Ankle Exercise Research Articles

Effects of different exercise methods of calf muscles on the hemodynamics of lower extremity vein.

To compare the effects of active and passive calf muscle contraction on the hemodynamics of the lower extremity vein. 30 females were selected by convenient sampling. The hemodynamic indexes of the common femoral vein were measured by Duplex ultrasound during the active ankle pump exercise, active circular exercise, passive ankle pump exercise, passive circular exercise, and massage the calf muscles. There was no significant difference in the velocity of common femoral vein when the subjects do active ankle pump exercise, active circular exercise, and massage the calf muscles (p > .05), but the velocity of common femoral vein was faster than that of passive ankle pump exercise and passive circular exercise (p < .01). The effects of active ankle exercise and massage on promoting venous blood return of lower extremity are better than that of passive ankle exercise.

Functional assessment of surgically managed ankle fractures

Background: Civilization has made man more prone to injuries. Ankle fractures are one of the most common injuries treated by orthopedic surgeons. Aims and Objectives: The aim of the study is to assess the functional outcome in surgically managed ankle fractures. Materials and Methods: Sixty patients were included in this study with ankle fractures that were surgically treated at NIMS Hospital, Hyderabad. Observations: The study had a male preponderance of 66.6%, with road traffic accidents being the major cause of injury. Supination-external rotation was the most common mechanism of injury and Weber's type B fractures were the most common type of fracture. The associated fractures and injuries noted and the comorbidities seen in these patients have been enumerated. Open reduction and internal fixation under image intensifier control was done in all patients. Postoperatively, patients were immobilized with a plaster splint for a period of 3–6 weeks and were followed up with full weight-bearing walking and active range of movement of ankle exercises. The final outcome as per the Weber's radiological criteria was 66.6% good, 26.6% fair, and 6.8% poor result which showed a good correlation between the immediate postoperative radiological score and the final radiological outcome. The factors that affected the final poor outcome were late presentation, patients with fracture subluxation, post massaging, the presence of long-standing and uncontrolled diabetes, and old age. Conclusion: The present study suggests that anatomical reduction of the ankle fracture and restoration of the joint congruity at the earliest will give a good functional outcome. The postoperative immobilization in a plaster slab up to 3–6 weeks (depending on associated injuries, fracture severity, bone quality, quality of fixation, and patient compliance) does not affect the final outcome with respect to achieving the ankle and subtalar range of movements as most of the patients had achieved full range of motion at the end of 12 weeks.

Comparison of the Immediate Effect of Ankle and Hip Joint Thera-band Exercise on the Balance Ability

Comparison of the Immediate Effect of Ankle and Hip Joint Thera-band Exercise on the Balance Ability

Effects of Ankle Joint Exercise Programs with Hip Joint and Lumbopelvic Exercises on the Muscle Activity of Adults with Functional Ankle Instability

In subjects with functional ankle instability, lumbopelvic instability causes instability of the hip and lower extremities. The purpose of this study is to determine whether an ankle exercise program with hip strengthening exercise and lumbopelvic stabilization exercise affects spine and ankle stability through muscle activity in adults with functional ankle instability. Thirty adults with functional ankle instability were randomly assigned to a hip joint strengthening exercise group and a lumbopelvic stabilization exercise group. The subjects participated in the designated program three times a week for 40 minutes a day. In the hip joint strengthening exercise group, a general hip joint strengthening exercise was used, and in the lumbopelvic stabilization exercise group, a lumbopelvic stabilization exercise using a sling was added. The intervention lasted 4 weeks, and both groups were instructed to refrain from other exercise during the 4-week intervention period. The muscle activity of the tibialis anterior, gluteus maximus, external oblique and contralateral latissimus dorsi was measured. Data were collected from the 30 patients. The results showed that the muscle activity of the tibialis anterior, gluteus maximus, lateral oblique muscle, and contralateral latissimus dorsi was significantly increased in both groups. This suggests that the existing hip joint strengthening exercise and lumbopelvic stabilization exercise are effective approaches which not only help reduce hip joint pain and improve function, but also reduce functional ankle instability. Therefore, if an appropriate exercise program is provided for subjects with functional ankle instability, it is expected that it will help improve pain and function by reducing ankle instability and the frequency of re- injury.

