Flexion Force Research Articles

Alteration of the calf strength by heel cord lengthening, gastrocnemius recession through tenotomy or fasciotomy. A retrospective clinical force analysis before and after surgery

BackgroundIndications for surgical corrections about the Achilles tendon are increasing as additional measures in reconstructive interventions about the foot. These indications include shortened gastrocnemii, which cause a so-called ‘functional pes equinus’ and secondary forefoot imbalances, as well as corrections of pes planus and cavus. Surgery about the heel cord may also be indicated for achillodynia and diabetic pressure ulcers. However, there is a lack of evidence that quantifies the results of lengthening procedures about the heel cord. The aim of this study was to quantify the exact changes in calf strength one year after elongating the triceps surae, by measuring flexion forces in 90 degrees knee flexion and knee extension. MethodsThis study involves 69 patients who were examined for calf strength preoperatively and 1 year after gastrocnemius release. A new device, the Leonardo Mechanograph® (Novotec Medical) was used to measure calf strength. Measurements were performed with the knee flexed and extended. ResultsThe operated leg had an overall statistically significant reduction in strength after surgery. Changes were similar on the contralateral leg. The difference in force reduction between the operated and non-operated leg was not statistically significant ConclusionA correlation between measured plantar flexion forces of the foot after a reconstructive foot operation with or without a lengthening procedure about the calf musculature could not be established. Level of evidenceLevel III: retrospective cohort study.

Sex-related differences in gait characteristics and their associations with symptoms in individuals with patellofemoral osteoarthritis

BackgroundPatellofemoral osteoarthritis (OA) is an important subgroup of knee OA. However, the influence of sex on gait characteristics in patients with patellofemoral OA is unknown. Research questionCompare gait characteristics in females and males with patellofemoral OA and investigate their associations with patellofemoral joint-related symptoms and limitations. MethodsMixed effects polynomial regression models compared knee flexion-extension and adduction moments, knee flexion angles, and vertical ground reaction forces over 100% of stance between 26 females and 22 males with patellofemoral OA, with and without adjustment for walking speed and body mass. Multivariable linear regression models were then used to investigate the associations of gait characteristics with symptoms and limitations measured with the Knee injury and Osteoarthritis Outcome Score Patellofemoral Pain and Osteoarthritis (KOOS-PF) Subscale. Models included a sex-by-gait interaction term, and if significant, separate models were built for females and males. ResultsWhile controlling for walking speed and body mass, females had lower knee flexion moment (6–19% and 97–100% of stance), knee extension moment (45–86% of stance), knee adduction moment (3–37% and 69–99% of stance), vertical ground reaction force (1–97% of stance) and knee flexion angle (90–100% of stance) compared with males, when fitted over 100% of stance. Lower cadence, lower knee flexion angular impulse, and higher peak knee flexion angle were associated with worse KOOS-PF scores. Associations were not modified by sex. SignificanceThere are distinct sex-based differences in gait characteristics throughout stance with patellofemoral OA when adjusting for body mass and walking speed. Lower cadence and knee flexion angular impulse, and higher peak knee flexion angle were associated with more extreme patellofemoral joint-related symptoms and limitations.

A powered simple walking model explains the decline in propulsive force and hip flexion torque compensation in human gait

Excessive hip flexion torque to prioritize leg swings in the elderly is likely to be a factor that reduces their propulsive force and gait stability, but the mechanism is not clear. To understand the mechanism, we investigated how propulsive force, hip flexion torque, and margin of stability (MoS) change when only the hip spring stiffness is increased without changing the walking speed in the simple walking model, and verified whether the relationship holds in human walking. The results showed that at walking speeds between 0.50 and 1.75 m/s, increasing hip spring stiffness increased hip flexion torque and decreased the propulsive force and MoS in both the model and human walking. Furthermore, it was found that the increase in hip flexion torque was explained by the increase in spring stiffness, and the decreases in the propulsive force and MoS were explained by the increase in step frequency associated with the increase in spring stiffness. Therefore, the increase in hip flexion torque likely decreased the propulsive force and MoS, and this mechanism was explained by the intervening hip spring stiffness. Our findings may help in the control design of walking assistance devices, and in improving our understanding of elderly walking strategies.

