Weight-bearing Ankle Dorsiflexion Range Research Articles

"Evaluation of Weight-bearing Ankle Dorsiflexion Range in Professional Soccer Players"

"Evaluation of Weight-bearing Ankle Dorsiflexion Range in Professional Soccer Players"

Dose-response of talus mobilizations in weight bearing ankle dorsiflexion ROM of the older adults with limited ankle mobility: A randomized clinical trial

BackgroundAlthough manual therapy is an effective technique for increasing ankle range of motion, the dose-response required is unclear. ObjectiveTo find out what number of sessions of talus mobilizations will induce a detectable change in weight bearing ankle dorsiflexion range of motion of older adults with limited ankle mobility. DesignFour-arm randomized clinical trial. SettingCommunity-dwelling. Methods62 older adults; aged over 60; with ankle dorsiflexion ROM below 35°. Four groups received from one to four treatment sessions. Each session consisted of 3 mobilizations of 30 s, with of the talus in anteroposterior glide, with a rest of 30 s. Grade IV mobilizations were applied to target the accessory movement of the ankle up to the resistance offered by periarticular tissues. The Lunge test was used to measure weight bearing ankle dorsiflexion. ResultsThe four groups increased their ankle mobility after one session, but two sessions were needed to overcome the established 4.7°’ threshold, regardless of group. Only those participants who received four sessions maintained the improvements for 8 weeks. ConclusionsTwo sessions of talus mobilizations are effective in improving weight bearing ankle dorsiflexion ROM. It will be necessary to deliver four sessions of treatment if these improvements are to be maintained for at least 8 weeks. Clinical trial registration numberNCT04563663.

THE LEVEL OF DORSIFLEXION IN YOUNG GYMNASTS COMPARED TO YOUNG ATHLETES - PILOT STUDY

Gymnastic training develops strength, flexibility, concentration, balance, precision, and speed. The purpose of the study is to determine if gymnastic preparation leads to an increase in weight-bearing ankle dorsiflexion range of motion in a closed kinematic chain in young artistic gymnasts compared to a different type of sport. The weight-bearing lunge was chosen to measure the dorsiflexion range of motion in the ankle joint in the closed kinematic chain. The first group consists of members of the Slovak national youth team in artistic gymnastics (n-26). The second group consists of members of the Slovak national team in rhythmic gymnastics (n-13). The control group consists of young athletes (n-22). The mean dorsiflexion range of motion in artistic gymnasts was 47.32 ° in the right ankle joint and 44.75 ° in the left ankle joint. The mean dorsiflexion range of motion in rhythmic gymnasts was 44.32 ° in the right ankle joint and 43.41 ° in the left ankle joint. The mean dorsiflexion range of motion in young athletes was 44.27 ° in the right ankle joint and 42.32 ° in the left ankle joint. Results indicate a statistically significant difference in favor of artistic gymnasts compared to rhythmic gymnasts at the right ankle joint (p-0.04). In the left ankle, the two groups did not differ significantly from each other (p-0.38). There was no significant difference between artistic gymnasts and athletes in the right ankle joint (p-0.09) and the left ankle joint (p-0.19). There was no significant difference between rhythmic gymnasts and athletes at the right ankle joint (p-0.38) and the left ankle joint (p-0.24). A greater dorsiflexion range of motion in a closed kinematic chain in the ankle joint was detected in young gymnasts compared to rhythmic gymnasts. There was no significant difference between artistic gymnasts and athletes.

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.

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.

Reliability of the weight-bearing ankle dorsiflexion range of motion measurement using a smartphone goniometer application.

BackgroundWeight-bearing ankle dorsiflexion range of motion measurement (weight-bearing lunge test) is gaining in popularity because it mimics lower extremity function in daily physical activities. The purpose of the study is to assess the intra-rater and the inter-rater reliability of the weight-bearing ankle dorsiflexion range of motion measurement with a flexed knee using a smartphone application Spirit Level Plus installed on an Android smartphone.MethodsThirty-two young, healthy subjects participated in the study and were measured in four sessions by two examiners. One measurement was taken on each ankle in every session. Eight measurements were taken from each participant. A total of 256 were taken from all the participants. The measurements for the individual subject were repeated no sooner than 24 hours after the first session. In order to assess the reliability, intraclass correlation coefficients (ICC), standard error measurements (SEM) and minimal detectable change (MDC) at the 95% confidence interval were calculated.ResultsStatistical data analysis revealed moderate intra-rater reliability for the right ankle (ICC = 0.72, 95% CI [0.49–0.85]) and good intra-rater reliability for the left ankle (ICC = 0.82, 95% CI [0.66–0.91]). Inter-rater reliability is moderate for the right (ICC = 0.73, 95% CI [0.52–0.86]) and the left ankle (ICC = 0.65, 95% CI [0.39–0.81]).ConclusionThe observed method is moderately reliable and appropriate when the main objective is to assess ankle dorsiflexion mobility in weight-bearing when weight-bearing is not contraindicated. The concurrent validity of the Spirit Level Plus application is excellent.

