Ankle Dorsiflexion Passive Range Of Motion Research Articles

Evaluation of arthrokinematics and posterior soft tissues of the ankle during ankle dorsiflexion using ultrasound

BackgroundArthrokinematics (caudal and posterior movements of the talus) and posterior soft tissues of the ankle during ankle dorsiflexion have not been objectively evaluated in detail. This study aimed to investigate the characteristics of arthrokinematics and posterior soft tissues of the ankle during ankle dorsiflexion using ultrasound. MethodsThirteen healthy adults participated in the study. Participants whose passive dorsiflexion range of motion (ROM) of the ankle joint was <35° were classified as the restricted group (n = 6), and participants whose passive ankle dorsiflexion ROM was ≥35° were classified as the control group (n = 7). Passive ankle dorsiflexion was performed to measure the ankle arthrokinematics. Strain elastography was performed to measure the elasticity of the flexor hallucis longus (FHL) and Kager's fat pad (KFP) at each dorsiflexion angle. ResultsA significant difference in the posterior movement of the talus at the ankle dorsiflexion of 30° was observed between the two groups (P = 0.04). The elasticity of the restricted group was increased at all angles in both FHL and KFP (P < 0.05). ConclusionThis study showed that it is possible to objectively evaluate the direction of ankle arthrokinematics and posterior ankle soft-tissue restrictions using ultrasound.

Role of Spasticity Severity in the Balance of Post-stroke Patients.

Background: Lower limb spasticity after stroke is common that can affect the balance, increase the risk of falling, and reduces the quality of life.Objective: First, evaluate the effects of spasticity severity of ankle plantar flexors on balance of patients after stroke. Second, to determine the relationship between the spasticity severity with ankle proprioception, passive ankle dorsiflexion range of motion (ROM), and balance confidence.Methods: Twenty-eight patients with stroke based on the Modified Modified Ashworth Scale (MMAS) were divided into two groups: High Spasticity Group (HSG) (MMAS > 2) (n = 14) or a Low Spasticity Group (LSG) (MMAS ≤ 2) (n = 14). The MMAS scores, Activities-Specific Balance Confidence Questionnaire, postural sway of both affected and non-affected limbs under the eyes open and eyes closed conditions, timed up and go (TUG) test, passive ankle dorsiflexion ROM, and ankle joint proprioception were measured.Results: The ankle joint proprioception was significantly better in the LSG compared to the HSG (p = 0.01). No significant differences were found between the LSG and HSG on all other outcome measures. There were no significant relationships between the spasticity severity and passive ankle dorsiflexion ROM, and balance confidence.Conclusion: The severity of ankle plantar flexor spasticity had no effects on balance of patients with stroke. However, the ankle joint proprioception was better in patients with low spasticity. Our findings suggest that the balance is affected regardless of the severity of the ankle plantar flexor spasticity in this group of participants with stroke.

The effects of serial casting on lower limb function for children with Cerebral Palsy: a systematic review with meta-analysis

BackgroundLower limb serial casting is commonly used therapeutically in paediatric clinical practice with some evidence to support its efficacy. This systematic review aimed to determine the effects of serial casting in isolation or combination with other therapies for the management of lower limb dysfunction in children with Cerebral Palsy (CP).MethodsA systematic literature search was conducted in February 2019 across eight databases (PUBMED, EMBASE, CINAHL, PEDro, OTSeeker, Cochrane, Scopus and Proquest) using key terms ‘Cerebral Palsy’ and ‘serial casting’ and associated synonyms. A meta-synthesis and meta-analysis were undertaken when sufficient results were available showing the effect of serial casting on functional outcomes including: Ankle range of motion; neurological measures of hypertonicity and spasticity, functional gait measures and; gross motor function.ResultsTwenty-five articles from 3219 possible citations were included. Serial casting was found to be effective for: Improving ankle dorsiflexion (DF) passive range of motion (PROM) in the immediate to short-term, decreasing hypertonicity measured by Modified Ashworth Scale (MAS) in the short-term and, enhancing functional gait outcomes in the mid-term. Serial casting with or without botulinum toxin type-A (BTX-A) did not significantly affect gross motor capacity measured by Gross Motor Function Measure (GMFM). Serial casting with pharmacological intervention achieved significantly more DF PROM than serial casting alone (MD − 3.19 degrees; 95% CI − 5.76 to − 0.62; P = 0.01; I2 = 0%), however the clinical importance of improving ankle DF PROM by an additional three degrees remains unclear.ConclusionsLower limb serial casting, improves several outcomes relevant to lower limb function supporting its clinical use for improving DF PROM, reducing hypertonicity and improving gait in children with CP. Further research using stronger methodological study designs, is indicated to explore long-term effects of serial casting on functional lower limb outcomes such as gross motor function in children with CP. Clinicians can use this information when developing individualised treatment plans for children who have CP during shared decision-making consultations.

