Efeito imediato de técnicas de terapia manual na limitação da dorsiflexão de tornozelo: ensaio clínico randomizado, controlado e cego

Abstract

Introduction: Adequate ankle dorsiflexion (DF) range is important for good movement mechanics during dynamic activities in the lower limb, and its limitation is a potential risk factor for lower limb injuries. Physiotherapy has joint mobilization techniques that bring positive effects to treat this limitation. However, the combined effect of short-term joint mobilization techniques is not known. In view of this, this study aims to evaluate the additional effects of the combination of joint mobilization techniques on range of motion, performance and dynamic postural balance. Methodology: Sixty volunteers were recruited with a mean age of 25.35 (±8.00) years and range of motion of FD less than 40º in closed kinetic chain (CCF), and after the inclusion criteria, the volunteers were randomized into two groups: Group 1 - Joint Mobilization using the Mulligan Concept; Group 2 - Joint Mobilization using the Mulligan Concept associated with Joint Mobilization of the Maitland Method. All volunteers were evaluated in 3 moments: A0, pre-intervention; A1, post-intervention and A2, 3-4 days post-intervention. For analysis, the primary outcomes were evaluated: Dorsiflexion range of motion (DF) in CKC and, as a secondary outcome ROM in open kinetic chain, performance tests and balance during the Y Balance Test (YBT). Results: The Mulligan group associated with Maitland was superior in improving the performance of the Triple Hop Test (THT) and YBT, and showed greater oscillation of the center of pressure. Both groups had significant improvements in the increase in range of motion in CKC and in the performance of the functional tests. Conclusion: Joint mobilization techniques to gain FD, when added together, bring superior benefits in functional performance. Both techniques are effective for gaining ankle DF.