Weight-bearing Dorsiflexion Range Of Motion Research Articles

Differences and relationships between weightbearing and non-weightbearing dorsiflexion range of motion in foot and ankle injuries

BackgroundThis study aimed to: (1) identify assessment methods that can detect greater ankle dorsiflexion range of motion (DROM) limitation in the injured limb; (2) determine whether differences in weightbearing measurements exist even in the absence of DROM limitations in the injured limb according to non-weightbearing measurements; and (3) examine associations between DROM in the weightbearing and non-weightbearing positions and compare those between a patient group with foot and ankle injuries and a healthy group.MethodsEighty-two patients with foot and ankle injuries (e.g., fractures, ligament and tendon injuries) and 49 healthy individuals participated in this study. Non-weightbearing DROM was measured under two different conditions: prone position with knee extended and prone position with knee flexed. Weightbearing DROM was measured as the tibia inclination angle (weightbearing angle) and distance between the big toe and wall (weightbearing distance) at maximum dorsiflexion. The effects of side (injured, uninjured) and measurement method on DROM in the patient groups were assessed using two-way repeated-measures ANOVA and t-tests. Pearson correlations between measurements were assessed. In addition, we analyzed whether patients without non-weightbearing DROM limitation (≤ 3 degrees) showed limitations in weightbearing DROM using t-tests with Bonferroni correction.ResultsDROM in patient groups differed significantly between legs with all measurement methods (all: P < 0.001), with the largest effect size for weightbearing angle (d = 0.95). Patients without non-weightbearing DROM limitation (n = 37) displayed significantly smaller weightbearing angle and weightbearing distance on the injured side than on the uninjured side (P < 0.001 each), with large effect sizes (d = 0.97–1.06). Correlation coefficients between DROM in non-weightbearing and weightbearing positions were very weak (R = 0.17, P = 0.123) to moderate (R = 0.26–0.49, P < 0.05) for the patient group, and moderate to strong for the healthy group (R = 0.51–0.69, P < 0.05).ConclusionsDROM limitations due to foot and ankle injuries may be overlooked if measurements are only taken in the non-weightbearing position and should also be measured in the weightbearing position. Furthermore, DROM measurements in non-weightbearing and weightbearing positions may assess different characteristics, particularly in patient group.Level of evidenceLevel IV, cross-sectional study.

Characteristics of the static muscle stiffness of ankle plantar flexors in individuals with chronic ankle instability.

Individuals with chronic ankle instability (CAI) have deficits in closed kinetic chain dorsiflexion that may perpetuate injury. Determining the characteristics of muscle stiffness in the plantar flexors of individuals with CAI may help in developing appropriate treatments. We aimed to highlight the characteristics of static muscle stiffness in ankle plantar flexor muscles during the passive dorsiflexion of the ankle joint in individuals with CAI. A total of 30 patients were included in the study based on the International Ankle Consortium criteria. The patients were categorized evenly into healthy, coper, and CAI groups (i.e., 10 patients in each group). After measuring the dorsiflexion range of motion (non-weight-bearing/weight-bearing) of the ankle joint, the static muscle stiffness measurements of the medial gastrocnemius, lateral gastrocnemius, soleus, and peroneus longus were obtained. The measurements were performed during the knee joint's extension and 50° flexion and passive dorsiflexion between the range of 40° plantar flexion and 20° dorsiflexion. The dorsiflexion range of motion of the CAI group was significantly smaller than that of the healthy and coper groups in the weight-bearing position. No interaction was observed for muscle stiffness in both the knee flexion and extension positions, and no significant differences were identified among the three groups. The shear modulus of the soleus at 20° ankle dorsiflexion with knee flexion had a significant negative correlation with the weight-bearing range of motion of the ankle. The limitation in the weight-bearing dorsiflexion range of motion in CAI was largely due to factors other than the increased elasticity of the ankle plantar flexor muscles.

Anterior Reach and Symmetry on the Y-Balance Test are Related to Dorsiflexion Range of Motion but not Single-Limb Balance in Physically Active Young Adults

Background: The anterior reach distance and symmetry of the Y-Balance Test (YBT) has been associated with increased injury risk in collegiate athletes. Examining the influence of dorsiflexion range of motion (DROM) and single-limb balance (SLB) on YBT performance may identify underlying factors associated with injury risk. Objective: The purpose of this study is to determine if YBT anterior reach is related to DROM or SLB in collegiate varsity and club sport athletes. Methods: A convenience sample of 124 university varsity and club sport athletes (females: 99, age: 20.0 ± 1.6 years, height: 168.9 ± 12.5 kg, body mass: 68.8 ± 14.0 kg) completed the anterior direction of the YBT, weight-bearing DROM, and SLB components (firm and foam surface) of the Balance Error Scoring System on both limbs at one testing session. Relative symmetry was calculated by subtracting values of the left limb from the right limb. Results: For the left and right limb, normalized anterior reach distance was moderately correlated to DROM (R = .55, p &lt; .001). Anterior reach distance and symmetry was weakly correlated to SLB and SLB symmetry (R = −.16 to −.03). Conclusion: There was a positive relationship between YBT anterior reach and weight-bearing DROM which was also observed in the between-limb symmetry. However, weak relationships were exhibited between YBT anterior reach and SLB. These findings may be useful for future injury prevention initiatives in athletic settings.