Associations between Range of Motion and Tissue Stiffness in Young and Older People.

The purpose of this study was to investigate differences in the associations between passive ankle dorsiflexion range of motion (ROM) and stiffness of the triceps surae, sciatic nerve, and deep fascia located in the posterior leg between young and older people. Twenty young and twenty older males were recruited and were placed in a prone position with their hip and knee fully extended. Passive ankle dorsiflexion ROM was determined based on the onset of pain during passive dorsiflexion at 1°·s using an isokinetic dynamometer. Shear wave speeds (as a stiffness index) of the triceps surae, the sciatic nerve, and the deep fascia in the posterior leg were evaluated by ultrasound shear wave elastography. The shear wave speeds of the medial and lateral gastrocnemius measured at 15° dorsiflexion correlated negatively with passive ROM in young but not in older participants. The shear wave speed of the sciatic nerve measured at 15° dorsiflexion correlated negatively with passive ROM only in older participants. No association was observed between passive ROM and shear wave speed of the deep fascia in the posterior leg. For data measured at maximal dorsiflexion angle (as an index of stretch tolerance), shear wave speeds of the triceps surae and passive joint torque correlated positively with passive ROM in both groups. These results suggest that the tissues limiting passive ankle dorsiflexion ROM are muscle and nerve for young and older people, respectively, whereas stretch tolerance influences passive ROM for both groups. This implies that the relative contribution of nonmuscular tissues to joint flexibility become stronger than that of muscles with age.

The Effect of Dry Needling on Lower Limb Dysfunction in Poststroke Survivors

Background: Spasticity is one of the main complications in poststroke survivors leading to difficulties in walking and standing resulting in high levels of disability. Objective: The aim of the study was to investigate the effects of deep dry needling on lower limb dysfunction in poststroke spastic patients. Methods: A randomized clinical trial conducted in poststroke survivors who were assigned to one of 2 groups: Deep dry needling (intervention group) and sham dry needling (control group). The primary outcome measures were Modified Modified Ashworth Scale (MMAS) and functional tests (timed up and go test, 10-meter walk test). Secondary outcome measures were active ankle dorsiflexion range of motion (AROM), passive ankle dorsiflexion range of motion (PROM), single leg stance test, and Barthel index. All measurements were assessed at baseline (T0), immediately after the third session 1 week later (T1), and 1 month after the end of the intervention (T2). Results: We recruited 24 patients (71% male; mean age 57 ± 10 years; 26.4 ± 1.8 kg•m−2; time since event: 25.2 ± 12.5 months). There were significant improvements in MMAS, timed up and go test, 10-meter walk test, Barthel scale, and PROM (P < .05) in the intervention group compared to controls across the time-points. There were no significant improvements in AROM assessments (P > .05). Conclusions: Deep dry needling decreases muscle spasticity and improves lower limb function and gait speed in poststroke survivors.

Four-week training involving self-ankle mobilization with movement versus calf muscle stretching in patients with chronic stroke: a randomized controlled study

ABSTRACTBackground: In self-ankle mobilization with movement (S-MWM) therapy, a strap can be utilized to stabilize the posterior glide of the talus during ankle dorsiflexion movements.Objectives: Our objective was to compare the effects of 4-week self-mobilization with movement (S-MWM) with those of calf muscle stretching (CMS) on ankle dorsiflexion passive range of motion (DF-PROM), gait parameters, and fall risk in patients with chronic stroke with limited ankle dorsiflexion.Methods: Participants were randomized into the S-MWM (n = 19) and CMS groups (n = 19). Both groups received conventional physiotherapy for 30 minutes per session. In addition, S-MWM and CMS techniques were performed 3 times per week for 4 weeks and were performed by the participants themselves. Ankle DF-PROM, gait parameters, and fall risk were measured after 4 weeks of training.Results: After 4 weeks of training, both groups showed significant improvement in all outcome measures (p < .05). Furthermore, ankle DF-PROM, gait parameters (gait speed, cadence, and stride lengths on both sides), and fall risk showed greater improvement in the S-MWM group than in the CMS group (p < .05).Conclusions: This study shows that S-MWM training combined with conventional physiotherapy improved ankle DF-PROM, gait parameters, and fall risk in patients with chronic stroke.

