Efficacy of ankle mobilization on postural control in older people: A systematic review with meta-analysis

Objective To determine whether manual therapy based on joint mobilization techniques applied to recover a limited range of motion (ROM) in older adults could have a beneficial effect on balance. Methods Systematic review from MEDLINE, Embase, Cochrane Library, PEDro, WOS, Scopus, and Scielo, including studies with participants over 60, an experimental intervention based on ankle joint mobilization techniques, oriented to restore ankle ROM and assessing the effects on balance and ROM. A descriptive synthesis and a meta-analysis were conducted to estimate the effect of the interventions on balance and ROM, based on mean differences, with CI set at 95 %. Quality was assessed with PEDro scale and risk of bias with the Cochrane tool. Results A total of 8 studies were included in qualitative and 5 in quantitative synthesis. Manual therapy shown to be effective, by overall increasing 11.3° (95 % CI 6.4 to 15.6) the ankle ROM. The monopodal stability was improved in 5.8 s (95 % CI 0.1 to 11.4) and the margins of stability in 4.4 cm (95 % CI 0.6 to 8.6). The static balance improved in terms of the center of pressure swayed area with a decrease of 78.4 mm 2 (95 % CI 46.1 to 110.6), but not of velocity (95 % CI 24.7 to −36.7). The Timed up and go time decreased by 0.86 s (95 % CI 0.38 to −2.08). Conclusions Manual therapy based on joint mobilization techniques is an effective approach to increase ankle ROM, with benefits on the stability of older adults.