The effect of Tuina based on the concept of hip-knee-ankle conjugation in patients with chronic ankle instability: study protocol for a randomized controlled trial

Front Rehabil Sci. 2023 Aug 25:4:1165548. doi: 10.3389/fresc.2023.1165548. eCollection 2023.

Abstract

Background: Chronic ankle instability (CAI) is a common sports injury disease and characterized by limited mobility, perceived instability and muscle weakness, combined treatment of hip-knee-ankle is a common rehabilitation method. Tuina, as a traditional Chinese manual therapy, is usually used for CAI, but many of them only focus on the local ankle joint rather than the combination of hip and knee joint. Therefore, we have designed a randomized controlled trial (RCT) to investigate the effects of Tuina base on the concept of hip-knee-ankle conjugation on the stability and balance of lower limbs and ankle function in patients with CAI.

Methods: We have designed a randomized controlled trial. A total of 72 participants with CAI will be randomly divided into functional training groups and hip-knee-ankle Tuina combined with functional training group in a 1:1 ratio. Participants in control group will receive 8 sessions of functional training (30 min per session, twice a week for 4 weeks). Participants in intervention group will receive 8 sessions of Tuina combined with functional training (twice a week for 4 weeks). The primary outcomes include the Y-Balance Test (YBT) and Cumberland Ankle Instability Tool (CAIT). The Secondary outcomes include the Foot and Ankle Ability Measure (FAAM) and ankle range of motion (ROM). The outcome assessments will be conducted before the first intervention and after the last intervention.

Discussion: The aim of this study is to explore a safe and effective manipulation program and serve as reference for clinical treatment of CAI and expect to provide the necessary theoretical and practical support to our future research.

Clinical trial registration: Chinese Clinical Trail Registry ChiCTR2300068274.

Keywords: chronic ankle instability; clinical trial; functional training; hip-knee-ankle conjugation; physical therapy; tuina.

Grants and funding

This trial is funded by Traditional Chinese Medicine research project of Shanghai Health Commission (No. 2022QN091) and Shanghai Three Year Action Plan for the Development of Traditional Chinese Medicine (Shanghai Traditional Chinese Medicine School Inheritance Project) (NO. ZYSNXD CC HPGC JD 001). The funder did not have a role in the study design, collection, management, analysis, interpretation of data, manuscript writing, or decision making for publication.