The Effects of Deep Oscillation Therapy for Individuals with Lower-Leg Pain

Purpose: Lower extremity (LE) pain accounts for 13-20% of injuries in the active population. LE pain has been contributed to inflexibility and fascial restrictions. Deep oscillation therapy (DOT) has been proposed to improve range of motion and reduce pain following musculoskeletal injuries. Therefore, our objective was to determine the effectiveness of DOT on ankle dorsiflexion range of motion (ROM) and pain in individuals with and without lower-leg pain. Methods: We used a single blind, pre-post experimental study in a research laboratory. Thirty-two active participants completed this study. Sixteen individuals reporting lower-leg pain and sixteen non-painful individuals completed the study. Participants received a single session of DOT performed by one researcher to their affected limb or matched limb. The intervention parameters included a 1:1 mode and 70-80% dosage. The intervention began by stimulating the lymphatic channels at the cisterna chyli, the inguinal lymph node, and the popliteal lymph node at a frequency of 150 Hz all for a minute each. Next, the researcher treated the triceps surae complex for 11 minutes at three different frequencies. Finally, the participant was treated distal to the popliteal lymph node at 25 Hz for 5 minutes. The main outcome measures included pain using the VAS and ankle dorsiflexion ROM with the weight-bearing lunge test (WBLT). Statistical analyses included descriptive statistics and F-test comparisons between and within groups. Results: The average WBLT measures for all participants increased 0.6 cm, which not to the minimal detectable change for passive ankle dorsiflexion ROM. Significant differences from pre-post measures were identified for pain on the VAS. Conclusion: While increases in ROM were identified, the difference was not clinically important. DOT was successful in decreasing lower-leg pain

Commentary on "Progression of Ankle Plantarflexion Contractures and Functional Decline in Duchenne Muscular Dystrophy: Implications for Physical Therapy Management".

“How might I apply this information?” This information can be best applied by establishing early and ongoing intervention programs to minimize development of plantar flexor contractures in individuals with Duchenne muscular dystrophy (DMD) and being aware of trends and correlations suggesting the need for additional interventions. Trends reported showed progressive decline in ankle dorsiflexion passive range of motion (PROM) with age, progressive functional decline after 7 years of age as measured by North Star Ambulatory Assessment (NSAA), and correlation between functional decline and decline in ankle dorsiflexion PROM. Understanding and acting on the relationship between contracture and functional losses are critical in providing preventive, anticipatory care in DMD as shown across all ages in this study. Decreases in ankle dorsiflexion PROM emerged before the age of 7 years despite increasing function, supporting the importance of initiating early preventive intervention to minimize contracture development rather than waiting for functional losses, especially in those younger than 7 years. Older individuals who were walking had less extreme ranges of plantar flexor contracture than those 7 to 15 years of age despite lower NSAA functional scores, highlighting the functional importance of minimizing plantar flexor contractures over time, with adequate dorsiflexion range a potential requirement for walking with increased age and weakness. Challenges in preventing plantar flexor contractures, evidenced by variability in the data, support the need for comprehensive individualized approaches described, including home stretching, regular direct skilled physical therapy, orthotic intervention, serial casting, optimal positioning, supported standing, and assessment of PROM and muscle extensibility with sufficient frequency to identify needs for additional interventions. “What I might be mindful of when applying this information?” Individual correlations between ankle dorsiflexion PROM, functional scores, walking status, genetic mutations, steroid use, and therapeutic intervention in participants were not reported, details that might provide insight into individual interactions between factors in the successful prevention of plantar flexor contractures and optimizing function. Laura E. Case, PT, DPT, MS, PCS Doctor of Physical Therapy Division Duke University School of Medicine Durham, North Carolina Julie Coats, PT, DPT Department of Physical Therapy and Occupational Therapy Duke University Medical Center Durham, North Carolina

Four-week training involving ankle mobilization with movement versus static muscle stretching in patients with chronic stroke: a randomized controlled trial

