• Journal of International Academy of Physical Therapy Research
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• v.9 no.4
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• pp.1642-1650
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• 2018

The purpose of this study was to identify the effect of proprioceptive neuromuscular facilitation (PNF) stretching exercise and joint mobilization on ankle joint range of motion (ROM), plantar pressure, and balance in subjects with stroke. Thirty patients (n=30) were organized into three groups, each of which received different treatments: PNF stretching (n=10), joint mobilization (n=10), and joint mobilization and PNF stretching combined (n=10). Each group received three exercise sessions per week for four weeks. The ankle ROM was measured using a goniometer, and plantar pressure and balance ability were measured using BioResque static posturography. In comparison within each group, the joint mobilization group and the joint mobilization with PNF stretching group showed significant improvements in ankle ROM, plantar pressure, and balance ability (p<.05). In comparison between the groups, a statistically significant difference was found in SECS change between the PNF stretching group, joint mobilization group and the joint mobilization with PNF stretching group. This study found demonstrates that the joint mobilization and joint mobilization with the PNF stretching methods were effective in improving ankle ROM, plantar pressure, and balance ability in stroke patients.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.3
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• pp.277-286
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• 2011

Purpose : This study was to investigate the prevention of spasticity with modified Ashworth scale(MAS) and range of motion(ROM) increase with goniometer in ankle joint by functional electrical stimulation(FES) and exercise for 4 weeks in chronic stroke patients. Methods : 60 chronic stroke patients participated in this study. The subjects were divided into 3 groups, FES group(n=20), FES+exercise group(n=20) and control croup(n=20). After FES application on tibialis anterior muscle by 35Hz for 4 weeks, the change of ankle joint movement was measured by goniometer. Results : The spasticity in ankle joint was decreased greatly in FES and FES+excercise groups(p<.05), and the ROM of ankle joint was increased greatly in FES and FES +exercise groups(p<.05) than control group(p>.05). Conclusion : It shows that FES made the angle of dorsiflexion in spastic ankle joint increase with functional improvement of tibialis anterior muscle in chronic stroke patients. This show that the FES is avaliable for facilitation of ROM and decrease of spasticity as a therapeutic tool.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.1
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• pp.71-79
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• 2011

Purpose : The purpose of this study was carried out to investigate the effect of repetitive transcranial magnetic stimulation on increase of H-reflex inhibition and fascilitation of range of motion of spastic ankle joint in chronic stroke patients. Methods : 30 chronic stroke patients were randomly divided into three groups, a control group(placebo rTMS group), 5 Hz rTMS group and manual therapy group. The MAS and ROM of ankle joint and H-reflex inhibition of soleus muscle were evaluated on each group. Results : The rTMS group decreased MAS of ankle joint and increased H-reflex inhibition of soleus muscle, and ROM of ankle joint than manual therapy group. The placebo rTMS group did not affected the change of MAS, ROM of ankle joint and H-reflex inhibition of soleus muscle. Conclusion : The rTMS was a good therapeutic tool to improve the foot drop in the chronic stroke patients.

• The Journal of Korean Physical Therapy
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• v.34 no.4
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• pp.168-174
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• 2022

Purpose: The purpose of this study was to analyze the correlation between balance control ability and leg circumference, proprioception, range of motion (ROM), and muscle strength in young adults. Methods: The subjects of this study were 30 university students who were enrolled in D university in Gyeongbuk province. We measured the dynamic balance and static balance using the Biorescue. The muscular strengths of the hip, knee, and ankle joints were measured using a muscle contraction dynamometer. The ROM and proprioception were measured using an inclinometer. Pearson correlation analysis was used to test the correlations between balance control ability and variables. Results: Sway length was significantly correlated with knee and hip joint muscle strength, ROM, and proprioception of hip and ankle joints (p<0.05). Sway speed was significantly correlated with ROM and proprioception in hip joints (p<0.05). Limit of stability was significantly correlated with muscle strength and ROM in ankle joints, and proprioception in hip, knee, and ankle joints (p<0.05). Conclusion: The sway length was most related to hip extension and ankle joint plantar flexion in the range of motion and ankle joint plantar flexion in proprioception. Overall, balance training for young adults will be of effective help if the treatment focuses on the knee and hip joints, range of motion and the ankle and hip joints' proprioception.

