Chronic ankle instability in females: effectiveness of home-based exercises following joint mobilisation

Purpose
Ankle sprains are the most common musculoskeletal disorder, with up to 70% developing CAI, linked to mechanical and functional insufficiencies such as reduced DFROM and disrupted afferent transmission. Joint mobilisations improve DFROM, increase afferent input, enhance dynamic balance, and self-reported function in those with ankle sprains. However, research on the combined effect of mobilisation and home-based exercises is limited. The study determines if home-based rehabilitation can enhance functional improvements in WB-DFROM and dynamic postural control, following Grade IV anterior-to-posterior ankle joint mobilisation in females with CAI.

Methods
The study adopted a randomised comparative intervention design. Forty-eight female athletes (age 22.5 ± 3.5 years) with unilateral CAI were randomly assigned to intervention or control groups. All participants received three 120-s Grade IV anterior-to-posterior talar joint mobilisation sessions, 48 h apart. The intervention group then completed 4 weeks of home-based rehabilitation exercises, with the control group maintaining normal activities. WB-DFROM and SEBT (ANT, PM, PL) were measured bilaterally before the first session, after the third, and weekly during rehabilitation. The uninjured limb served as a control. Data were analysed using mixed model ANOVAs and effect sizes with Hedge’s g.

Results
Significant differences were found after initial mobilisation in both groups (p ≤ 0.001) with ‘huge’ effect sizes. The intervention group showed significant improvements in WB-DFROM, PM, and PL across all 4 weeks, and in ANT for weeks 1, 2, and 3.

Conclusion
Joint mobilisation followed by home-based rehabilitation effectively treats CAI in females. An effective protocol includes three 120-s joint mobilisations in the first week, followed by 2 weeks of daily exercises targeting self-mobilisation and dynamic postural control.