Effects of Talocrural Mobilization with Movement on Ankle Strength, Mobility, and Weight-Bearing Ability in Hemiplegic Patients with Chronic Stroke: A Randomized Controlled Trial

Abstract

In general, adequate movement of the ankle joint is known to play an important role in functional activities. Stroke survivors frequently have limited range of motion of the ankle, leading to dysfunctional weight transfer toward the paretic lower limb during standing or gait. The purpose of this study was to investigate the effects of talocrural mobilization with movement (MWM) on ankle strength, dorsiflexion passive range of motion (DF-PROM), and weight-bearing ability on the paretic limb during standing or gait in stroke patients with limited ankle dorsiflexion. Twenty-six participants with chronic hemiplegia (>6 months post stroke) were divided into 2 groups: MWM group (n = 13) and control group (n = 13). Both groups attended conventional physiotherapy sessions 3 times a week for 5 weeks. Additionally, the MWM group underwent talocrural MWM 3 times a week for 5 weeks. Isokinetic ankle strength, DF-PROM, and weight-bearing ability measures included the limit of stability (LOS); gait parameters were evaluated before and after interventions. Plantarflexors peak torque and DF-PROM significantly increased in the MWM group. In addition, forward and forward-paretic direction LOS significantly increased in the MWM group. Paretic direction LOS, single-limb support phase of the paretic limb significantly increased and double limb support phase significantly decreased within the MWM group. This study demonstrates that talocrural MWM has an augmented effect on ankle strength, mobility, and weight-bearing ability in chronic stroke patients with limited ankle motion when added to conventional therapy.