ABSTRACTBackground: Patients with stroke generally have diminished balance and gait. Mobilization with movement (MWM) can be used with manual force applied by a therapist to enhance talus gliding movement. Furthermore, the weight-bearing position during the lunge may enhance the stretch force.Objectives: This study aimed to compare the effects of a 4-week program of MWM training with those of static muscle stretching (SMS). Ankle dorsiflexion passive range of motion (DF-PROM), static balance ability (SBA), the Berg balance scale (BBS), and gait parameters (gait speed and cadence) were measured in patients with chronic stroke.Methods: Twenty patients with chronic stroke participated in this study. Participants were randomized to either the MWM (n = 10) or the SMS (n = 10) group. Patients in both groups underwent standard rehabilitation therapy for 30 min per session. In addition, MWM and SMS techniques were performed three times per week for 4 weeks. Ankle DF-PROM, SBA, BBS score, and gait parameters were measured after 4 weeks of training.Results: After 4 weeks of training, the MWM group showed significant improvement in all outcome measures compared with baseline (p < 0.05). Furthermore, SBA, BBS, and cadence showed greater improvement in the MWM group compared to the SMS group (p < 0.05).Conclusions: This study demonstrated that MWM training, combined with standard rehabilitation, improved ankle DF-PROM, SBA, BBS scores, and gait speed and cadence. Thus, MWM may be an effective treatment for patients with chronic stroke.

Relationship Between Weightbearing Ankle Dorsiflexion Passive Range of Motion and Ankle Kinematics During Gait.

Measurement of weightbearing ankle dorsiflexion (DF) passive range of motion (PROM) has been suggested as a way to estimate ankle kinematics during gait; however, no previous study has demonstrated the relationship between ankle DF during gait and ankle DF PROM with knee extension. We examine the relationship between maximum ankle DF during gait and nonweightbearing and weightbearing ankle DF PROM with knee extension. Forty physically active individuals (mean ± SD age, 21.63 ± 1.73 years) participated in this study. Ankle DF PROM with knee extension was measured in the nonweightbearing and weightbearing conditions; maximum ankle DF during gait was assessed using a three-dimensional motion analysis system. The relationship between each variable was calculated using the Pearson product moment correlation coefficient, and the difference in ankle DF PROM between the nonweightbearing and weightbearing conditions was analyzed using a paired t test. The weightbearing measurement (r = 0.521; P < .001) for ankle DF PROM showed a greater correlation with maximum ankle DF during gait than did the nonweightbearing measurement (r = 0.245; P = .029). Ankle DF PROM was significantly greater in the weightbearing than in the nonweightbearing condition (P < .001) despite a significant correlation between the two measurements (r = 0.402; P < .001). These findings indicate that nonweightbearing and weightbearing measurements of ankle DF PROM with knee extension should not be used interchangeably and that weightbearing ankle DF PROM with the knee extended is more appropriate for estimating ankle DF during gait.

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

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.

Ankle Joint Angle and Lower Leg Musculotendinous Unit Responses to Cryotherapy.

Akehi, K, Long, BC, Warren, AJ, and Goad, CL. Ankle joint angle and lower leg musculotendinous unit responses to cryotherapy. J Strength Cond Res 30(9): 2482-2492, 2016-The use of cold application has been debated for its influence on joint range of motion (ROM) and stiffness. The purpose of this study was to determine whether a 30-minute ice bag application to the plantarflexor muscles or ankle influences passive ankle dorsiflexion ROM and lower leg musculotendinous stiffness (MTS). Thirty-five recreationally active college-aged individuals with no history of lower leg injury 6 months before data collection volunteered. On each testing day, we measured maximum passive ankle dorsiflexion ROM (°) and plantarflexor torque (N·m) on an isokinetic dynamometer to calculate the passive plantarflexor MTS (N·m per degree) at 4 joint angles before, during, and after a treatment. Surface electromyography amplitudes (μV), and skin surface and ambient air temperature (°C) were also measured. Subjects received an ice bag to the posterior lower leg, ankle joint, or nothing for 30 minutes in different days. Ice bag application to the lower leg and ankle did not influence passive ROM (F(12,396) = 0.67, p = 0.78). Passive torque increased after ice bag application to the lower leg (F(12,396) = 2.21, p = 0.011). Passive MTS at the initial joint angle increased after ice bag application to the lower leg (F(12,396) = 2.14, p = 0.014) but not at the other joint angles (p > 0.05). Surface electromyography amplitudes for gastrocnemius and soleus muscles increased after ice application to the lower leg (F(2,66) = 5.61, p = 0.006; F(12,396) = 3.60, p < 0.001). Ice bag application to the lower leg and ankle joint does not alter passive dorsiflexion ROM but increases passive ankle plantarflexor torque in addition to passive ankle plantarflexor MTS at the initial joint angle.

