Die Effektivität manueller Therapie beim Supinationstrauma

Zusammenfassung

Das Supinationstrauma ist eine der häufigsten Sportverletzungen weltweit. Die Betroffenen klagen oft über persistierende Beschwerden mehrere Jahre nach dem ersten Supinationstrauma. Bewegungsmangel sowie eine verminderte gesundheitsbezogene Lebensqualität können die Folge sein. Manuelle Therapie ist eine effektive Interventionsform bei muskuloskelettalen Erkrankungen und hat möglicherweise eine positive Wirkung bei Patient*innen mit Supinationstrauma.

Eine systematische Literaturübersichtsarbeit und Meta-Analyse wurden durchgeführt. Mittels einer systematischen Literatursuche auf PubMed, Embase, OVID, PEDro sowie Google Scholar wurden 14 RCTs in die qualitative Auswertung eingeschlossen und anhand der PEDro-Skala und des Risk-of-Bias-Tools der Cochrane Collaboration (RoB 2.0) bewertet. Danach wurden die Ergebnisparameter „Bewegungsausmaß der Dorsalextension“, „Schmerz“ und „Funktion“ extrahiert und miteinander verglichen.

Die 14 eingeschlossenen Studien verfügten über eine gute methodologische Qualität und hatten ein geringes Bias-Risiko. Zwölf Studien wurden in die quantitative Auswertung eingeschlossen. Für das Bewegungsausmaß der Dorsalextension ergab sich ein gepoolter Effekt (g) von 1,08 (KI=0,20; 1,96), für den Schmerz ein statistisch nicht-signifikanter Effekt (g) von 1,00 (KI=− 2,01; 0,01) und für die Funktion ein statistisch nicht-signifikanter Effekt (g) von 0,36 (KI=− 0,32; 1,03).

Manuelle Therapie hat eine positive Wirkung auf das Bewegungsausmaß der Dorsalextension. Keine Aussage kann über deren Wirkung auf die Funktion und Schmerzen bei Patient*innen mit Supinationstrauma getroffen werden. Es gibt Hinweise dafür, dass manuelle Therapie eine langfristige Wirkung auf das Bewegungsausmaß der Dorsalextension bei Patient*innen mit Supinationstrauma haben könnte.

Abstract

Lateral ankle sprains are one of the most common sports injuries worldwide. Affected persons often complain of persistent symptoms several years after the index trauma, which can result in a lack of exercise and a reduced health-related quality of life. Manual therapy is an effective form of intervention for musculoskeletal disorders and may have a positive effect in patients with lateral ankle sprains.

A systematic review and meta-analysis were conducted. Using a systematic literature search on PubMed, Embase, OVID, PEDro and Google Scholar, 14 RCTs were included in the qualitative analysis and assessed using the PEDro scale and the Cochrane Collaborationʼs risk-of-bias tool (RoB 2.0). The outcome parameters “dorsiflexion range of motion”, “pain” and “function” were then extracted and compared.

The 14 included studies were of good methodological quality and had a low risk of bias. Twelve studies were included in the quantitative analysis. There was a pooled effect (g) of 1.08 (CI=0.20; 1.96) for dorsiflexion range of motion, a statistically non-significant effect (g) of 1.00 (CI=− 2.01; 0.01) for pain and a statistically non-significant effect (g) of 0.36 (CI=− 0.32; 1.03) for function.

Manual therapy has a positive effect on the range of motion of dorsiflexion. No statement can be made about its effect on function and pain in patients with lateral ankle sprains. There are indications that manual therapy could have a long-term effect on the range of motion of dorsiflexion in patients with lateral ankle sprains.

