Effect of joint mobilization on chronic instability of the ankle:a systematic review with meta-analysis

The present work aims to analyze the effect of joint mobilization in patients with chronic ankle instability on the outcomes ofpain and dorsiflexion range of motion of the ankle after systematic review study with meta-analysis. The period for developingthe research and collection was from August 2022. The databases used for collection were CENTRAL, MEDLINE/PUBMED,EMBASE, CINAHL, PEDro and SPORTDiscus, and only randomized controlled trials were included. Studies that included theclinical question by PICO (P = chronic ankle instability; I = joint mobilization; C = placebo and minimal intervention; O = painand range of motion). The analysis was performed using the Review Manager 5.4.1. The I2 test was used for heterogeneity ofthe studies. A total of 6 studies were selected for the meta-analysis in which they measured the range of motion. The findingswere statistically significant for range of motion of dorsiflexion (mean difference – MD = 0.86, 95%CI = 0.06;1.66, p = 0.04),however the findings became insignificant after the sensitivity analysis (MD = 0.58, 95%CI = -0.07;1.23, p = 0.08). There wasnot enough literature for the pain outcome. The study obtained a satisfactory result for joint mobilization when all studies inthe literature were grouped, but the result did not obtain statistical significance using better quality studies. Therefore, thereis a need for better quality of evidence for the joint mobilization technique, as well as studies with better methodologicalquality so that we can more accurately state the real effects of this technique. Systematic Review Registration: Prospectivelyregistered with PROSPERO (CRD42020193292).(AU)