Response profile of fibular repositioning tape on ankle osteokinematics, arthrokinematics, perceived stability and confidence in chronic ankle instability

BackgroundPreliminary evidence suggests that fibular repositioning tape reduces risk of recurrent ankle injuries, but the underlying mechanism has not been investigated. ObjectiveTo investigate the effects of fibular repositioning tape on ankle osteokinematics, arthrokinematics and perceived stability and confidence in individuals with chronic ankle instability immediately post-tape and following exercise. DesignCross-sectional repeated measures study. MethodPassive ankle plantarflexion-inversion range of motion, weight-bearing dorsiflexion range of motion, anteroposterior translation, inversion-eversion tilt, and perceived ankle stability and confidence during hopping were assessed before and immediately after the application of fibular repositioning tape and after 15 min of exercise in 14 individuals with chronic ankle instability. ResultsAnkle plantarflexion-inversion range of motion, inversion-eversion tilt and anteroposterior translation were reduced immediately after the application of tape compared to pre-tape (p < 0.01). After exercise, total inversion-eversion tilt was significantly lower than pre-tape (p = 0.01), but there were no differences for any of the other mechanical outcomes. Dorsiflexion range of motion did not differ between conditions (p > 0.11). Perceived ankle stability, ankle and task confidence were greater immediately post-tape and post-exercise compared to pre-tape (p < 0.01). ConclusionsFibular repositioning tape was associated with a restriction of ankle total inversion-eversion tilt and improved perceived ankle stability and confidence both immediately after application of tape and after participating in exercise. This data provides grounds for exploring mechanical and psychological mechanisms underpinning any clinical efficacy of fibular repositioning tape.

Acute Effects of Increased Joint Mobilization Treatment Duration on Ankle Function and Dynamic Postural Control in Female Athletes With Chronic Ankle Instability.

Background:Chronic ankle instability (CAI) is linked to mechanical and functional insufficiencies. Joint mobilization is purported to be effective at treating these deficits.Purpose:To examine the effect of different treatment durations of a grade IV anterior-to-posterior ankle joint mobilization on weightbearing dorsiflexion range of motion (WB-DFROM), posterior talar glide (PG), and dynamic postural control in individuals with CAI.Study Design:Controlled laboratory study.Methods:A total of 48 female athletes (mean age, 22.8 ± 4.8 years) with unilateral CAI participated in this study. Participants were randomly assigned to 1 of 3 treatment conditions: 30 seconds, 60 seconds, and 120 seconds. Treatment was provided to the injured limb on 3 separate occasions 48 hours apart and consisted of a Maitland grade IV anterior-to-posterior talar joint mobilization based on the participant’s initial group assignment. WB-DFROM; PG; and the anterior (ANT), posteromedial (PM), and posterolateral (PL) reach directions of the Star Excursion Balance Test were measured bilaterally before and after each treatment. The uninjured limb acted as a control. Data were analyzed using 2-way mixed-model analyses of variance, and effect sizes were calculated through use of Hedges g.Results:Significant differences were detected after all treatment sessions for all outcome measures (P ≤ .001) and between treatment groups after sessions 1, 2, and 3 for all outcome measures (P ≤ .001). Effect sizes were very large or huge for all treatment groups for WB-DFROM, PG, and ANT reach direction. Substantial variation was found in effect sizes for PM and PL measures.Conclusion:Accessory mobilization is an effective treatment to induce acute changes in ankle motion and dynamic postural control in patients with CAI, with longer treatment durations conferring greater improvements.Clinical Relevance:This study adds clarity to the use of joint mobilization treatments and will add to the current clinical practice strategy for patients with CAI.

Decreased dynamic balance and dorsiflexion range of motion in young and middle-aged adults with chronic ankle instability

ObjectivesThe purpose of this study was to compare dynamic balance and weight-bearing dorsiflexion range of motion between young and middle-aged adults with and without chronic ankle instability. DesignCross-sectional. MethodsOne hundred and two young adults were classified as either having chronic ankle instability (n = 38), coper (n = 27) or a healthy-control (n = 37). A total of 55 middle-aged adults were identified as having chronic ankle instability (n = 16), coper (n = 15) or a healthy-control (n = 24). Participants completed the weight-bearing lunge test and the anterior, posteromedial and posterolateral reach directions of the star excursion balance test. ResultsMiddle-aged adults had shorter reach distances for each direction of the star excursion balance test compared to the young adults (p < 0.001). Regardless of age, participants with chronic ankle instability performed worse on the star excursion balance test compared to the coper (p < 0.05) and healthy-control group (p < 0.05). Similarly, participants with chronic ankle instability had less dorsiflexion compared to healthy-controls (p < 0.05), but not the coper group (p > 0.05). ConclusionsDeficits in dynamic postural control do not continue to decline with advancing age in individuals with chronic ankle instability, however, these impairments appear to continue to persist compared to uninjured controls.