Student Competition (Technology Innovation) ID 1985239

Background Deep vein thrombosis (DVT) is a blood clot that forms in the deep veins and is the third most common cardiovascular disease today. One of the causes of DVT is venous stasis. Current methods of DVT prevention include anticoagulants and mechanical prophylaxis. Anticoagulant use is contraindicated in individuals with bleeding risks and mechanical interventions are often cumbersome and uncomfortable. Objective The overall goal of this project is to investigate a novel method for DVT prevention, termed intermittent electrical stimulation (IES). The current study investigated the effects of IES on healthy typical as well as post-stroke persons. Method Of the 32 participants, 22 were healthy subjects from Edmonton, and 10 were inpatient post-stroke subjects at the Glenrose Rehabilitation Hospital, Edmonton. A two-channel stimulator was used to administer IES through electrodes placed on the posterior and anterior sides of the leg and was applied in increasing stimulation amplitudes to the gastrocnemius muscle and the resulting plantar flexion force and changes in popliteal and femoral venous velocities were recorded for each stimulation respectively using B-mode ultrasound. Results IES-induced contractions produced significant increases in venous flow compared to baseline. Small contractions induced by comfortable levels of stimulation in typical and in post-stroke persons were sufficient to increase flow in the popliteal and femoral veins. Conclusion The results indicate that IES can sufficiently increase venous flow to prevent venous stasis and is comfortable for end users. Incorporation of IES into a clinical device could provide a feasible and effective alternative for DVT prophylaxis.

Force capacity of trunk muscle extension and flexion in healthy inactive, endurance and strength-trained subjects—a pilot study

Recreational sports are becoming increasingly important in overcoming the drawbacks of our modern sedentary lifestyle. We wanted to know whether ambitious strength or endurance training has a systematic effect on the maximum strength capacity of the trunk muscles compared to no sport at all. We investigated two groups of physically active men who practised either endurance (ET; cycling and triathlon, n = 13) or strength training (ST; power lifting, n = 13), and a group of healthy physically inactive men (control [C], n = 12). Training intensity was at competition level in both active groups. All participants performed isometric maximum voluntary contractions in flexion and extension direction. Independent of force direction maximum torque levels were highest for the ST group (p < 0.001 vs. ET and C), but after normalizing to the subject’s upper body weight these differences decreased, together with a drop in significance levels (extension: p < 0.01 vs. C; flexion: p < 0.05 vs. ET; p < 0.01 vs. C). With respect to the ratio between extension and flexion maximum forces due to the small group size no systematic differences could be detected between the groups, but effect sizes imply relevant effects (ET vs. ST: d = 0.588, ST vs C: d = −0.811). The results of this pilot study indicate that ST show higher functional force capacity values for flexion compared to the other groups. For extension, ST and ET did not differ. These results imply relevant differences for the extension to flexion force ratio.

The influence of patellar height on patellofemoral contact force during total knee arthroplasty

PurposeResidual anterior knee pain following total knee arthroplasty was reported to be related to high patellofemoral contact force. This study tried to show the relationship between patellar height and patellofemoral contact force in vivo, which has been demonstrated only in vitro thus far. MethodsFifty-five patients who had undergone a primary mobile-bearing posterior-stabilized total knee arthroplasty (28 cases using PFC Sigma and 27 cases using Attune) were included. After all the trial prostheses were placed, the patellar contact forces on the medial and lateral sides were measured using specially designed two uniaxial ultrathin force transducers at 0°–135° of knee flexion guided by the navigation system. Correlations between the pre-operative Insall-Salvati index and the medial or lateral patellar contact force in each flexion angle were analyzed using linear regression. Correlations between each patellar contact force and postoperative flexion angle were also assessed. ResultThere was a positive correlation between Insall-Salvati index and the lateral patellar contact force at 135° of flexion in all the patients, at 120° and 135° of flexion in patients with PFC Sigma and 135° of flexion in patients with Attune. The lateral patellar contact force at 120° and 135° of flexion in patients with PFC Sigma inversely correlated with postoperative flexion angle. ConclusionsPatients with patella alta tended to demonstrate high lateral patellar contact force in deep knee flexion after total knee arthroplasty, which can affect the post operative flexion angle and should be treated to prevent residual anterior knee pain.

Reference Values for Cervical Muscle Strength in Healthy Women Using a Hand-Held Dynamometer and the Association with Age and Anthropometric Variables.

