The effect of manual therapy on ankle dorsiflexion range of motion: A pilot crossover randomised trial

Passive accessory mobilisation of the ankle joint Materials: treatment plinth, stop watch. Procedures: Participants were randomised to receive ankle joint mobilisation in the first session and calf massage in the second session, or calf massage in the first session and ankle joint mobilisation in the second session. Attendance at both sessions was confirmed by an attendance checklist. There was a washout period of one to two weeks between intervention sessions. At each session, ankle dorsiflexion ROM for both ankles was measured pre- and post-intervention. Passive accessory mobilisation was applied to both ankles. Participants sat in a reclined supine position with their foot over the end of the plinth and the therapist applied a rhythmic mobilisation to the talocrural joint in a posterior to anterior direction. For subtalar mobilisation, the participant laid on one side with the lateral aspect of the ankle uppermost at the edge of the plinth. A medial glide of the calcaneus with respect to the talus was applied. The participant then laid on their other side with the medial aspect of the ankle uppermost and a lateral glide of the calcaneus was applied with respect to the talus. Grade III mobilisations were applied to joints and in directions of stiffness (hypomobility). Grade II mobilisations were applied to joints where no restriction was felt, or joints were hypermobile. The intervention consisted of 2-4 sets of 30 seconds each at approximately one mobilisation per second, with an interval of 10 seconds between sets. For hypermobile joints, 2 sets of 30 seconds using a Grade II was applied and for restricted joints, 3-4 sets of 30 seconds using a Grade III was applied. Time for the intervention was 5 minutes. Who: The manual therapy interventions were performed by a physiotherapist with more than 20 years of musculoskeletal physiotherapy experience. Mode of delivery: In person / face-to face Number of times: a single session. Location: Laboratory setting at a regional Australian university.