A Randomized Controlled Trial Assessing the Evolution of the Weight-Bearing Ankle Dorsiflexion Range of Motion Over 6 Sessions of Talus Mobilizations in Older Adults.

Ankle range of motion declines with age, affecting mobility and postural control. The objective of this study was to investigate the effects of a talus mobilization-based intervention among healthy community-dwelling older adults presenting with limited weight-bearing ankle dorsiflexion range of motion and determine how ankle mobility evolved over the treatment. This was a randomized clinical trial. This study was conducted in an outpatient clinic. Community-dwelling, older adults over 60 years of age who had limited ankle mobility participated in this study. The experimental intervention consisted of 6 sessions of manual therapy applied in the ankle joint. The control group received the same volume of sham treatment. The primary outcome was the weight-bearing ankle dorsiflexion range of motion as measured using the lunge test. Data were collected at 9 time points: baseline, after each session, and follow-up. A total of 36 participants were analyzed. A single session of mobilization increased ankle range of motion by 8 degrees (95% confidence interval = 6 to 11). At the end of the sixth session, this effect had increased slightly to 11 degrees (95% confidence interval = 9 to 13). Significant between-group differences were found throughout the intervention. Optimal dose and effects from follow-up evaluations for treatment volumes of fewer than 6 sessions remain unknown. Six sessions of a talus mobilization-based intervention in healthy community-dwelling older adults found that the greatest mobility gain in terms of the weight-bearing ankle dorsiflexion range of motion is produced after the first session. Additional sessions produce smaller improvements with a slight upward trend. Importantly, the restoration of joint mobility is enhanced over time after the end of the intervention.

Associations of foot and ankle characteristics with knee symptoms and function in individuals with patellofemoral osteoarthritis

BackgroundFoot and ankle characteristics are associated with patellofemoral pain (PFP) and may also relate to patellofemoral osteoarthritis (PFOA). A greater understanding of these characteristics and PFOA, could help to identify effective targeted treatments.ObjectivesTo determine whether foot and ankle characteristics are associated with knee symptoms and function in individuals with PFOA.MethodsFor this cross-sectional study we measured weightbearing ankle dorsiflexion range of motion, foot posture (via the Foot Posture Index [FPI]), and midfoot mobility (via the Foot Measurement Platform), and obtained patient-reported outcomes for knee symptoms and function (100 mm visual analogue scales, Anterior Knee Pain Scale [AKPS], Knee injury and Osteoarthritis Outcome Score, repeated single step-ups and double-leg sit-to-stand to knee pain onset). Pearson’s r with significance set at p < 0.05 was used to determine the association between foot and ankle charateristics, with knee symptoms and function, adjusting for age.Results188 participants (126 [67%] women, mean [SD] age of 59.9 [7.1] years, BMI 29.3 [5.6] kg/m2) with symptomatic PFOA were included in this study. Lower weightbearing ankle dorsiflexion range of motion had a small significant association with higher average knee pain (partial r = − 0.272, p < 0.001) and maximum knee pain during stair ambulation (partial r = − 0.164, p = 0.028), and lower scores on the AKPS (indicative of greater disability; partial r = 0.151, p = 0.042). Higher FPI scores (indicating a more pronated foot posture) and greater midfoot mobility (foot mobility magnitude) were significantly associated with fewer repeated single step-ups (partial r = − 0.181, p = 0.023 and partial r = − 0.197, p = 0.009, respectively) and double-leg sit-to-stands (partial r = − 0.202, p = 0.022 and partial r = − 0.169, p = 0.045, respectively) to knee pain onset, although the magnitude of these relationships was small. The amount of variance in knee pain and disability explained by the foot and ankle characteristics was small (R2-squared 2 to 8%).ConclusionsLower weightbearing ankle dorsiflexion range of motion, a more pronated foot posture, and greater midfoot mobility demonstrated small associations with worse knee pain and greater disability in individuals with PFOA. Given the small magnitude of these relationships, it is unlikely that interventions aimed solely at addressing foot and ankle mobility will have substantial effects on knee symptoms and function in this population.Trial registrationThe RCT was prospectively registered on 15 March 2017 with the Australia and New Zealand Clinical Trials Registry (ANZCTRN12617000385347).

