Abstract
Objective
Distal fibular mobilization with movement (MWM), with and without a posterior gliding fibular tape, and anteroposterior mobilization of the talus (MOB) are widely used to treat acute lateral ankle sprains. The purpose of this study was to investigate the short-term and long-term relative effectiveness of these techniques.
Methods
In this double-blind randomized controlled trial, 45 amateur soccer players with acute (<72 hours) lateral ankle sprain were randomly allocated to 6 sessions (3 per week within the first 2 weeks) of either MWM, MWM with tape (MWMtape), or MOB.
All participants also received general advice, transcutaneous electrical nerve stimulation, edema-draining massage, and a program of proprioception exercises. Participant ratings of function on the Foot and Ankle Ability Measure (FAAM) and Patient Global Impression of Improvement Scale (PGI-I) were the primary outcomes measured over 52 weeks. Secondary outcomes were ankle pain, pressure pain threshold, range of motion, volume, and strength.
Results
MWM and MWMtape were equally effective, and participants demonstrated greater function on the FAAM at 12 and 52 weeks compared with those receiving MOB; however, the latter demonstrated superior function at 2 weeks. No differences between groups were observed for the PGI-I or any of the secondary outcomes.
Conclusion
There are limited short-term differences among techniques, except for better sport function with MOB. Over the long term, distal fibular MWM is most effective for achieving activities of daily living and sport function when added to standard physical therapy care. The addition of a posterior gliding fibular tape provides no additional benefit.
Impact
Distal fibular mobilization with movement may be the most appropriate treatment for acute lateral ankle sprain to achieve long-term improvement in daily and sport function. In the short term, anteroposterior mobilization of the talus offers greater improvement in sport function. The use of fibular tape provides no added benefit when combined with distal fibular mobilization with movement.