Osteopathic manipulative treatment of the ankle-foot complex in individuals with limited dorsiflexion: Study protocol for a randomized crossover clinical trial

Reduced ankle dorsiflexion range of motion leads to changes in daily functional activities such as walking. Myofascial, muscular, and joint techniques are commonly used to restore this range. Joint techniques typically focus on the talocrural joint, treating the foot as a rigid segment. This study aims to propose an evaluation and treatment protocol for the ankle and foot complex in healthy individuals with reduced dorsiflexion. A randomized crossover clinical trial, with a 2-week washout period and follow-up to assess the retention of the intervention's effects, will be conducted in adults aged 18–40 years. Thirty participants will be recruited and assessed before and after intervention for ankle range of motion using the weight-bearing lunge test, as well as for kinematic and spatiotemporal gait variables measured by inertial sensors. The intervention, consisting of osteopathic manipulative treatment, will target the talocrural, distal tibiofibular, subtalar, midtarsal (Chopart), tarsal-metatarsal, and metatarsal-phalangeal joints. This study has been submitted to the Ethics Committee of the Universidade Federal de Juiz de Fora (protocol no. 6.917.725) and registered in the Brazilian Registry of Clinical Trials (RBR-10rvpcp3). An acute improvement in ankle dorsiflexion range of motion is expected, along with additional effects on the spatiotemporal and kinematic gait variables, which could assist in clinical decision-making for treating dorsiflexion limitations.