Dorsiflexion Range Research Articles

To Determine the Effectiveness of Tibialis Posterior Strengthening along with Conventional Therapy on Ankle Dorsiflexion Range of Motion, Functional Status and Navicular Position in Patients with Plantar Fasciitis

Background: Plantar fasciitis is most common cause of heel pain. Plantar fasciitis is common inflammatorycondition of the plantar fascia and surrounding perifascial structure. Strengthening of tibialis posterior alongwith conventional therapy helps to improve functional status, ankle dorsiflexion range of motion and navicularposition.Method: 40 subjects with plantar fasciitis participated in the experiment study underwent treatment duration forfour weeks after giving their informed consent. They were evaluated and randomize into experimental groupreceiving tibialis posterior strengthening along with conventional therapy and control group receiving onlyconventional therapy. The pre and post values of ankle dorsiflexion range of motion, Navicular drop and FootFunction were recorded at start of the treatment and consequently after the end of treatment.Conclusion: Tibialis posterior strengthening along with conventional therapy were found to be more effectivein improving functional disability, ankle dorsiflexion ROM and Navicular drop values. Tibialis posteriorstrengthening shows better result in improving over pronation of foot, hence decreasing risk of plantar fasciitis.

Determinants of the Squatting Ability of Young Children: Its Relationships with the Age, Sex, Physique, and Ankle Dorsiflexion Range of Motion

〔目的〕幼児のしゃがみ込み動作の可否を調査し，動作の可否と年齢，性別，体格，足関節背屈可動域との関係について検討すること．〔対象と方法〕健常幼児166名を対象にしゃがみ込み動作の可否を調査した．動作の可否と年齢，性別，肥満度，足関節背屈可動域との関連を検討した．〔結果〕しゃがみ込み動作可能群は，加齢に伴い有意に増加した．また，女児の可能群の割合は，男児より有意に多かった．肥満度や足関節背屈可動域との関連は認められなかった．〔結語〕幼児のしゃがみ込み動作を規定する要因は体格や足関節背屈可動域だけでなく，加齢に伴って獲得する学習や経験の影響も推察された．

Evaluation of the Correlation Between Flamenco Dance and Ankle and Foot Posture.

The practice of flamenco dance involves great biomechanical demands, comparable with a high-performance sport. The technical movements of the footwork tap, the jumps, and the turns increase the prevalence of injuries and pathologic disorders of the foot and lower limb. Limited research has examined adaptation of the foot posture and dorsiflexion of the ankle in flamenco dancing. Therefore, the aim of this study was to evaluate whether the practice of flamenco dancing produces modifications in the ankle's dorsiflexion range of motion, Foot Posture Index, or pronation. A cross-sectional observational study with intentional sampling was performed with 26 individuals (52 feet) in two groups: professional female flamenco dancers (n = 13) and nondancers (n = 13). The participants were assessed in a single session for ankle dorsiflexion, foot pronation (navicular drop test), and foot posture (Foot Posture Index). Significant differences were found between the two groups for left foot Foot Posture Index (P = .007) and right foot navicular drop test (P = .006). The results of this study indicate that flamenco dancing can produce modifications in the Foot Posture Index and foot pronation versus nondancers. Further research is required.

COMPARISON OF ANKLE DORSIFLEXION IN CLOSED KINEMATIC CHAIN OF FOOTBALL PLAYERS AND ICE HOCKEY PLAYERS

Limitation in ankle dorsiflexion is associated with the development of injury to the musculoskeletal system. However, little is known about the impact of different sports disciplines on the dorsiflexion range of motion in the ankle joint. Therefore, the aim of the study is to compare the dorsiflexion range of motion of ice hockey players and football players. The sample included 26 professional football players with an average age of 22.46 (± 3.75). The control group included 37 professional ice hockey players with an average age of 24.62 (± 4.34). The range of motion of ankle dorsiflexion in closed kinematic chain was tested using a mobile phone application. The mean ankle dorsiflexion range of motion in football players was 41.40° (± 5.36) at the right ankle joint and 45° (± 5.91) at the left ankle joint. The mean ankle dorsiflexion range of motion in football players was 42.49° (± 6.92) in the right ankle joint and 45.92° (± 5.45) in the left ankle joint. The ranges of motion of the dorsiflexion of the right ankle (p<0.016) and the dorsiflexion of the left ankle (p – 0.031) ranges of motion in ice hockey players were significantly higher compared to football players. The average ankle dorsiflexion range of motion in the closed kinematic chain of ice hockey players was significantly higher compared to football players.