Knowledge of reference values for cervical muscle strength is a key tool for clinicians to use as a clinical reference measure and to establish goals during rehabilitation. The objective was to establish reference values for the maximal strength of cervical muscles in healthy women using a handheld dynamometer and verify the association of cervical muscle strength with age and anthropometric measurements. A hundred women were classified into four groups (n = 25) according to age: 18-29 years, 30-39 years, 40-49 years, and 50-60 years. Maximal muscle strength of the cervical spine was measured using a Lafayette® handheld dynamometer for flexion, extension, and bilateral lateral flexion. No differences in cervical muscle strength were observed among the groups (p > 0.05). However, the 18-29-year-old group took less time to reach the peak of force for flexion than the 50-60-year-old group. Moderate correlations were observed between cervical flexor strength and weight, body mass index, and neck circumference, and between cervical extensor strength and weight and body mass index (r = 0.43-0.55; p < 0.05). Reference values for cervical muscle strength in healthy women were established using a handheld dynamometer, and the association between muscle strength and anthropometric data was moderate.

Concurrent Prediction of Dexterous Finger Flexion and Extension Force via Deep Forest.

Neuromuscular injuries can impair hand function and profoundly impacting the quality of life. This has motivated the development of advanced assistive robotic hands. However, the current neural decoder systems are limited in their ability to provide dexterous control of these robotic hands. In this study, we propose a novel method for predicting the extension and flexion force of three individual fingers concurrently using high-density electromyogram (HD-EMG) signals. Our method employs two deep forest models, the flexor decoder and the extensor decoder, to extract relevant representations from the EMG amplitude features. The outputs of the two decoders are integrated through linear regression to predict the forces of the three fingers. The proposed method was evaluated on data from three subjects and the results showed that it consistently outperforms the conventional EMG amplitude-based approach in terms of prediction error and robustness across both target and non-target fingers. This work presents a promising neural decoding approach for intuitive and dexterous control of the fingertip forces of assistive robotic hands.

Mathematical model of knee joint degenerative dystrophic changes formation in its flexion contracture at late stages of rheumatoid arthritis

Background. Rheumatoid arthritis (RA) is an immunomodulatory, chronic inflammatory disease accompanied by the proliferation and articular cartilage destruction that cause disability. Biomechanical factors in RA can play an important role in the onset and progress of the joint degenerative processes, secondary to the inflammation process. The biomechanical factors in RA can play an essential role in the start and progress of the degenerative processes within the joint that are secondary to the inflammatory process. Materials and methods. A solid simulation 3D-model of the knee joint was created that contained both tibia and fibula, the femur bone, femoral condyle cartilage and tibial plateau cartilage, menisci. It was done for further analytical calculations and finite element modeling calculations. Analytical calculations are based on the data of previous studies of quantitative evaluation of the knee joint contracture (compliance of contracture to the external corrective action) and on calculations data of the joint forces that manifest in ambulation of the patient with RA. Results. The created simulation computer 3D-model of a knee joint with its flexion contracture at late stages of RA shows that the forced passive flexion in the knee joint to 6°, the load on the condyles of the tibial plateau increased by 12.8 %, and as a result of forced passive flexion in the knee joint to 3°, the load on the condyles of the tibial plateau increased by 95.2 %, which is critical and may cause degradation of the bone tissue in the contact area. Conclusions. Increase of load on the lateral areas of the tibial plateau and, correspondingly, the tensions on the contact areas of the femur bone condyles with the tibial plateau, may contribute to the progress of the clinical picture of RA with the increase of arthrofibrosis and osteoarthritis events, particularly in the lateral areas of the knee joint.

Assessment of jaw muscles and cervical spine muscles isometric force using a hand-held dynamometer in young adults

Our study aims to investigate the jaw and cervical spine muscle isometric forces in healthy young adults. Fifty-four subjects (21.2 ± 4.82 years) met the inclusion criteria and agreed to par-ticipate in the study. Muscle forces were assessed with a hand-held dynamometer. A significant positive correlation was found between jaw opening forces and cervical flexors forces (r=0.62, p0.0001) and between lateral mandible deviation forces and cervical spine lateral flexion forces, both for right and left side (r=0.65, p&lt;0.0001; r=0.69, p&lt;0.0001, respectively. In healthy young adults, using a hand-held dynamometer for muscle strength testing, significant positive correla-tion was found between jaw opening forces and cervical flexors forces and between lateral mo-uth deviation force and cervical spine lateral flexion forces, both for right and left side. The rela-tionship between jaw muscles forces and cervical spine muscles forces is a topic that needs to be further studied, also together with posture and balance.

