J Sport Rehabil. 2021 Dec 29;30(5):697-706. doi: 10.1123/jsr.2020-0183.
Restriction in ankle dorsiflexion range of motion (ROM) has been previously associated with excessive dynamic knee valgus. This, in turn, has been correlated with knee pain in women with patellofemoral pain.
To investigate the immediate effect of 3 ankle mobilization techniques on dorsiflexion ROM, dynamic knee valgus, knee pain, and patient perceptions of improvement in women with patellofemoral pain and ankle dorsiflexion restriction.
Randomized controlled trial with 3 arms.
Biomechanics laboratory.
A total of 117 women with patellofemoral pain who display ankle dorsiflexion restriction were divided into 3 groups: ankle mobilization with anterior tibia glide (n = 39), ankle mobilization with posterior tibia glide (n = 39), and ankle mobilization with anterior and posterior tibia glide (n = 39).
INTERVENTION(S): The participants received a single session of ankle mobilization with movement technique.
Dorsiflexion ROM (weight-bearing lunge test), dynamic knee valgus (frontal plane projection angle), knee pain (numeric pain rating scale), and patient perceptions of improvement (global perceived effect scale). The outcome measures were collected at the baseline, immediate postintervention (immediate reassessment), and 48 hours postintervention (48 h reassessment).
There were no significant differences between the 3 treatment groups regarding dorsiflexion ROM and patient perceptions of improvement. Compared with mobilization with anterior and posterior tibia glide, mobilization with anterior tibia glide promoted greater increase in dynamic knee valgus (P = .02) and greater knee pain reduction (P = .02) at immediate reassessment. Also compared with mobilization with anterior and posterior tibia glide, mobilization with posterior tibia glide promoted greater knee pain reduction (P < .01) at immediate reassessment.
In our sample, the direction of the tibia glide in ankle mobilization accounted for significant changes only in dynamic knee valgus and knee pain in the immediate reassessment.
踝关节背屈活动范围受限与过度动态膝外翻有关。反过来，这与髌股疼痛女性的膝关节疼痛有关。
研究 3 种踝关节松动技术对背屈活动范围、动态膝外翻、膝关节疼痛以及髌股疼痛女性踝关节背屈受限患者对改善的感知的即刻影响。
随机对照试验，共 3 组。
生物力学实验室。
共 117 名患有髌股疼痛且存在踝关节背屈受限的女性患者被分为 3 组：胫骨前滑（n = 39）、胫骨后滑（n = 39）和胫骨前、后滑（n = 39）。
参与者接受了一次踝关节松动术治疗。
背屈活动范围（负重下蹲试验）、动态膝外翻（额状面投影角）、膝关节疼痛（数字疼痛评分量表）和患者对改善的感知（总体感知效果量表）。在基线、即刻后评估（即刻再评估）和 48 小时后评估（48 小时再评估）时收集这些测量结果。
在背屈活动范围和患者对改善的感知方面，3 种治疗组之间无显著差异。与胫骨前、后滑相比，胫骨前滑在即刻再评估时能更大程度地增加动态膝外翻（P =.02）和减轻膝关节疼痛（P =.02）。与胫骨前、后滑相比，胫骨后滑在即刻再评估时也能更大程度地减轻膝关节疼痛（P <.01）。
在我们的样本中，踝关节松动术中胫骨的滑动方向仅在即刻再评估时对动态膝外翻和膝关节疼痛的变化有显著影响。