Association of Ankle Dorsiflexion and Landing Forces in Jumping Athletes.

Dorsiflexion range of motion restriction has been associated with patellar tendinopathy, but the mechanisms of how dorsiflexion restriction could contribute to knee overload remain unknown. Peak ankle dorsiflexion and ankle dorsiflexion excursion are negatively associated with peak vertical ground-reaction force (vGRF) and loading rate, and with peak patellar tendon force and loading rate, and positively associated with peak ankle plantar flexor moment. Cross-sectional study. Level 4. Kinematic and kinetic data of 26 healthy recreational jumping athletes were measured during a single-leg drop vertical jump. Pearson's correlation coefficients were calculated to establish the association between peak ankle dorsiflexion and ankle dorsiflexion excursion with peak vGRF and vGRF loading rate, with peak patellar tendon force and patellar tendon force loading rate, and with peak ankle plantar flexor moment. Ankle dorsiflexion excursion negatively correlated with peak vGRF loading rate (r = -0.49; P = 0.011) and positively correlated with peak ankle flexor plantar moment (r = 0.52; P = 0.006). In addition, there was a positive correlation between peak ankle dorsiflexion and peak vGRF (r = 0.39; P = 0.05). Ankle kinematics are associated with vGRF loading rate, ankle flexor plantar moment and peak vGRF influencing knee loads, but no association was observed between ankle kinematics and patellar tendon loads. These results suggest that increasing ankle dorsiflexion excursion may be an important strategy to reduce lower limb loads during landings but should not be viewed as the main factor for reducing patellar tendon force.

EFFECTS OF NEURODEVELOPMENTAL THERAPY ON FUNCTION AND MUSCLE ULTRASOUND PARAMETERS IN CHILDREN WITH CEREBRAL PALSY

Purpose: This study aimed to evaluate the effectiveness of neurodevelopmental therapy (NDT) for improving lower extremity functions, ankle dorsiflexion range of motion (ROM), popliteal angle, medial gastrocnemius (GCM) muscle thickness (MT), and functionality of lower extremity on children with hemiparetic Cerebral Palsy (CP).
 Methods: Eighteen children with hemiparetic CP aged between 6-15 years were included in the study. Structured NDT (s-NDT) was applied 40 minutes per session, three times a week over 12 weeks. Children were evaluated with Gross Motor Function Measurement-88 (GMFM-88) for motor function level; with goniometer for ankle dorsiflexion ROM and popliteal angle; with ultrasound for medial GCM MT, and with ultrasound Lower Extremity Function Test (LEFT) for the functionality of lower extremity. Children were evaluated before and after the intervention. 
 Results: After the treatment, statistically significant differences were obtained in mean values of GMFM-88, ankle dorsiflexion ROM, medial GCM MT, and LEFT (p0.05). 
 Conclusion: In conclusion, it was observed that s-NDT might be effective on motor function level, ankle dorsiflexion, medial GCM MT, and lower extremity functionality in children with hemiparetic CP. These improvements will make significant positive contributions to the mobility of children.

Comparison Between High- and Low-Intensity Static Stretching Training Program on Active and Passive Properties of Plantar Flexors.

