Clinical benefits of joint mobilisation on ankle sprains: a systematic review and meta-analysis

Publication date: Available online 4 September 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Ishanka Weerasekara, Peter Osmotherly, Suzanne Snodgrass, Jodie Marquez, Rutger de Zoete, Darren A. Rivett
ObjectiveTo assess the clinical benefits of joint mobilisation on ankle sprains.Data sourcesMEDLINE, MEDLINE In Process, Embase, AMED, PsycINFO, CINAHL, Cochrane library, PEDro, Scopus, SPORTDiscus and Dissertations and Thesis were searched from inception to June, 2017.Study SelectionStudies investigating humans with a grade I or II lateral or medial sprains of the ankle in any pathological state from acute to chronic, who had been treated with joint mobilisation were considered for inclusion. Any conservative intervention was considered as a comparator. Commonly reported clinical outcomes were considered such as ankle range of movement, pain, and function. After screening of 1530 abstracts, 56 studies were selected for full text screening, and 23 were eligible for inclusion. Eleven studies on chronic sprains reported sufficient data for meta-analysis.Data ExtractionData were extracted using the participants, interventions, comparison, outcomes and study design approach. Clinically relevant outcomes (dorsiflexion range, proprioception, balance, function, pain threshold, pain intensity) were assessed at immediate, short term and long term follow-up points.Data SynthesisMethodological quality was assessed independently by two reviewers and most studies were found to be of moderate quality, with no studies rated as poor.Meta-analysis revealed significant immediate benefits of joint mobilisation compared to comparators on improving postero-medial dynamic balance (p=0.0004), but not for improving dorsiflexion range (p= 0.16), static balance (p = 0.96) or pain intensity (p= 0.45). Joint mobilisation was beneficial in the short term for improving weight-bearing dorsiflexion range (p= 0.003) compared to a control.ConclusionJoint mobilisation appears to be beneficial for improving dynamic balance immediately after application and dorsiflexion range in the short term. Long term benefits have not been adequately investigated.



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