Does treatment duration of manual therapy influence functional outcomes for individuals with chronic ankle instability: A systematic review with meta-analysis?

Xiaojian Shi, Jia Han, Jeremy Witchalls, Gordon Waddington, Roger Adams

Research output: Contribution to journalReview article

Abstract

QUESTION: Can manual therapy improve functional outcomes for individuals with chronic ankle instability?

DESIGN: Systematic review with meta-analysis of randomized controlled trials.

PARTICIPANTS: Individuals with chronic ankle instability.

INTERVENTION: Manual therapy is defined as an intervention that involves joint mobilization, and mobilization with movement.

OUTCOME MEASURE: The primary outcome is patient reported function (PRF) questionnaires scores, the secondary outcomes are ankle dorsiflexion range of motion (DFROM) and balance control.

RESULTS: Four studies were included (n = 208, mean age = 24.4) in the meta-analysis, with moderate to high quality on the PEDro scale (range 6-8). For patient reported function (PRF) questionnaires, two studies reported significant improvement after six-session manual therapy measured by foot and ankle ability measures sport subscale (FAAMS) and Cumberland ankle instability tool (CAIT), respectively. For DFROM, one session manual therapy had no significant effect on the weight-bearing lunge test (WBLT) (3 studies, n = 147, SMD = 1.24 (95%CI -0.87 to 3.36), I2 = 96%) or non-weight-bearing inclinometer test (2 studies, n = 47, MD = 3.41° (95%CI -0.26 to 7.09),I2 = 43%), while six-sessions manual therapy showed, a significantly positive effect on WBLT(2 studies, n = 80, SMD = 2.39, (95% CI 0.55, to 4.23), I2 = 93%). For the SEBT, one-session manual therapy had no significant effect on overall star excursion balance test (SEBT) score (3 studies, n = 137,MD = 2.05,95%CI (-0.96,5.05), I2 = 75%), while qualitative analysis of 2 included studies showed significant improvement both on the SEBT score and single limb balance test (SLBT).

CONCLUSIONS: Six sessions rather than one session of manual therapy improves ankle functional performance for individuals with CAI.

TRIAL REGISTRATION NUMBER: PROSPERO CRD42017054715.

LanguageEnglish
Pages87-95
Number of pages9
JournalMusculoskeletal Science and Practice
Volume40
Early online date7 Feb 2019
DOIs
Publication statusPublished - 2019

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Musculoskeletal Manipulations
Ankle
Meta-Analysis
Weight-Bearing
Articular Range of Motion
Therapeutics
Sports
Foot
Extremities
Randomized Controlled Trials
Joints

Cite this

@article{5aac75e5b05f42d1a1ae83f406ccbbb8,
title = "Does treatment duration of manual therapy influence functional outcomes for individuals with chronic ankle instability: A systematic review with meta-analysis?",
abstract = "QUESTION: Can manual therapy improve functional outcomes for individuals with chronic ankle instability?DESIGN: Systematic review with meta-analysis of randomized controlled trials.PARTICIPANTS: Individuals with chronic ankle instability.INTERVENTION: Manual therapy is defined as an intervention that involves joint mobilization, and mobilization with movement.OUTCOME MEASURE: The primary outcome is patient reported function (PRF) questionnaires scores, the secondary outcomes are ankle dorsiflexion range of motion (DFROM) and balance control.RESULTS: Four studies were included (n = 208, mean age = 24.4) in the meta-analysis, with moderate to high quality on the PEDro scale (range 6-8). For patient reported function (PRF) questionnaires, two studies reported significant improvement after six-session manual therapy measured by foot and ankle ability measures sport subscale (FAAMS) and Cumberland ankle instability tool (CAIT), respectively. For DFROM, one session manual therapy had no significant effect on the weight-bearing lunge test (WBLT) (3 studies, n = 147, SMD = 1.24 (95{\%}CI -0.87 to 3.36), I2 = 96{\%}) or non-weight-bearing inclinometer test (2 studies, n = 47, MD = 3.41° (95{\%}CI -0.26 to 7.09),I2 = 43{\%}), while six-sessions manual therapy showed, a significantly positive effect on WBLT(2 studies, n = 80, SMD = 2.39, (95{\%} CI 0.55, to 4.23), I2 = 93{\%}). For the SEBT, one-session manual therapy had no significant effect on overall star excursion balance test (SEBT) score (3 studies, n = 137,MD = 2.05,95{\%}CI (-0.96,5.05), I2 = 75{\%}), while qualitative analysis of 2 included studies showed significant improvement both on the SEBT score and single limb balance test (SLBT).CONCLUSIONS: Six sessions rather than one session of manual therapy improves ankle functional performance for individuals with CAI.TRIAL REGISTRATION NUMBER: PROSPERO CRD42017054715.",
keywords = "Manual therapy, Patient reported function, Chronic ankle instability, Range of motion, Function",
author = "Xiaojian Shi and Jia Han and Jeremy Witchalls and Gordon Waddington and Roger Adams",
note = "Copyright {\circledC} 2019 Elsevier Ltd. All rights reserved.",
year = "2019",
doi = "10.1016/j.msksp.2019.01.015",
language = "English",
volume = "40",
pages = "87--95",
journal = "Musculoskeletal Science and Practice",
issn = "1356-689X",
publisher = "Churchill Livingstone",

}

TY - JOUR

T1 - Does treatment duration of manual therapy influence functional outcomes for individuals with chronic ankle instability

T2 - Musculoskeletal Science and Practice

AU - Shi, Xiaojian

AU - Han, Jia

AU - Witchalls, Jeremy

AU - Waddington, Gordon

AU - Adams, Roger

N1 - Copyright © 2019 Elsevier Ltd. All rights reserved.

