ClinicalTrials.gg
RecruitingNCT06849076Updated Jul 27, 2026

The Influence of Talocrural Manipulation on Proprioception in Stroke

An interventional study of Placebo Talocrural Joint Manipulation and Talocrural Joint Manipulation in Stroke, sponsored by Bitlis Eren University. Recruiting at 1 site in Turkey (Türkiye). Open to participants aged 45 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-07-27.

Sponsored by Bitlis Eren University · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Apr 2025; still recruiting 1 year 6 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
26
Allocation
Randomized
Ages
45 Years to 75 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 10 studies in Stroke by Bitlis Eren University — 5 open to participants now, 5 under way, none of them phase 3. Stroke · Bitlis Eren University.

Planned enrollment
10th of 10
26 · median 44
Started
2025
with 3 others
No phase
10 of 10
5 open now
Registered
3rd of 10
by date

Among the 10 studies in Stroke by Bitlis Eren University, this one is the 10th largest by planned enrollment, is one of 4 that started in 2025, is one of 10 with no phase, and was the 3rd registered.

By phase

10 studies; the count open now beside each. This study's row is marked.

No phasethis study10 · 5 open

By the year they started

First in 2024; this study’s year is marked. 4 started in 2025.

Size and results

Median enrollment 44 across the 10 interventional studies. Of the 5 that completed or were terminated, 1 (20%) have results posted.

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Watch this landscapeDownload CSVWith an account: a weekly mail of what changed among 10 studies in Stroke by Bitlis Eren University, or all of them as a file.
02

Study summary

The aim of the study is to investigate the effect of talocrural joint manipulation on the ankle proprioception of patients with stroke.

Read the detailed description

The study, utilizing a randomized crossover design, is planned to be conducted on a minimum of 26 patients with stroke who meet the inclusion and exclusion criteria. Patients included in the study will be randomly assigned to receive both placebo talocrural joint manipulation and talocrural joint manipulation interventions.

03

Conditions studied

  • Stroke

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Keywords

  • Proprioception
04

Who can participate

Ages eligible
45 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Two months or longer elapsed since the stroke,
  2. A score of 24 or higher,
  3. Being between 45 and 75 years of age,
  4. Having a Brunnstrom stage of 4 or above

Exclusion criteria

Exclusion Criteria:

  1. The presence of severe osteoarthritis in the lower extremity,
  2. The presence of cancer or diabetic neuropathy,
  3. The presence of vestibular disorder,
  4. The presence of lower extremity ulceration or amputation,
  5. Hemodynamic instability,
  6. The presence of other neurological disorders (such as multiple sclerosis, Parkinson's disease),
  7. Having experienced an acute lower extremity injury in the last six weeks,
  8. History of lower extremity surgery
  9. Lack of available range of motion values required for the ankle proprioception test
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

MMSE and MoCA

Short tests of memory and thinking, each scored out of 30. Lower scores suggest more difficulty; criteria give a range, either to include people with memory problems or to leave them out.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
26 participants (estimated)

Study arms

  • Placebo comparator
    Placebo Talocrural Joint Manipulation Group

    In this group, patients will receive placebo talocrural joint manipulation. The application will be similar to that in the experimental group, however, hands will be positioned to avoid creating traction or manipulation force, and this position will be maintained for 20 seconds.

    Other: Placebo Talocrural Joint Manipulation

  • Experimental
    Talocrural Joint Manipulation Group

    In this group, talocrural joint manipulation will be applied. After positioning the patient, high velocity low amplitude traction will be applied.

    Other: Talocrural Joint Manipulation

Interventions

  • OtherPlacebo Talocrural Joint Manipulation

    This intervention is a classic method used to evaluate the effect of talocrural joint manipulation.

  • OtherTalocrural Joint Manipulation

    This technique, aiming to increase ankle dorsiflexion and mechanoreceptor activation, is based on the application of high velocity low amplitude traction to the joint.

06

What researchers measure

Primary outcomes

  1. Ankle Proprioception

    The effect of talocrural joint manipulation on ankle proprioception will be evaluated using the Cybex isokinetic dynamometer. The device will analyze the passive joint position sense of the ankle in various positions.

