Mulligan Mobilization With Movement for Acute Lateral Ankle Sprains

This randomized controlled trial evaluates the effects and clinical specificity of Mulligan Mobilization With Movement (MWM) in adults with grade I or II lateral ankle sprains occurring less than 6 weeks before enrollment. The primary study population consists of participants enrolled within 2 weeks of the index lateral ankle sprain. Participants with an injury occurring between 2 and less than 6 weeks before enrollment are also eligible. Approximately 110 participants will be allocated to a Mulligan MWM intervention group or a control group receiving usual-care rehabilitation without Mulligan treatment. In the intervention group, three MWM techniques targeting the inferior tibiofibular, talocrural, and cubometatarsal joints are tested in a randomized order and adapted according to the participant's immediate pain-free response. Treatment includes up to six sessions provided twice weekly. Clinical outcomes are assessed at baseline, 3 weeks, and 3 months. The primary outcomes are ankle dorsiflexion range of motion, ankle joint arthrokinematics, and pain during weight-bearing dorsiflexion.

Inclusion Criteria: * Grade I or II lateral ankle sprain Index lateral ankle sprain occurring less than 6 weeks before enrollment Age 18 years or older No fracture associated with the index lateral ankle sprain No immobilization in a plaster cast Able to provide written informed consent Exclusion Criteria: * Grade III lateral ankle sprain Index lateral ankle sprain occurring 6 weeks or more before enrollment Additional lower-limb musculoskeletal disorder or injury incompatible with study participation Neurological disorder Severe hypertension Renal disease Cardiorespiratory disorder Sickle cell disease Arterial calcification Varicose veins Current anticoagulant treatment Current risk of or history of deep-vein thrombosis Fragile skin Previous surgery affecting sports performance