Investigating the Combined Effects of Fascial Distortion Model Manual Therapy and Balance-Strength Training in Individuals with Chronic Ankle Instability

Overview

Journal Sports (Basel)

Publisher MDPI

Specialty Public Health

Date 2024 Jan 22

PMID 38251307

Authors

Amin Mohammadi

Seyed Ehsan Sakhtemani

Lukas Trimmel

Krisztina Petricsevics

Alexandra Makai

Istvan Zsenak

Csaba Melczer

Peter Sandor Tardi

Affiliations

Soon will be listed here.

Abstract

Background: The Fascial Distortion Model (FDM) is a relatively new manual therapy approach in the field of musculoskeletal physical therapy, and its potential effectiveness in treating chronic ankle instability (CAI) remains unexplored.

Methods: A randomized controlled trial with 23 participants was conducted. Patients were randomly assigned to either the FDM + balance-strength training (BST) group ( = 8), receiving extra FDM sessions weekly in addition to two sessions of BST, or the BST group ( = 7). Healthy controls ( = 8) did not receive any treatment and participated only in pre- and post-test measurements. Objective measurements including Y-Balance Test Lower Quarter (YBT-LQ), Flamingo Balance Test (FBT), Weight-Bearing Lunge Test (WBLT), ankle joint range of motion (ROM), and Cumberland Ankle Instability Tool (CAIT) were recorded at baseline and the end of the intervention. The results demonstrated significant differences between the FDM + BST and BST groups for supination ROM ( = 0.008) and similarly for WBLT ( = 0.041), FBT ( = 0.40), YBT-LQ ( = 0.023), and CAIT score ( = 0.008). Moreover, while both groups demonstrated significant improvement at the post-test compared with their pre-test for plantarflexion and pronation ROM, WBLT, and CAIT score, the FDM + BST group demonstrated significant improvements in supination ROM, FBT, and YBT-LQ.

Conclusion: Our study suggests that the addition of FDM concepts to a BST may lead to enhanced improvements in ankle ROM, static and dynamic balance, and self-reported outcomes in individuals with CAI compared to BST.

References

Thompson C, Schabrun S, Romero R, Bialocerkowski A, van Dieen J, Marshall P . Factors Contributing to Chronic Ankle Instability: A Systematic Review and Meta-Analysis of Systematic Reviews. Sports Med. 2017; 48(1):189-205. DOI: 10.1007/s40279-017-0781-4. View

Bennell K, Talbot R, Wajswelner H, Techovanich W, Kelly D, Hall A . Intra-rater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion. Aust J Physiother. 2001; 44(3):175-180. DOI: 10.1016/s0004-9514(14)60377-9. View

Pirri C, Fede C, Stecco A, Guidolin D, Fan C, De Caro R . Ultrasound Imaging of Crural Fascia and Epimysial Fascia Thicknesses in Basketball Players with Previous Ankle Sprains Versus Healthy Subjects. Diagnostics (Basel). 2021; 11(2). PMC: 7911860. DOI: 10.3390/diagnostics11020177. View

Cruz-Diaz D, Lomas-Vega R, Osuna-Perez M, Contreras F, Martinez-Amat A . Effects of 6 Weeks of Balance Training on Chronic Ankle Instability in Athletes: A Randomized Controlled Trial. Int J Sports Med. 2015; 36(9):754-60. DOI: 10.1055/s-0034-1398645. View

Witchalls J, Pantanowitz M, Funk S, Waddington G, Svorai Band S, Adams R . Self-reported chronic ankle instability effects on the development of fitness during an Infantry Commanders Course. J Sci Med Sport. 2021; 24(11):1130-1135. DOI: 10.1016/j.jsams.2021.04.016. View

Valderrabano V, Hintermann B, Horisberger M, Fung T . Ligamentous posttraumatic ankle osteoarthritis. Am J Sports Med. 2005; 34(4):612-20. DOI: 10.1177/0363546505281813. View

Hertel J . Sensorimotor deficits with ankle sprains and chronic ankle instability. Clin Sports Med. 2008; 27(3):353-70, vii. DOI: 10.1016/j.csm.2008.03.006. View

Allois R, Niglia A, Pernice A, Cuesta-Barriuso R . Fascial therapy, strength exercises and taping in soccer players with recurrent ankle sprains: A randomized controlled trial. J Bodyw Mov Ther. 2021; 27:256-264. DOI: 10.1016/j.jbmt.2021.03.022. View

Cain M, Ban R, Chen Y, Geil M, Goerger B, Linens S . Four-Week Ankle-Rehabilitation Programs in Adolescent Athletes With Chronic Ankle Instability. J Athl Train. 2020; 55(8):801-810. PMC: 7462179. DOI: 10.4085/1062-6050-41-19. View

10.