Schlüsselwörter

Manuelle Therapie - Supinationstrauma - Dorsalextension - Schmerz - Funktion

Keywords

manual therapy - lateral ankle sprain - dorsiflexion - pain - function

Publication History

Received: 01 September 2023

Accepted: 20 March 2024

Article published online:
12 July 2024

• Literatur

• 1 Klein C, Bloch H, Burkhardt K. et al. VBG-Sportreport 2021 – Analyse des Verletzungsgeschehens in den zwei höchsten Ligen der Männer: Basketball, Eishockey, Fußball, Handball. Hamburg: VBG; 2022
• 2 Beynnon BD, Murphy DF, Alosa DM. Predictive Factors for Lateral Ankle Sprains: A Literature Review. J Athl Train 2002; 37: 376-380
• 3 Pflüger P, Wurm M, Biberthaler P. et al. Analyse von 6581 Fuß- und Sprunggelenkverletzungen einer Notaufnahme im Zeitraum von 2010–2017. Unfallchirurgie (Heidelb) 2022; 125: 801-810 DOI: 10.1007/s00113-021-01081-9.
• 4 Cavazos GJ, Harkless LB. The epidemiology, evaluation, and assessment of lateral ankle sprains in athletes. J Sports Med Ther 2021; 6: 8-17 DOI: 10.29328/journal.jsmt.1001052.
• 5 Gribble PA, Bleakley CM, Caulfield BM. et al. 2016 consensus statement of the International Ankle Consortium: prevalence, impact and long-term consequences of lateral ankle sprains. Br J Sports Med 2016; 50: 1493-1495 DOI: 10.1136/bjsports-2016-096188.
• 6 van Rijn RM, van Os AG, Bernsen RMD. et al. What is the clinical course of acute ankle sprains? A systematic literature review. Am J Med 2008; 121: 324-331.e6 DOI: 10.1016/j.amjmed.2007.11.018.
• 7 Hertel J, Corbett RO. An Updated Model of Chronic Ankle Instability. J Athl Train 2019; 54: 572-588 DOI: 10.4085/1062-6050-344-18.
• 8 Al Mahrouqi MM, MacDonald DA, Vicenzino B. et al. Quality of life, function and disability in individuals with chronic ankle symptoms: a cross-sectional online survey. J Foot Ankle Res 2020; 13: 67 DOI: 10.1186/s13047-020-00432-w.
• 9 Wikstrom EA, Hubbard TJ. Talar positional fault in persons with Chronic Ankle Instability. Arch Phys Med Rehabil 2010; 91: 1267-1271 DOI: 10.1016/j.apmr.2010.04.022.
• 10 Crosbie J, Green T, Refshauge K. Effects of reduced ankle dorsiflexion following lateral ligament sprain on temporal and spatial gait parameters. Gait Posture 1999; 9: 167-172 DOI: 10.1016/s0966-6362(99)00010-7.
• 11 Hoch MC, Staton GS, McKeon PO. Dorsiflexion range of motion significantly influences dynamic balance. J Sci Med Sport 2011; 14: 90-92 DOI: 10.1016/j.jsams.2010.08.001.
• 12 de Noronha M, Refshauge KM, Herbert RD. et al. Do voluntary strength, proprioception, range of motion, or postural sway predict occurrence of lateral ankle sprain. Br J Sports Med 2006; 40: 824-828 DOI: 10.1136/bjsm.2006.029645.
• 13 Pope R, Herbert R, Kirwan J. Effects of ankle dorsiflexion range and pre-exercise calf muscle stretching on injury risk in Army recruits. Aus J Physiother 1998; 44: 165-172 DOI: 10.1016/s0004-9514(14)60376-7.
• 14 Konradsen L, Bech L, Ehrenbjerg M. et al. Seven years follow-up after ankle inversion trauma. Scand J Med Sports 2002; 12: 129-135 DOI: 10.1034/j.1600-0838.2002.02104.x.
• 15 Houston MN, van Lunen BL, Hoch MC. Health-related quality of life in individuals with Chronic Ankle Instability. J Athl Train 2014; 49: 758-763 DOI: 10.4085/1062-6050-49.3.54.
