None listed
Conditions
Brief summary
Lateral ankle sprains are one of the most frequent injuries occurring within active populations. The initial lateral ankle sprain commonly results from excessive plantar flexion, adduction and supination of the ankle joint complex. This motion overloads joint structures and may cause dysfunction (hypermobility or hypomobility) of one or more joints in the ankle complex (Denegar and Miller, 2002). While it seems intuitive to understand the joint hypermobility and instability as results of damage to the joint structures, the role of hypomobility in producing ankle instability must be considered. Limited dorsiflexion range of motion (ROM) is an important risk factor for recurrence of ankle sprains (Martin et al, 2013) and can predispose to injuries (Mason-Macaya et al., 2015). Chiropractic care can improve sensorimotor function and enhance proprioception of the ankle joint (Holt, 2014).Increased sensory feedback contributes to enhanced proprioception and neuromuscular control.In order to further understand the potential role of chiropractic care in the restoration of ankle function in subjects with perceived ankle instability, it is crucial to investigate the effects of chiropractic care on functional tasks involving load absorption. Therefore, the aim of this project is to investigate the effects of chiropractic care on ankle joint function in subjects with perceived ankle joint instability.
Interventions
The intervention will be a single session of chiropractic care for the intervention group. The chiropractic session will approximately take 10 minutes. The entire spine and both sacroiliac joints will be assessed for segmental dysfunction, and treated where deemed necessary by a registered chiropractor. The peripheral joints will also be assessed and adjusted when necessary. The clinical indicators that will be used to assess joint function prior to and after each intervention include assessing
The intervention will be a single session of chiropractic care for the intervention group. The chiropractic session will approximately take 10 minutes. The entire spine and both sacroiliac joints will be assessed for segmental dysfunction, and treated where deemed necessary by a registered chiropractor. The peripheral joints will also be assessed and adjusted when necessary. The clinical indicators that will be used to assess joint function prior to and after each intervention include assessing for tenderness to palpation of the relevant joints, manually palpating for restricted range of motion, assessing for palpable asymmetric muscle tension, and any abnormal or blocked joint play and end--feel of the joints. All of these biomechanical characteristics are used by the chiropractors as clinical indicators of joint dysfunction (Kockum & Heijne, 2014). All of the manipulations carried out in this study will be high--velocity, low--amplitude thrusts to the appropriate joints. This is a standard manipulation technique used by chiropractors, and is also referred to as spinal or peripheral joint adjustments. The mechanical properties of this intervention have been investigated; and although the actual force applied to the subject's spine depends on the therapist, the patient, and the spinal location of the manipulation, the general shape of the force--time history of spinal manipulations is very consistent (Hessell, Herzog, Conway, & McEwen, 1990) and the duration of the thrust is always less than 200 milliseconds (Herzog, 1996). The high--velocity type of manipulation is chosen specifically because previous research has shown that reflex electromyographic activation observed after manipulations only occurred after high-- velocity, low--amplitude manipulations (as compared with lower--velocity mobilizations) (Herzog, Conway, Zhang, Gal, & Guimaraes, 1995). This manipulation technique has also been previously used in studies that have investigated the neurophysiological effects of spinal manipulation (Haavik & Murphy, 2012). The washout period for this project is 1 week.
Sponsors
New Zealand College of Chiropractic
Study design
Allocation
Randomised controlled trial
Intervention model
Crossover
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
15 subjects will be recruited via advertising within the New Zealand College of Chiropractic community. Participants may include students, staff, faculty, and previous patients of the College’s chiropractic centre and also family, friends and acquaintances of the New Zealand College of Chiropractic community. The experimental protocol will be advertised inviting volunteers that have experienced more than one ankle sprain and have signs of perceived ankle instability. Inclusion criteria will be history of ankle sprain with a score of below 27 on the Cumberland Ankle Instability Tool (CAIT) questionnaire (Hiller et al., 2006). Further, subjects must be English speaking and aged 18-50.
Exclusion criteria
Exclusion criteria will be recent osteomioligamentar injury (within the last month) and/or vestibular dysfunction. Subjects will also be ineligible to participate if they exhibit no evidence of vertebral subluxations, have absolute contraindications to spinal adjustment, have experienced previous significant adverse reactions to chiropractic care, or they are suffering from a current lower limb disorder/dysfunction that would make them unable to carry out data recording sessions (e.g. severe sprain/strain/fracture).
Outcome results
None listed