The purpose of this study was to compare two static stretching (SS) training programs at high-intensity (HI-SS) and low-intensity (LI-SS) on passive and active properties of the plantar flexor muscles. Forty healthy young men were randomly allocated into three groups: HI-SS intervention group (n = 14), LI-SS intervention group (n = 13), and non-intervention control group (n = 13). An 11-point numerical scale (0–10; none to very painful stretching) was used to determine SS intensity. HI-SS and LI-SS stretched at 6–7 and 0–1 intensities, respectively, both in 3 sets of 60 s, 3×/week, for 4 weeks. Dorsiflexion range of motion (ROM), gastrocnemius muscle stiffness, muscle strength, drop jump height, and muscle architecture were assessed before and after SS training program. The HI-SS group improved more than LI-SS in ROM (40 vs. 15%) and decreased muscle stiffness (−57 vs. −24%), while no significant change was observed for muscle strength, drop jump height, and muscle architecture in both groups. The control group presented no significant change in any variable. Performing HI-SS is more effective than LI-SS for increasing ROM and decreasing muscle stiffness of plantar flexor muscles following a 4-week training period in young men. However, SS may not increase muscle strength or hypertrophy, regardless of the stretching discomfort intensity.

Effects of dry needling in gluteus medius muscle in individuals with chronic ankle instability: a randomized single-blinded controlled clinical trial

IntroductionBackground: Lateral ankle sprain (LAS) is the most common musculoskeletal injuries in sport and general population. The goal of the present study was to observe the effectiveness of dry needling (DN) in gluteus medius muscle in patients with chronic ankle instability (CAI).Material and methodsA two-arm (1:1), single-blinded (participants), randomized clinical trial was performed in 40 subjects with chronic ankle instability and were divided in two groups: intervention group who received one session of dry needling in the most hyperalgesic gluteus medius myofascial trigger point (MTrP), (n = 20) and control group (n = 20). Dynamic balance, pain intensity, pain pressure threshold (PPT) and ankle dorsiflexion range of motion (ROM) were assessed at baseline, post-intervention and a 1-week follow up.ResultsThe experimental group reported significant differences with respect to the control group for the anterior and medial dynamic balance (p = .001), PPT -ATL (p = .002) and ankle dorsiflexion ROM (p = .001).ConclusionsThe findings of the present study suggested that the DN in the most hyperalgesic MTrP of the Gmed muscle may increase the anterior and medial dynamic balance, ankle ROM and PPT-ATL at short-term in individuals with CAI. Pain intensity benefits were reported in both groups. Future studies should consider DN as a possible intervention in conjunction with a physical therapy program for individuals with CAI.

Inter and Intra Rater Reliability of Different Measurement Techniques of Weight Bearing Ankle Dorsiflexion Range of Motion

Background: Measurement of range of motion is a crucial parameter in the physiotherapeutic evaluation and follow up. Ankle dorsiflexion is important for functional activities like running, jogging, waking, stair climbing. Restricted ankle dorsiflexion is seen in various lower limb injuries. Therefore, assessment of dorsiflexion is important to assess function. Goniometer, tape measure, mobile goniometer, inclinometer is used to measure ankle dorsiflexion range of motion in weight bearing and non-weight bearing positions. Weight bearing dorsiflexion has reported higher intra and inter-rater reliability as compared to non-weight bearing ankle dorsiflexion. All these measures may be taken by the same and by different therapists in the management of one patient. Therefore, it is necessary to determine if the measurements used are reliable both within and between the therapists. Material and Methods: 50 healthy subjects were recruited and their role was explained in the study. Written consent was taken from all the subjects. Weight bearing lunge was done in which the subject was asked to stand with the heel in contact with the ground and the great toe 10 cm away from the wall and the knee touching the wall. Inclinometer, standard goniometer, mobile goniometer and tape measure were administered to check for ankle dorsifexion range of motion. Results: ICC for inter rater reliability was almost perfect for tape measure and goniometer (0.968 and 0.837 respectively) and it was substantial for inclinometer and mobile goniometer (0.746 and 0.796 respectively). ICC for intra rater reliability was almost perfect for tape measure, inclinometer and goniometer (0.965,0.894 and 0.837 respectively) and it was substantial for mobile goniometer (0.802). Conclusion: The inter-rater reliability of tape measure, goniometer is almost perfect and for mobile goniometer, inclinometer is substantial. The intra rater reliability of tape measure, inclinometer, goniometer is almost perfect and mobile goniometer is substantial. KEY WORDS: Dorsiflexion, Mobile goniometer, Tape measure, Goniometer, Inclinometer, Reliability.