The analysis of venous blood flow velocity increase during ankle exercise

The analysis of venous blood flow velocity increase during ankle exercise

Bicycle exercise ankle brachial index recovery time as a novel metric for evaluating the hemodynamic significance of external iliac endofibrosis in competitive cyclists.

Subtle radiographic findings can increase the challenge of diagnosing external iliac artery endofibrosis. We evaluated a new metric, the bicycle exercise ankle brachial index recovery time (BART), in a cohort of cyclists with symptomatic external iliac artery endofibrosis. BART was defined as the time required in minutes for the ankle brachial index to return to 0.9 after a period of exercise. Surgical correction resulted in an improvement in BART postoperatively (4.5 ± 4.1 vs 9.1 ± 4.3 minutes; P < .001), with improved values correlating with better patient satisfaction. Documentation of the BARTs before and after surgical treatment provides an additional measure of postoperative hemodynamic improvement.

Biceps Femoris Activation during Hamstring Strength Exercises: A Systematic Review.

Background: The aim of the study was to systematically evaluate the biceps femoris long head activation across cross-sectional hamstring strength exercise studies. Methods: A systematic review design was followed. The search strategy conducted in PubMed, Cochrane Library, and Web of Sciences databases found a total of 3643 studies. Once inclusion and exclusion criteria were applied, 29 studies were finally included in this systematic review. A total of 507 participants and 114 different exercises were analyzed. Exercises were evaluated individually and grouped into several categories: Nordics, isokinetic exercises, lunges, squats, deadlifts, good mornings, hip thrusts, bridges, leg curls, swings, hip and back extensions, and others. Results: Results showed the isokinetic and Nordic exercises as the categories with highest biceps femoris activation (>60% of Maximal Voluntary Isometric Contraction). Nordic hamstring exercise ankle dorsiflexion was the exercise that achieved the highest biceps femoris long head activation (128.1% of its Maximal Voluntary Isometric Contraction). Conclusions: The results from this systematic review suggest that isokinetic and Nordic exercises seem to be the best option to activate biceps femoris long head. Future studies evaluating the implementation of these exercises in prevention programs are needed.

Сучасні уявлення про фізичну терапію пацієнтів після оперативного лікування переломів кісток гомілково-надп’яткового суглоба

The purpose of the study is to determine and analyze modern means of restoring motor functions used for patients with fractures of the ankle joint bones after surgical treatment. Materials and methods. The work is the result of analysis and generalization of special scientific and methodological literature of domestic and foreign authors and Internet data on the features of the use of modern methods of physical therapy for patients with fractures of the ankle joint bones after surgical treatment. Results and discussion. Physical therapy for patients with fractures of the ankle joint bones is integral to a speedy recovery. Due to the fact that after surgery, it is mandatory to apply a plaster cast or a fixator to the joint for about 6 weeks – the strength of the lower extremities is lost, joint contracture appears, there is aching pain and a decrease in the range of motion. It is necessary to start classes with a physical therapist as early as possible, already on the second day after the operation, if the general condition of the patient is satisfactory. Patients require early postoperative functional physical therapy under the supervision of a physical therapist to improve joint function and proprioception, and to promote edema regression (lymphatic drainage). Patients with fractures associated with ligament injuries especially require proprioceptive neuromuscular facilitation to protect them from the risk of chronic ankle instability. Generally, recovery for patients with this trauma is slow and requires patience. There is some evidence that early introduction of activity during the immobilization period may be beneficial for patients. By doing light ankle exercises, the range of motion is improved, pain disappears and the function of the joint improves. Also, early stress on body weight is associated with many benefits, including better mobility, shorter hospital stays, and earlier return to work. However, there are other claims that early exercise increases the risk of surgical site infection, reoperation, and surgical fixation failure. Given the lack of evidence to determine it should be noted that additional research is needed to address this issue. Conclusions. Current evidence on the physical therapy of fractures of the ankle joint bones after immobilization shows that separate physical therapies do not accelerate the recovery process. This suggests that physical therapy must be comprehensive and must necessarily focus on a progressive and structured exercise program. Also, recent studies have shown that exercise is an effective mean of physical therapy, especially balance exercises

