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Investigators and resources are no longer available for completion of the study due to retirements, relocations and reassignments.
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| Name | Class |
|---|---|
| McMaster University | OTHER |
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The purpose of the study is to determine whether manipulation of the subtalar joint (one of the two joints of the ankle) has an effect on ankle range of motion in a group of ankles that have sustained a subacute inversion ankle sprain.
The investigators expect subtalar joint manipulation will increase ankle range of motion about the subtalar joint, but not at the talocrural joint (the other joint of the ankle).
Ankle inversion sprain is a common injury that can cause joint stiffness and range of motion deficits.(Holmer 1994, Beynnon 2001, Denegar 2002, Green 2001) Subtalar joint manipulation has been advocated as an intervention for inversion sprains to reduce pain, decrease joint stiffness, and improve range of motion.(Lopez-Rodriguez 2007)
The ankle is comprised of the talocrural and subtalar joints and their respective joint axes.(Hubbard 2006) Ankle rotation about these axes can be parameterized using quaternions, a four dimensional unit vector. Range of motion (ROM) about these axes can be determined by performing an eigen analysis of the quaternion matrices to determine the root mean squared values of the motion data about these axes.
The objective of the study is to investigate the immediate effects of subtalar joint manipulation on the ROM about the ankle's talocrural and subtalar joints on ankles that have sustained a subacute, grade II inversion sprain.
Forty patients with one sprained ankle and one asymptomatic ankle will be recruited. The subjects will be randomized into either a subtalar manipulation group or a sham manipulation group. The sprained ankle of each patient will receive either a standardized subtalar joint manipulation or a sham manipulation. The same patient's asymptomatic ankle will serve as the non-treatment control group. Range of motion pre- and post-manipulation will be quantified utilizing a quaternion eigen analysis. Kinematic and kinetic parameters will be collected during the manipulation to biomechanically characterize the manipulation. Pain pressure threshold and visual analog scale measurements for pain, stiffness, and quality of movement will be collected.
Our primary hypothesis is subtalar joint manipulation will increase subtalar ROM, but will have no effect on talocrural ROM. Our secondary hypothesis is subtalar joint manipulation will have positive effects on pain, stiffness, and quality of movement.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Subtalar joint manipulation | Experimental | Each subject in this group will recieve a subtalar joint manipulation to their symptomatic ankle |
|
| Sham Manipulation | Sham Comparator | Each subject in this group will recieve a sham subtalar joint manipulation to their symptomatic ankle |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Subtalar joint manipulation | Procedure | The intervention is defined as a toggle-recoil, high-velocity, low-amplitude subtalar joint manipulation. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Range of Motion determined by a biomechanical ankle model (quaternion eigen analysis) | Outcome measure will be collected immediately pre-manipulation and immediately post-manipulation on day of testing (ie. 1 day) |
| Measure | Description | Time Frame |
|---|---|---|
| Visual Analog Scales for self-reported pain, stiffness, and quality of movement | Outcome measure will be collected immediately pre-manipulation and immediately post-manipulation on the day of testing (ie. 1 day) | |
| Pain pressure threshold | Outcome measure will be collected immediately pre-manipulation and immediately post-manipulation on the day of testing (ie. 1 day) |
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Inclusion Criteria:
Exclusion Criteria: (Pellow 2001, Fryer 2002, Lopez-Rodriguez 2007)
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| Name | Affiliation | Role |
|---|---|---|