PY - 2019

Y1 - 2019

N2 - QUESTION: Can manual therapy improve functional outcomes for individuals with chronic ankle instability?DESIGN: Systematic review with meta-analysis of randomized controlled trials.PARTICIPANTS: Individuals with chronic ankle instability.INTERVENTION: Manual therapy is defined as an intervention that involves joint mobilization, and mobilization with movement.OUTCOME MEASURE: The primary outcome is patient reported function (PRF) questionnaires scores, the secondary outcomes are ankle dorsiflexion range of motion (DFROM) and balance control.RESULTS: Four studies were included (n = 208, mean age = 24.4) in the meta-analysis, with moderate to high quality on the PEDro scale (range 6-8). For patient reported function (PRF) questionnaires, two studies reported significant improvement after six-session manual therapy measured by foot and ankle ability measures sport subscale (FAAMS) and Cumberland ankle instability tool (CAIT), respectively. For DFROM, one session manual therapy had no significant effect on the weight-bearing lunge test (WBLT) (3 studies, n = 147, SMD = 1.24 (95%CI -0.87 to 3.36), I2 = 96%) or non-weight-bearing inclinometer test (2 studies, n = 47, MD = 3.41° (95%CI -0.26 to 7.09),I2 = 43%), while six-sessions manual therapy showed, a significantly positive effect on WBLT(2 studies, n = 80, SMD = 2.39, (95% CI 0.55, to 4.23), I2 = 93%). For the SEBT, one-session manual therapy had no significant effect on overall star excursion balance test (SEBT) score (3 studies, n = 137,MD = 2.05,95%CI (-0.96,5.05), I2 = 75%), while qualitative analysis of 2 included studies showed significant improvement both on the SEBT score and single limb balance test (SLBT).CONCLUSIONS: Six sessions rather than one session of manual therapy improves ankle functional performance for individuals with CAI.TRIAL REGISTRATION NUMBER: PROSPERO CRD42017054715.

AB - QUESTION: Can manual therapy improve functional outcomes for individuals with chronic ankle instability?DESIGN: Systematic review with meta-analysis of randomized controlled trials.PARTICIPANTS: Individuals with chronic ankle instability.INTERVENTION: Manual therapy is defined as an intervention that involves joint mobilization, and mobilization with movement.OUTCOME MEASURE: The primary outcome is patient reported function (PRF) questionnaires scores, the secondary outcomes are ankle dorsiflexion range of motion (DFROM) and balance control.RESULTS: Four studies were included (n = 208, mean age = 24.4) in the meta-analysis, with moderate to high quality on the PEDro scale (range 6-8). For patient reported function (PRF) questionnaires, two studies reported significant improvement after six-session manual therapy measured by foot and ankle ability measures sport subscale (FAAMS) and Cumberland ankle instability tool (CAIT), respectively. For DFROM, one session manual therapy had no significant effect on the weight-bearing lunge test (WBLT) (3 studies, n = 147, SMD = 1.24 (95%CI -0.87 to 3.36), I2 = 96%) or non-weight-bearing inclinometer test (2 studies, n = 47, MD = 3.41° (95%CI -0.26 to 7.09),I2 = 43%), while six-sessions manual therapy showed, a significantly positive effect on WBLT(2 studies, n = 80, SMD = 2.39, (95% CI 0.55, to 4.23), I2 = 93%). For the SEBT, one-session manual therapy had no significant effect on overall star excursion balance test (SEBT) score (3 studies, n = 137,MD = 2.05,95%CI (-0.96,5.05), I2 = 75%), while qualitative analysis of 2 included studies showed significant improvement both on the SEBT score and single limb balance test (SLBT).CONCLUSIONS: Six sessions rather than one session of manual therapy improves ankle functional performance for individuals with CAI.TRIAL REGISTRATION NUMBER: PROSPERO CRD42017054715.

KW - Manual therapy

KW - Patient reported function

KW - Chronic ankle instability

KW - Range of motion

KW - Function

U2 - 10.1016/j.msksp.2019.01.015

DO - 10.1016/j.msksp.2019.01.015

M3 - Review article

VL - 40

SP - 87

EP - 95

JO - Musculoskeletal Science and Practice

JF - Musculoskeletal Science and Practice

SN - 1356-689X

ER -