User perspectives on the design and setup of lower limb mirror therapy equipment after stroke: a technical report

ObjectivesTo co-design lower limb mirror therapy (MT) equipment and setup by working directly with stroke survivors and physiotherapists. DesignCo-design approach through focus groups. ParticipantsTwenty-six participants. Sixteen stroke survivors and ten physiotherapists. Data collection and analysisData were collected in an iterative process through two sets of focus groups. Firstly, prototype one of the MT equipment was presented to the participants. They were encouraged to use and comment on it. Then, the key requirements for ankle exercise with MT were presented, and participants discussed whether the prototype one was able to deliver these requirements. These findings informed iterations to the device, and a second prototype was produced and discussed in the second set of focus groups. The final prototype was then produced based on the participants’ feedback. All focus groups were audio-recorded, followed by verbatim transcriptions and thematic analysis. ResultsMain characteristics required of the lower limb MT device were found to be: the ability to produce MT ankle exercise from an upright sitting posture, an adjustable angle between 5 to 15 degree from the midline to allow clear lower limb reflection during seated exercise, and a lightweight device to enable easy use for stroke survivors. ConclusionThis work produced an iteratively co-design lower limb MT to be used with stroke survivors.

Bicycle Exercise Ankle-Brachial Index Recovery Time as a Novel Metric for Evaluating the Hemodynamic Significance of External Iliac Endofibrosis in Competitive Cyclists

Subtle radiographic findings can increase the challenge of diagnosing external iliac artery endofibrosis. We evaluated a new metric, the bicycle exercise ankle brachial index recovery time (BART), in a cohort of cyclists with symptomatic external iliac artery endofibrosis. BART was defined as the time required in minutes for the ankle brachial index to return to 0.9 after a period of exercise. Surgical correction resulted in an improvement in BART postoperatively (4.5 ± 4.1 vs 9.1 ± 4.3 minutes; P < .001), with improved values correlating with better patient satisfaction. Documentation of the BARTs before and after surgical treatment provides an additional measure of postoperative hemodynamic improvement.

Incorporating regenerative medicine into rehabilitation programmes: a potential treatment for ankle sprain

Ankle sprain has a great effect on morbidity and complications of chronic diseases. Experts have come to a consensus where ankle sprain can be managed by rest, ice, compression and elevation, non-steroidal anti-inflammatory drugs, immobilisation, functional support such as the use of an ankle brace, exercise, surgery and other therapies that include physiotherapy modalities and acupuncture. However, the time required for healing is still relatively long in addition to post-operative complications. Because of the challenges and setbacks faced by interventions to manage ankle sprains and in view of the recent trend and development in the field of regenerative medicine, this article discusses future treatments focusing on a personalised and holistic approach for ankle sprain management. This narrative review provides a novel idea for incorporating regenerative medicine into conventional therapy as an intervention for ankle sprain based on theoretical concepts and available evidence on regenerative medicine involving ligament injuries.

Do the heel-rise test and isometric strength improve after Achilles tendon repair using Dresden technique?

BackgroundAchilles’ tendon ruptures result in impaired plantar flexion strength and endurance. It is interesting to know the plantar flexion strength, the number of heel-rise repetitions, and the maximal calf circumference following Achilles’ tendon ruptures repair. MethodsBoth the injured and non-injured legs of thirty male patients with Achilles’ tendon ruptures treated with the percutaneous Dresden technique were compared with the ankle function of 30 healthy participants. Rehabilitation involved partial weight-bearing for three weeks and then increased to full weight-bearing and ankle exercises. ResultsThe injured legs had weaker plantar flexion strength (1.64 ± 0.17 Nm/kg) compared with the non-injured legs (1.91 ± 0.24 Nm/kg; p = 0.002) and the healthy participants’ legs (1.93 ± 0.32 Nm/kg; p < 0.001). The non-injured leg had greater ability in doing heel-rise repetitions (39.4 ± 6.1 rep.) compared with the injured legs (37.2 ± 5.7 rep.; p < 0.023) and the healthy participants’ legs (31.0 ± 13.0 rep.; p < 0.001). ConclusionsThe injured leg had not recovered full isometric strength but had improved heel-rise repetition.

