Immediate Effects of Mulligan Mobilization on Ankle Proprioception, Dorsiflexion Range of motion and Balance in individuals with Chronic Hemiparetic Stroke: A Quasi-Experimental study

Balance deficits and decreased mobility are common complaints after chronic hemiparetic stroke and may be due to decreased ankle proprioception and dorsiflexion range of motion. Mulligan Mobilisation with Movement (MWM) is a manual therapy technique to improve joint mechanics and sensorimotor function, however evidence on its immediate effects is limited. The immediate effects of ankle MWM on proprioception, dorsiflexion ROM, balance and functional mobility were assessed in the present study.
 The sample consisted of 60 patients who were diagnosed with chronic hemiparetic stroke (post-stroke) and were recruited from rehabilitation centers and hospitals in Erbil city, Iraq and were used in a one group pretest - posttest quasi experimental study. One session of weight bearing ankle MWM was provided to participants. Ankle joint position sense (absolute error), non-weight-bearing dorsiflexion, weight-bearing dorsiflexion (Weight-Bearing Lunge Test), the Berg Balance Scale, and the Timed Up and Go test were measured. Pre- and 5-minute post-treatment measurements were taken. Data were analysed with paired statistical test for normality distributed changes scores (p< 0.05) and Wilcoxon singed-rank testes for non-normal change scores.
There was a significant improvement in ankle joint position sense (mean difference = −0.22°), non-weight-bearing dorsiflexion (0.45°), and weight-bearing dorsiflexion (0.57°). There were no significant differences in balance or functional mobility.
Ankle proprioception and dorsiflexion range of motion was immediately enhanced after 1 ankle MWM session while balance and functional mobility was not. Further randomized controlled trials are needed to determine its long-term clinical effectiveness.