THE EFFECT OF NOVEL ANKLE-REALIGNING SOCKS ON DYNAMIC POSTURAL STABILITY IN INDIVIDUALS WITH CHRONIC ANKLE INSTABILITY

A dynamic postural stability deficit has been suggested to be present in individuals with chronic ankle instability (CAI). Interventions to improve postural control in individuals with CAI have been reported, but they required a long period of and compliance with interventions. To examine the effect of novel ankle-realigning socks on dynamic postural stability in individuals with CAI using the star excursion balance test (SEBT). Case-control study. Twenty-eight control and 22 subjects with CAI (who were tested in both barefoot and with socks) were enrolled. The weight-bearing ankle dorsiflexion range of motion (DF-ROM) and SEBT were measured in the control group, the barefoot CAI group, and the CAI with socks group. In addition, subjective ankle instability during SEBT was measured using a visual analog scale (0 - 100). DF-ROM was 48.3 ± 7.4 º in the control group, 43.3 ± 8.0 º in the barefoot CAI group, and 45.7 ± 6.8 º in the CAI with socks group. DF-ROM was significantly less in the barefoot CAI group than in the control group. The SEBT scores were significantly less in the barefoot CAI group than in the control group in all directions. The SEBT score was significantly larger in the CAI with socks group than in the barefoot CAI group in the posteromedial, posterior, and posterolateral directions. In addition, there were no significant differences between the control group and the CAI with socks group in six directions. Wearing the novel ankle-realigning socks immediately improved dynamic postural stability as measured by the SEBT and subjective ankle instability in individuals with CAI. Level 3b.

Inter-rater reliability and validity of angle measurements using smartphone applications for weight-bearing ankle dorsiflexion range of motion measurements

ObjectivesThe purpose of this study was to examine the inter-rater reliability, validity, and error of angle measurements for ankle dorsiflexion range of motion while in the weight-bearing position using a smartphone application. DesignReliability and validity study. SettingMeasurement positions were performed by one experienced examiner. ParticipantsEighteen volunteers participated in the study. Three examiners (examiner 1 and examiner 2 had completed the course to become qualified certified athletic trainers and examiner 3 did not belong to the course) performed smartphone application measurements. Main outcome measuresAnkle dorsiflexion range of motion was measured in the lunge position. Radiographic measurements were performed using a bony landmark. The markerless method for application measurements was used, using a body part as a landmark. ResultsUsing the markerless method for application measurements, the intra-class correlation coefficients were 0.945. Using Pearson's correlation coefficient and intra-class correlation coefficients to compare the radiographic measurements and markerless method for application measurements, three examiners showed very high correlation (r > 0.9) and almost perfect (>0.81) intra-class correlation coefficient. Error values were less than 5° according to examiner 1 and examiner 2. ConclusionSmartphone application measurements using the markerless method of ankle dorsiflexion range of motion exhibited inter-rater reliability and high validity.

Weightbearing ankle dorsiflexion range of motion and sagittal plane kinematics during single leg drop jump landing in healthy male athletes.

Passive ankle dorsiflexion range of motion (DROM) measures have been identified as a risk factor for injury during landings. However, passive measurements might not be indicative of dynamic ankle movement, whereas a weightbearing ROM might be a better tool when evaluating movement. The purpose of this study was to investigate the relationship between weightbearing DROM and sagittal plane landing mechanics in a single leg drop jump task. Seventy-three male athletes (22.1±3.9 years old, height 186.2±11 cm, and weight 100.2±21.8 kg) performed bilateral modified-lunge tasks and bilateral single leg drop jump landings while 3D kinematic data were collected. Hip, knee, and ankle joint angles were calculated at initial contact (IC) maximum knee flexion (MKF), and total excursion (TE) during a single leg drop jump landing. No bilateral differences in DROM and single leg landing mechanics existed. Decreased ankle DROM was correlated to decreased ankle dorsiflexion at MKF (P=0.00) and TE (P=0.00) for both dominant and non-dominant limbs. Decreased ankle DROM was also correlated to decreased knee flexion at IC (P=0.00), MKF (P=0.00), and TE (P=0.1), for both dominant and non-dominant limbs. Ankle DROM correlated to hip flexion at MKF (r=0.25) and TE (r=0.30) in the dominant limb. Restrictions in DROM may contribute to a stiff landing with less flexion at the ankle and knee. These findings may be useful in designing training programs aimed at increasing DROM in order to improve an athlete's landing mechanics and decrease risk of injury.