Effects of intermittent pneumatic compression on femoral vein peak venous velocity during active ankle exercise.

The risk of developing deep vein thrombosis (DVT) is high even after the period of bed rest following major general surgery including total joint arthroplasty (TJA). Mobile intermittent pneumatic compression (IPC) devices allow the application of IPC during postoperative exercise. Although ambulation included ankle movement, no reports have been made regarding the effects of IPC during exercise, including active ankle exercise (AAE), on venous flow. This study was performed to examine whether using a mobile IPC device can effectively augment the AAE-induced increase in peak velocity (PV). PV was measured by Doppler ultrasonography in the superficial femoral vein at rest, during AAE alone, during IPC alone, and during AAE with IPC in 20 healthy subjects in the sitting position. PV in AAE with IPC was measured with a mobile IPC device during AAE in the strong compression phase. AAE was interrupted from the end of the strong compression phase to minimize lower limb fatigue. AAE with IPC (76.2 cm/s [95%CI, 69.0-83.4]) resulted in a significant increase in PV compared to either AAE or IPC alone (47.1 cm/s [95%CI, 38.7-55.6], p < 0.001 and 48.1 cm/s [95%CI, 43.7-52.4], p < 0.001, respectively). Reduced calf muscle pump activity due to the decline in ambulation ability reduced venous flow. Therefore, use of a mobile IPC device during postoperative rehabilitation in hospital and activity including self-training in an inpatient ward may promote venous flow compared to postoperative exercise without IPC. Use of a mobile IPC device significantly increased the PV during AAE, and simultaneous AAE with IPC could be useful evidence for the prevention of DVT in clinical settings, including after TJA.

Ankle exercise with functional electrical stimulation affects spasticity and balance in stroke patients.

Stroke patients have limited motor function due to ankle spasticity, and various interventions are applied to solve this problem. The purpose of this study was to investigate the effects of functional electrical stimulation (FES) with ankle exercise on spinal cord motor neuron excitability and balance in stroke patients. Twenty-five stroke patients were divided into the three groups. For the intervention, the control group applied general physiotherapy, the experimental group I applied a sham FES with ankle exercise, and the experimental group II applied a FES with ankle exercise. All groups applied the intervention for 30 min per session, 5 times a week, for a total of 8 weeks. The functional reaching test (FRT), Timed Up and Go test was used to measure balance ability, and H-reflex was used to measure spinal motor neuron excitability. All tests were measured before and after the intervention. In the ankle exercise with FES group, spinal motor neuron excitability significantly decreased (P<0.05), and FRT was significantly increased (P<0.05). Therefore, FES with ankle exercise for stroke patients could be suggested as an effective intervention for improving motor function.

The efficiency of mirror therapy on drop foot in Multiple Sclerosis Patients.

Although the effectiveness of mirror therapy (MT) has been proved in stroke persons, there is no scientific evidence about the results in people with multiple sclerosis. The aim was to investigate whether adding MT to exercise training and neuromuscular electrical stimulation (NMES) has any effect on clinical measurements, mobility, and functionality in people with multiple sclerosis (MS). Ambulatory people with MS, with unilateral drop foot, were included. MT group (n=13) applied bilateral ankle exercise program with mirror following NMES for 3days a week at hospital and exercise program for 2days a week at home. Control group (n=13) performed same treatment without mirror box (6weeks). The later 6weeks both groups performed only exercise program. Clinical measurements included proprioception, muscle tone of plantar flexor muscles (MAS), muscle strength of dorsiflexor, ankle angular velocity, and range of motion (ROM) of ankle. Functionality (Functional Independence Measurement-FIM), mobility (Rivermead Mobility Index-RMI), ambulation (Functional Ambulation Scale-FAS), duration of stair climb test, and 25-foot walking velocity were assessed at the beginning, in 6th and 12th weeks. More positive improvements were obtained in MT group than control group in terms of range of motion (0.012), muscle strength (0.008), proprioception (0.001), 25 feet walking duration (0.015), step test duration (0.001), FAS (0.005), RMI (0.001), and FIM (0.001) after 6weeks treatment. It was seen that this improvement maintained to 12th week on all clinical and functional measurements (p<.05). The trial revealed that adding MT to exercise training and NMES has more beneficial effects on clinical measurements, mobility, and functionality in people with multiple sclerosis with unilateral drop foot.