Functional Deep Squat Performance is Associated with Hip and Ankle Range of Motion

Objectives: To assess the associations between performance of the deep squat component of the Functional Movement Screen (FMS) and the range of motion (ROM) of the hip, knee, ankle joints, and lumbar spine of healthy athletes. Methods: We assessed the passive ROM of the hip, knee, ankle joints, and lumbar spine of 126 participants who underwent an injury prevention evaluation using a goniometer (extremities) or inclinometer (spine). Performance on the deep squat subtest of the FMS was evaluated by a level 1 certified FMS instructor. The ROM at each joint was then compared between participants who scored a 1, 2, and 3 on the deep squat using one-way analysis of variance (ANOVA) tests. Results: Participants who scored a 1 on the deep squat had significantly less passive hip flexion ROM and passive ankle dorsiflexion ROM as measured by a goniometer on both the right side and left side than participants who received a 3. We also observed that those who scored a 2 demonstrated significantly less ankle dorsiflexion ROM and hip flexion ROM on the left side only compared to those who scored a 3 on the deep squat. Conclusion: ROM of the hip and ankle joints may be one contributing factor to poor performance on the FMS deep squat. Our findings indicate that in an effort to improve functional squat performance, treatments designed to increase sagittal plane hip and ankle ROM may prove to be advantageous.

The effect of balance training with plantar flexor stretching on range of motion, balance, and gait in stroke patients: a randomized controlled pilot trial

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

Reliability of ankle dorsiflexion passive range of motion measurements obtained using a hand-held goniometer and Biodex dynamometer in stroke patients.

[Purpose] This study investigated the reliability of ankle dorsiflexion passive range of motion (DF-PROM) measurements obtained using a goniometer and Biodex dynamometer in stroke patients. [Subjects] Fifteen stroke patients participated in this study. [Methods] Ankle DF-PROM was assessed using a goniometer and Biodex dynamometer. Ankle DF-PROM was measured during two sessions with 7 days between tests. Intraclass correlation coefficient, standard error of measurement, and minimal detectable change values were used to assess the reliability of measurements obtained using both instruments. [Results] The intra-rater reliability for ankle DF-PROM using the goniometer was moderate and good for the two raters, while using the Biodex dynamometer, it was good for both raters. Inter-rater reliability using the goniometer was moderate; using the Biodex, it was good. [Conclusion] Both intra- and inter-reliability measurements of ankle DF-PROM were higher using a Biodex dynamometer than with a goniometer.

Changes in Kinetic, Kinematic, and Temporal Parameters of Walking in People With Limited Ankle Dorsiflexion: Pre-Post Application of Modified Mobilization With Movement Using Talus Glide Taping

ObjectiveThe purpose of this study was to investigate the changes in passive ankle dorsiflexion range of motion (ROM), maximum plantar force, force-time integral, and time to heel off during walking between pre- and postapplication of modified mobilization with movement (MWM) using talus glide taping in people with limited ankle dorsiflexion. MethodsEighteen feet with limited ankle dorsiflexion in 13 people were examined. Participants performed 3 different walking tasks in the following order: walking before and immediately after applying the modified MWM using talus glide taping and walking after 5-minute walking with the modified MWM using talus glide taping. A floor-mat pressure measurement system (HR-mat) was used to measure maximum plantar force, force-time integral, and time to heel off; and passive ankle dorsiflexion ROM was measured using a standard goniometer. The significance of differences was assessed using repeated one-way analysis of variance. ResultsPassive ankle dorsiflexion ROM and time to heel off were significantly increased after 5-minute walking with the modified MWM using talus glide taping compared with walking before and immediately after applying the tape. Significantly increased maximum plantar force and force-time integral on the hindfoot and significantly decreased force-time integral on the forefoot during walking after 5-minute walking were observed with the modified MWM using talus glide taping compared with before applying the tape. No significant difference between before and immediately after applying the tape was observed in any variable. ConclusionsOur results suggest that walking an additional 5-minute with the modified MWM using talus glide taping increased passive ankle dorsiflexion ROM and time to heel off and improved dynamic plantar loading during walking.