    Time frame: Change from baseline ankle proprioception immediately after the intervention

Secondary outcomes

  1. Ankle Dorsiflexion Measurement

    For the measurement of dorsiflexion range of motion, patients will be asked to stand facing a wall with the assessed leg positioned at the back. They will place their hands on the wall at shoulder width. While keeping the back knee in at least 20 degrees of flexion and ensuring the foot remains in contact with the ground, they will be instructed to lean forward as far as possible. The dorsiflexion range of motion will then be measured using a spirit level application on an iPhone placed one centimeter above the calcaneal tuberosity.

    Time frame: Change from baseline ankle dorsiflexion immediately after the intervention

07

Study locations

1 of 1 sites recruiting
08

References and documents

Publications

  • Vorkas PA, Shalhoub J, Lewis MR, Spagou K, Want EJ, Nicholson JK, Davies AH, Holmes E. Metabolic Phenotypes of Carotid Atherosclerotic Plaques Relate to Stroke Risk: An Exploratory Study. Eur J Vasc Endovasc Surg. 2016 Jul;52(1):5-10. doi: 10.1016/j.ejvs.2016.01.022. Epub 2016 May 23. PubMed 27231199 ↗
  • Mansfield A, Inness EL, Mcilroy WE. Stroke. Handb Clin Neurol. 2018;159:205-228. doi: 10.1016/B978-0-444-63916-5.00013-6. PubMed 30482315 ↗
  • Tyson SF, Hanley M, Chillala J, Selley A, Tallis RC. Balance disability after stroke. Phys Ther. 2006 Jan;86(1):30-8. doi: 10.1093/ptj/86.1.30. PubMed 16386060 ↗
  • de Haart M, Geurts AC, Huidekoper SC, Fasotti L, van Limbeek J. Recovery of standing balance in postacute stroke patients: a rehabilitation cohort study. Arch Phys Med Rehabil. 2004 Jun;85(6):886-95. doi: 10.1016/j.apmr.2003.05.012. PubMed 15179641 ↗
  • Mayo NE, Wood-Dauphinee S, Cote R, Durcan L, Carlton J. Activity, participation, and quality of life 6 months poststroke. Arch Phys Med Rehabil. 2002 Aug;83(8):1035-42. doi: 10.1053/apmr.2002.33984. PubMed 12161823 ↗
  • Li J, Zhong D, Ye J, He M, Liu X, Zheng H, Jin R, Zhang SL. Rehabilitation for balance impairment in patients after stroke: a protocol of a systematic review and network meta-analysis. BMJ Open. 2019 Jul 19;9(7):e026844. doi: 10.1136/bmjopen-2018-026844. PubMed 31326927 ↗
  • Goto Y, Otaka Y, Suzuki K, Inoue S, Kondo K, Shimizu E. Incidence and circumstances of falls among community-dwelling ambulatory stroke survivors: A prospective study. Geriatr Gerontol Int. 2019 Mar;19(3):240-244. doi: 10.1111/ggi.13594. Epub 2019 Jan 8. PubMed 30623545 ↗
  • Darekar A, McFadyen BJ, Lamontagne A, Fung J. Efficacy of virtual reality-based intervention on balance and mobility disorders post-stroke: a scoping review. J Neuroeng Rehabil. 2015 May 10;12:46. doi: 10.1186/s12984-015-0035-3. PubMed 25957577 ↗
  • Liu H, Yin H, Yi Y, Liu C, Li C. Effects of different rehabilitation training on balance function in stroke patients: a systematic review and network meta-analysis. Arch Med Sci. 2023 Jun 21;19(6):1671-1683. doi: 10.5114/aoms/167385. eCollection 2023. PubMed 38058731 ↗
  • Buvarp D, Rafsten L, Abzhandadze T, Sunnerhagen KS. A cohort study on longitudinal changes in postural balance during the first year after stroke. BMC Neurol. 2022 Aug 30;22(1):324. doi: 10.1186/s12883-022-02851-7. PubMed 36042404 ↗
  • An M, Shaughnessy M. The effects of exercise-based rehabilitation on balance and gait for stroke patients: a systematic review. J Neurosci Nurs. 2011 Dec;43(6):298-307. doi: 10.1097/JNN.0b013e318234ea24. PubMed 22089406 ↗
  • Oliveira CB, Medeiros IR, Greters MG, Frota NA, Lucato LT, Scaff M, Conforto AB. Abnormal sensory integration affects balance control in hemiparetic patients within the first year after stroke. Clinics (Sao Paulo). 2011;66(12):2043-8. doi: 10.1590/s1807-59322011001200008. PubMed 22189728 ↗
  • Powden CJ, Hogan KK, Wikstrom EA, Hoch MC. The Effect of 2 Forms of Talocrural Joint Traction on Dorsiflexion Range of Motion and Postural Control in Those With Chronic Ankle Instability. J Sport Rehabil. 2017 May;26(3):239-244. doi: 10.1123/jsr.2015-0152. Epub 2016 Aug 24. PubMed 27632835 ↗
  • Marron-Gomez D, Rodriguez-Fernandez AL, Martin-Urrialde JA. The effect of two mobilization techniques on dorsiflexion in people with chronic ankle instability. Phys Ther Sport. 2015 Feb;16(1):10-5. doi: 10.1016/j.ptsp.2014.02.001. Epub 2014 Feb 14. PubMed 24679362 ↗
