• Journal of International Academy of Physical Therapy Research
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• v.9 no.3
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• pp.1517-1520
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• 2018

It has been reported that gastrocnemius tightness and posterior talar glide are crucial factors influencing ankle dorsiflexion. However, the relationship of ankle dorsiflexion and these factors is not identified in previous studies. The purpose of this study was to identify the relationship of ankle dorsiflexion passive range of motion and gastrocnemius tightness and posterior talar glide. Twenty-five male subjects participated in this study. Bilateral weight-bearing ankle dorsiflexion passive range of motion and amount posterior talar glide of participants were measured using an inclinometer. Change in myotendinous junction of medial gastrocnemius was measured using ultrasonography to identify gastrocnemius tightness. Pearson product moment correlations were performed to examine correlations between ankle dorsiflexion passive range of motion and gastrocnemius tightness and posterior talar glide. Present findings revealed significant correlation between ankle dorsiflexion passive range of motion and gastrocnemius tightness (p=0.017, r=0.336). Also, ankle dorsiflexion passive range of motion was correlated with posterior talar glide (p=0.001, r=0.470). The present findings provide experimental evidence for factors influencing weight-bearing ankle dorsiflexion.

• Physical Therapy Rehabilitation Science
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• v.10 no.1
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• pp.10-15
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• 2021

Objective: Limited ankle dorsiflexion is related to ankle injuries. There are various exercises to increase the flexibility of the gastrocnemius for improving the passive range of motion in ankle dorsiflexion. However, to performances in daily activities and athletic sports and higher efficiency of walking and running, both ankle dorsiflexion passive and active range of motion are needed. To investigate the effects of combined gastrocnemius stretching and tibialis anterior resistance exercise on ankle kinematics (passive and active range of motion of ankle dorsiflexion) and tibialis anterior muscle activity in subjects with limited ankle dorsiflexion. Design: Cross-sectional single-group repeated measures design. Methods: Fourteen subjects with limited ankle dorsiflexion were recruited (in the right ankle in 7 and the left ankle in 7). All subjects performed gastrocnemius stretching alone and tibialis anterior resistance exercise after gastrocnemius stretching. The passive and active range of motion of ankle dorsiflexion were measured after interventions immediately. The tibialis anterior activity was measured during active range of motion of ankle dorsiflexion measurement. Results: There was no significant difference of ankle dorsiflexion passive range of motion between gastrocnemius stretching alone and the tibialis anterior resistance exercise after gastrocnemius stretching. The tibialis anterior resistance exercise after gastrocnemius stretching significantly increased active range of motion of ankle dorsiflexion compared to gastrocnemius stretching alone (p<0.05). The tibialis anterior resistance exercise after gastrocnemius stretching significantly increased tibialis anterior activity better than did gastrocnemius stretching alone. Conclusions: Thus, subjects with limited ankle dorsiflexion should be encouraged to perform tibialis anterior resistance exercises.

• The Journal of Korean Physical Therapy
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• v.29 no.2
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• pp.95-100
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• 2017

Purpose: This study aimed to evaluate the changes in dorsiflexion and balance following proximal and distal tibiofibular joint manipulation in individuals with a history of lateral ankle sprain (LAS). Methods: Fifteen participants with a history of unilateral LAS, exhibiting a restriction in ankle dorsiflexion were included in this study. LAS ankle received a manipulation to the proximal and distal tibiofibular joint, while the opposite control ankle received no manipulation intervention. The outcome measures included ankle dorsiflexion and balance. Ankle dorsiflexion was measured using weight-bearing lunge test. Static and dynamic balances were measured using the overall, anterioposterior, and mediolateral balance index via the biodex balance system. Measurements were obtained prior to and following manipulation. Results: This study showed that ankle dorsiflexion and dynamic balance were improved following the manipulation compared to those prior to the manipulation (p<0.05). There was no significant change in static balance (p>0.05). Conclusion: The joint manipulation technique applied to the ankle of those with a history of LAS appears to improve ankle dorsiflexion and dynamic balance. This suggest that a manipulation to the proximal and distal tibiofibular joint could be provided as preliminary data regarding the prophylactic effects of recurrent LAS.

