Ankle Inversion Sprain Clinical Trial
Official title:
Changes in the Ankle Range of Motion Following Subtalar Joint Manipulation in Patients With Sub-acute, Grade II, Ankle Inversion Sprains Quantified Using Quaternion Eigen Analysis.
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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