| Alexander D Lee, BSc, DC | Canadian Memorial Chiropractic College | Principal Investigator |
| John J Triano, DC, PhD | Canadian Memorial Chiropractic College | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| McMaster University | Hamilton | Ontario | L8S 1C7 | Canada | ||
| Canadian Memorial Chiropractic College |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 7981804 | Background | Holmer P, Sondergaard L, Konradsen L, Nielsen PT, Jorgensen LN. Epidemiology of sprains in the lateral ankle and foot. Foot Ankle Int. 1994 Feb;15(2):72-4. doi: 10.1177/107110079401500204. | |
| 11347693 | Background | Beynnon BD, Renstrom PA, Alosa DM, Baumhauer JF, Vacek PM. Ankle ligament injury risk factors: a prospective study of college athletes. J Orthop Res. 2001 Mar;19(2):213-20. doi: 10.1016/S0736-0266(00)90004-4. |
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| ID | Term |
|---|---|
| D016512 | Ankle Injuries |
| ID | Term |
|---|---|
| D007869 | Leg Injuries |
| D014947 | Wounds and Injuries |
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| Sham subtalar joint manipulation | Procedure | The sham manipulation is conducted by placing the ankle in a non-manipulative position, and the operator simply engages the toggle board to simulate the audible noise of the toggle board dropping. No force or thrust is applied to the ankle. |
|
|
| preload force | Outcome measure will be collected during the manipulation on the day of testing (ie. 1 day) |
| peak force | Outcome measure will be collected during the manipulation on the day of testing (ie. 1 day) |
| thrust duration | Outcome measure will be collected during the manipulation on the day of testing (ie. 1 day) |
| force - time slope | Outcome measure will be collected during the manipulation on the day of testing (ie. 1 day) |
| subtalar joint angle | Outcome measure will be collected during the manipulation on the day of testing (ie. 1 day) |
| talocrural joint angle | Outcome measure will be collected during the manipulation on the day of testing (ie. 1 day) |
| Toronto |
| Ontario |
| M2H 3J1 |
| Canada |
| 12937564 | Background | Denegar CR, Miller SJ 3rd. Can Chronic Ankle Instability Be Prevented? Rethinking Management of Lateral Ankle Sprains. J Athl Train. 2002 Dec;37(4):430-435. |
| 11949665 | Background | Denegar CR, Hertel J, Fonseca J. The effect of lateral ankle sprain on dorsiflexion range of motion, posterior talar glide, and joint laxity. J Orthop Sports Phys Ther. 2002 Apr;32(4):166-73. doi: 10.2519/jospt.2002.32.4.166. |
| 11276181 | Background | Green T, Refshauge K, Crosbie J, Adams R. A randomized controlled trial of a passive accessory joint mobilization on acute ankle inversion sprains. Phys Ther. 2001 Apr;81(4):984-94. |
| 17416272 | Background | Lopez-Rodriguez S, Fernandez de-Las-Penas C, Alburquerque-Sendin F, Rodriguez-Blanco C, Palomeque-del-Cerro L. Immediate effects of manipulation of the talocrural joint on stabilometry and baropodometry in patients with ankle sprain. J Manipulative Physiol Ther. 2007 Mar-Apr;30(3):186-92. doi: 10.1016/j.jmpt.2007.01.011. |
| 16526836 | Background | Hubbard TJ, Hertel J. Mechanical contributions to chronic lateral ankle instability. Sports Med. 2006;36(3):263-77. doi: 10.2165/00007256-200636030-00006. |
| 11174691 | Background | Pellow JE, Brantingham JW. The efficacy of adjusting the ankle in the treatment of subacute and chronic grade I and grade II ankle inversion sprains. J Manipulative Physiol Ther. 2001 Jan;24(1):17-24. doi: 10.1067/mmt.2001.112015. |
| 12183696 | Background | Fryer GA, Mudge JM, McLaughlin PA. The effect of talocrural joint manipulation on range of motion at the ankle. J Manipulative Physiol Ther. 2002 Jul-Aug;25(6):384-90. doi: 10.1067/mmt.2002.126129. |
| 10914867 | Background | Grahame R, Bird HA, Child A. The revised (Brighton 1998) criteria for the diagnosis of benign joint hypermobility syndrome (BJHS). J Rheumatol. 2000 Jul;27(7):1777-9. No abstract available. |
| 16182419 | Background | Redmond AC, Crosbie J, Ouvrier RA. Development and validation of a novel rating system for scoring standing foot posture: the Foot Posture Index. Clin Biomech (Bristol). 2006 Jan;21(1):89-98. doi: 10.1016/j.clinbiomech.2005.08.002. Epub 2005 Sep 21. |