The aim of this study is to evaluate the acute effects of posterior talar glide mobilisation on dorsiflexion range of motion wieght bearing (measured using the Weight-Bearing Lunge Test) and walking speed, using a randomised, sham-controlled study design.
Walking is a fundamental component of daily living activities and depends on adequate range of motion and coordination in the lower limb joints. The ankle joint plays a significant role in regulating stride length and walking speed by allowing the tibia to move forward, particularly during the stance phase of the gait cycle. In this process, sufficient ankle dorsiflexion range of motion is considered critical for maintaining a functional and fluid walking pattern. It has been reported that measurements taken under load (weight-bearing dorsiflexion) better reflect functional activities when assessing ankle dorsiflexion range of motion. The Weight-Bearing Lunge Test (WBLT) is a valid and reliable method widely preferred in clinical practice, enabling the assessment of ankle dorsiflexion range under load. It is thought that restricted dorsiflexion range under load may lead to compensatory mechanisms such as early heel lift, reduced step length and decreased walking speed during walking. However, it appears that the relationship between ankle dorsiflexion range of motion under load and walking speed in healthy individuals has not been sufficiently clarified. From the perspective of talocrural joint mechanics, the talus bone must perform a posterior glide movement during dorsiflexion. Restriction in this posterior glide movement is considered one of the mechanical factors limiting dorsiflexion range. Posterior talar glide mobilisations are among the non-invasive manual therapy approaches frequently used in clinical practice, aimed at improving talocrural joint mechanics and increasing dorsiflexion range. Whilst studies examining the acute effects of these mobilisations on dorsiflexion range of motion exist in the literature, findings regarding whether this mechanical change is reflected in walking speed-a functional outcome-are limited. Therefore, establishing the relationship between ankle dorsiflexion range of motion under load and walking speed, and evaluating the acute effects of posterior talar glide mobilisation on these mechanical parameters using a sham-controlled design, is of importance from both clinical and biomechanical perspectives. The aim of this study is to evaluate the acute effects of posterior talar glide mobilisation on ankle dorsiflexion range of motion weight bearing (measured using the Weight-Bearing Lunge Test) and walking speed, using a randomised, sham-controlled study design.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
60
Movement Combined with Weight-Shifting Mobilisation The therapist applies a continuous posteroanterior gliding force to the tibia via the strap by shifting their weight backwards. This technique functionally mimics the posterior gliding mechanism of the talus. The patient is asked to perform a slow dorsiflexion to the end of their range of motion. During this, the therapist maintains the posterior gliding force on the talus. Once the end point is reached, the gliding force is maintained for 10 seconds. One set of 10 repetitions of mobilisation is performed. \- Movement Combined with Mobilisation Without Weight Shifting The participant lies supine with the tibia in contact with the treatment table, whilst the foot and ankle are left free at the edge of the table. The ankle is stabilised with a non-elastic band, and the therapist applies posterior glide to the talus.
Both mobilisation techniques and positions were explained to the participants; however, although the therapist assumed the glide position, no sliding movement was performed, and the participants were held in that position for 10 seconds. Posterior talar glide mobilisation and dorsiflexion measurements were performed on both the affected and unaffected ankles. All measurements will be repeated three times each-before and after treatment-and the average values will be recorded.
Hasan Kalyoncu University
Gaziantep, Şahinbey, Turkey (Türkiye)
Weight Bearing Lunge Testi
The WBLT is a valid and reliable clinical measurement method widely used to identify dorsiflexion restrictions, particularly in individuals with chronic ankle instability, and to monitor changes occurring during the rehabilitation process. Its concurrent validity has been demonstrated in the literature using both angular and distance-based measurement methods. During measurement, the maximum lunge distance between the big toe and the wall will be recorded in centimetres using a standard tape measure fixed to the floor. Participants will undergo bilateral assessment during the test. Participants will be asked to touch the wall with their knees without lifting their heels off the ground. A vertical reference line on the floor will be used to minimise subtalar joint compensation and ensure measurement standardisation. The contralateral limb will be positioned comfortably behind the tested limb, and participants will be permitted to place their hands on the wall for balance.
Time frame: through of the study, average 1 day
10-meter walk test
The test is a valid and reliable assessment method widely used in clinical and research settings to measure an individual's walking speed over a short distance. The test will be conducted on a flat, non-slip surface. The total walking distance will be set at 14 metres; the first 2 metres will be designated as an acceleration zone, the final 2 metres as a deceleration zone, and the middle 10-metre section as the measurement zone. Participants will be asked to walk the specified distance at a natural walking speed that feels comfortable to them. The measurement will be taken by recording the time elapsed from the moment the participant enters the central 10-metre section until the moment they exit it, using a stopwatch to record the time in seconds. The test will be repeated three times, and the average of the measurements will be used in the analysis.
Time frame: through of the study, average 1 day
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