NCT06828744

Brief Summary

Background: Ankle dorsiflexion is a crucial factor for functional lower limb performance, particularly in sports like basketball, where dynamic movements, direction changes, jumps, and landings are essential for athletic success. Eccentric exercise has been shown to improve dorsiflexion range of motion (ROM), enhancing muscle strength, flexibility, and athletic performance. Additionally, ankle joint mobilization, specifically posterior talocrural glide, has demonstrated promising results in improving mobility, restoring ROM, and reducing compensatory movement strategies. However, the combined effects of eccentric exercise and joint mobilization on increasing ankle dorsiflexion ROM and improving athletic performance in young basketball athletes have not yet been sufficiently investigated. Objective: The purpose of this study is to investigate the effectiveness of combining eccentric exercise and posterior talocrural glide mobilization in improving ankle dorsiflexion ROM and enhancing athletic performance in young basketball athletes. Methods: A randomized controlled trial will be conducted, including 38 young basketball athletes with confirmed restricted ankle dorsiflexion ROM. Participants will be randomly assigned to an intervention group and a control group. Both groups will follow a five-week training program consisting of eccentric exercises and stretching, performed two times per week, to improve athletic performance. The intervention group, in addition to the exercise program, will undergo ankle joint mobilization sessions for the same duration. Ankle dorsiflexion ROM, maximum isometric strength of the ankle muscles, fatigue resistance through specific endurance tests, and performance via functional tests will be assessed at baseline, at the end of the five-week program, and three months after the intervention. Statistical analysis will be conducted using a two-way repeated-measures ANOVA, with the significance level set at p \< 0.05.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
38

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Mar 2025

Shorter than P25 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

February 11, 2025

Completed
3 days until next milestone

First Posted

Study publicly available on registry

February 14, 2025

Completed
25 days until next milestone

Study Start

First participant enrolled

March 11, 2025

Completed
9 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 30, 2025

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

November 30, 2025

Completed
Last Updated

February 3, 2026

Status Verified

January 1, 2026

Enrollment Period

9 months

First QC Date

February 11, 2025

Last Update Submit

January 31, 2026

Conditions

Keywords

Unilateral Restricted Ankle DorsiflexionRange of motion (ROM)Eccentric exercisePosterior talocrural glideBasketball athletes

Outcome Measures

Primary Outcomes (2)

  • Active Range of Motion of Ankle Dorsiflexion using a Digital Goniometer

    The active range of motion (ROM) of ankle dorsiflexion will be measured using a digital goniometer, which provides joint angle measurements. The measurement will be performed with the participant in a seated position and the knee slightly flexed. The goniometer will be placed on the lateral malleolus and aligned with the axis of the tibia and the foot. The athlete will perform maximum active dorsiflexion, and the angle (in degrees) formed between the tibia and the foot will be recorded. Three trials will be performed and the mean value will be used for analysis. This measurement provides information regarding ankle mobility and helps identify potential motion restrictions. The use of a digital goniometer for ROM assessment is widely applied in clinical and research settings when standardized procedures are followed.

    Baseline, end of 5th week, 3-moth follow-up

  • Dorsiflexion Range of Motion in a Closed Kinetic Chain using the Weight-Bearing Lunge Test (WBLT)

    The Weight-Bearing Lunge Test (WBLT) is used to assess the range of motion (ROM) of ankle dorsiflexion in a closed kinetic chain. The test is performed with the participant standing facing a wall and advancing the tibia while keeping the heel in contact with the ground. The toe-to-wall distance (in cm) is measured while the knee remains in contact with the wall. Three trials are recorded and the mean value is used for analysis. This test provides a functional measure of ankle dorsiflexion under weight-bearing conditions and is widely used in both clinical and research settings.