Total hip arthroplasty monobloc stem neck rupture in patient with massive heterotopic ossifications: a case report and literature review.

Fractures of the femoral stem neck are a rare complication in hip prosthetic surgery, especially in non-modular components. The authors report a case associated with massive heterotopic ossifications, with the purpose to analyze risk factors and specific characteristics. A case of femoral monobloc stem neck rupture is described. A non-systematic literature review regarding risk factors for femoral stem neck fracture was conducted in the PubMed database. We report the case of a 61-year-old male who underwent surgery to remove calcifications four years after THA. Four months later the patient reported acute pain in the left hip, arising after a combined movement of external rotation and axial load while standing on the left foot, in the absence of any prodromic symptom. On radiographs, a displaced fracture of the neck of the hip prosthesis was revealed, together with massive heterotopic ossifications. After THA revision the patient's symptoms were resolved. Prosthetic femoral neck fractures are a rare complication. We suggest that this case represents a unique type of fatigue rupture, where neck length and the presence of massive heterotopic calcifications contributed to flexion forces, resulting in failure in the midpoint of the neck.

Acute intermittent hypoxia enhances strength, and modulates spatial distribution of muscle activation in persons with chronic incomplete spinal cord injury

Acute intermittent hypoxia (AIH) is an emerging technique for facilitating neural plasticity in individuals with chronic incomplete spinal cord injury (iSCI). A single sequence of AIH enhances hand grip strength and ankle plantarflexion torque, but underlying mechanisms are not yet clear. We sought to examine how AIH-induced changes in magnitude and spatial distribution of the electromyogram (EMG) of the biceps and triceps brachii contributes to improved strength. Seven individuals with iSCI visited the laboratory on two occasions, and received either AIH or Sham AIH intervention in a randomized order. AIH consisted of 15 brief (∼60s) periods of low oxygen (fraction of inspired O2 = 0.09) alternating with 60s of normoxia, whereas Sham AIH consisted of repeated exposures to normoxic air. High-density surface EMG of biceps and triceps brachii was recorded during maximal elbow flexion and extension. We then generated spatial maps which distinguished active muscle regions prior to and 60 min after AIH or Sham AIH. After an AIH sequence, elbow flexion and extension forces increased by 91.7 ± 88.4% and 51.7 ± 57.8% from baseline, respectively, whereas there was no difference after Sham AIH. Changes in strength were associated with an altered spatial distribution of EMG and increased root mean squared EMG amplitude in both biceps and triceps brachii muscles. These data suggest that altered motor unit activation profiles may underlie improved volitional strength after a single dose of AIH and warrant further investigation using single motor unit analysis techniques to further elucidate mechanisms of AIH-induced plasticity.

Lower Patellofemoral Joint Contact Force During Side-Step Cutting After Return-to-Sports Clearance Following Anterior Cruciate Ligament Reconstruction

Background: Low patellofemoral joint (PFJ) contact force has been associated with PFJ osteoarthritis. Quadriceps force and knee flexion angles, which are typically altered after an anterior cruciate ligament reconstruction (ACLR), primarily influence PFJ contact forces. It is still inconclusive whether differences in PFJ contact forces are present during high knee flexion tasks such as side-step cutting after clearance to return to sports (RTS) after ACLR. Purpose: To explore PFJ contact forces in the ACLR limb and compare them with those of the contralateral and control limbs during side-step cutting tasks after clearance to RTS. Study Design: Controlled laboratory study. Methods: A total of 26 male athletes with ACLR who were previously cleared to RTS were matched with 23 healthy men serving as the control group. Three-dimensional motion capture and force plate data were collected while both groups performed anticipated side-step cutting tasks. Joint kinematics, kinetics, muscle forces, and PFJ contact forces were calculated using musculoskeletal modeling. Results: Peak PFJ force was lower in the ACLR limbs compared with the contralateral limbs (mean difference [MD], 5.89 body weight [BW]; 95% CI, 4.7-7.1 BW; P < .001) and the control limbs (MD, 4.44 BW; 95% CI, 2.1-6.8 BW; P < .001). During peak PFJ force, knee flexion angle was lower in ACLR limbs compared with the contralateral (MD, 4.88°; 95% CI, 3.0°-6.7°; P < .001) and control (MD, 6.01°; 95% CI, 2.0°-10.0°; P < .002) limbs. A lower quadriceps force compared with the contralateral (MD, 4.14 BW; 95% CI, 3.4-4.9 BW; P < .001) and control (MD, 2.83 BW; 95% CI, 1.4-4.3 BW; P < .001) limbs was also found. Conclusion: Lower PFJ contact forces and a combination of quadriceps force deficits and smaller knee flexion angle were found in the ACLR compared with the contralateral and control limbs even after clearance to RTS. Clinical Relevance: Despite rehabilitation and subsequent clearance to RTS, differences in PFJ contact forces are present after ACLR. Current rehabilitation and RTS battery may not be effective and sensitive enough to identify and address these differences.