• 16 Al Mahrouqi MM, MacDonald DA, Vicenzino B. et al. Quality of life, function and disability in individuals with chronic ankle symptoms: a cross-sectional online survey. Foot Ankle Res 2020; 13: 67 DOI: 10.1186/s13047-020-00432-w.
• 17 Anandacoomarasamy A, Barnsley L. Long term outcomes of inversion ankle injuries. Br J Sports Med 2005; 39: e14 DOI: 10.1136/bjsm.2004.011676.
• 18 Clar C, Tsertsvadze A, Court R. et al. Clinical effectiveness of manual therapy for the management of musculoskeletal and non-musculoskeletal conditions: systematic review and update of UK evidence report. Chiropr Man Therap 2014; 22: 12 DOI: 10.1186/2045-709X-22-12.
• 19 Vuurberg G, Hoorntje A, Wink LM. et al. Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. Br J Sports Med 2018; 52: 956 DOI: 10.1136/bjsports-2017-098106.
• 20 Martin RL, Davenport TE, Fraser JJ. et al. Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021. J Orthop Sports Phys Ther 2021; 51: CPG1-CPG80 DOI: 10.2519/jospt.2021.0302.
• 21 Weerasekara I, Osmotherly P, Snodgrass S. et al. Clinical Benefits of Joint Mobilization on Ankle Sprains: A Systematic Review and Meta-Analysis. Arch Phys Med Reahbil 2018; 99: 1395-1412.e5 DOI: 10.1016/j.apmr.2017.07.019.
• 22 Vallandingham RA, Gaven SL, Powden CJ. Changes in Dorsiflexion and Dynamic Postural Control After Mobilizations in Individuals With Chronic Ankle Instability: A Systematic Review and Meta-Analysis. J Athl Train 2019; 54: 403-417 DOI: 10.4085/1062-6050-380-17.
• 23 Page MJ, McKenzie JE, Bossuyt PM. et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372: n71 DOI: 10.1136/bmj.n71.
• 24 CEBM. Centre for Evidence-Based Medicine. OCEBM Levels of Evidence. “The Oxford 2011 Levels of Evidence”. Im Internet: https://bit.ly/3R65FVJ; Stand: 02.06.2024
• 25 PEDro. Physiotherapy Evidence Database. PEDro Scale (1999). Im Internet: https://bit.ly/4aHVCwV; Stand: 02.06.2024
• 26 Sterne AC, Savović J, Page MJ. et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019; 366: l4898 DOI: 10.1136/bmj.l4898.
• 27 Borenstein M. Common Mistakes in Meta-Analysis and How to Avoid Them. 1^st ed. New Jersey: Biostat Inc; 2019
• 28 The R Foundation. The R Project for Statistical Computing. Im Internet: https://www.R-project.org/; Stand: 02.06.2024
• 29 Cosby NL, Koroch M, Grindstaff TL. et al. Immediate effects of anterior to posterior talocrural joint mobilizations following acute lateral ankle sprain. J Man Manip Ther 2011; 19: 76-83 DOI: 10.1179/2042618610Y.0000000005.
• 30 Gogate N, Satpute K, Hall T. The effectiveness of mobilization with movement on pain, balance and function following acute and sub acute inversion ankle sprain – A randomized, placebo controlled trial. Phys Ther Sport 2021; 48: 91-100 DOI: 10.1016/j.ptsp.2020.12.016.
• 31 Izaola-Azkona L, Vicenzino B, Olabarrieta-Eguia I. et al. Effectiveness of Mobilization of the Talus and Distal Fibula in the Management of Acute Lateral Ankle Sprain. Phys Ther 2021; 101: pzab111 DOI: 10.1093/ptj/pzab111.
• 32 Nguyen AP, Pitance L, Mahaudens P. et al. Effects of Mulligan Mobilization with Movement in Subacute Lateral Ankle Sprains: A Pragmatic Randomized Trial. J Man Manip Ther 2021; 29: 341-352 DOI: 10.1080/10669817.2021.1889165.