    Baseline, end of 5th week, 3-moth follow-up

Secondary Outcomes (7)

  • Maximum Isometric Strength of Ankle Dorsiflexors and Plantar Flexors using a Handheld Dynamometer

    Baseline, end of 5th week, 3-moth follow-up

  • Jump Height (cm) using the Countermovement Jump (CMJ) Test

    Baseline, end of 5th week, 3-moth follow-up

  • Endurance and Fatigue Resistance using the Fatigue Index (FI) derived from repeated single-leg hops

    Baseline, end of 5th week, 3-moth follow-up

  • Performance Assessment using the Single-Leg 6m Timed Hop Test

    Baseline, end of 5th week, 3-moth follow-up

  • Performance Assessment using the Triple Hop for Distance Test

    Baseline, end of 5th week, 3-moth follow-up

  • +2 more secondary outcomes

Study Arms (2)

Exercise Group

ACTIVE COMPARATOR

Participants will follow an exercise and stretching program for five weeks, performed two times per week. The program will consist of eccentric strengthening and stretching exercises targeting the gastrocnemius and soleus muscles. The eccentric strengthening component will include heel-lowering exercises. For the gastrocnemius, the participant will stand on an elevated surface with the knee fully extended and will slowly lower the heel. For the soleus, the participant will perform the same movement with the knee slightly flexed. Participants will perform three sets of fifteen repetitions for each exercise, with approximately one-minute rest intervals between sets. In addition, step-lunge dorsiflexion drills will be performed to promote functional dorsiflexion under load. The stretching component will focus on the gastrocnemius and soleus muscles. The gastrocnemius stretch will be performed in a lunge position with both heels on the ground and the back knee extended, while the soleus

Other: Exercise

Exercise + Joint mobilization

EXPERIMENTAL

In addition to the exercise and stretching program followed by the control group, participants will receive a manual therapy program targeting talocrural joint arthrokinematics, delivered twice per week for five weeks by the same physiotherapist. Each supervised session will last approximately 25 minutes. The manual therapy protocol will include posterior talar glide mobilization with active dorsiflexion according to the mobilization-with-movement concept. This technique will be applied for three sets of ten repetitions using grade III-IV oscillatory mobilizations. In addition, posterior talar glide mobilizations will be applied in non-weight-bearing conditions, as well as in weight-bearing using a stabilization belt, while the participant actively dorsiflexes the ankle within a pain-free range. Furthermore, participants will be instructed to perform a talocrural joint self-mobilization technique using a belt at home, performed daily for three sets of 30 to 60 seconds.

Other: Exercise plus Joint Mobilization

Interventions

Participants in this group will follow an exercise and stretching program for five weeks, performed two times per week.

Exercise Group

Participants in this group will follow a five-week exercise and stretching program, performed two times per week, in combination with an ankle joint mobilization program.

Exercise + Joint mobilization

Eligibility Criteria

Age18 Years - 25 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64)

You may qualify if:

  • Participants healthy and actively engaged in basketball training at the time of the study.
  • No presence of ankle pain or use of medication for musculoskeletal injuries or pain management at the time of the study.
  • Participation in regular training for at least one month prior to the study.
  • A restriction in ankle dorsiflexion of at least 2 cm in one foot compared to the other, as measured using the Weight-Bearing Lunge Test (WBLT).
  • Written informed consent must be provided before participation in the study.

You may not qualify if:

  • History of lower extremity surgery.
  • Musculoskeletal injury to the lower extremity within the past six months.
  • Presence of neurological, vestibular, or balance disorders, or diagnosed connective tissue disease.
  • Inability to comply with the intervention or assessment procedures.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

International Hellenic University

Thessaloniki, Greece, 57 400, Greece

Location

MeSH Terms

Interventions

Exercise

Intervention Hierarchy (Ancestors)

Motor ActivityMovementMusculoskeletal Physiological PhenomenaMusculoskeletal and Neural Physiological Phenomena

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Masking Details
A masked assessor will conduct the measurements
Purpose
PREVENTION
Intervention Model
PARALLEL
Model Details: A randomized controlled trial will be conducted, including 38 young basketball athletes with confirmed restricted ankle dorsiflexion ROM. Participants will be randomly assigned to an intervention group and a control group. Both groups will follow a five-week training program consisting of eccentric exercises and stretching, performed two times per week, to improve athletic performance. The intervention group, in addition to the exercise program, will undergo ankle joint mobilization sessions for the same duration.
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Dimitrios Lytras, Assistant Professor in the Department of Physiotherapy at the International Hellenic University

Study Record Dates

First Submitted

February 11, 2025

First Posted

February 14, 2025

Study Start

March 11, 2025

Primary Completion

November 30, 2025

Study Completion

November 30, 2025

Last Updated

February 3, 2026

Record last verified: 2026-01

Data Sharing

IPD Sharing
Will not share

Locations