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.

Foot kinematics and leg muscle activation patterns are altered in those with limited ankle dorsiflexion range of motion during incline walking

BackgroundLarger ankle dorsiflexion (DF) is required when walking on inclined surfaces. Individuals with limited DF range of motion (ROM) may experience greater tissue stress on sloped surfaces and walk in altered gait patterns compared to the those with normal DF ROM. Research questionWould the individuals with limited DF ROM walk with distinctive ankle DF patterns compared to those with normal DF ROM on the inclined surfaces? MethodsTen Limited DF ROM (passive ROM=35.3 ± 2.7°) and nine Normal DF ROM (passive ROM=46.4 ± 4.2°) participants walked on a treadmill at five slope angles (0°, 5°, 10°, 15°, 20°) for 2 min at a self-selected speed. The peak DF angles and the peak myoelectric activity levels of the tibialis anterior (TA) and soleus (SOL) muscles were quantified during the swing and stance phases of each walking trial, and they were compared between the two groups. ResultsParticipants with limited DF ROM walked with smaller peak DF (3.1° at 0° slope ~ 8.4° at 20° slope) and greater peak TA activity in swing than those of the Normal ROM participants (3.4° ~ 12.2°), with significant differences at 20° slope. The peak DF angle in stance (Limited: 9.6° ~ 19.0°; Normal: 10.1° ~ 21.0°) did not differ between the two groups at all slopes, but the peak activity of the SOL muscle was significantly greater for the Limited group at slopes of 10° and higher. SignificanceStudy results indicate that incline walking could be more challenging to the individuals with limited DF ROM as they need to approach and push-off the sloped surfaces with more efforts of the dorsiflexor and the plantar flexor muscles, respectively. Prolonged walking on inclined surfaces may produce faster development of muscle fatigue or tissue damage than those with normal DF ROM.

Post-activation performance enhancement after inclusion of opponent versus no opponent during isoinertial crossover step exercise: A randomized crossover trial

This study sought to determine whether the inclusion of an opponent on an isoinertial crossover step task influenced the post-activation response and power production. Twenty adult male team-sports athletes participated in a randomized crossover trial. We used a novel design in which the performance of an isoinertial flywheel exercise was tested with or without the inclusion of sport-specific constraints (inclusion of an opponent vs. no opponent) in one of the two sequences (sequence one: constraint manipulation followed by no constraint manipulation; and sequence two: no constraint manipulation followed by constraint manipulation). Maximal power was recorded during exercise; then the coefficient of variation of maximal power was estimated. Post-activation responses were measured using unilateral jump height and change-of-direction time. Also, ankle dorsiflexion range of motion was measured. The use of an isoinertial flywheel resulted in improved ankle dorsiflexion and the capacity to repeat change-of-direction. Furthermore, the inclusion of an opponent was associated with a higher variability of the power output in the concentric phase of the movement. Importantly, performing the crossover step task in front of an opponent was also linked to a positive correlation between unilateral countermovement jump and power output. We conclude that the inclusion of typical constraints of the performance environment may have induced movement adaptations to accommodate the unpredictability associated with the actions of the opponent.

Does Self-Myofascial Release Cause a Remote Hamstring Stretching Effect Based on Myofascial Chains? A Randomized Controlled Trial.

Background: The hamstring muscles are described as forming part of myofascial chains or meridians, and the superficial back line (SBL) is one such chain. Good hamstring flexibility is fundamental to sporting performance and is associated with prevention of injuries of these muscles. The aim of this study was to measure the effect of self-myofascial release (SMR) on hamstring flexibility and determine which segment of the SBL resulted in the greatest increase in flexibility. Methods: 94 volunteers were randomly assigned to a control group or to one of the five intervention groups. In the intervention groups, SMR was applied to one of the five segments of the SBL (plantar fascia, posterior part of the sural fascia, posterior part of the crural fascia, lumbar fascia or epicranial aponeurosis) for 10 min. The analyzed variables were hamstring flexibility at 30 s, 2, 5, and 10 min, and dorsiflexion range of motion before and after the intervention. Results: Hamstring flexibility and ankle dorsiflexion improved when SMR was performed on any of the SBL segments. The segments with the greatest effect were the posterior part of the sural fascia when the intervention was brief (30 s to 2 min) or the posterior part of the crural fascia when the intervention was longer (5 or 10 min). In general, 50% of the flexibility gain was obtained during the first 2 min of SMR. Conclusions: The SBL may be considered a functional structure, and SMR to any of the segments can improve hamstring flexibility and ankle dorsiflexion.

