• The Journal of Korean Physical Therapy
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• 제32권4호
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• pp.238-244
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• 2020

Purpose: This study compared the effects of the fascial distortion model (FDM), foam rolling (FR), and self-stretching (SS) on the ankle dorsiflexion range of motion (ROM). Methods: Thirty subjects who had no more than 30° of ankle dorsiflexion ROM at the weight-bearing lunge test were recruited in this study. They were divided into three groups: (FDM, FR, and SS), and underwent each intervention for five minutes. Before and after the intervention, the ankle dorsiflexion ROM in the supine (the open-) and standing (the closed-kinetic chain) of the subjects were tested. The changes in the ROM between pre- and post-intervention and among the groups were analyzed. Results: All groups showed increased ankle dorsiflexion ROM after the intervention in both positions. In the position of the open kinetic chain, the changes in the ROM between pre- and post-intervention had significant differences among the groups, and the FDM was higher than the FR and SS. In the position of the closed kinetic chain, the ROM after the interventions and the changes in the ROM had significant differences among the groups, and FDM was higher than the FR (ROM after the intervention, the change in ROM) and SS (the change in ROM). Conclusion: These findings showed that FDM had more efficiency than the FR and SS as FDM had a stronger effect on increasing ankle dorsiflexion in a short, limited time. Clinicians who have limited time to treat their patients, particularly trying to increase ankle dorsiflexion ROM, should consider the application of FDM.

• The Journal of Korean Physical Therapy
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• 제34권3호
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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.

• 국제물리치료학회지
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• 제12권1호
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• pp.2272-2278
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• 2021

Background: Vibration stimulation has emerged as a treatment tool to help reduce spasticity during physical therapy. Spasticity includes problems of reduced range of motion (ROM) and stiffness. However, the benefits of vibration rolling (VR) on interventions for stroke patients are unclear. Objectives: This study aimed to investigate the effect of VR intervention on the ankle ROM and ankle stiffness in stroke patients. Design: A randomized crossover study. Methods: Seven stroke patients completed two test sessions (one VR and one non-VR [NVR]) in a randomized order, with 48 hours of rest between each session. Participants completed intervention and its measurements on the same day. The measurements included ankle dorsiflexion and plantarflexion ROM and stiffness of ankle muscles, including the tibialis anterior, medial, and lateral gastrocnemius muscle. Results: After VR, ankle dorsiflexion ROM, lateral gastrocnemius stiffness, and medial gastrocnemius stiffness improved significantly (all P<.05). After NVR, only the lateral gastrocnemius stiffness improved significantly (P<.05). Furthermore, in the cases of changed values for ankle dorsiflexion ROM and lateral gastrocnemius stiffness were compared within groups, VR showed a more significant difference than NVR (P<.05) Conclusion: VR improved ankle ROM and muscle stiffness. Therefore, we suggest that practitioners need to consider VR as an intervention to improve dorsiflexion ROM and gastrocnemius stiffness in stroke patients.

• Physical Therapy Rehabilitation Science
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• 제3권1호
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• pp.63-68
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• 2014

Objective: The purpose of this study was to examine the effects of ankle Kinesio taping on range of motion and agility during exercise in university students. Design: Cross-sectional study. Methods: Thirty subjects were randomly allocated to two groups: taping group (n=15) and non-taping group (n=15). All groups underwent the same exercise program including stretching for 30 minutes. The exercise program proceeded in the following order: five minutes of stretching, a 20-minutes exercise program, and additional five minutes of stretching. Of the eight exercise methods suggested by Purcell et al, seven were chosen (lateral shuffle, forward and backward running, agility ladder, figure-of-8, forward jogging while jumping over cones, wall jumps and zigzags); $90^{\circ}$ cuts with lateral shuffle were omitted. The range of motion of ankle dorsiflexion and plantarflexion was measured using the goniometer. Agility was measured using the side hop test. Results: For ankle range of motion, the taping group showed significant differences in dorsiflexion and plantarflexion on both sides (p<0.05). The non-taping group showed significant differences only in left plantarflexion (p<0.05). There was a significant difference in dorsiflexion on both sides between the taping group and the non-taping group (p<0.05). All groups showed significant differences in agility on the left and right ankle (p<0.05). There was a significant difference in left ankles between the taping group and the non-taping group (p<0.05). Conclusions: Kinesio taping increased range of motion and agility during exercise in university students. Additional research on Kinesio taping for improving range of motion and agility is needed.

• 한국전문물리치료학회지
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• 제26권3호
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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.

• 한국운동역학회지
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• 제33권4호
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• pp.147-154
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• 2023

