Mulligan Mobilization With Movement for Acute Lateral Ankle Sprains

ConditionLateral Ankle Sprain

Trial statusRecruiting

Trial phaseNot applicable

Trial typeInterventional

Biological sexAll

Age18+

SponsorUniversité Catholique de Louvain

About this trial

This randomized controlled trial evaluates the effects and clinical specificity of Mulligan Mobilization With Movement (MWM) in adults with grade I or II lateral ankle sprains occurring less than 6 weeks before enrollment. The primary study population consists of participants enrolled within 2 weeks of the index lateral ankle sprain. Participants with an injury occurring between 2 and less than 6 weeks before enrollment are also eligible. Approximately 110 participants will be allocated to a Mulligan MWM intervention group or a control group receiving usual-care rehabilitation without Mulligan treatment. In the intervention group, three MWM techniques targeting the inferior tibiofibular, talocrural, and cubometatarsal joints are tested in a randomized order and adapted according to the participant's immediate pain-free response. Treatment includes up to six sessions provided twice weekly. Clinical outcomes are assessed at baseline, 3 weeks, and 3 months. The primary outcomes are ankle dorsiflexion range of motion, ankle joint arthrokinematics, and pain during weight-bearing dorsiflexion.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Grade I or II lateral ankle sprain Index lateral ankle sprain occurring less than 6 weeks before enrollment Age 18 years or older No fracture associated with the index lateral ankle sprain No immobilization in a plaster cast Able to provide written informed consent

Disqualifiers

Grade III lateral ankle sprain Index lateral ankle sprain occurring 6 weeks or more before enrollment Additional lower-limb musculoskeletal disorder or injury incompatible with study participation Neurological disorder Severe hypertension Renal disease Cardiorespiratory disorder Sickle cell disease Arterial calcification Varicose veins Current anticoagulant treatment Current risk of or history of deep-vein thrombosis Fragile skin Previous surgery affecting sports performance

Trial design

Design model

Parallel

Treatments tested in this trial

Mulligan Mobilization With Movement
Other intervention
A physiotherapist trained in the Mulligan Concept applies Mobilization With Movement while the participant actively performs ankle dorsiflexion. Three techniques targeting the inferior tibiofibular, talocrural, and cubometatarsal joints are tested according to a randomized sequence. The intervention is performed without pain and is evaluated for an immediate response. According to the protocol, an immediate clinically relevant response is defined as a 2-point improvement in pain on the numerical rating scale or an improvement greater than 1.9 cm in ankle dorsiflexion measured with the Weight-Bearing Lunge Test. If the response criterion is not met, the next MWM technique in the randomized sequence is tested. Up to six treatment sessions are provided twice weekly.
Usual-Care Rehabilitation for Lateral Ankle Sprain
Other intervention
Participants receive traditional rehabilitation for lateral ankle sprain without Mulligan Mobilization With Movement. Rehabilitation is adapted to the participant's clinical presentation and is documented by the treating physiotherapist.

Treatment groups

110 Participants

are divided into 2 treatment groups

Group A: Mulligan Mobilization With MovementExperimental treatment 2 interventions

Group B: Usual-Care RehabilitationActive comparator 1 intervention

Trial outcomes

Primary outcomes

Ankle Dorsiflexion Range of Motion Measured With the Weight-Bearing Lunge Test

Ankle dorsiflexion range of motion is measured in centimeters (hallux-to-wall distance) and degrees (tibial inclination) using the Weight-Bearing Lunge Test performed against a wall. Higher values indicate greater weight-bearing ankle dorsiflexion.

Time frame