CONTEXT: To investigate the effects of midfoot joint mobilization and a 1-week home exercise program, compared with a sham intervention, and home exercise program on pain, patient-reported outcomes, ankle-foot joint mobility, and neuromotor function in young adults with chronic ankle instability. DESIGN: Crossover clinical trial. METHODS: Twenty participants with chronic ankle instability were instructed in a stretching, strengthening, and balance home exercise program and were randomized a priori to receive either midfoot joint mobilizations (forefoot supination, cuboid glide, and plantar first tarsometatarsal) or a sham laying of hands on the initial visit. Changes in foot morphology, joint mobility, strength, dynamic balance, and patient-reported outcomes assessing pain, physical, and psychological function were assessed pre to post treatment and 1 week following post treatment. Participants crossed over to receive the alternate treatment and were assessed pre to post treatment and 1 week following. Linear modeling was used to assess changes in outcomes. RESULTS: Participants demonstrated significantly greater perceived improvement immediately following midfoot mobilization in the single assessment numeric evaluation (sham: 5.0% (10.2%); mobilization: 43.9% (26.2%); beta: 6.8; p < 0.001; adj R2: 0.17; Hedge g: 2.09), and global rating of change (sham: -0.1 (1.1); mobilization: 1.1 (3.0); beta: 1.8; p = 0.01; adj R2: 0.12; Hedge g: 0.54), and greater improved 1-week outcomes in rearfoot inversion mobility (sham: 4.4 degree (8.4 degree); mobilization: -1.6degree (6.1 degree); beta: -6.37; p = 0.01; adj R2: 0.19; Hedge g: 0.81), plantar flexion mobility (sham: 2.7 degree (6.4 degree); mobilization: -1.7 degree (4.3 degree); beta: -4.36; p = 0.02; adj R2: 0.07; Hedge g: 0.80), and posteromedial dynamic balance (sham: 2.4% (5.9%); mobilization: 6.0% (5.4%); beta: 3.88; p = 0.04; adj R2: 0.10; Hedge g: 0.59) compared to the sham intervention. CONCLUSION: Greater perceived improvement and physical signs were observed following midfoot joint mobilization.
Copyright Human Kinetics. Reprinted with permission from Human Kinetics (Champaign, IL).

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