Objective: This study aimed 1) to compare the Landing Error Scoring System (LESS) score and movement patterns during landing of the lesser dorsiflexion range of motion (LDFROM) group to that with the greater dorsiflexion range of motion group, and 2) to identify the correlation between the weight-bearing dorsiflexion range of motion (WBDF ROM), LESS score, and movement patterns during landing. Method: Fifty health adults participated in this study. WBDF ROM was measured using the weight bearing lunge test while movement patterns during landing was assessed using the LESS. The joint angles of the ankle, knee and hip joints during landing were analyzed using the 2D video analysis. After mean value of WBDF ROM was calculated, participants were divided into two groups (GDFROM and LDFROM) based on the mean value. The Mann-Whiteny 𝒰 test was used to identify differences in movement strategies during landing between two groups and the Pearson's correlation analysis was performed to determine relationships between WBDF ROM and movement strategies. Results: The LDFROM group showed the poorer LESS score and stiffer landing kinematics during landing compared to the GDFROM group (p<0.05). In addition, DFROM was significantly related to the LESS score and landing kinematics (p<0.05) except for total hip excursion (p=0.228). Conclusion: Our main findings showed that the LDFROM group had poorer landing quality and stiffer landing movements compared to the GDFROM group. In addition, increase of WBDF ROM significantly improved landing quality and soft-landing movements. To reduce shock during landing such as ground reaction forces, individuals need to better utilize WBDF ROM and lower extremity movements based on our findings. Therefore, intervention programs for safer landings should include exercises that increase WBDF ROM and utilize eccentric contraction.

• 한국전문물리치료학회지
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• 제15권3호
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• pp.8-16
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• 2008

The range of motion (ROM) of ankle dorsiflexion in older women was associated with gait abnormalities and the risk of falls. The purpose of this study was to investigate the effect of self-stretching exercise on the flexibility of the plantar flexors of the ankle and the characteristics of gait in healthy elderly women. Fifteen participants were assigned randomly into an exercise (n=8) or control (n=7) group. The exercise group attended a self-stretching program approximately 30 minutes for 3 days per week for 4 weeks. The active ankle dorsiflexion ROM and gait measurements were taken prior to beginning the stretching program and 1 day after the last stretching day. Results showed that the active ankle dorsiflexion ROM was significantly increased in the exercise group than in the control group after the stretching program (p<.05). However, gait parameters, including gait speed, cadence, and stride length were not significantly different between the two groups (p>.05). The results suggest that a 4-week self-stretching program is capable of provoking a significant increase in ankle dorsiflexion ROM in elderly, community-dwelling women. Additional research is needed to investigate the effect of gait-specific exercise combined with stretching exercise on gait ability.

• Physical Therapy Rehabilitation Science
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• 제4권2호
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• pp.66-72
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• 2015

Objective: The aim of this study was to investigate the effect of balance training with plantar flexor stretching on ankle dorsi flexion range of motion (ROM), balance, and gait ability in stroke patients. Design: A randomized controlled pilot trial. Methods: Thirty stroke patients volunteered to participate in this study. The subjects were randomly allocated to two groups: the experimental group (n=15) received the neurodevelopment therapy plus balance training with plantar flexor stretching for 20 minutes in one session. The control group (n=15) received the same neurodevelopment therapy plus plantar flexor static stretching for 20 minutes in one session. Both groups underwent sessions four times a week, for a total of 4 weeks. Measurements included passive range of motion (PROM), active range of motion (AROM) of ankle dorsiflexion using a goniometer, timed up and go (TUG), the functional reaching test (FRT), and the 10 m walk test (10 MWT). Results: There were significant improvements in AROM and PROM of ankle dorsiflexion, TUG, and FRT scores after the intervention in the experimental group (p<0.05). However, the control group showed no statistically significant differences except for PROM of ankle dorsiflexion. The experimental group showed a significant improvement in PROM, TUG, and FRT scores compared to the control group (p<0.05). Conclusions: Balance training with plantar flexor stretching improves ankle dorsiflexion ROM and balance ability in patients with stroke. Therefore, this therapeutic intervention will be effective for rehabilitation of stroke patients in the clinical setting.

• 대한물리의학회지
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• 제6권1호
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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.

• 한국전문물리치료학회지
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• 제27권4호
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• pp.241-249
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• 2020

Background: Prolonged standing during work causes a lower extremity pain and disorders. Patellofemoral pain syndrome (PFPS) is one of the common diagnoses of the knee pain. Although the etiology of PFPS is not completely understood, it is considered to be multifactorial. Objects: The purpose of this study was to investigate difference in strength of knee muscles, quadriceps:hamstring muscles strength ratio (Q:H ratio), asymmetry ratio of knee muscles strength and dorsiflexion range of motion (ROM) between standing workers with and without PFPS. Methods: Twenty-eight standing workers with PFPS and 26 age-, height-, and weight-matched standing workers without PFPS participated in this study. A tension sensor measured knee muscle strength, and motion sensor measured dorsiflexion ROM. The asymmetry ratio of knee muscles was calculated by a specific formula using the knee muscles strength of the dominant side and the sound side. An independent t-test was used to identify significant differences in the strength, ROM, Q:H ratio, and asymmetry ratio between the PFPS and normal groups. Results: The standing worker with PFPS have significantly lower dorsiflexion ROM (p < 0.000) and higher asymmetry ratio of the hamstring muscles strength (p < 0.000) compare to the standing worker without PFPS. No significant differences were seen in the strength of quadriceps muscle and hamstring muscles, Q:H ratio, and asymmetry ratio of quadriceps muscle strength. Conclusion: There was a significant difference in the asymmetry ratio of the isometric hamstring muscle strength. This finding suggests that the asymmetry ratio of isometric hamstring muscle strength may be more important than measuring only the hamstring muscle strength of the PFPS side. Furthermore, the results of this study showed a significant difference in dorsiflexion ROM between the standing industrial workers with and without PFPS. Dorsiflexion ROM and isometric hamstring muscle strength should be considered when evaluating the subjects with PFPS.