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.