Comparison of manual therapy techniques on ankle dorsiflexion range of motion and dynamic single leg balance in collegiate athletes

Introduction/purposeLiterature consistently identifies two key examination components when managing ankle/foot pathologies: 1) dorsiflexion range of motion (DFROM) and 2) single limb balance. Mobilizations with movement (MWM) and Instrument-Assisted Soft Tissue (IASTM) are two emerging manual therapy (MT) options in the management of ankle/foot conditions. Methodology/sampleIn this observational cohort study, 147 subjects were randomized in a block fashion as follows: 1) Control, 2) IASTM, 3) MWM, and 4) Combination of both MT interventions. Descriptive statistics of the sample were conducted with integrity checks followed by comparative analysis for mean change between the variables or DFROM and YBTLQ ™ performance. ResultsANOVA Welch's F indicated significant differences between the treatment conditions (Welch's F (3,75.669) = 4.533, p = .006). Games-Howell post hoc tests indicated significantly more change in DFROM in the IASTM (p = .043) and CKCMOB (p = .026) conditions when they were administered as single treatments, than in the Control Condition or when the treatments were combined. Dynamic balance, as measured by the YBT-LQ™, did not yield a significant response based on the intervention arm. Discussion/clinical relevanceSpecifically, IASTM or closed kinetic chain (CKC) MWM MT techniques used in isolation can be considered a cost-effective intervention that can be administered by a skilled MT practitioner in a “low risk-high reward” clinical scenario with potential biomechanical and neurophysiological benefits for improving CKCDFROM.

Gastrocnemius Release in the Management of Chronic Plantar Fasciitis: A Systematic Review.

Background:This systematic review aims to summarize the outcomes of gastrocnemius recession in the treatment of plantar fasciitis.Methods:A systematic review was performed according to PRISMA guidelines using the PubMed, Embase, Emcare, Web of Science, Scopus, and CINAHL databases. A 2-stage title/abstract and full text screening process was performed independently by 2 reviewers. Randomized controlled trials, cohort, and case-control studies reporting the results of gastrocnemius recession in patients with plantar fasciitis were included. The MINORS and Joanna Briggs Institute Criteria were used to assess study quality and risk of bias.Results:A total of 285 articles were identified, with 6 of these studies comprising 118 patients being ultimately included. Significant postoperative improvement in American Orthopaedic Foot & Ankle Society, visual analog scale, 36-Item Short Form Health Survey, Foot Forum Index, and Foot and Ankle Ability Measure scores were reported. Included studies also described an increase in ankle dorsiflexion range of motion and plantarflexion power. An overall pooled complication rate of 8.5% was seen, with persistent postoperative pain accounting for the most common reported complication. Gastrocnemius recession is associated with greater postoperative improvement than plantar fasciotomy and conservative stretching exercises.Conclusion:The current evidence demonstrates that gastrocnemius recession is effective in the management of plantar fasciitis, specifically in patients with gastrocnemius contracture who do not respond to conservative treatment.Level of Evidence:Level III, Systematic review of level I-III studies.

