Journal CME February 2025, Mobilization with movement is effective for improving ankle range of motion and walking ability in individuals after stroke: A systematic review with meta-analysis-PM R - 2024 - Nascimento - Mobilization with movement is effective for improving ankle range of motion and walking ability

PM R - 2024 - Nascimento - Mobilization with movement is effective for improving ankle range of motion and walking ability

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The systematic review by Lucas R. Nascimento and colleagues investigates the impact of mobilization with movement (MWM) on ankle range of motion and walking ability in adults post-stroke. The study design is a systematic review of randomized controlled trials focusing on individuals who are ambulatory after a stroke. Six trials with 160 participants were included in the analysis, with the main objective being to assess the effects of adding MWM to standard exercises.<br /><br />The review found that integrating MWM with standard exercise therapy enhanced ankle dorsiflexion by 4 degrees more than exercise alone, with potential benefits extending to walking speed, cadence, and step length. Walking speed increased by 0.08 m/s, cadence by 9 steps/min, and step length by 5 cm when MWM was added. Although improvements were noted, the quality of the evidence varied, being low for range of motion yet moderate for walking outcomes.<br /><br />The intervention involves applying a specific glide to the ankle joint as the patient moves, aiming to correct positional faults and improve joint mechanics. The systematic review highlights that this approach can significantly improve gait parameters, which are critical for rehabilitation after stroke, by addressing dorsiflexion weakness and impairments that typically follow a stroke. The results advocate for the clinical implementation of MWM as a complementary therapy in post-stroke rehabilitation to improve functional mobility.<br /><br />However, the review also notes limitations like small sample sizes and methodological variations that could introduce bias, and suggests that further large-scale studies are needed. Additionally, the long-term benefits of these interventions remain uncertain as most studies did not measure effects past the intervention period. Nonetheless, this review provides promising insights into enhancing rehabilitation strategies for individuals affected by stroke-related mobility deficits.

Keywords

mobilization with movement

ankle range of motion

walking ability

post-stroke rehabilitation

systematic review

randomized controlled trials

gait parameters

dorsiflexion improvement

functional mobility

stroke-related deficits