Ankle Injuries and Disorders : Chronic Ankle Instability Clinical Trial
Official title:
Influence of Fascial Manipulation on Postural Sway and Ankle Range of Motion in Participants With Chronic Ankle Instability
Fascia is defined as the soft tissue component of the connective tissue system. It is a
continuous mesh that has several functions such as maintaining structural integrity and
providing support and protection. Ligaments are part of the dense connective tissue system.
Studies conducted for ankle retinacula, which are thickened bands of fascia, also confirmed
the presence of nervous tissue and proprioceptors within. Specific changes are seen in the
MRI of ankle retinacula of individuals with chronic ankle instability. These changes include
thickening of subcutaneous tissue. These structural changes may be responsible for
interrupting the signals from the mechanoreceptors or also in damaging them.
Since fascial manipulation can help reduce the densifications of deep fascia, it is possible
that on restoring the original structural and material properties, the proprioception may
improve due to clearer signals from the mechanoreceptors. For a normal individual, recurrent
sprains may lead to occupational absence and difficulty with their ADLs. Hence, there is a
need for this study to determine the influence of FM on chronic ankle instability.
Chronic ankle instability (CAI) is defined as "repetitive bouts of lateral ankle instability
due to the sprain of the lateral collateral ligament of the ankle, resulting in numerous
ankle sprains, episodes of giving way and decreased physical activity.
Individuals with chronic ankle instability often complain of repeated turning of the ankle
especially on uneven surfaces, self-reported feelings of the ankle feeling wobbly way and a
past history of at least one severe lateral ankle sprain.
The recurrence of ankle sprains can be attributed to the proprioceptive deficits that occur
due to joint deafferentation. Freeman et al originally proposed that joint deafferentation is
the loss of sensory input from the articular mechanoreceptors located in the capsule and
ligaments of the affected joint. Proprioceptive deficits manifest in the form of impaired
balance and postural control.
The objective of the study is to determine the effectiveness of fascial manipulation on
improving ankle instability by measuring pre- and post-intervention measures of postural sway
and ankle range of motion.
Luigi Stecco's biomechanical model acts as the foundation for describing the framework of the
fascial system. This model describes a myofascial unit (MFU) as the functional unit of this
system. A myofascial unit consists of unidirectional muscle fibers, fascia, nerve structures
and other retinacular structures such as joint capsules and ligaments. Two crucial points can
be identified along a myofascial unit. These points are known as the centre of perception
(CP) and centre of coordination (CC). A total of six myofascial units have been established
for each body segment and it is in these myofascial units that dysfunction will be seen. The
indication or exhibition of these dysfunctions varies from one individual to the next.
However, the etiology remains universal i.e. densification of the CC due to abnormal tensile
and mechanical stresses. Movement and palpation assessments are carried out to identify the
involved CCs which are focused on during treatment using fascial manipulation.
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| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Recruiting |
NCT05942417 -
Echoguided Percutaneous Neuromodulation in the Management of Chronic Ankle Instability in Physically Active Subjects.
|
N/A |