The Effect of Two Forms of Talocrural Joint Traction on Dorsiflexion Range of Motion and Postural Control in Those With Chronic Ankle Instability.

CONTEXT: Talocrural joint mobilizations are commonly used to address deficits associated with chronic ankle instability (CAI).

OBJECTIVE: Examine the immediate effects of talocrural joint traction in those with CAI.

DESIGN: Blinded, crossover.

SETTING: Laboratory.

PARTICIPANTS: Twenty adults (14 females; age=23.80±4.02years; height=169.55±12.38cm; weight=78.34±16.32kg) with self-reported CAI participated. Inclusion criteria consisted of a history of ≥1 ankle sprain, ≥2 episodes of giving way in the previous three months, answering "yes" to ≥4 questions on the Ankle Instability Instrument, and ≤24 on the Cumberland Ankle Instability Tool.

INTERVENTION: Subjects participated in three sessions in which they received a single treatment session of sustained traction (ST), oscillatory traction (OT) or a sham condition in a randomized order. Interventions consisted of four, 30 seconds sets of traction with a minute of rest between sets. During ST and OT, the talus was distracted distally from the ankle mortise to the end-range of accessory motion. ST consisted of continuous distraction and OT involved 1-second oscillations between the mid and end-range of accessory motion. The sham condition consisted of physical contact without force application. Pre and post-intervention measurements of weight-bearing dorsiflexion, dynamic balance, and static single-limb balance were collected.

MAIN OUTCOME MEASURES: The independent variable was treatment (ST, OT, sham). The dependent variables included pre-to-post-treatment change scores for the WBLT (cm), normalized SEBT-AR (%) and time-to-boundary (TTB) variables (s). Separate one-way ANOVAs examined differences between treatments for each dependent variable. Alpha was set a-priori at p<0.05.

RESULTS: No significant treatment effects were identified for any variables.

CONCLUSION: A single intervention of ST or OT did not produce significant changes in weight-bearing dorsiflexion range of motion or postural control in individuals with CAI. Future research should investigate the effects of repeated talocrural traction treatments and the effects of this technique when combined with other manual therapies.