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Mulligan Concept in the Treatment of Ankle Sprains

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ClinicalTrials.gov Identifier: NCT03948503
Recruitment Status : Not yet recruiting
First Posted : May 14, 2019
Last Update Posted : May 14, 2019
Sponsor:
Information provided by (Responsible Party):
Université Catholique de Louvain

Brief Summary:
Aim of the study is to establish the efficiency of the mulligan concept vs a sham group (who will also serve as control). Patient with an subacute ankle sprains will be assess following the mulligan concept and then randomized in two groups: Mobilization with movement (MWM) group and Sham group. MWM group will receive 3 sets of 10 repetitions of treatment (i.e. passive accessory glide during an active dorsiflexion) while the sham treatment will do 3 sets of 10 active dorsiflexion with the hand of the Physiotherapist only apply on the skin. 3 sessions with 4 days apart will take place. outcomes will be measure before and after every sessions.

Condition or disease Intervention/treatment Phase
Ankle Sprain 1St Degree Ankle Sprain 2Nd Degree Procedure: Mulligan concept Procedure: Placebo Not Applicable

Detailed Description:
All included subject will received the Mulligan concept assessment. First investigator will applied non-weight bearing inferior tibiofibular mobilization with movement (MWM), i.e. passive accessory glide in a posterior and superior direction on the inferior tibiofibular joint. If not painful, Weightbearing inferior tibiofibular MWM will be applied 6 times. it consist on applying a passive accessory glide on the subject while he/she is doing an active dorsiflexion of the injured ankle. Dorsiflexion range of motion, pain and function will be reassess. If either one of previously cited outcomes is improve, subject is considered respondents. If he/she feels any pain or no improvements at all, he/she will be considered non-respondents. If non-weight-bearing inferior tibiofibular MWM is painful, talocrural MWM will be apply, first in non-weightbearing and if painfree, in weight bearing position. Talocrural MWM consist on a posterior glide of the talus while the subject realized an active dorsiflexion of the injured ankle. Same outcomes as previsouly cited will be assess and will determine if the patient is respondent or non-respondent. If the subject is non-respondent of the talocrural MWM or if he/she felt any pain during the talocrural MWM, a non weightbearing cubometatarsal MWM, i.e. cranio-caudal glide of the lateral cubometatarsal joint during an active dorsiflexion of the injured ankle, will be applied. If painfree, a tape will be placed as to replicate the cubometatarsal MWM, and the patient will reassess ROM, pain and function with the tape to see whether he/she is a respondent or non respondent subject. If the subject is non-respondent to neither of the three MWM, he/she is considered a drop-out. Respondent patient will then be randomized into two groups: MWM group and Sham group. MWM group will receive 3 sessions with 4 days apart of 3 sets of 10 repetitions of preferential MWM (inferior tibiofibular, talocrural, cubometatarsal) while the sham group will receive 3 sessions with 4 days apart of 3 sets of 10 repetitions with the first investigator doing a light touch during an active dorsiflexion, mimicking the real MWM techniques. Outcomes will be measures at T0 (beginning of the treatment-beginning of the first session), T1 (end of the first session), T2 (beginning of the second session), T3 (end of the second session), T4 (beginning of the third session) and T5 (end of the treatment-end of the third session).

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 60 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Mulligan Concept in the Treatment of Subacute Ankle Sprains: a Randomized Placebo Trial.
Estimated Study Start Date : June 1, 2019
Estimated Primary Completion Date : July 31, 2019
Estimated Study Completion Date : October 30, 2019

Arm Intervention/treatment
Experimental: Mobilization with movement (MWM) group
Application of the Mulligan concept
Procedure: Mulligan concept
Mobilization with movement during an active dorsi-flexion of the ankle

Placebo Comparator: Sham group
Sham treatment
Procedure: Placebo
Sham mobilization with movement during an active dorsi-flexion of the ankle




Primary Outcome Measures :
  1. Change in Ankle dorsiflexion Range of motion [ Time Frame: At the beginning (Time1) and end (Time2) of each session (one session is 30 minutes). Every session is separated by 4 days. Outcomes is taken at Day 1(session1) at Time1 & Time2 ,Day 5(session2) at Time1 & Time2 and Day 9(session3) at Time1 & Time2 . ]
    Wall toe test (distance in cm and degree in °)


Secondary Outcome Measures :
  1. Change in Pain [ Time Frame: At the beginning (Time1) and end (Time2) of each session (one session is 30 minutes). Every session is separated by 4 days. Outcomes is taken at Day 1(session1) at Time1 & Time2 ,Day 5(session2) at Time1 & Time2 and Day 9(session3) at Time1 & Time2 . ]
    a 10cm Visual Analog Scale

  2. Change in Stiffness sensation [ Time Frame: At the beginning (Time1) and end (Time2) of each session (one session is 30 minutes). Every session is separated by 4 days. Outcomes is taken at Day 1(session1) at Time1 & Time2 ,Day 5(session2) at Time1 & Time2 and Day 9(session3) at Time1 & Time2 . ]
    Visual Analog Scale (VAS)

  3. Change in Dynamic function [ Time Frame: At the beginning (Time1) and end (Time2) of each session (one session is 30 minutes). Every session is separated by 4 days. Outcomes is taken at Day 1(session1) at Time1 & Time2 ,Day 5(session2) at Time1 & Time2 and Day 9(session3) at Time1 & Time2 . ]
    Y-test

  4. Change in fonctionnel movement [ Time Frame: At the beginning (Time1) of Day1 (Session1) and end of Day9 (Session3). One session is 30 minutes long. Each session is separated by 4 days. ]
    Forward step down test

  5. Change inDaily-life function [ Time Frame: At the beginning (Time1) of Day1 (Session1) and end (Time2) of Day9 (Session3). One session is 30 minutes long. Each session is separated by 4 days. ]
    Foot and Ankle Ability Measure (FAAM) questionnaire



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Ages Eligible for Study:   18 Years to 30 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • ankle sprain since 2 weeks to 12 weeks
  • Grade 1 or 2 ankle sprain
  • Asymetrical dorsi-flexion limitation

Exclusion Criteria:

  • Acute or Grade 3 ankle sprain
  • More than 12 weeks ankle sprain
  • Any other trauma of the lower limb

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Responsible Party: Université Catholique de Louvain
ClinicalTrials.gov Identifier: NCT03948503     History of Changes
Other Study ID Numbers: 2018/21NOV/439
First Posted: May 14, 2019    Key Record Dates
Last Update Posted: May 14, 2019
Last Verified: April 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Université Catholique de Louvain:
ankle sprain
Mulligan
manual therapy

Additional relevant MeSH terms:
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Sprains and Strains
Ankle Injuries
Wounds and Injuries
Leg Injuries