Influence of Weight Bearing Dorsiflexion (WBDF) on Ankle Injury History Among Semi-professional Recreational Basketball Players

Ankle injuries are one of the most common occurrences in the field of sports. Weight bearing dorsiflexion range can be an effecting factor in ankle injuries. Weight bearing lunge test is used to assess weight bearing dorsiflexion. By using this test as a standard testing protocol, it is possible to minimize development of further sport related ankle injuries. But this test for basketball players with ankle injuries has not been studied yet. The current study will aim to examine the weight bearing dorsiflexion of basketball players related to their gender, ankle injury history and leg dominance. A quasi-experimental design study was conducted. Thirty-four (34) participants were recruited and initially and two (2) were excluded. 18 participants were male and 14 were female basketball players in Colombo Blues and Kotelawala Defence University basketball teams. The average of age of the sample was 21.8 years. Demographic data, information about training time, injury history of the participants was obtained using an interview administered assessment form. The Weight Bearing Dorsiflexion was measured using digital inclinometer. Findings indicated that the weight bearing dorsiflexion range is smaller than that of males (p>0.05). There was a significant difference in weight bearing dorsiflexion and ankle injury history (p<0.01) among players. Significant differences were seen in influence in leg dominance to weight bearing dorsiflexion (p<0.05). This is the first study that is investigated weight bearing dorsiflexion among basketball players in Sri Lanka. No significant difference was found between gender and weight bearing dorsiflexion. A significant difference was determined between ankle injury history and weight bearing dorsiflexion. Furthermore, a significant difference was found in leg dominance and weight bearing dorsiflexion.

대학야구선수의 Y Balance Test와 하지 가동성의 관계

The purpose of this study is to present the Y Balance Test (YBT) profile of college baseball players and determine the relationship between YBT and ankle and hip mobility. The subjects of this study were 27 college baseball players. The dynamic balance ability of the lower extremities was measured using the YBT Kit. Ankle mobility was measured using the modified weight bearing lunge test(WBLT) and the non-weight bearing dorsiflexion(NWBD) range of motion(ROM) test. Hip mobility was measured for flexion and extension ROM. ROM was measured with passive ROM using a goniometer. The dynamic balance and mobility of the left and right lower extremities were compared using the paired-T test. The relationship between dynamic balance and mobility of the lower extremities was analyzed using Pearson’s correlation. The YBT results of college baseball players showed no significant difference between left and right(p＞.05). The lower extremity mobility of college baseball players was significant only in the NWBD ROM of the ankle(p=.012), and other variables were not significantly different(p＞.05). YBT right anterior reach had a significant correlation with WBLT right(r=.628, p=.000) and WBLT left(r=.507, p=.007). YBT left anterior reach had a significant correlation with WBLT right(r=.807, p=.000) and WBLT left(r=.691, p=.000). In addition, the YBT left posteromedial reach had a significant correlation with the right hip extension ROM(r=.394, p=.046). However, there was no significant correlation with other variables(p＞.05). Overall, the decrease in ankle mobility of college baseball players is related to the decrease in dynamic balance ability. In particular, the decrease in dorsiflexion mobility of the ankle in the weight-bearing lower extremity is related to the limitation of the anterior reach motion of the non-weight-bearing lower extremity. Therefore, it is recommended that college baseball players regularly evaluate their ankle mobility to improve dynamic balance ability and prevent injuries.

Proprioceptive Neuromuscular Facilitation Kinesio Taping Improves Range of Motion of Ankle Dorsiflexion and Balance Ability in Chronic Stroke Patients.

This study aimed to determine the effect of a proprioceptive neuromuscular facilitation (PNF) pattern Kinesio taping (KT) application on the ankle dorsiflexion range of motion (DF-ROM) and balance ability in patients with chronic stroke. This crossover study included 18 patients with stroke. The subjects were randomly assigned to three interventions: barefoot, ankle KT (A-KT), and PNF-KT. The A-KT was applied to the gastrocnemius and tibialis anterior (TA) muscles, and subtalar eversion. The PNF-KT was applied on the extensor hallucis, extensor digitorum, and TA muscles. DR-ROM was measured using the iSen™, a wearable sensor. Balance ability was assessed based on static balance, measured by the Biodex Balance System (BBS), and dynamic balance, measured by the timed up and go (TUG) test and dynamic gait index (DGI). Compared with the barefoot and A-KT interventions, PNF-KT showed significant improvements in the ankle DF-ROM and BBS scores, TUG, and DGI. PNF-KT, for functional muscle synergy, improved the ankle DF-ROM and balance ability in patients with chronic stroke. Therefore, the application of PNF-KT may be a feasible therapeutic method for improving ankle movement and balance in patients with chronic stroke. Additional research is recommended to identify the long-term effects of the PNF-KT.