Comparison of the Intrinsic Foot Muscle Activities between Therapeutic and Three-Dimensional Foot-Ankle Exercises in Healthy Adults: An Explanatory Study.

Background: In recent years, a three-dimensional ankle exercise has been proposed as a practice for strengthening the intrinsic foot muscles, however this topic still requires further research. This study aimed to compare the activities of the intrinsic muscles in healthy participants during 3D foot–ankle exercises, namely, short foot (SF), and toe spread out (TSO). Methods: Prior to the experiment, 16 healthy adults were trained on how to perform SF, TSO, and 3D foot–ankle exercises for an hour. Once all participants passed the foot–ankle exercise performance test, we randomly measured the activity of the intrinsic foot muscles using electromyography while the patients were performing foot–ankle exercises. Results: The abductor hallucis (AbH), extensor hallucis longus (EHL), and flexor hallucis brevis (FHB) activities showed significant differences among the exercises for intrinsic foot muscle strengthening (p < 0.01). Additionally, the AbH/AdH (adductor hallucis) ratio showed significant differences among the exercises for strengthening the intrinsic foot muscles (p < 0.01). Conclusions: Our results showed that the 3D extension exercise is as effective as the therapeutic exercise in terms of the AbH and FHB activities, and the AbH/AdH ratio. On the contrary, the 3D flexion exercise showed superiority in terms of the EHL activity.

Comparison of Effects After Applying Virtual Reality Ankle Exercise and High-frequency Current to Functional Ankle Instability

The purpose of this study is to find an optimal rehabilitation therapy intervention, especially in this study, by comparing the effects of applying both virtual reality (VR) programs and microwave diathermy (MWD) at the same time. The subjects of this study participated 19 college students in their 20s. The subjects were randomly divided into two groups. The first group received MWD (male:2 female:8) and VR ankle training, while the second group (male:2 female:7) received only the VR training. The interventions were conducted three times a week for four weeks. Biodex Balance System® is a tool to measure balance degree in this study. The MWD (PM-800S, ITO, Japan) intervention was conducted by setting the frequency of 2450㎒ and the output of 100W before the implementation of the VR exercise program. The exercise in this study was conducted using the Nintendo Wii Fit Plus program for VR exercise. Comparison of the results of the groups that implemented MWD and VR at the same time and those that implemented VR only are as follows. In the static balance, VR groups were significantly lower in all directions such as overall, anterior-posterior, and medial-lateral (p .05). If the therapist does not properly perform the examination when applying MWD for FAI, the effect might not be significant. VR exercise programs can also be used to improve the balance of FAI, although it has limitations.

HUBUNGAN EDUKASI KESEHATAN TENTANG CEDERA ANKLE DAN TERAPI LATIHANNYA TERHADAP TINGKAT PENGETAHUAN MAHASISWA KEDOKTERAN PEMAIN FUTSAL

Pendahuluan: Olahraga futsal termasuk ke dalam 10 olahraga yang paling sering menyebabkan cedera, dengan tingkat insidensi mencapai 55,2 cedera per 10000 jam partisipasi olahraga. Cedera pergelangan kaki atau ankle merupakan cedera yang paling banyak terjadi. Cedera ankle yang tidak ditangani dengan baik bisa berakibat pada chronic ankle instability. Tujuan dari penelitian ini adalah mengetahui hubungan edukasi kesehatan tentang cedera ankle dan terapi latihannya terhadap tingkat pengetahuan anggota futsal FKIK UAJ.&#x0D; Metode: Penelitian ini merupakan penelitian pre-experimental dengan pendekatan cross-sectional, yang dilakukan di Fakultas Kedokteran Dan Ilmu Kesehatan Unika Atma Jaya dengan purposive sampling. Edukasi kesehatan diberikan dengan menggunakan alat bantu slideshow dan tingkat pengetahuan diukur dengan menggunakan kuesioner. Data dianalisis dengan uji t-test berpasangan.&#x0D; Hasil: Total responden adalah 36 mahasiswa. Tingkat pengetahuan mahasiswa sebelum diberikan edukasi kesehatan tentang cedera ankle dan terapi latihannya memiliki nilai rata-rata 66,3 s.d.11,6 (kisaran 40,0 - 93,3) yang meningkat bermakna menjadi rata-rata 78,5 s.d. 6,3 (kisaran 63,3 - 96,7) setelah diberikan edukasi kesehatan tentang cedera ankle dan terapi latihannya (p &lt;0.05, uji t-test berpasangan)Simpulan: Terdapat peningkatan pengetahuan anggota Medsoccer setelah pemberian edukasi kesehatan tentang cedera ankle dan terapi latihannya. Untuk itu sebelum memulai suatu olahraga, perlu diberikan pembekalan terkait cedera yang mungkin terjadi.