• Journal of the Korean Society of Physical Medicine
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• v.19 no.1
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• pp.69-79
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• 2024

PURPOSE: This study compared the effect of the muscle energy technique (MET) and stretching technique on ankle dorsiflexion passive range of motion, balance, and gait ability of stroke patients with limited ankle dorsiflexion. METHODS: Forty-four post-stroke patients participated. The participants were randomized into the MET group (METG; n = 22) and the stretching group (STG; n = 22). The METG was subjected to the MET to relax the dorsiflexion, while the STG was subjected to the dorsiflexion stretching technique. Both groups completed standard neurological physical therapy for 30 min per session. The intervention was conducted five times a week over 3 weeks for a total of 15 times. All participants underwent ankle dorsiflexion passive range of motion measurement and Berg Balance Scale score determination and completed a 10-m walking test and the timed up and go test before and after the intervention. RESULTS: After the 3-week intervention, both groups showed significant improvement after the intervention (p < .05). METG participants showed greater improvements in ankle dorsiflexion passive range of motion and 10-m walking test results compared to STG participants (p < .05). CONCLUSION: Both interventions improved ankle dorsiflexion passive range of motion, balance, and gait ability in stroke patients with limited ankle dorsiflexion. Moreover, the MET was superior to ankle dorsiflexion passive range of motion on the 10-m walking test.

• The Journal of Korean Physical Therapy
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• v.34 no.3
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• pp.91-97
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• 2022

Purpose: This study investigated the short-term effectiveness of extracorporeal shock wave therapy (ESWT) on pain, the ankle instability, the ankle function, dorsiflexion range of motion (ROM), and dynamic balance in patients with chronic ankle instability (CAI). Methods: Eighteen participants were divided into an experimental (n=9) and control group (n=9). The ESWT in the experimental group was applied to the lateral collateral ligament in combination with the tibialis anterior whereas the ESWT was applied to the lateral collateral ligament of the ankle alone in the control group. Pain, the ankle instability, the ankle function, dorsiflexion ROM, and dynamic balance were measured using the Visual analog scale, Cumberland ankle instability tool, American Orthopedic Foot and Ankle Society ankle-hindfoot score, weight-bearing lunge, and Y-balance test, before and after ESWT intervention. Results: Significant interactions (group × time) and time effects were observed in the dorsiflexion ROM and dynamic balance. Bonferroni's post-hoc analysis showed that the experimental group revealed a more significant change in dorsiflexion ROM and dynamic balance than the control group. There was a significant time effect in the pain, the ankle instability, and the ankle function, but no significant interaction (group × time) was observed. Conclusion: The ESWT could improve the pain, ankle instability, ankle function, dorsiflexion ROM, and dynamic balance in patients with CAI. Furthermore, the ESWT combined with lateral ankle ligaments and tibialis anterior more improves the dorsiflexion ROM and dynamic balance.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.1
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• pp.103-108
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• 2011

Purpose : The purposes of this study were to compare the muscle activity ratio of tibialis anterior (TA) / extensor digitorum longus (EDL) during the active ankle dorsiflexion in subjects with the normal toe (NT) and the hammer toe (HT). Methods : Nineteen subjects with the NT group and nineteen subjects with the HT group were recruited for this study. The muscle activities of TA and EDL were measured by using surface electromyography (EMG) and the angles of ankle dorsiflexion and eversion of the subtalar joint were measured by using 3-dementional motion analysis during the active ankle dorsiflexion in prone position. Results : The muscle activity ratio of TA / EDL was significantly lower in the HT group compared to the NT group (p<.05). The angle of ankle dorsiflexion was significantly lower in the HT group compared to the NT group (p<.05). Conclusions : These results suggest that muscle imbalance between TA and EDL muscle and decreased ankle dorsiflexion range of motion may contribute to hammer toe deformity. Further studies are needed to confirm that the correcting of this imbalance and the increasing ankle dorsiflexion could improve toe alignment in the subjects with HT.

• PNF and Movement
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• v.19 no.1
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• pp.87-95
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• 2021

Purpose: The purpose of this study was to determine the effects of talus stability taping during gastrocnemius stretching on ankle passive dorsiflexion, talus posterior glide, and balance in subjects with limited ankle dorsiflexion. Methods: Fifteen subjects (eight males and seven females) with limited ankle dorsiflexion participated in this study. Ankle passive dorsiflexion range of motion (ROM), talus posterior glide, and the lower quarter Y-balance test (YBT-LQ) were measured pre-stretching, after applying gastrocnemius stretching (GS), and after applying gastrocnemius stretching with talus stability taping (GSTST). The two types of stretching were performed at random. Results: Ankle passive dorsiflexion ROM was significantly increased by both types of stretching (p < 0.05), and ROM was significantly more increased post-GSTST than post-GS (p < 0.05). In addition, talus posterior glide was significantly increased post-GSTST than pre-stretching and post-GS (p < 0.05). However, there was no significant difference between post-GS and pre-stretching (p > 0.05). YBT-LQ score was significantly increased post-GSTST than pre-stretching (p < 0.05). Conclusion: Gastrocnemius stretching with talus stability taping is an effective method for subjects with limited ankle dorsiflexion to improve ankle passive dorsiflexion, talus posterior gliding, and balance.