The Ankle Lunge Test for measurement of dorsiflexion in individuals following stroke; reliability, validity and evaluation of change following intervention for spasticity of the lower limb.

The Ankle Lunge Test (ALT) is a reliable method of measuring weight bearing ankle dorsiflexion range, a key component of gait, in healthy ankles and a range of musculoskeletal conditions. The aim of this study is to evaluate the reliability and concurrent validity of the ALT in people with stroke and investigate whether change in ALT is observed following treatment of spasticity with Botulinum Toxin. Repeated Measure Design: Forty stroke survivors were recruited for reliability testing. Twenty three stroke survivors were evaluated with the ALT before and after treatment of the lower limb with Botulinum Toxin. Measurement with the ALT was performed for all participants. For the reliability group, two physiotherapists evaluated the ALT on Day 1 and one therapist re-evaluated the ALT one to 5days later. For the change evaluation group, the ALT was tested prior to and six to eight weeks after intervention. Other measures evaluated were velocity, the Functional Ambulation Category, Timed Up and Go and the Modified Tardieu Scale. Intra-rater, inter-rater and test-retest reliability yielded intra-class correlation coefficients at or above 0.92. Moderate correlations were found between the ALT and velocity r=0.605 (p<0.01), the Timed Up and Go r=-0.598 (p<0.01) and the Functional Ambulation Category r=0.380 (p<0.05). Following intervention with Botulinum Toxin, there was significant (p<0.02) improvement in the ALT; pre-median 20mm (IQR -25 to 35) to post-median 21mm (IQR 0 to 40) and the Timed Up and Go; pre-median 21.40s (IQR 13.43 to 28.82) to post-median 20.08s (IQR 14.06 to 28.47). The ALT is a reliable and valid measure which may be applied in clinical practice to evaluate change in weight bearing ankle dorsiflexion in people with stroke.

Stability boots for the treatment of Achilles tendon injuries: Gait analysis of healthy participants

BackgroundAchilles tendon injuries are commonly treated with stability boots that secure the ankle at a specific position and aim to reduce loading of the tendon. These boots allow full weight bearing by limiting the range of movement. It is, however, unknown, to what extent these boots can reduce tendon loading and if the biomechanics are altered during walking. Research questionHow do orthopedic boots influence lower extremity biomechanics during walking? MethodsFor this cross-sectional study, ten healthy participants walked with three orthopedic boots (Oped Vacoped, Kuenzli Ortho Rehab Absolut, Orthotech Variostabil) commonly used to treat Achilles tendon injuries. Kinematics and kinetics of the lower extremity of the booted leg and spatiotemporal parameters of both sides were collected using motion-capturing system and dynamometry. Each boot was tested in the maximally plantarflexed position. Group differences between boot conditions were analyzed by means of repeated-measures ANOVA and post-hoc paired t-test. ResultsThe boot dorsiflexion range of motion differed significantly between boots with Vacoped (1.8° (0.3)) showing the smallest range, followed by Kuenzli (5.0° (1.3)) and Orthotech (7.9° (1.7)). Orthotech displayed a higher peak plantarflexion moment (1.36 Nm/kg (0.09)) than both Kuenzli (1.06 Nm/kg (0.12)) and Vacoped (1.04 Nm/kg (0.14)). Concerning loading over time, significant differences in the plantarflexion impulse were found, with the highest impulse in Vacoped (0.42 Nms/kg (0.06)), followed by Orthotech (0.29 Nms/kg (0.03)) and Kuenzli (0.25 Nms/kg (0.05)). In addition, asymmetries were seen in stance and step length for the booted and contralateral sides. SignificanceThe lower extremity biomechanics were affected by the boots, with Kuenzli showing the lowest joint loading, Vacoped the smallest joint motion and Orthotech the most natural gait pattern. Future research is needed to determine the most relevant variable expressing the risk of re-rupture of the Achilles tendon in order to conclude which boot may be most favorable to use in clinical practice.