Effectiveness of Dorsal Glide Mobilization on Ankle Mobility and Basketball Performance

International Hellenic University

Status: Completed

Conditions: Unilateral Restricted Ankle Dorsiflexion

Treatments: Other: Exercise plus Joint Mobilization; Other: Exercise

Study type: Interventional

Funder types: Other

Identifiers

NCT06828744

EC-2/2025

Details and patient eligibility

About

Background: Ankle dorsiflexion is a crucial factor for functional lower limb performance, particularly in sports like basketball, where dynamic movements, direction changes, jumps, and landings are essential for athletic success. Eccentric exercise has been shown to improve dorsiflexion range of motion (ROM), enhancing muscle strength, flexibility, and athletic performance. Additionally, ankle joint mobilization, specifically posterior talocrural glide, has demonstrated promising results in improving mobility, restoring ROM, and reducing compensatory movement strategies. However, the combined effects of eccentric exercise and joint mobilization on increasing ankle dorsiflexion ROM and improving athletic performance in young basketball athletes have not yet been sufficiently investigated.

Objective: The purpose of this study is to investigate the effectiveness of combining eccentric exercise and posterior talocrural glide mobilization in improving ankle dorsiflexion ROM and enhancing athletic performance in young basketball athletes.

Methods: A randomized controlled trial will be conducted, including 38 young basketball athletes with confirmed restricted ankle dorsiflexion ROM. Participants will be randomly assigned to an intervention group and a control group. Both groups will follow a five-week training program consisting of eccentric exercises and stretching, performed two times per week, to improve athletic performance. The intervention group, in addition to the exercise program, will undergo ankle joint mobilization sessions for the same duration.

Ankle dorsiflexion ROM, maximum isometric strength of the ankle muscles, fatigue resistance through specific endurance tests, and performance via functional tests will be assessed at baseline, at the end of the five-week program, and three months after the intervention. Statistical analysis will be conducted using a two-way repeated-measures ANOVA, with the significance level set at p < 0.05.

Full description

Background: Ankle dorsiflexion is a crucial factor for functional lower limb performance, particularly in sports like basketball, where dynamic movements, direction changes, jumps, and landings are essential for athletic success. Eccentric exercise has been shown to improve dorsiflexion range of motion (ROM), enhancing muscle strength, flexibility, and athletic performance. Additionally, ankle joint mobilization, specifically posterior talocrural glide, has demonstrated promising results in improving mobility, restoring ROM, and reducing compensatory movement strategies. However, the combined effects of eccentric exercise and joint mobilization on increasing ankle dorsiflexion ROM and improving athletic performance in young basketball athletes have not yet been sufficiently investigated.

Objective: The purpose of this study is to investigate the effectiveness of combining eccentric exercise and posterior talocrural glide mobilization in improving ankle dorsiflexion ROM and enhancing athletic performance in young basketball athletes.

Methods: A randomized controlled trial will be conducted, including a total of 38 young basketball athletes with confirmed restricted ankle dorsiflexion ROM. Participants will be randomly assigned to an intervention group and a control group. Both groups will follow a five-week training program consisting of eccentric exercises and stretching, performed two times per week, to improve athletic performance. In addition, all participants will continue their regular basketball-specific and plyometric team training throughout the study period, ensuring equivalent overall training exposure between groups and controlling for potential confounding effects of training load. The intervention group, in addition to the exercise program, will undergo ankle joint mobilization sessions for the same duration, whereas the control group will not receive joint mobilization.

Ankle dorsiflexion ROM, maximum isometric strength of the ankle muscles, fatigue resistance through specific endurance tests, and performance via functional tests will be assessed at baseline, at the end of the five-week program, and three months after the intervention. Statistical analysis will be conducted using a two-way repeated-measures ANOVA, with the significance level set at p < 0.05.

Expected Outcomes: Improvements in ankle dorsiflexion ROM, muscle strength, and athletic performance are expected, along with a reduction in fatigue and compensatory movement strategies. The intervention is also anticipated to enhance ankle stability and lower the risk of injuries.

Enrollment: 38 patients

Sex: All

Ages: 18 to 25 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Participants healthy and actively engaged in basketball training at the time of the study.
• No presence of ankle pain or use of medication for musculoskeletal injuries or pain management at the time of the study.
• Participation in regular training for at least one month prior to the study.
• A restriction in ankle dorsiflexion of at least 2 cm in one foot compared to the other, as measured using the Weight-Bearing Lunge Test (WBLT).
• Written informed consent must be provided before participation in the study.

Exclusion criteria

• History of lower extremity surgery.
• Musculoskeletal injury to the lower extremity within the past six months.
• Presence of neurological, vestibular, or balance disorders, or diagnosed connective tissue disease.
• Inability to comply with the intervention or assessment procedures.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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38 participants in 2 patient groups

Exercise Group

Active Comparator group

Description:

Participants will follow an exercise and stretching program for five weeks, performed two times per week. The program will consist of eccentric strengthening and stretching exercises targeting the gastrocnemius and soleus muscles. The eccentric strengthening component will include heel-lowering exercises. For the gastrocnemius, the participant will stand on an elevated surface with the knee fully extended and will slowly lower the heel. For the soleus, the participant will perform the same movement with the knee slightly flexed. Participants will perform three sets of fifteen repetitions for each exercise, with approximately one-minute rest intervals between sets. In addition, step-lunge dorsiflexion drills will be performed to promote functional dorsiflexion under load. The stretching component will focus on the gastrocnemius and soleus muscles. The gastrocnemius stretch will be performed in a lunge position with both heels on the ground and the back knee extended, while the soleus

Treatment:

Other: Exercise

Exercise + Joint mobilization

Experimental group

Description:

In addition to the exercise and stretching program followed by the control group, participants will receive a manual therapy program targeting talocrural joint arthrokinematics, delivered twice per week for five weeks by the same physiotherapist. Each supervised session will last approximately 25 minutes. The manual therapy protocol will include posterior talar glide mobilization with active dorsiflexion according to the mobilization-with-movement concept. This technique will be applied for three sets of ten repetitions using grade III-IV oscillatory mobilizations. In addition, posterior talar glide mobilizations will be applied in non-weight-bearing conditions, as well as in weight-bearing using a stabilization belt, while the participant actively dorsiflexes the ankle within a pain-free range. Furthermore, participants will be instructed to perform a talocrural joint self-mobilization technique using a belt at home, performed daily for three sets of 30 to 60 seconds.

Treatment:

Other: Exercise plus Joint Mobilization