuries
Ethics approval: Nione, because single case studies do not need an Ethic approval in Switzerland.
All authors, affiliations and abstracts have been published as submitted.
