• 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 International Academy of Physical Therapy Research
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• v.5 no.2
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• pp.738-742
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• 2014

This study was conducted to investigate the effect of FES and ankle mobilization on the ankle motion and the quality of gait of chronic hemiplegic patients with limited ankle joint motions. As research subjects, 24 chronic hemiplegic patients who could walk independently, regardless of assistive aids, were selected. Then, 8 subjects received mobilization randomly and 8 subjects received FES and 8 subjects received mobilization and FES, at the same time. The dorsiflexion PROM significantly increased in the group of mobilization therapy, mobilization and FES all together(p<.01). There were statistically significant differences among the three groups(p<.01). The 10m walking test significantly decreased in the group of mobilization therapy, mobilization and FES all together(p<.05). There were statistically significant differences among the three groups(p<.01). The gait velocity significantly increased in the group of mobilization therapy, FES therapy, mobilization and FES all together(p<.05). There were statistically significant differences among the three groups(p<.01). The stride length significantly increased in the group of mobilization therapy, mobilization and FES all together(p<.05). There were statistically significant differences among the three groups(p<.05). In conclusion, these findings demonstrate that rather than only using one treatment technique, applying mobilization and FES together brings a more satisfactory result to hemiplegic patients with limited ankle joint motions.

• 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.

• Journal of International Academy of Physical Therapy Research
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• v.9 no.4
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• pp.1651-1656
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• 2018

The purpose of this study was to assess the changes in balance and proprioception of adults with limited ankle joint dorsiflexion, after the application of talocrural joint mobilization. The subjects of this study included 23 college students in their twenties with limited ankle joint dorsiflexion. The students were randomly assigned to the ankle joint mobilization group (AJMG, n=12) and the control group (CG, n=11). After 2 weeks of intervention using grade III talocrural joint mobilization in the anterior-posterior movement, the balance and proprioception of the subjects were assessed. Static/dynamic balance capabilities and ankle proprioception were analyzed using paired t-test and independent t-test. The dynamic balance and proprioception of AJMG were significantly improved after intervention (p<.05), In the comparison between the groups after the intervention, the dynamic balance and proprioceptive sense of AJMG were significantly improved compared to the control group (p<.05). This study suggests that AJMG can help improve the dynamic balance and proprioception.

• Korean Journal of Applied Biomechanics
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• v.26 no.2
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• pp.153-159
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• 2016

Objective: The purpose of this study was to investigate the effects of joint mobilization on foot pressure, ankle moment, and vertical ground reaction force in subjects with ankle instability. Method: Twenty male subjects (age, $25.38{\pm}3.62yr$; height, $170.92{\pm}5.41cm$; weight, $60.74{\pm}9.63kg$; body mass index (BMI), $19.20{\pm}1.67kg/m^2$) participated and underwent ankle joint mobilization. Weight-bearing distribution, ankle dorsi/plantar flexion moment, and vertical ground reaction force were measured using a GPS 400 and a VICON Motion System (Oxford, UK), and subsequently analyzed. SPSS 20.0 for Windows was used for data processing and paired t-tests were used to compare pre- and post-mobilization measurements. The significance level was set at ${\alpha}$ = .05. Results: The results indicated changes in weight-bearing, ankle dorsi/plantar flexion moment, and vertical ground reaction force. The findings showed changes in weight-bearing distribution on the left (pre $29.51{\pm}6.31kg$, post $29.57{\pm}5.02kg$) and right foot (pre $32.40{\pm}6.30kg$, post $31.18{\pm}5.47kg$). There were significant differences in dorsi/plantar flexion moment (p < .01), and there were significant increases in vertical ground reaction forces at initial stance (Fz1) and terminal stance (Fz2, p < .05). Additionally, there was a significant reduction in vertical ground reaction force at midstance (Fz2, p < .001). Conclusion: Joint mobilization appears to alter weight-bearing distribution in subjects with ankle instability, with resultant improvements in stability.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.30 no.1
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• pp.51-60
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• 2024

Background: Ankle sprains are a common clinical ankle disorder and alternations in tibiofibular joint biomechanics along with the talus are thought to contribute to its occurrence. During ankle joint dorsi flexion, proper movement requires the talus to glide posteriorly. Due to the wider front of the talus head, achieving the end range of dorsi flexion necessitates both superior and posterior glide of the distal fibula and anterior glide of the proximal fibula. The purpose of this study was to investigate the effects of tibiofibular joint mobilization on pain, range of motion, and balance in patients with lateral ankle sprains. Methods: Participants were randomly assigned to a control group (n=33) or an experimental group (n=31). Both groups underwent ankle joint mobilization three times a week for two weeks. Additionally, the experimental group received proximal and distal tibiofibular joint mobilization three times a week for two weeks. Measurements were obtained pre-intervention and post-intervention (after 2 weeks). Results: Evaluation parameters included the visual analog scale score (VAS), range of motion (ROM), and one-leg standing test (OLS). Post-intervention, both groups demonstrated significantly improved results for all assessments (p<.01). A significant intergroup difference was observed only in the ROM (p<.01) and OLS (p<.05). Conclusion: Our findings suggest that tibiofibular joint mobilization, combined with ankle joint mobilization, may be beneficial in enhancing outcomes for individuals with lateral ankle sprains.

