J Sport Rehabil. 2020 Nov 1;29(8):1060-1068. doi: 10.1123/jsr.2019-0198. Epub 2019 Nov 19.
Ankle proprioception is one of the crucial components contributing to postural control. Although the effects of Mulligan's mobilization with movement (MWM) on postural control, ankle dorsiflexion range of motion (DFROM), and muscle strength in people with ankle disorders have previously been investigated, it is still unclear whether ankle MWM had ability to change postural control, DFROM, and muscle strength.
To reveal pure effects of MWM on postural control, ankle DFROM, and muscle strength in healthy individuals.
A prospective, randomized, double-blinded, sham-controlled study.
Musculoskeletal laboratory, Dokuz Eylul University, Turkey.
Forty students in good health recruited from a local university.
Mulligan's MWM or sham application over ankle joint.
The primary outcome was postural control and measured using limits of stability (LOS) test. The secondary outcomes were tibialis anterior muscle strength and ankle DFROM, which were measured using handheld dynamometer and weight-bearing lunge test, respectively. All outcomes were assessed before and immediately after intervention.
Left and right ankle DFROM and LOS overall score showed a statistically significant improvement compared with first measurement in both groups (P < .05). However, LOS time was significantly improved only in the MWM group (P < .05). Statistical analyses of between-group mean differences showed that Mulligan's MWM provided significant improvement in the LOS in forward-right direction compared with sham application (P = .03).
The results of this study suggest that the application of Mulligan's MWM on ankle joint might be beneficial to improve postural control in forward right direction in individuals with healthy ankles. On the other hand, both MWM and sham application were able to increase overall postural control and DFROM, and MWM had no superiority over sham application for increasing these 2 variables.
踝关节本体感觉是维持姿势控制的关键组成部分之一。虽然先前已经研究了 Mulligan 关节松动术（MWM）对踝关节疾病患者的姿势控制、踝关节背屈活动度（DFROM）和肌肉力量的影响，但目前仍不清楚 MWM 是否能够改变健康个体的姿势控制、DFROM 和肌肉力量。
揭示 MWM 对健康个体姿势控制、DFROM 和肌肉力量的纯效应。
前瞻性、随机、双盲、假对照研究。
土耳其多乌埃尔多安大学肌骨实验室。
从当地一所大学招募的 40 名身体健康的学生。
踝关节 MWM 或假治疗。
主要结局是使用稳定性极限（LOS）测试评估姿势控制。次要结局是使用手持测力计和负重前弓步测试分别评估胫骨前肌力量和踝关节 DFROM。所有结局均在干预前后进行评估。
与干预前第一次测量相比，两组的左、右侧踝关节 DFROM 和 LOS 总评分均有统计学显著改善（P <.05）。然而，只有 MWM 组的 LOS 时间有显著改善（P <.05）。组间平均差异的统计学分析显示，与 sham 应用相比，Mulligan 的 MWM 在向前-右方向的 LOS 中提供了显著的改善（P =.03）。
本研究结果表明，踝关节 MWM 的应用可能有益于改善健康踝关节个体向前-右方向的姿势控制。另一方面，MWM 和 sham 应用均能提高整体姿势控制和 DFROM，MWM 在增加这两个变量方面没有优于 sham 应用。
