Therapy for Ankle Spasticity

Does Ankle Mulligan Mobilisation Improve Range of Motion?

Children with cerebral palsy often experience musculoskeletal issues that make participation in physical activities challenging. For example, children with Spastic Diplegia can often walk but with difficulty due to leg stiffness. Children can also experience ankle spasticity, which contributes to restricted ankle joint movement, compromised gait performance and impaired balance. Parents may be interested in a variety of therapy options to improve their child’s ankle joint function and range of motion.

The Mulligan Concept Mobilization with Movement (MWM) is a manual therapy approach that applies mobilisation forces during active movement or function. It is theorized that when done properly, the treatment could restore function and reduce pain in the joints. However, its effectiveness in improving the ankle range of motion in children with CP is unclear. A recent study sought to answer this question.

The study assessed changes in the ankle range of motion, balance, functional performance and quality of life, following 4 weeks of MWM therapy in diplegic children with CP aged 4-12 years.

What were the results?

 

MWM had a significant effect on active and passive range of motion for the left and right ankles, as well as on balance, gross motor function and quality of life. However, MWM had no significant effect on the distance covered during the 6-minute walk test (gait function).

 

The study says more research with long-term follow-up may be helpful in understanding the benefits of MWM therapy, and whether the benefits are sustained over time. The current study also has limitations as it did not take into account the diverse cognitive levels and motivations of children with CP. Based on the current data, the study encourages the use of MWM therapy alongside traditional physiotherapy. Parents interested in MWM therapy can talk to the child’s health care provider to learn more.

Parent resources

Looking to connect with other families who understand what you're going through? 

Join the CP Support Canada Facebook Parent Group

CP Smile Project

The CP Smile Project is a community project that helps ensure children with cerebral palsy have access to recreational opportunities that allow them to engage in play and community involvement. We give monthly bursaries to families to help them provide the support needed for their child to engage in play and have fun.