Manipulative therapy and rehabilitation for recurrent ankle sprain with functional instability: a short-term, assessor-blind, parallel-group randomized trial

J Manipulative Physiol Ther. 2015 Jan;38(1):22-34. doi: 10.1016/j.jmpt.2014.10.001. Epub 2014 Nov 6.


Objective: The purpose of this study was to compare manipulative therapy (MT) plus rehabilitation to rehabilitation alone for recurrent ankle sprain with functional instability (RASFI) to determine short-term outcomes.

Methods: This was an assessor-blind, parallel-group randomized comparative trial. Thirty-three eligible participants with RASFI were randomly allocated to receive rehabilitation alone or chiropractic MT plus rehabilitation. All participants undertook a daily rehabilitation program over the course of the 4-week treatment period. The participants receiving MT had 6 treatments over the same treatment period. The primary outcome measures were the Foot and Ankle Disability Index and the visual analogue pain scale, with the secondary outcome measure being joint motion palpation. Data were collected at baseline and during week 5. Missing scores were replaced using a multiple imputation method. Statistical analysis of the data composed of repeated-measures analysis of variance.

Results: Between-group analysis demonstrated a difference in scores at the final consultation for the visual analogue scale and frequency of joint motion restrictions (P ≤ .006) but not for the Foot and Ankle Disability Index (P = .26).

Conclusions: This study showed that the patients with RASFI who received chiropractic MT plus rehabilitation showed significant short-term reduction in pain and the number of joint restrictions in the short-term but not disability when compared with rehabilitation alone.

Keywords: Ankle Injuries; Musculoskeletal Manipulations; Rehabilitation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Ankle Injuries / therapy*
  • Combined Modality Therapy
  • Disability Evaluation
  • Female
  • Humans
  • Joint Instability / etiology
  • Joint Instability / therapy*
  • Male
  • Manipulation, Chiropractic*
  • Physical Therapy Modalities*
  • Recurrence
  • Single-Blind Method
  • Sprains and Strains / therapy*
  • Visual Analog Scale
  • Young Adult