Alghadir A, Iqbal Z, Iqbal A, Ahmed H, Ramteke S . Effect of Chronic Ankle Sprain on Pain, Range of Motion, Proprioception, and Balance among Athletes. Int J Environ Res Public Health. 2020; 17(15). PMC: 7432694. DOI: 10.3390/ijerph17155318. View

11.

Ziaei Ziabari E, Haghpanahi M, Razi M, Lubberts B, Ashkani-Esfahani S, DiGiovanni C . The Effects of Chronic Ankle Instability on the Biomechanics of the Uninjured, Contralateral Ankle During Gait. Orthop Surg. 2022; 14(9):2238-2244. PMC: 9483063. DOI: 10.1111/os.13307. View

12.

Molla-Casanova S, Ingles M, Serra-Ano P . Effects of balance training on functionality, ankle instability, and dynamic balance outcomes in people with chronic ankle instability: Systematic review and meta-analysis. Clin Rehabil. 2021; 35(12):1694-1709. DOI: 10.1177/02692155211022009. View

13.

Deodato M, Coan L, Buoite Stella A, Ajcevic M, Martini M, Di Lenarda L . Inertial sensors-based assessment to detect hallmarks of chronic ankle instability during single-leg standing: Is the healthy limb "healthy"?. Clin Biomech (Bristol). 2023; 107:106036. DOI: 10.1016/j.clinbiomech.2023.106036. View

14.

Brandolini S, Lugaresi G, Santagata A, Ermolao A, Zaccaria M, Marchand A . Sport injury prevention in individuals with chronic ankle instability: Fascial Manipulation versus control group: A randomized controlled trial. J Bodyw Mov Ther. 2019; 23(2):316-323. DOI: 10.1016/j.jbmt.2019.01.001. View

15.

Schleip R, Gabbiani G, Wilke J, Naylor I, Hinz B, Zorn A . Fascia Is Able to Actively Contract and May Thereby Influence Musculoskeletal Dynamics: A Histochemical and Mechanographic Investigation. Front Physiol. 2019; 10:336. PMC: 6455047. DOI: 10.3389/fphys.2019.00336. View

16.

Wang B, Zhang X, Zhu F, Zhu W, Wang X, Jia F . A randomized controlled trial comparing rehabilitation with isokinetic exercises and Thera-Band strength training in patients with functional ankle instability. PLoS One. 2022; 17(12):e0278284. PMC: 9714719. DOI: 10.1371/journal.pone.0278284. View

17.

Maetzler M, Ruescher M, Punzenberger F, Wang W, Abboud R . Progressive rehabilitation of the sprained ankle: A novel treatment method. Foot (Edinb). 2020; 43:101645. DOI: 10.1016/j.foot.2019.09.007. View

18.

Han J, Anson J, Waddington G, Adams R, Liu Y . The Role of Ankle Proprioception for Balance Control in relation to Sports Performance and Injury. Biomed Res Int. 2015; 2015:842804. PMC: 4637080. DOI: 10.1155/2015/842804. View

19.

Shi X, Han J, Witchalls J, Waddington G, Adams R . Does treatment duration of manual therapy influence functional outcomes for individuals with chronic ankle instability: A systematic review with meta-analysis?. Musculoskelet Sci Pract. 2019; 40:87-95. DOI: 10.1016/j.msksp.2019.01.015. View

20.

Kim H, Son S, Seeley M, Hopkins J . Altered movement strategies during jump landing/cutting in patients with chronic ankle instability. Scand J Med Sci Sports. 2019; 29(8):1130-1140. DOI: 10.1111/sms.13445. View