  • Pellow JE, Brantingham JW. The efficacy of adjusting the ankle in the treatment of subacute and chronic grade I and grade II ankle inversion sprains. J Manipulative Physiol Ther. 2001 Jan;24(1):17-24. doi: 10.1067/mmt.2001.112015. PubMed 11174691 ↗
  • Dananberg HJ, Shearstone J, Guillano M. Manipulation method for the treatment of ankle equinus. J Am Podiatr Med Assoc. 2000 Sep;90(8):385-9. doi: 10.7547/87507315-90-8-385. PubMed 11021048 ↗
  • Fisher BE, Piraino A, Lee YY, Smith JA, Johnson S, Davenport TE, Kulig K. The Effect of Velocity of Joint Mobilization on Corticospinal Excitability in Individuals With a History of Ankle Sprain. J Orthop Sports Phys Ther. 2016 Jul;46(7):562-70. doi: 10.2519/jospt.2016.6602. Epub 2016 Jun 6. PubMed 27266885 ↗
  • Picelli A, Tamburin S, Cavazza S, Scampoli C, Manca M, Cosma M, Berto G, Vallies G, Roncari L, Melotti C, Santilli V, Smania N. Relationship between ultrasonographic, electromyographic, and clinical parameters in adult stroke patients with spastic equinus: an observational study. Arch Phys Med Rehabil. 2014 Aug;95(8):1564-70. doi: 10.1016/j.apmr.2014.04.011. Epub 2014 May 2. PubMed 24792138 ↗
  • Cho KH, Lee HJ, Lee WH. Intra- and inter-rater reliabilities of measurement of ultrasound imaging for muscle thickness and pennation angle of tibialis anterior muscle in stroke patients. Top Stroke Rehabil. 2017 Jul;24(5):368-373. doi: 10.1080/10749357.2017.1285745. Epub 2017 Feb 15. PubMed 28198659 ↗
  • Picelli A, Bonetti P, Fontana C, Barausse M, Dambruoso F, Gajofatto F, Girardi P, Manca M, Gimigliano R, Smania N. Is spastic muscle echo intensity related to the response to botulinum toxin type A in patients with stroke? A cohort study. Arch Phys Med Rehabil. 2012 Jul;93(7):1253-8. doi: 10.1016/j.apmr.2012.02.005. Epub 2012 Apr 12. PubMed 22502807 ↗
  • Heckmatt JZ, Leeman S, Dubowitz V. Ultrasound imaging in the diagnosis of muscle disease. J Pediatr. 1982 Nov;101(5):656-60. doi: 10.1016/s0022-3476(82)80286-2. PubMed 7131136 ↗
  • Pillen S, van Keimpema M, Nievelstein RA, Verrips A, van Kruijsbergen-Raijmann W, Zwarts MJ. Skeletal muscle ultrasonography: Visual versus quantitative evaluation. Ultrasound Med Biol. 2006 Sep;32(9):1315-21. doi: 10.1016/j.ultrasmedbio.2006.05.028. PubMed 16965971 ↗
  • Picelli A, Bonetti P, Fontana C, Barausse M, Dambruoso F, Gajofatto F, Tamburin S, Girardi P, Gimigliano R, Smania N. Accuracy of botulinum toxin type A injection into the gastrocnemius muscle of adults with spastic equinus: manual needle placement and electrical stimulation guidance compared using ultrasonography. J Rehabil Med. 2012 May;44(5):450-2. doi: 10.2340/16501977-0970. PubMed 22549655 ↗
  • Gao F, Grant TH, Roth EJ, Zhang LQ. Changes in passive mechanical properties of the gastrocnemius muscle at the muscle fascicle and joint levels in stroke survivors. Arch Phys Med Rehabil. 2009 May;90(5):819-26. doi: 10.1016/j.apmr.2008.11.004. PubMed 19406302 ↗
  • Maganaris CN, Baltzopoulos V. Predictability of in vivo changes in pennation angle of human tibialis anterior muscle from rest to maximum isometric dorsiflexion. Eur J Appl Physiol Occup Physiol. 1999 Feb;79(3):294-7. doi: 10.1007/s004210050510. PubMed 10048637 ↗
  • Manal K, Roberts DP, Buchanan TS. Optimal pennation angle of the primary ankle plantar and dorsiflexors: variations with sex, contraction intensity, and limb. J Appl Biomech. 2006 Nov;22(4):255-63. doi: 10.1123/jab.22.4.255. PubMed 17293622 ↗
  • Raj IS, Bird SR, Shield AJ. Reliability of ultrasonographic measurement of the architecture of the vastus lateralis and gastrocnemius medialis muscles in older adults. Clin Physiol Funct Imaging. 2012 Jan;32(1):65-70. doi: 10.1111/j.1475-097X.2011.01056.x. Epub 2011 Sep 25. PubMed 22152081 ↗
  • Fryer GA, Mudge JM, McLaughlin PA. The effect of talocrural joint manipulation on range of motion at the ankle. J Manipulative Physiol Ther. 2002 Jul-Aug;25(6):384-90. doi: 10.1067/mmt.2002.126129. PubMed 12183696 ↗
09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Apr 2025 (actual). Primary completion is estimated for Nov 2026, 18 months after the start.

