• Journal of International Academy of Physical Therapy Research
• /
• v.9 no.4
• /
• pp.1642-1650
• /
• 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
• /
• v.12 no.2
• /
• pp.2359-2364
• /
• 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 the Korean Society of Physical Medicine
• /
• v.14 no.2
• /
• pp.41-51
• /
• 2019

PURPOSE: This study was conducted to investigate the effects of combined Joint Mobilization and Functional Electrical Stimulation on Muscle Activation and Mobility of ankle joints in stroke patients and their Modified Functional Reach Test (MFRT) results. METHODS: A total of 26 patients with stroke were randomly selected for enrollment in this study. (1) Functional Electrical Stimulation (FES) (2) combined Joint Mobilization and FES. An EMG system was used to measure tibialis anterior and gastrocnemius activities. Range Of Motion (ROM) of Ankle Joint and MFRT for Dynamic Balance. Pre and post intervention results were compared by paired-t-tests and differences in changes after intervention between groups were identified by the independent t-test. RESULTS: The muscle activation, ROM, and MFRT differed significantly in the experimental group (p<.05). The ROM was significantly different for the active dorsiflexion pre and post intervention in the group that received FES alone (p<.05). CONCLUSION: The results of this study suggest use of a systematic program of proactive posture control to prevent dysfunction when planning interventions for ankle joints can help stroke patients walk efficiently.

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

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.28 no.1
• /
• pp.61-69
• /
• 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.

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

• Physical Therapy Korea
• /
• v.19 no.3
• /
• pp.20-30
• /
• 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.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.23 no.2
• /
• pp.27-32
• /
• 2017

Background: The purpose of this study was to compare the effects of IASTM and static stretching techniques on ankle joint range of motion (ROM), static foot pressure. Methods: Twenty four subjects with gastrocnemius shortness participated in this study. The subjects were assigned randomly to one of two groups: The soft tissue mobilization technique (IASTM) group received intervention using a IASTM instrument for two minutes, and the stactic stretching group performed self stretching for 30 seconds, four times. The ROM of the ankle joint was measured by active ankle dorsi-flexion test, and a TPScan was utilized to collect the plantar foot pressure. This experiment was performed by two physical therapists. The significant level was set at ${\alpha}=.05$. Results: The results were as follows: 1) The ROM of the ankle joint and was significantly increased in both groups. 2) Plantar foot pressure was no significant in both groups. 3) There were no significant differences between the IASTM group and static stretching group for any variable. Conclusions: The results of this study suggest that static stretching is an effective and easy technique for restoring proper muscle length in subjects with gastrocnemius shortness. We recommend that static stretching technique be used for treat gastrocnemius shortness in clinical setting and home program.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.28 no.2
• /
• pp.57-65
• /
• 2022

Background: This study examined the effects of adding fibular repositioning taping (FRT) to ankle mobilization with movement taping (AMT) on the ankle range of motion (ROM), balance, and gait performance in patients with chronic stroke with limited ankle dorsiflexion. Methods: The participants were randomized into the control (n=15) and AMT+FRT groups (n=15). The control groups applied only non-elastic taping on the affected ankle, and the AMT+FRT groups also applied non-elastic taping to the inferior tibiofibular joint. Both groups performed treadmill walking for 10 minutes. The ankle dorsiflexion passive ROM, balance, gait velocity, and cadence were measured before and after the intervention. Results: Both groups showed a significant difference after the intervention in the dorsiflexion ROM (p<.01), balance (p<.01), and gait performance (p<.01). On the other hand, no significant difference was observed between the two groups (p>.05). Conclusion: AMT improved ankle dorsiflexion passive ROM, balance, gait velocity, and cadence in patients with chronic stroke, but there was no difference between the two groups. Therefore, the addition of FRT to AMT does not influence the ankle dorsiflexion ROM, balance, and gait performance in patients with chronic stroke.

• Journal of the Korean Society of Physical Medicine
• /
• v.11 no.4
• /
• pp.93-103
• /
• 2016

PURPOSE: The purpose of this study is to determine the effect of therapeutic exercise on pain, range of motion and strength, and balance ability in a patient with an anterior ankle impingement (AAI). METHODS: A-32-year-old male presented limited ankle motion and pain with forced dorsiflexion at both ankle joints. In response, a therapeutic exercise program consisted of ankle joint mobilization, strength exercises using an elastic band, and proprioceptive exercises including semi-squats and a one-legged standing exercise with open and closed eyes. The program was performed for 40 min/day, twice per week, for 8 weeks. Pain, range of motion (ROM), and muscle strength (ankle dorsiflexion, plantarflexion, inversion, and eversion), as well as a one-legged standing test of both ankles, were measured before and after 4 and 8 weeks of therapeutic exercise. RESULTS: VAS decreased in both ankles after 8 weeks of exercise, respectively, compared to baseline levels. Range of motion and strength increased in both ankles for dorsiflexion, plantarflexion, inversion, and eversion after 8 weeks of exercise compared to baseline levels. In addition, the ability to perform a one-legged standing test with eyes opened and closed improved in both legs after 8 week of exercise compared to baseline levels. CONCLUSION: These results suggest that therapeutic exercise improves pain, ROM, muscle strength, and balancing ability in patients with AAI.