Efficacy of adding mobilization and balance exercises to a home-based exercise program in patients with ankle disability: a randomized controlled trial

Background: Ankle joint fractures account for 10.2% of all fractures. It has
been hypothesized that mobilizing the ankle joint is a crucial intervention for
improving balance and range of motion (ROM).
Objective: The current study explores the impact of incorporating mobilization,
balance training, and physical therapy exercises into a home-based program
on pain, ROM, health-related quality of life (HRQoL), and peak muscle torque in
patients with ankle disability following road traffic accidents (RTAs).
Methods: In this single-blinded, randomized controlled trial, 60 participants with
post-RTA ankle disability were randomly assigned to either the experimental
group or the control group. The experimental group underwent home-based
exercises combined with mobilization, balance training, and physical therapy for
2 months, while the control group followed only a home exercise program. The
interventions were then implemented 3 days per week. Pain was evaluated using
the Visual Analogue Scale (VAS), ankle ROM was measured using a universal
goniometer, HRQoL was evaluated using the Short Form (SF 36) survey, and
peak torque was assessed using the Biodex System isokinetic dynamometer.
Results: Significant improvements were observed in the experimental group
compared to the control group in pain, ROM, HRQoL, and peak muscle torque
(p < 0.001). After 8 weeks, the experimental group outcomes for VAS, ROM of ankle dorsiflexion/plantarflexion (DF/PF), peak torque of DF/PF, and HRQoL
physical and mental component summaries (PCS and MCS) were 2.55 ± 0.22,
13.02 ± 0.38, 25.06 ± 0.40, 34.12 ± 0.81, 47.46 ± 0.90, 43.15 ± 0.78, and
45.01 ± 0.68, respectively. In contrast, the results of the control group were
5.98 ± 0.31, 6.16 ± 0.28, 14.97 ± 0.35, 26.17 ± 0.90, 41.38 ± 0.94, 33.05 ± 1.10,
and 34.52 ± 1.06, respectively.
Conclusion: Incorporating mobilization and balance exercises into a physical
therapy program significantly improves pain, ankle ROM, HRQoL, and muscle
torque (DF/PF) in patients with ankle disability following RTAs.