• 33 Norouzi A, Delkhoush CT, Mirmohammadkhani M. et al. A comparison of mobilization and mobilization with movement on pain and range of motion in people with lateral ankle sprain: A randomized clinical trial. J Bodyw Mov Ther 2021; 27: 654-660 DOI: 10.1016/j.jbmt.2021.05.006.
• 34 Beazell JR, Grindstaff TL, Sauer LD. et al. Effects of a proximal or distal tibiofibular joint manipulation on ankle range of motion and functional outcomes in individuals with Chronic Ankle Instability. J Orthop Sports Phys Ther 2012; 42: 125-134 DOI: 10.2519/jospt.2012.3729.
• 35 Bolton C, Hale S, Telemeco T. The Effects of Therapeutic Exercise With and Without Mobilization in Participants With Chronic Ankle Instability: A Randomized Controlled Trial. J Sport Rehabil 2020; 30: 206-213 DOI: 10.1123/jsr.2019-0373.
• 36 Cruz-Díaz D, Lomas Vega R, Osuna-Pérez MC. et al. Effects of joint mobilization on Chronic Ankle Instability: a randomized controlled trial. Disab Rehabil 2015; 37: 601-610 DOI: 10.3109/09638288.2014.935877.
• 37 Harkey M, McLeod M, van Scoit A. et al. The immediate effects of an anterior-to-posterior talar mobilization on neural excitability, dorsiflexion range of motion, and dynamic balance in patients with Chronic Ankle Instability. J Sport Rehabil 2014; 23: 351-359 DOI: 10.1123/JSR.2013-0085.
• 38 Lubbe D, Lakhani E, Brantingham JW. et al. 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; 38: 22-34 DOI: 10.1016/j.jmpt.2014.10.001.
• 39 Plaza-Manzano G, Vergara-Vila M, Val-Otero S. et al. Manual therapy in joint and nerve structures combined with exercises in the treatment of recurrent ankle sprains: A randomized, controlled trial. Man Ther 2016; 26: 141-149 DOI: 10.1016/j.math.2016.08.006.
• 40 Marrón-Gómez D, Rodríguez-Fernández ÁL, Martín-Urrialde JA. The effect of two mobilization techniques on dorsiflexion in people with Chronic Ankle Instability. Phys Ther Sport 2015; 16: 10-15 DOI: 10.1016/j.ptsp.2014.02.001.
• 41 McKeon PO, Wikstrom EA. Sensory-Targeted Ankle Rehabilitation Strategies for Chronic Ankle Instability. Med Sci Sports Exerc 2016; 48: 776-784 DOI: 10.1249/MSS.0000000000000859.
• 42 Shin H-J, Kim S-H, Jung HJ. et al. Manipulative Therapy Plus Ankle Therapeutic Exercises for Adolescent Baseball Players with Chronic Ankle Instability: A Single-Blinded Randomized Controlled Trial. Int J Environ Res Public Health 2020; 17: 4997 DOI: 10.3390/ijerph17144997.
• 43 McGuinness LA, Higgins JPT. Risk-of-bias VISualization (robvis): An R package and Shiny web app for visualizing risk-of-bias assessments. Res Synth Methods 2021; 12: 55-61 DOI: 10.1002/jrsm.1411.
• 44 Kim H, Moon S. Effect of Joint Mobilization in Individuals with Chronic Ankle Instability: A Systematic Review and Meta-Analysis. J Funct Morphol Kinesiol 2022; 7: 66 DOI: 10.3390/jfmk7030066.
• 45 de Ruvo R, Russo G, Lena F. et al. The Effect of Manual Therapy Plus Exercise in Patients with Lateral Ankle Sprains: A Critically Appraised Topic with a Meta-Analysis. J Clin Med 2022; 11: 4925 DOI: 10.3390/jcm11164925.
• 46 Hiller CE, Refshauge KM, Bundy AC. et al. The Cumberland ankle instability tool: a report of validity and reliability testing. Arch Phys Med Rehabil 2006; 87: 1235-1241 DOI: 10.1016/j.apmr.2006.05.022.