• Physical Therapy Rehabilitation Science
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• v.10 no.1
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• pp.1-9
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• 2021

Objective: Joint mobilization for arthrokinematics altered by the positional fault of chronic ankle instability (CAI) is an effective intervention for stabilization. In this study, we compared the effects of ankle dorsi flexion range of motion (DFROM) and dynamic balance ability (DBA) in CAI patients via passive joint mobilization (PJM), a method traditionally performed in previous studies, and active joint mobilization (AJM), a method that can have a greater effect on cortical excitability with spontaneous movements. Design: Single-blind two-arm randomized controlled trial Methods: A total of 30 participants were registered: 15 each to the PJM and AJM groups. Each participant received a total of 10 intervention sessions, 10 minutes per session, 5 times a week for 2 weeks. PJM used Maitland's mobilization method to apply joint mobilization with talus in the posterior direction and AJM used an angular joint motion to induce patient's voluntary motion of medial malleolus anterior gliding and lateral malleolus posterior gliding, respectively. DFROM of the ankle was measured by using tape and DBA was evaluated by using the balance system. Results: Significant improvement was observed after intervention in both the PJM and AJM groups except for the DBA-anterior and DBA-right variables of the PJM group. There were statistically significant differences between the AJM and PJM groups in the DFROM, DBA-anterior, DBA-posterior, and DBA-right variables. Conclusions: The overall improvement of DFROM and DBA was found to be more effective in joint mobilization including voluntary movement. When it is accompanied by voluntary movement, it further affects the neuromuscular system of the ankle.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.26 no.1
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• pp.37-46
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• 2020

Background: The present study aimed to investigate the immediate effects of Soft Tissue Mobilization (STM) before Mobilization with Movement (MWM) on ankle ROM, pennation angle, balance in stroke patients. Methods: A total of 22 subjects were randomly assigned to one of two groups: the experimental group and the control group. The experimental group received intervention STM before MWM. STM was applied for one minute, MWM was applied one set of six times, in a total 3 sets. The passive ankle joint range of motion (ROM) was measured using a goniometer, the pennation angle was measured using RUSI, and the balance was measured using Timed Up & Go Test. Results: The ROM of the ankle dorsi-flexion, muscle tissue (pennation angle) and balance were significantly increased. Conclusion: In this study, it was confirmed that the ankle dorsi-flexion ROM, pennation angle of the medial gastrocnemius muscle, and balance were significantly improved in the group where STM was performed before the MWM intervention. Therefore, the physiotherapists should consider these results in their intervention. If MWM is applied to stroke patients, applying STM first is a better intervention.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.26 no.1
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• pp.55-63
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• 2020

Background: This study was conducted to compare the effects of an incline board, proprioceptive neuromuscular facilitation (PNF) stretching, and joint mobilization on the dorsiflexion of the ankle joint and muscle tone of the plantar flexor and ankle in stroke patients. Methods: Forty-five stroke subjects were randomly divided into three groups: each JMG (Joint Mobilization Group), IBG (Inclined Board Group) and PSG (PNF Stretching Group). The experiment was performed for eight weeks between August 1 and October 31, 2018. Results: The dorsiflexion of the ankle joint was significant between the groups and by period (p<.05). JMG had a significant change by period (p<.05). Differences between groups by period increased after 8 weeks in the PSG and the JMG (p>.05). The gastrocnemius lateral muscle tone was significant between the groups (p<.05), and medial muscle tone was interacted between groups and time (p<.05). Conclusion: An effective intervention method to increase the dorsiflexion of the ankle joint and decrease the muscle tone when performing PNF stretching, and joint mobilization in stroke patients was confirmed. Future studies are recommended to variety research of PNF stretching and joint mobilization.

• The Journal of Korean Physical Therapy
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• v.16 no.4
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• pp.264-282
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• 2004

The purpose of the study was to investigate the effectiveness of ankle mobilization on neck and shoulder position. One hundred volunteers, aged between 18 and 26 years (mean age 22), were recruited and each subject was divided into four mobilization groups by their body type, which is based on the concept from 'general coordinative manipulation' and a control group. Ankle mobilization was applied based on their body type and no mobilization was applied on those of the control group. The positions of shoulders and neck were measured in comfortable standing posture. All measurements were taken before and after ankle mobilization from each subject in mobilization groups and those of control group was measured twice between ten minutes by a different tester on three different occasions. Twenty subjects were in each group basis of their body type and a control. In the position of neck and shoulder, all subjects regardless group showed significantly changed their neck