The Relationship of Anthropometric and Physical Performance Characteristics on Competitive Success in Amateur, Elite, and Professional Rodeo Athletes.

Oranchuk, DJ, Gullett, LK, Kicia, M, Thome, B, and Game, A. The relationship of anthropometric and physical performance characteristics on competitive success in amateur, elite, and professional rodeo athletes. J Strength Cond Res 37(7): 1495-1506, 2023-Reference anthropometric and physical performance qualities can improve understanding of sporting needs and streamline preparation and rehabilitation programs. However, these data and their relationships with competitive success are absent in rodeo athletes. We hypothesized that riding performance would be most correlated with hip adductor, neck, and grip strength, whereas jump, reactive strength index (RSI), and change of direction abilities would best predict bull-fighting performance. Forty-three amateur ( n = 9), professional ( n = 23), or internationally ranked ( n = 11) male rodeo athletes (bareback = 9, bull riders = 16, saddle bronc = 7, bullfighters = 11) (26.8 ± 5.6 years) volunteered for this study. Anthropometrics included body mass, height, and body fat percentage. Performance measures included isometric hip adduction and abduction, neck flexion and extension, handgrip strength, squat and countermovement jump heights, eccentric utilization ratio, reactive strength index, change of direction, bike sprints, and several pneumatic power measures. Bullfighters were taller and heavier than bull riders (effect size [ES] = 0.84-0.87, p = 0.008-0.017). Bull riders were leaner than bullfighters (ES = 0.74, p = 0.012). Fighters had greater RSI than riders (ES = 0.73-1.47, p < 0.001-0.030). Competitive level of rodeo riders ( n = 32) correlated with age, rodeo experience (ρ = 0.37-0.43, p = 0.013-0.049), bent-leg abduction (ρ = 0.43, p = 0.014), straight-leg hip adduction and abduction (ρ = 0.49-0.56, p < 0.001-0.005), neck flexion force (ρ = 0.43, p = 0.016), and rotational power (ρ = 0.50, p = 0.004). The competitive level of the fighters correlated with age (ρ = 0.64, p = 0.036) and time trial performance (ρ = -0.76, p = 0.006). This is the first study providing normative and correlational strength and power performance data in a rodeo population. These data highlight the need for more event-specific physical preparation. Riders should focus their physical preparation on hip and neck strength and rotational power. Bullfighters should prioritize stiffness and anaerobic power.

Comparing the Effects of Differential and Visuo-Motor Training on Functional Performance, Biomechanical, and Psychological Factors in Athletes after ACL Reconstruction: A Randomized Controlled Trial.