JUMPER'S KNEE: A PROSPECTIVE EVALUATION OF RISK FACTORS IN VOLLEYBALL PLAYERS USING AN OVERUSE MEASURE OF INJURY

BackgroundA multitude of risk factors have been reported to increase an athlete's risk of developing jumper's knee. An overuse injury definition has been cited as more sensitive in capturing knee...

Weight-bearing ankle dorsiflexion range of motion-can side-to-side symmetry be assumed?

In clinical practice, the range of motion (ROM) of the non involved side often serves as the reference for comparison with the injured side. Previous investigations of non-weight-bearing (NWB) ankle dorsiflexion (DF) ROM measurements have indicated bilateral symmetry for the most part. Less is known about ankle DF measured under weight-bearing (WB) conditions. Because WB and NWB ankle DF are not strongly correlated, there is a need to determine whether WB ankle DF is also symmetrical in a healthy population. To determine whether WB ankle DF is bilaterally symmetrical. A secondary goal was to further explore the correlation between WB and NWB ankle DF ROM. Cross-sectional study. Training facility of the Israeli Defense Forces. A total of 64 healthy males (age = 19.6 ± 1.0 years, height = 175.0 ± 6.4 cm, and body mass = 71.4 ± 7.7 kg). Dorsiflexion ROM in WB was measured with an inclinometer and DF ROM in NWB was measured with a universal goniometer. All measurements were taken bilaterally by a single examiner. Weight-bearing ankle DF was greater on the nondominant side compared with the dominant side (P < .001). Non-weight-bearing ankle DF was not different between sides (P = .64). The correlation between WB and NWB DF was moderate, with the NWB DF measurement accounting for 30% to 37% of the variance of the WB measurement. Weight-bearing ankle DF ROM should not be assumed to be bilaterally symmetrical. These findings suggest that side-to-side differences in WB DF may need to be interpreted while considering which side is dominant. The difference in bilateral symmetry between the WB and NWB measurements, as well as the only moderate level of correlation between them, suggests that both measurements should be performed routinely.

The Immediate Effect of Ankle Balance Taping using Kinesiology Tape on the Weight-bearing Ankle Dorsiflexion Range of Motion and the Dynamic Balance in Asymptomatic Subjects

PURPOSE: The purpose of this study was to examine the immediate changes in the weight-bearing ankle dorsiflexion range of motion (ROM) and the dynamic balance in asymptomatic subjects using the modified Star Excursion Balance Test (SEBT) after ankle balance taping (ABT) and placebo ABT with kinesiology tape METHODS: A total of 23 active participants (11 men, 12 women) volunteered for this study. Ankle flexibility was assessed using the weight-bearing lunge test, and dynamic balance was assessed using the modified SEBT. Participants were asked to respond to questions regarding their perception of stability, reassurance, and confidence when performing modified SEBT. RESULTS: The weight-bearing ankle dorsiflexion ROM did not show a significant decrease after real ABT or placebo ABT compared to the ROM prior to ABT. The anterior, posterolateral, and posteromedial reach distances of SEBT did not increase significantly after real ABT or placebo ABT compared to the distances prior to ABT. However, the participants' perception of stability, reassurance, and confidence, when performing SEBT with real ABT, was increased compared to that during the control trial. CONCLUSION: This study showed that although real ABT did not immediately improve the reach distances in the 3 directions during modified SEBT, it improved the participants' perception of stability, reassurance, and confidence without decreasing weight-bearing ankle dorsiflexion ROM.