Of 3,108 non-industry interventional studies with no phase under Stroke, half reached primary completion within 23 months of starting (the median), counting those still running; a quarter within 10 and three quarters within 46. This study's planned 18 months is below that.

Counting every sponsor, half of 3,252 studies reached it within 23 months; a quarter within 10 and three quarters within 46.

How these figures are worked out, and which studies are left out of them.

Registered
Feb 22, 2025
First posted
Feb 27, 2025
StartActual
Apr 14, 2025
Primary completionEst.
Nov 1, 2026
CompletionEst.
Dec 1, 2026
Last update
Jul 27, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jul 27, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06849076
Lead sponsor
Bitlis Eren University
Responsible party
Omer Dursun (Asst. Prof., Bitlis Eren University) — Principal investigator
First posted
Feb 27, 2025
Start date
Apr 14, 2025
Primary completion
Nov 1, 2026 (estimated)
Completion
Dec 1, 2026 (estimated)
Last update
Jul 27, 2026

Study contacts

ömer dursun, Asst. Prof.
Contact
fztomrdrsn@gmail.com
5426088687 ext. +90
burak mavuş, M.Sc.
Contact
a.burakmavus@gmail.com
5388178351 ext. +90
ömer dursun, Asst. Prof.
principal investigator · Bitlis Eren University
burak mavuş, M.Sc.
principal investigator · Bolu Abant İzzet Baysal Physiotherapy and Rehabilitation Training and Research Hospital
merve tunçdemir, Asst. Prof.
principal investigator · Bitlis Eren University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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