Variation during practice is widely accepted to be advantageous for motor learning and is, therefore, a valuable strategy to effectively reduce high-risk landing mechanics and prevent primary anterior cruciate ligament (ACL) injury. Few attempts have examined the specific effects of variable training in athletes who have undergone ACL reconstruction. Thereby, it is still unclear to what extent the variations in different sensor areas lead to different effects. Accordingly, we compared the effects of versatile movement variations (DL) with variations of movements with emphasis on disrupting visual information (VMT) in athletes who had undergone ACL reconstruction. Forty-five interceptive sports athletes after ACL reconstruction were randomly allocated to a DL group (n = 15), VT group (n = 15), or control group (n = 15). The primary outcome was functional performance (Triple Hop Test). The secondary outcomes included dynamic balance (Star Excursion Balance Test (SEBT)), biomechanics during single-leg drop-landing task hip flexion (HF), knee flexion (KF), ankle dorsiflexion (AD), knee valgus (KV), and vertical ground reaction force (VGRF), and kinesiophobia (Tampa Scale of Kinesiophobia (TSK)) assessed before and after the 8 weeks of interventions. Data were analyzed by means of 3 × 2 repeated measures ANOVA followed by post hoc comparison (Bonferroni) at the significance level of p ≤ 0.05. Significant group × time interaction effects, main effect of time, and main effect of group were found for the triple hop test and all eight directions, SEBT, HF, KF, AD, KV, VGRF, and TSK. There was no significant main effect of group in the HF and triple hop test. Additionally, significant differences in the triple hop test and the seven directions of SEBT, HF, KF, KV, VGRF, and TSK were found between the control group and the DL and VMT groups. Between group differences in AD and the medial direction of SEBT were not significant. Additionally, there were no significant differences between VMT and the control group in the triple hop test and HF variables. Both motor learning (DL and VMT) programs improved outcomes in patients after ACL reconstruction. The findings suggest that DL and VMT training programs lead to comparable improvements in rehabilitation.

Design and construction of a device for the capture of force and dorsal flexion of the foot in older adults of the Ecuadorian population

Design and construction of a device for the capture of force and dorsal flexion of the foot in older adults of the Ecuadorian population

COMPARISON BETWEEN UNIPEDAL AND BIPEDAL PLANTAR FLEXIONS USING TIME UNDER TENSION METHOD

ABSTRACT. Introduction. Bodybuilding is a sport that requires all muscle groups to be similarly developed, bringing an aesthetic physique to the observers. The development of the triceps surae may be a difficult goal to achieve for some athletes. Considering this, we chose to focus on a new training method that induces less stress in muscle groups: the time under tension. Objective. The purpose of the study was to compare exercises used for calf hypertrophy using the time under tension method and to identify the optimal situations in which this method could be used. Methods. Ten subjects, 6 male and 4 female, age of 25.7±4.9 years old, height 174.7±9.5 centimeters, body weight 82±17.8 kg and with varied levels of fitness, participated in the study. The plantar flexions were done with body weight only on one and both feet. The exercises we tested were done on a 3 second cycle: 3 seconds on the upwards movement and 3 seconds for the downwards one. The subjects performed a total of 10 repetitions for each exercise. Results. A significant statistical difference was found between the types of plantar flexion measured. This indicates that the analysis of time under tension plantar flexion should take into account the actual type of movement done. Conclusions. Time under tension method for calf muscle hypertrophy should take into consideration the movement characteristics for the focused muscle group. Our results showed that postural balance and body position can influence the force and power output of plantar flexion.

Do biomechanical foot-based interventions reduce patellofemoral joint loads in adults with and without patellofemoral pain or osteoarthritis? A systematic review and meta-analysis

ObjectiveTo evaluate the effects of biomechanical foot-based interventions (eg, footwear, insoles, taping and bracing on the foot) on patellofemoral loads during walking, running or walking and running combined in adults...

Effects of a home-based, exergaming intervention on physical function and pain after total knee replacement in older adults: a randomised controlled trial

ObjectivesTo investigate the effects of 4 months of customised, home-based exergaming on physical function and pain after total knee replacement (TKR) compared with standard exercise protocol.MethodsIn this non-blinded randomised controlled...

발목두께와 체간유연성 개선을 위한 발란스이완요법 효과검증

This study was conducted to find out how the balance relaxation therapy affects ankle thickness and trunk flexibility. This was to systematically investigate the effect of balance relaxation therapy on ankle thickness and trunk flexibility. Based on the results of analyzing the differences in changes in each variable after performing balance relaxation therapy only in the experimental group for 10 minutes twice a week for a total of 5 weeks, The following conclusions were obtained. The ankle thickness of the experimental group (right) showed a significant decrease. Trunk flexion and extension showed a significant increase in both trunk flexion and extension in the experimental group. Lateral trunk flexion showed a significant increase in both trunk lateral flexion (left and right) in the experimental group. Trunk rotational force showed a significant increase in both trunk rotational force (left and right) in the experimental group. In summary, balance relaxation therapy reduced the thickness of the ankle and had a positive effect on the increase in trunk flexibility (extension, flexion, left and right lateral flexion, left and right rotational force). If the body shape is imbalanced, it is judged to be a therapy that can give positive improvement to the change in ankle thickness and recovery of trunk flexibility.