Mobilization with movement is effective for improving ankle range of motion and walking ability in individuals after stroke: A systematic review with meta-analysis

BackgroundMobilization with movement has been recommended to improve foot mobility in people with ankle impairments and could improve walking after stroke.ObjectiveTo examine the effects of the addition of mobilization with movement to commonly used exercises in physiotherapy for improving ankle range of motion and walking in people who have had a stroke.DesignSystematic review of randomized controlled trials.SettingsNot applicable.ParticipantsAmbulatory adults at any time after stroke.InterventionThe experimental intervention was exercises plus ankle mobilization with movement, in comparison with exercises alone.Main outcomeAnkle range of motion.MeasurementsWalking parameters (ie., walking speed, cadence, step length).ResultsSix trials, involving 160 participants, were included. The mean PEDro score of the trials was 6 (range 4 to 7). Mobilization with movement in addition to exercises improved range of motion by 4 degrees (95% CI 2 to 6), walking speed by 0.08 m/s (95% CI 0.05 to 0.11), cadence by 9 steps/min (95% CI 7 to 12), and step length by 5 cm (95% CI 3 to 7) more than exercises alone. The quality of evidence was low for range of motion and moderate for walking outcomes.ConclusionThis systematic review provided evidence that the addition of mobilization with movement to commonly used exercises in neurological rehabilitation increases ankle dorsiflexion, and benefits are carried over to improving walking speed, cadence, and step length in moderately disabled individuals with chronic stroke.Review RegistrationPROSPERO (CRD42023405130).