Neurodynamic Technique on Functional Ankle Instability: A Case Report (original) (raw)
2018, JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH
A 17-year-old male, a medium pacecricket bowler reported with numerous ankle sprains on his right side during his training sessions, especially in trailing foot during contact phase prior to the delivery of a ball. For the past five months before the intervention, the patient experienced right ankle medial roll three times. He was referred by a sports medicine specialist for physiotherapy management at National Sports Institute, Malaysia. He walked independently with ankle brace support and was worried on his performance. The informed consent was taken from the patient and his subjective findings revealed that he was experiencing right lateral ankle pain during ankle inversion movements and especially while repeating bowling actions and the numeric pain rating score was 4/10. Dynamic balance: Dynamic balance was measured by using Y Balance Test Kit ™ [1], which consists of a stance platform to which three pieces of a bamboo wooden bar scale is attached in the anterior, posteromedial, and posterolateral reach directions. The posterior bars are positioned at 45° and 135° from the anterior wooden bar. Each wooden bar is marked at 5 millimetre increments to record the dynamic balance measurement score. The participant was instructed to stand on the centre wooden block in single leg and to push the indicator over the wooden scale bar anteriorly, postero-laterally and postero-medially along the stick, with the foot reaching the bar by bending the hip, knee and ankle joint of the tested leg. The participant was also instructed to return to the starting position without pushing off with the foot reaching the bar and without losing his balance. A standardised test protocol was created with sufficient rest in between the trails and it was ensured that the test was disregarded if the subject lost his balance and touched his reaching foot to the ground [2] as shown in [Table/Fig-1]. Range of motion: The participant was positioned on a high seated bench and instructed to place his hands behind to adopt a slumped spinal posture, facilitating the thoracic and lumbar spine to maintain a flexed posture. The hip joints were at 90° flexion, as measured by a universal goniometer and the active knee extension range of motion was measured with a neutral ankle joint by using the twin axis electro-goniometer as shown in [Table/Fig-2]. The accuracy of placement of the electrogoniometer was obtained by identifying the zero position in long sitting posture prior to the start of test.
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