Ankle-Joint Self-Mobilization and CrossFit Training in Patients With Chronic Ankle Instability: A Randomized Controlled Trial

CONTEXT: Ankle-joint mobilization and neuromuscular and strength training have been deemed beneficial in the management of patients with chronic ankle instability (CAI). CrossFit training is a sport modality that involves these techniques. OBJECTIVE: To determine and compare the influence of adding self-mobilization of the ankle joint to CrossFit training versus CrossFit alone or no intervention in patients with CAI. DESIGN: Randomized controlled clinical trial. SETTING: Research laboratory. PATIENTS OR OTHER PARTICIPANTS: Seventy recreational athletes with CAI were randomly allocated to either self-mobilization plus CrossFit training, CrossFit training alone, or a control group. INTERVENTION(S): Participants in the self-mobilization plus CrossFit group and the CrossFit training-alone group pursued a CrossFit training program twice a week for 12 weeks. The self-mobilization plus CrossFit group performed an ankle self-mobilization protocol before their CrossFit training, and the control group received no intervention. MAIN OUTCOME MEASURE(S): Ankle-dorsiflexion range of motion (DFROM), subjective feeling of instability, and dynamic postural control were assessed via the weight-bearing lunge test, Cumberland Ankle Instability Tool, and Star Excursion Balance Test (SEBT), respectively. RESULTS: After 12 weeks of the intervention, both the self-mobilization plus CrossFit and CrossFit training-alone groups improved compared with the control group (P < .001). The self-mobilization plus CrossFit intervention was superior to the CrossFit training-alone intervention regarding ankle DFROM as well as the posterolateral- and posteromedial-reach distances of the SEBT but not for the anterior-reach distance of the SEBT or the Cumberland Ankle Instability Tool. CONCLUSIONS: Ankle-joint self-mobilization and CrossFit training were effective in improving ankle DFROM, dynamic postural control and self-reported instability in patients with CAI.