Dorsiflexion and dynamic postural control deficits are present in those with chronic ankle instability

ObjectivesTo determine if differences in weight-bearing ankle dorsiflexion range of motion (DFROM) and Star Excursion Balance Test (SEBT) reach distances were present between participants with chronic ankle instability (CAI) and healthy individuals. A secondary objective was to re-examine the relationship between these measures in participants with and without CAI. DesignCase–control. MethodsThirty participants with CAI were matched to 30 healthy participants. All participants performed maximum reach in the anterior, posteromedial and posterolateral directions of the SEBT; as well as, the Weight-Bearing Lunge Test (WBLT) to measure DFROM. Dependent variables included maximal DFROM (cm) and normalized SEBT reach distances (%). Independent t-tests were used for group comparisons (a priori p≤0.05). Simple-linear regression examined the relationship between the WBLT and each SEBT direction. ResultsSignificant differences were detected between groups for the WBLT (CAI: 10.73±3.44cm, healthy: 12.47±2.51cm; p=0.03) and anterior reach distance (CAI: 76.05±6.25%, healthy: 80.12±5.88%; p=0.01). No differences were identified in posteromedial or posterolateral (ps>0.70) reach. The WBLT had a significant moderate correlation to anterior reach in both groups (ps<0.05) but was not significantly correlated to posteromedial or posterolateral reach distance (ps>0.70). ConclusionsThe results indicate that participants with CAI demonstrated less DFROM and anterior SEBT reach distance compared to health controls. Additionally, both groups demonstrated similar correlations between WBLT and SEBT performance. These findings suggest that participants with CAI have alterations in ankle motion which may negatively influence dynamic postural control; however, the relationship between WBLT and SEBT performance is consistent in those with and without CAI.

Initial effects of the ankle dorsiflexion mobilization with movement on ankle range of motion and limb coordination in young healthy subjects

Background and purpose: Clinically, ankle dorsiflexion mobilization with movements (MWM) is a manual therapy technique widely used to increase joint range of motion, reduce pain, and improve functions. It has been reported in a single case study to have initial effects of improved functional outcomes and pain relief on acute ankle sprains. However, no study has examined the immediate effects of this technique on gait patterns in the ankle joint of healthy individuals. Methods: A total of 60 healthy collegiate students (40 females and 20 males, age 21±1.8 years; BMI 21.02±2.4) participated in three consecutive days. Spatial and temporal parameters of gait during level walking using a pressure sensor walkway and weight-bearing ankle dorsiflexion range using ankle lunge test were analyzed before and immediately after a single session of ankle dorsiflexion MWM intervention. Tests were repeated at day two and three after the intervention. Results: Significant improvements of ankle dorsiflexion range of motion on the dominant side were found between pre-and post-intervention (p＜0.0001), at day two (p＜0.0001) and at day three (p＜0.0001). Significant changes in spatial (step length, stride length, and base of support) during slow walking and in temporal (gait cycle time and step time) variables on both sides were also observed during self-paced walking at day two (p＜0.004) and day three (p＜0.004) compared with pre-intervention. Conclusion: The results suggest that immediate and sustained spatio-temporal effects occur following ankle MWM. Changes during level walking indicate possible effects of alterations in motor strategies during functional tasks following ankle MWM.

Weight bearing ankle dorsiflexion range of motion in idiopathic pes cavus compared to normal and pes planus feet

Background: Various factors are considered influential in the development of pes cavus. Short tendo-Achilles is one factor that has been hypothesised as a deforming mechanism of ‘idiopathic’ pes cavus. Objective: To measure tendo-Achilles length in subjects with idiopathic pes cavus, compared to normal and pes planus feet, and to examine the relationship between tendo-Achilles length and foot type. Method: Fifty-three healthy volunteers (34 female, 19 male) were recruited to encompass a wide range of foot types, varying in degree of cavoid, normal and planus features. Foot type was measured weight bearing using the Foot Posture Index (FPI). The length of the tendo-Achilles was also measured weight bearing using the lunge test. Results: Twenty-four subjects with pes cavus, 24 subjects with a normal foot type and five subjects with pes planus completed the study. Lunge angle in the pes cavus group was significantly less than the normal and pes planus groups ( P < 0.001). A strong, positive correlation was identified between tendo-Achilles length and foot type ( r = 0.757, P < 0.001; r 2 = 57.3%). Conclusion: Distinct differences exist in tendo-Achilles length in individuals with a pes cavus foot type, compared to normal and pes planus feet. A strong positive relationship between tendo-Achilles shortness and pes cavus severity has been identified.