Effect of an educational booklet for prevention and treatment of foot musculoskeletal dysfunctions in people with diabetic neuropathy: the FOotCAre (FOCA) trial II, a study protocol of a randomized controlled trial

BackgroundThis study is a part of a series of two clinical trials. We consider diabetic polyneuropathy (DPN), a common chronic and progressive complication of diabetes mellitus that has several impacts on individuals’ foot health and quality of life. Based on the current trends of self-monitoring and self-care, providing a tool with foot-related exercises and educational care may help patients to avoid or reduce the musculoskeletal complications resulting from DPN, improving autonomous performance in daily living tasks. The aim of this trial is to evaluate the effects of an educational booklet for foot care and foot muscle strengthening on DPN symptoms and severity, clinical outcomes, and gait biomechanics in patients with DPN.Methods/designThe FOotCAre (FOCA) trial II study has been designed as a single-blind, two-parallel-arm randomized controlled trial. It will include 48 patients with DPN who will be randomly allocated to a control (recommended foot care by international consensus with no foot exercises) group or an intervention (foot-related exercises using an educational booklet three times/week at home for 8 weeks) group. Participants from both groups will be assessed at baseline, after 8 weeks, and at 16 weeks for follow-up. The primary outcomes are the DPN symptoms and severity, and the secondary outcomes are foot–ankle kinematics, gait kinetics, plantar pressure distribution during gait, tactile and vibratory sensitivities, foot strength, functional balance, and foot health and functionality.DiscussionThe booklet is a management tool that allows users to be autonomous in their treatment by choosing how and where to perform the exercises. This allows the patients to perform the exercises regularly as a continuous habit for foot care and health, which is an important element in the management of the diabetic foot. As the booklet focuses on specific foot–ankle exercises, we expect that it will improve the clinical aspects of DPN and produce beneficial biomechanical changes during gait, becoming a powerful self-management tool that can be easily implemented to improve the performance of daily living tasks.Trial registrationClinicalTrials.gov, NCT04008745. Registered on 2 July 2019.

\xb4Feet are second class citizens`: exploring the perceptions of Scottish and Portuguese older adults about feet, falls and exercise- a qualitative study

IntroductionFoot problems are likely to contribute to falls risk in older adults. Foot and ankle exercises may be beneficial, but uptake may be influenced by cultural factors. Few studies have explored the views of older adults from different cultural backgrounds about foot-specific falls risk factors, and foot and ankle falls prevention exercises.ObjectivesTo explore the views of Scottish and Portuguese community-dwelling older adults who have experienced a fall, about any foot risk factors for falls, and foot and ankle exercises.MethodsCross-cultural qualitative study with (n = 6) focus groups exploring the perceptions of Scottish (n = 10, mean age 76 yrs) and Portuguese older adults (n = 14, mean age 66 years) aged, applying thematic analysis.ResultsOne main theme `evolving awareness about feet and falls prevention´ and three subthemes; (i) Feet are often forgotten, (ii) the important role of footwear, (iii) need to look at my feet and do the exercises were identified. Scottish participants had more experience of falls prevention but there was a lack of knowledge surrounding foot-specific falls risk factors, and the role of ankle and foot exercise in the prevention of falls. Portuguese participants exhibited a fatalistic approach to falls.ConclusionsOlder adults from both nations had little knowledge of foot-specific falls risk factors, being initially unaware of the functional status of their feet and of the role of exercise in foot care and falls management. There were differences between national groups that should be accounted for when developing culturally adequate interventions.