• 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 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.

• 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.

• 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.

• PNF and Movement
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• v.21 no.1
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• pp.19-25
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• 2023

Purpose: The aim of this study is to determine the effects of gastrocnemius stretching with talus-stabilizing taping on ankle dorsiflexion and subtalar joint pronation during walking. Methods: In total, 26 subjects with limited ankle dorsiflexion were equally divided into two groups: a gastrocnemius stretching with talus-stabilizing taping group (13 subjects) and a gastrocnemius stretching group (13 subjects). They were assessed according to ankle dorsiflexion and subtalar joint pronation during walking before and after an intervention, which involved two types of gastrocnemius stretches performed three times a week for six weeks. Results: Ankle dorsiflexion was significantly increased in both groups (p<0.05), though the gastrocnemius stretching with talus-stabilizing taping group showed a significantly greater improvement in ankle dorsiflexion than the gastrocnemius stretching group (p<0.05). However, subtalar joint pronation showed no difference between the two groups before and after (p>0.05), also between groups (p>0.05). Conclusion: Gastrocnemius stretching with talus-stabilizing taping is a useful stretching exercise that improves ankle dorsiflexion during walking in subjects with limited ankle dorsiflexion movement.

• PNF and Movement
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• v.6 no.3
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• pp.29-35
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• 2008

Purpose : To describes the important aspects of the foot and ankle movement and function used when git and balance strategy. Method : The foot and ankle was a very important roles in the lower limb movement and gait. This study summarizes the physiologic movement of knee to the PNF lower extremity patterns. Result : The ankle joint composed of the talocural joint, the subtalarl joint, transverse tarsal joint, talocalcaneonavicular joint. The onset of dorsiflexion muscle activity starts in pre swing gait patterns. First contract muscle is the extensor hallucis. Activity of tibialis anterior and extensor digitorum longus quickly follows in mid swing gait phase. During stance phase, the soleus and gastrocnemius muscle provided plantar flexor torque, which muscle reacts quickly to restrain ankle dorsiflexion, and contributes modulated control of the ankle motion in gait patterns. Conclusions : The understanding of ankle kinematics, could provide a good therapeutic approach for improving gait patterns in patients with various pathological condition.

• The Journal of Korean Physical Therapy
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• v.33 no.1
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• pp.40-46
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• 2021

Purpose: This study compared the muscle activity of the lower limb according to the three types of fixed angles of the ankle joint during a lunge exercise. Methods: Twenty healthy subjects performed the lunge motion in a trial including the three types of fixed angle. The lunge motion with a neutral, 20° dorsiflexion, and 20° plantarflexion of the ankle joint were randomized and measured repeatedly. The muscle activity of the rectus femoris (RF), vastus medialis (VM), vastus lateralis (VL), biceps femoris (BF), and semitendinosus (ST) was measured by surface electromyography. Results: In the change in ankle joint angle, the RF, VL, BF, and ST muscle activity showed significant differences (p<0.05). In the 20° dorsiflexion position, the muscle activity of VL, BF, and ST showed a significant decrease compared to that in the neutral position (p<0.017). The muscle activity of RF and VL in the neutral position was greater than that in the 20° plantarflexion position (p<0.017). Only the muscle activity of the BF in the 20° plantarflexion position was significantly greater than the 20° dorsiflexion position (p<0.017). Conclusion: These results revealed a difference in the muscle activity of lower extremities in the proximal region according to the angle of the ankle joint during the lunge.

• Physical Therapy Korea
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• v.26 no.3
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• pp.23-31
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• 2019

Background: Measurement of passive ankle dorsiflexion range of motion (ADROM) is often part of a physical therapy assessment. Objects: The objective of this study was to identify the effects of subtalar joint neutral position (SJNP) on passive ADROM according to knee position in young adults. Methods: We recruited 14 young adult participants for this study. Two examiners used a universal goniometer to measure passive ADROM with and without SJNP. Dorsiflexion force was applied to the forefoot until maximum resistance was reached in two knee positions (extension and $90^{\circ}$ flexion) in the prone position. Subtalar joint position was also recorded at maximum ADROM. Passive ADROM was measured three times at different knee and subtalar joint positions, in random order. Two-way repeated-measures analysis of variance was used to compare the effects of subtalar joint and knee position on passive ADROM. Results: Passive ADROM was significantly lower with than without SJNP during both knee extension (mean difference: $7.4^{\circ}$) and $90^{\circ}$ flexion (mean difference: $16.9^{\circ}$) (p<.01). Passive ADROM was significantly higher during $90^{\circ}$ knee flexion than during knee extension both with (mean difference: $5.8^{\circ}$) and without SJNP (mean difference: $15.2^{\circ}$) (p<.01). The valgus position of the subtalar joint was significantly lower with than without SJNP during both knee extension (mean difference: $3.3^{\circ}$) and $90^{\circ}$ flexion (mean difference: $4.3^{\circ}$) (p<.01). Conclusion: Our results indicate that the gastrocnemius may limit ankle dorsiflexion more than the soleus does. Greater dorsiflexion at the subtalar and midtarsal joints was observed during passive ADROM measurement without than that with SJNP; therefore, SJNP should be maintained for accurate measurement of ADROM.

• The Journal of Korean Physical Therapy
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• v.35 no.2
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• pp.43-47
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• 2023

Purpose: This study compared the movement control ability of the ankle joint according to the type of muscle contraction, namely, eccentric or concentric contractions. Methods: Thirty-four healthy adult subjects participated in this study. As a single group, before the experiment, the subjects were trained on achieving the required position of the ankle around the target point by manually controlling the ankle dorsiflexion by 10°. Concentric contraction starts at 0° and continues until the target point of 10° is reached. During an eccentric contraction, the ankle joint starts at 20° ankle dorsiflexion and continues till the target point is reached. Movements using eccentric contraction and concentric contraction were randomly performed 3 times each. Results: The results of comparing the difference in the movement control ability of each type of muscle contraction of ankle dorsiflexion showed that the measurement-remeasurement error was significant in eccentric contraction. Conclusion: In this study, we found a difference in the ability to control movement according to whether the contraction is eccentric or concentric. Therefore, we propose that the ability to control movement is affected by the type of muscle contraction.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.1
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• pp.9-14
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• 2023

PURPOSE: This study examined the effect of vibration stimulation of a vibration foam roller on the change in the range of motion of the ankle joint and proprioception in patients with chronic ankle instability. An additional aim was to provide basic data for rehabilitation programs for chronic ankle instability patients. METHODS: This study was a randomized crossover design of 22 patients with chronic ankle instability. All subjects were divided into a vibrating group, a non-vibrating group, and a control group. The vibration and non-vibration groups performed the interventions, but the control group did not. For the measurement, the range of motion and proprioception of the ankle joint was measured using an electronic protractor (Electrogoniometer, BPM Pathway, UK). RESULTS: The vibration group showed significant differences in the dorsiflexion angle, dorsiflexion proprioception, and plantar flexion proprioception (p < .05). The non- vibration group showed significant differences in the dorsiflexion angle and dorsiflexion proprioceptive sensation (p < .05). The vibration group and the control group showed significant differences in dorsiflexion proprioception and plantar flexion proprioception (p < .05). CONCLUSION: The range of motion and proprioception of the ankle joint were improved in the group that received vibration stimulation after the intervention than before the intervention. Future research will be needed on patients with various diseases.