• 국제물리치료학회지
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• 제5권2호
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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.

• Physical Therapy Rehabilitation Science
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• 제10권1호
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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.

• Physical Therapy Rehabilitation Science
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• 제10권3호
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• pp.257-262
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• 2021

Objective: Patients with stroke generally diminished ankle range of motion, which decreases balance and walking ability. This study aimed to determine the effect of ankle self-mobilization with movement (s-MWM) on ankle dorsiflexion passive range of motion, timed up and go test, and dynamic gait index in patients with chronic stroke. Design: Randomized controlled trial design Methods: Twenty-four post-stroke patients participated in this study. The participants were randomized into the control (n = 12) and self-MWM groups (n = 12). Both groups attended standard rehabilitation therapy for 30 minutes per session. In addition, self-MWM group was performed 3 times per week for 8 weeks. All participants have measured ankle dorsiflexion passive range of motion, timed up and go test, and dynamic gait index in before and after the intervention. Results: After 8 weeks of training, self-MWM group showed greater improvement in ankle dorsiflexion passive range of motion, timed up and go test, and dynamic gait index than in the control group (p<0.05). Further, self-MWM group had significantly improvement in all dependent variables compared to the pre-test (p<0.05). Conclusions: Our investigation demonstrates that self-MWM is beneficial for improving functional ability. Also, self-MWM was superior to control with respect to improving ankle dorsiflexion passive range of motion, timed up and go test, and dynamic gait index.

• 대한정형도수물리치료학회지
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• 제26권1호
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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 Physical Therapy
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• 제28권5호
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• pp.303-307
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• 2016

Purpose: This study was conducted to determine the effects of Mulligan's mobilization with movement (MWM) on changes in the talofibular interval in the sagittal plane in subjects with chronic ankle instability (CAI). Methods: Sixteen subjects with chronic ankle instability participated in this study. The talofibular intervals were measured from US images, and the weight-bearing lunge test was used to assess dorsiflexion of the ankle joint. Each dependent variable were measured on the both affected side and sound side in three trials in pre- and post-MWM. Dependent variables were examined with a two-way mixed-design analysis of variance (ANOVA). The two factors were side (sound side versus affected side) and intervention (pre- versus post-intervention). For post hoc analysis, paired t-tests were performed to compare the dependent variables. A p<0.05 was considered to indicate significance. Results: Dorsiflexion and talofibular interval differed significantly pre- and post-intervention (p<0.05). Post-hoc analysis revealed that the talofibular interval post-MWM was significantly less than that pre-MWM on the both the affected and sound side (p<0.05). The ankle dorsiflexion in the post-MWM group was significantly greater than that in the pre-MWM group on the affected side and the sound side (p<0.05). Conclusion: The Mulligan's MWM decreased the talofibular interval in subjects with CAI. These findings suggest that the MWM technique can change the position of the talus relative to the fibular in the weight bearing position.

• 국제물리치료학회지
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• 제9권4호
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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.

• 대한정형도수물리치료학회지
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• 제28권1호
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• pp.61-69
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• 2022

Background: This study aimed to investigate the effect of maitland mobilization and mobilization with movement (MWM) applied to the ankle joint on ankle dorsiflexion range of motion (ROM), static and dynamic balance, plantar pressure, and gait ability. Methods: A total of 24 individuals were assigned to either the maitland mobilization group (n=12) or the MWM group (n=12). Dorsiflexion ROM, static and dynamic balance, plantar pressure, 10-meter walk test were measured before and 4 weeks after the intervention. Results: Both groups showed a significant difference in the evaluation after 4 weeks as the dorsiflexion ROM of the ankle increased (p<.05), and the sway length and sway area indicating static balance decreased (p<.05). Furthermore, the movement area showing dynamic balance showed a significant increase (p<.05), the plantar pressure difference between both feet significantly decreased (p<.05). In the 10-meter walk test, there was a significant difference as the time decreased (p<.05). However, no significant difference between the two groups was observed (p>.05). Conclusion: According to the results of this study where, maitland mobilization and MWM were applied to the ankle joint of hemiplegic patients for 4 weeks, we found no difference between the two groups. However, each technique was found to be effective for dorsiflexion ROM, static and dynamic balance, plantar pressure, and gait.

• 한국전문물리치료학회지
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• 제19권3호
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• pp.20-30
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• 2012

The purpose of this study was to determine the effect of ankle joint mobilization with movement (MWM) on the range of motion (ROM) in the ankle, on the muscle strength of lower extremities, and on spatiotemporal gait parameters in chronic hemiplegic patients. Fifteen subjects with chronic stroke were divided into two groups: an experimental group (8 subjects) and a control group (7 subjects). Both groups attended two or three sessions of physical therapy each week. The experimental group also attended additional MWM training sessions three times a week for five weeks. For both groups, the ROM of the ankle, the muscle strength of the lower extremities, and the spatiotemporal gait parameters in paretic limbs were evaluated before and after the training period. The results showed that the experimental group experienced more significant increases than did the control group in terms of passive (6.10%) and active (21.96%) ROM of the ankle, gait velocity (12.96%), and peak torque, of the knee flexor (81.39%), the knee extensor (24.88%), and the ankle plantar flexor (41.75%)(p<.05). These results suggest that MWM training in patients with chronic stroke may be beneficial in increasing ROM in the ankle, muscle strength in the lower extremities, and gait speed.

• 대한정형도수물리치료학회지
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• 제30권1호
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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.

• 대한정형도수물리치료학회지
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• 제27권1호
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• pp.51-62
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• 2021

Background: The purpose of this study was conducted to investigate the effects of the ankle mobilization with movement (MWM) technique on ankle dorsiflexion range of motion (ROM), balance, and gait in patients who underwent total knee replacement (TKR). Methods: Thirty patients with knee osteoarthritis were recruited and randomly divided into two groups: the experimental group (EG; n=15) and the control group (CG; n=15). For five days a week for 3 weeks, participants in the EG were treated with the ankle MWM technique and traditional total knee replacement (TKR) exercise, and those in the CG only performed traditional TKR exercises. The dorsiflexion ROM, balance, and gait of the patients were before and after exercise. Results: Balance system SD was used compare changes in dynamic balance. Patients in the EG group showed statistically significant differences after the intervention (p<.05). In addition, there was a statistically significant difference in dynamic balance between the EG and CG groups after the intervention (p<.05). STT-IBS was used to compare changes in velocity, step length, stride length, and ankle dorsiflexion ROM. Patients in the EG group showed statistically significant differences after the intervention (p<.05). In addition, there was a statistically significant difference in the velocity, step length, stride length, and ankle dorsiflexion ROM between the EC and CG groups after the intervention (p<.05). Conclusion: Our results showed that applying the ankle MWM technique with traditional TKR exercises improved ankle dorsiflexion ROM, dynamic balance, and gait in patients.