Comparison of the Duration of Maintained Calf Muscle Flexibility After Static Stretching, Eccentric Training on Stable Surface, and Eccentric Training on Unstable Surfaces in Young Adults With Calf Muscle Tightness

The objective of this study was to determine the duration of maintained calf muscle flexibility gained in young adults with calf muscle tightness, as measured by increases in ankle active and passive dorsiflexion range of motion (DFROM) after three stretching interventions. Twenty subjects (5 men and 15 women) with calf muscle tightness received the following three stretching interventions in one leg (assigned at random): static stretching (SS), eccentric training on stable surface (ETS), and eccentric training on unstable surfaces (ETU). The subjects received all three interventions to the same leg, applied in a random order. Each intervention had a break of at least 24 h in-between, in order to minimize any carryover effect. Each intervention used two types of stretching: with the calf muscle stretched and both knees straight, and with the knee slightly bent in order to maximize the activation of the soleus muscle. All three interventions were performed for 200 seconds. We measured the duration of maintained calf muscle flexibility through active and passive ankle DFROM before intervention, immediately after intervention (time 0), and then 3, 6, 9, 15, and 30 min after intervention. We found a difference in the duration of maintained calf muscle flexibility between the three interventions. In the ETS and ETU interventions, a significant improvement in calf muscle flexibility, both ankle active and passive dorsiflexion ranges of motion (ADFROM and PDFROM), was maintained for 30 min. In the SS intervention, however, ADFROM before 9 min and PDFROM before 6 min were statistically different from the baseline. Our results suggest that ETS and ETU may be more effective than SS for maintaining calf muscle flexibility in young adults.

Immediate effect of walking with talus-stabilizing taping on ankle kinematics in subjects with limited ankle dorsiflexion

ObjectiveTo determine the effects of walking with talus-stabilizing taping (TST) on ankle dorsiflexion (DF) and heel-off time in the stance phase of gait and ankle DF passive range of motion (PROM). DesignPre- and post-intervention study. SettingUniversity motion analysis laboratory. ParticipantsTen subjects participated in this study. Sixteen ankles with limited ankle DF PROM were tested. Main outcome measuresAnkle DF PROM was measured using a goniometer, and maximum ankle DF before heel-off and time to heel-off in the stance phase of gait were measured using a 3D motion analysis system before and after walking with TST. Data were analyzed using a paired t-test. ResultsAnkle maximum DF before heel-off (p = 0.001), time to heel-off during the stance phase of gait (p = 0.005), and ankle DF PROM (p < 0.001) were significantly increased post-intervention compared with pre-intervention. ConclusionsWalking with TST is an effective self-exercise for improving ankle kinematics during gait and increasing ankle DF PROM in individuals with limited ankle DF PROM.

INFLUENCE OF GENDER ON GASTROCNEMIUS MUSCLE ACTIVITY DURING THE STANCE PHASE OF GAIT

Purpose: Differences in muscle activity have been observed between men and women in numerous lower extremity muscles in a variety of activities. These differences may be related to observed differences in the incidence of injuries between men and women. The purpose of this work is to determine if gender had an effect on the activity of the medial and lateral gastrocnemius muscles during the early part of the stance phase of gait. Method: An observational cohort study was set up using sixteen volunteers (9 men and 7 women, mean age = 27 years) with less than 5° of passive ankle-dorsiflexion range of motion. Maximum dorsiflexion, maximum knee flexion, stance time and EMG magnitude were measured for both men and women during early stance (heel strike to heel off). Results: EMG amplitude of the LG muscle in women was significantly higher than that of men. No significant differences were observed between men and women for maximum dorsiflexion, maximum knee flexion or stance time. Conclusions: A gender difference in gastrocnemius muscle EMG magnitude exists that is independent of knee and ankle kinematics and walking speed.

Effect of Stretching on Ankle and Knee Angles and Gastrocnemius Activity during the Stance Phase of Gait

Stretching exercises are commonly prescribed for patients and healthy individuals with limited extensibility of the gastrocnemius muscle. To determine effects of gastrocnemius stretching on ankle dorsiflexion, knee extension, and gastrocnemius muscle activity during gait. Randomized-control trial. Biomechanical laboratory. Sixteen volunteers (9 men and 7 women, mean age = 27 y) with less than 5 degrees of passive ankle-dorsiflexion range of motion randomly assigned to an experimental or control group. The experimental group performed gastrocnemius stretching for 3 wk. Maximum ankle dorsiflexion, maximum knee extension, and EMG amplitude of the gastrocnemius muscles were measured between heel strike and heel-off before and after intervention. No significant effect of group or time was found on maximum ankle dorsiflexion, maximum knee extension, or EMG activity of the medial or lateral gastrocnemius muscles between heel strike and heel-off. The experimental group had significantly greater passive ankle-dorsiflexion range of motion bilaterally at posttest than the control group. Stretching did not alter joint angles or gastrocnemius muscle activity in the early to midstance phase of gait.