• The Journal of Korean Physical Therapy
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• v.32 no.4
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• pp.233-237
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• 2020

Purpose: This study compared the electromyographic activity of the tibialis anterior (TA) and isometric dorsiflexor strength during dorsiflexion according to the toe postures in individuals with ankle dorsiflexor weakness. Methods: Twenty subjects with ankle dorsiflexor weakness participated in this study. The electromyographic activity of the TA and isometric dorsiflexor strength during dorsiflexion between with toe flexion, extension, and neutral postures were measured using an electromyography device and a hand-held dynamometer in individuals with ankle dorsiflexor weakness. One-way repeated measured analysis of variance, and a Bonferroni post hoc test was used. The level of statistical significance was set to α=0.01. Results: The electromyographic activity of the TA was greater with toe flexion during dorsiflexion than with toe extension and neutral postures (p<0.01). The isometric dorsiflexor strength was smaller with toe flexion during dorsiflexion than with toe extension and neutral postures (p<0.01). Conclusions: In individuals with ankle dorsiflexor weakness, the dorsiflexion with toe flexion can help improve the TA electromyographic activity. The toe posture during dorsiflexion for selective TA activation should be considered, especially in individuals with ankle dorsiflexor weakness.

• The Journal of Korean Physical Therapy
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• v.34 no.1
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• pp.12-17
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• 2022

Purpose: Ankle dorsiflexion is an essential element of normal functions, including walking, activities of daily living and sport activities. The tibialis anterior (TA) muscle functioned as a dorsiflexor and as a dynamic stabilizer of the ankle joint during walking and jumping. This study aimed to compare TA muscle thickness using ultrasonography according to the four different toe and ankle postures for the selective TA strengthening exercise. Methods: This study were recruited 26 (males: 15, females: 11) aged 20-30 years, with no injury ankle and calf in the medical history, had normal dorsiflexion and inversion range of motion (ROM). The thickness of the TA muscle was measured by ultrasonography in the four different toe and ankle postures: 1. Ankle dorsiflexion with all toe extension and ankle inversion (ITEDF); 2. Ankle dorsiflexion with all toe flexion and ankle inversion (ITFDF); 3. Ankle dorsiflexion with all toe extension and neutral position (NTEDF); 4. Ankle dorsiflexion with all toe flexion and neutral position (NTFDF). One-way repeated analysis of variance (ANOVA) and Bonferroni correction were used to confirm the significant difference among conditions. The level of statistical significance was set at α=0.01. Results: TA muscle thickness with ITFDF was significantly greater than in any other ankle positions, including ITEDF, NTFDF, and NTEDF (p<0.01). Conclusion: Among the four toe and ankle postures, isometric contraction in ITFDF postures showed the greatest increase in thickness of TA rather than ITEDF, NTEDF, and NTFDF postures. Based on these results, ITFDF can be recommended in an efficient way to selectively strengthen TA muscle.

• The Journal of Korean Physical Therapy
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• v.26 no.6
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• pp.459-463
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• 2014

Purpose: The purpose of this study was to investigate the correlations between functional movement screen (FMS) and ankle dysfunctions in subjects with chronic ankle instability (CAI). Methods: This study was a cross-sectional study of 20 participants with CAI. The ankle dorsiflexion range of motion (ROM), Foot and Ankle Disability Index (FADI), center of pressure (COP) path length, and COP velocity for ankle dysfunction were measured in all the subjects. All the subjects underwent the FMS concerned with ankle functions consisted of deep squats, hurdle steps and in-line lunges. The Spearman rank-order correlation coefficient was used to determine relationship between the ankle ROM, FADI, COP and FMS. Results: The results of the deep squat and in-line lunge exercises revealed a significant correlation with the ankle dorsiflexion ROM, FADI, COP path length, and COP velocity. The hurdle step showed no correlation with the ankle dorsiflexion ROM and FADI but a significant relationship with the COP path length and COP velocity. Conclusion: The results of this study showed that relationship deep squat and in-line lunge and it is suggested that an assessment tool using ankle dorsiflexion ROM and ankle instability would be clinically effective.