• Journal of International Academy of Physical Therapy Research
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• v.12 no.2
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• pp.2359-2364
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• 2021

Background: Patients with stroke have limited ankle range of motion (ROM) due to soft tissue abnormalities around the ankle and thus experience functional impairment. Increased muscle tension and reduced ankle ROM impair gait and hinder the activities of daily living. Joint mobilization and stretching are effective interventions that improve gait performance by enhancing the ankle ROM. Objectives: To investigate the effects of ankle joint mobilization and calf muscle stretching on gait speed and gait performance in patients with stroke. Design: This was a randomized controlled trial. Methods: Twenty patients with stroke patients were randomized into two groups. The joint mobilization group (JMG) underwent anteroposterior mobilization of the talocrural joint and the joint mobilization stretching group (JMSG) underwent calf muscle stretching in addition to joint mobilization. Gait speed and gait parameters were measured using the 10-meter walk test and the GAITRite. Results: Both the JMG and JMSG groups showed significant improvements in gait speed, affected-side step length, and cadence after the intervention (P<.05). Conclusion: Joint mobilization and stretching were effective interventions for improving gait performance by enhancing ankle function in patients with stroke.

• Physical Therapy Korea
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• v.22 no.2
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• pp.1-10
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• 2015

The common features of walking in patients with stroke include decreased gait velocity and increased asymmetrical gait pattern. The purpose of this study was to identify important factors related to impairments in gait velocity and asymmetry in chronic stroke patients. The subjects were 30 independently ambulating subjects with chronic stroke. The subjects' impairments were examined, including the isokinetic peak torque of knee extensors, knee flexors, ankle plantarflexors, and ankle dorsiflexors. Passive and active ranges of motion (ROM) of the ankle joint, ankle plantarflexor spasticity, joint position senses of the knee and ankle joint, and balance were examined together. In addition, gait velocity and temporal and spatial asymmetry were evaluated with subjects walking at their comfortable speed. Pearson correlations and multiple regressions were used to measure the relationships between impairments and gait speed and impairments and asymmetry. Regression analyses revealed that ankle passive ROM and peak torque of knee flexors were important factors for gait velocity ($R^2=.41$), while ankle passive ROM was the most important determinant for temporal asymmetry ($R^2=.35$). In addition, knee extensor peak torque was the most significant factor for gait spatial asymmetry ($R^2=.17$). Limitation in ankle passive ROM and weakness of the knee flexor were major contributors to slow gait velocity. Moreover, limited passive ROM in the ankle influenced the level of temporal gait asymmetry in chronic stroke patients. Our findings suggest that stroke rehabilitation programs aiming to improve gait velocity and temporal asymmetry should include stretching exercise for the ankle joint.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.3
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• pp.113-120
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• 2018

PURPOSE: This study was conducted to investigate the characteristics of a specific functional shoe in terms of the range of motion (ROM) of ankle and foot joints during walking when compared to a standardized shoe. METHODS: Kinematic ROM data pertaining to ankle, tarsometatarsal, and metatarsophalangeal joints were collected from twenty-six healthy individuals during walking using a ten-camera motion analysis system. Kinematic ROM of each joint in three planes was obtained over ten walking trials consisting of two different shoe conditions. Visual3D motion analysis was finally used to coordinate the kinematic data. All kinematic ROM data were interpolated using a cubic spline algorithm and low-pass filtered with a cutoff frequency of 6 Hz for smoothing. RESULTS: The overall ROM of the ankle joint in the sagittal and coronal planes when wearing the specific functional shoe was significantly decreased in both ankles during walking when compared to wearing a standard shoe (p<.05). Significantly more flexibility was observed when wearing the specific functional shoe in the tarsometatarsal and metatarsophalangeal joints compared to a standard shoe (p<.05). CONCLUSION: Although clinical application of the specific functional shoe has shown clear positive effects on knee and ankle moments, the results of this study provide important background information regarding the kinematic mechanisms of these effects.

• Korean Journal of Applied Biomechanics
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• v.21 no.1
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• pp.1-7
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• 2011

The purpose of this study was to investigate changes in kinetic and kinematic variables associated with an increase in upper body weight. Eighteen healthy male university students($175.96{\pm}4.19\;cm$, $70.79{\pm}8.26\;kg$) participated. Eight motion analysis cameras(Qualysis Oqus 500) and 2 force AMTI platforms(Advanced Mechanical Technologies Inc. OR6-7, US) were used to record motion and forces during the drop landing at a frequency of 120 Hz and 1200 Hz, respectively. QTM software(Qualisys Track Manager) was used to record the data, and the variables were analyzed with Visual 3D and Matlab 2009. For the drop landing, a box of $4{\times}2{\times}0.46\;m$ was constructed from wood. Knee and ankle maximum flexion angle, knee flexion angle, knee and ankle angle at landing, time for maximum ankle flexion after landing, and time for maximum knee flexion after landing were calculated. There was a significant change in the time for maximum and minimum ground force reaction and the time for maximum dorsal flexion after landing(p<.05) with increasing weight. There was no significant change for the hip, knee, and ankle ROM, whereas there was an increase in the angle ROM as the weight increased, in the order of ankle, knee, and hip ROM. This result shows that the ankle joint ROM increased with increasing weight for shock attenuation during the drop landing. There was a trend for greater ankle ROM than knee ROM, but there was no clear change in the ROM of the hip joint with increasing weight. In conclusion, this study shows the importance of ankle joint flexibility and strength for safe drop landing.

• Physical Therapy Korea
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• v.29 no.4
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• pp.274-281
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• 2022

Background: The range of motion (ROM) and balance ability of the ankle joint affect the stability of the ankle and prevent injuries or hurts from falling. In the clinical tests conducted recently, the floss band is widely used to enhance the range of joint motion and exercise performance, and there are many studies that have applied it to ankle joint increasing dorsi flexion (DF) angle. Objects: This study compared the effects on the range of ankle motion and static/dynamic balance ability of the ankle through three conditions (before floss band intervention, after floss band intervention, and after active exercise intervention) for adults. Methods: One intervention between floss band and active exercise was applied randomly and another intervention was applied the next day. After each intervention, the ROM of the ankle joints and the static balance was checked by measuring conducting one leg test. And the dynamic balance was checked by conducting a Y-balance test. Results: In the case of DF, the range of joint motion showed a significant increase after floss band intervention compared to before floss band intervention (p < 0.05). Static balance ability showed a significant increase after the intervention of floss band and active exercise compared to before the intervention of floss band (p < 0.05). The dynamic balance ability showed a significant increase after the intervention of the floss band compared to before intervention of the floss band and after active exercise intervention (p < 0.05). Conclusion: Based on these results, it was confirmed that the application of floss band to the ankle joint increases DF and improves the static and dynamic balance ability. Based on this fact, we propose the application of a floss band as an intervention method to improve the ROM of the ankle joint and improve the stability of the ankle in clinical field.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.3
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• pp.467-477
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• 2013

PURPOSE: The purpose of this study was to identify the effects of backward pedaling ergometer training on ankle ROM, lower extremities strength, foot pressure in hemiplegia. METHODS: The subjects consisted of control group(n=10) and experimental group(n=10), subjects were trained 5 times a week for 2 weeks each group. Control group were trained forward, experimental group were trained backward pedaling with physical therapy in both groups. Each group measured ankle joint ROM with DUALER IQ and ankle and knee joint flexor and extensor muscle strength by Manual Muscle Test System and foot pressure by Gait view system. RESULTS: The result of this study between pre and post test that experimental group had statistically significantly differences in ankle joint range of motion and lower extremities strength. But foot pressure had not statistically significant differences. There was not significantly difference of variation between groups. CONCLUSION: Therefore these results mean that backward and forward pedaling ergometer training effected an improvement of lower extremities function in hemiplegia.