The Effect of 2 Forms of Talocrural Joint Traction on Dorsiflexion Range of Motion and Postural Control in Those With Chronic Ankle Instability

Talocrural joint mobilizations are commonly used to address deficits associated with chronic ankle instability (CAI). Examine the immediate effects of talocrural joint traction in those with CAI. Blinded, crossover. Laboratory. Twenty adults (14 females; age = 23.80 ± 4.02 y; height = 169.55 ± 12.38 cm; weight = 78.34 ± 16.32 kg) with self-reported CAI participated. Inclusion criteria consisted of a history of ≥1 ankle sprain, ≥2 episodes of giving way in the previous 3 mo, answering "yes" to ≥4 questions on the Ankle Instability Instrument, and ≤24 on the Cumberland Ankle Instability Tool. Subjects participated in 3 sessions in which they received a single treatment session of sustained traction (ST), oscillatory traction (OT), or a sham condition in a randomized order. Interventions consisted of four 30-s sets of traction with 1 min of rest between sets. During ST and OT, the talus was distracted distally from the ankle mortise to the end-range of accessory motion. ST consisted of continuous distraction and OT involved 1-s oscillations between the mid and end-range of accessory motion. The sham condition consisted of physical contact without force application. Preintervention and postintervention measurements of weight-bearing dorsiflexion, dynamic balance, and static single-limb balance were collected. The independent variable was treatment (ST, OT, sham). The dependent variables included pre-to-posttreatment change scores for the WBLT (cm), normalized SEBTAR (%), and time-to-boundary (TTB) variables(s). Separate 1-way ANOVAs examined differences between treatments for each dependent variable. Alpha was set a priori at P < .05. No significant treatment effects were identified for any variables. A single intervention of ST or OT did not produce significant changes in weight-bearing dorsiflexion range of motion or postural control in individuals with CAI. Future research should investigate the effects of repeated talocrural traction treatments and the effects of this technique when combined with other manual therapies.

Trunk kinematics and lower lumbar spinal loading during paediatric cerebral palsy gait

The purpose of this study was to determine the contributions of strength, dorsiflexion range of motion (DFROM), plantar cutaneous sensation (PCS), and static postural control to Star Excursion Balance Test (SEBT) performance in individuals with chronic ankle instability (CAI). Forty individuals with CAI completed isometric strength, weight-bearing DFROM, PCS, static and dynamic balance assessments. Three separate backward multiple linear regression models were calculated to determine how strength, DFROM, PCS, and static postural control contributed to each reach direction of the SEBT. Explanatory variables included dorsiflexion, inversion, and eversion strength, DFROM, PCS, and time-to-boundary mean minima (TTBMM) and standard deviation (TTBSD) in the medial–lateral (ML) and anterior–posterior (AP) directions. Criterion variables included SEBT-anterior, posteromedial, and posterolateral directions. The strength of each model was determined by the R2-value and Cohen's f2 effect size. Regression models with an effect size ≥0.15 were considered clinically relevant. All three SEBT directions produced clinically relevant regression models. DFROM and PCS accounted for 16% of the variance in SEBT-anterior reach (f2 = 0.19, p = 0.04). Eversion strength and TTBMM-ML accounted for 28% of the variance in SEBT-posteromedial reach (f2 = 0.39, p < 0.01). Eversion strength and TTBSD-ML accounted for 14% of the variance in SEBT-posterolateral reach (f2 = 0.16, p = 0.06). DFROM and PCS explained a clinically relevant proportion of the variance associated with SEBT-anterior reach. Eversion strength and TTB ML explained a clinically relevant proportion of the variance in SEBT-posteromedial and posterolateral reach distances. Therefore, rehabilitation strategies should emphasize DFROM, PCS, eversion strength, and static balance to enhance dynamic postural control in patients with CAI.

Weight-Bearing Dorsiflexion Range of Motion and Landing Biomechanics in Individuals With Chronic Ankle Instability.

People with chronic ankle instability (CAI) exhibit less weight-bearing dorsiflexion range of motion (ROM) and less knee flexion during landing than people with stable ankles. Examining the relationship between dorsiflexion ROM and landing biomechanics may identify a modifiable factor associated with altered kinematics and kinetics during landing tasks. To examine the relationship between weight-bearing dorsiflexion ROM and single-legged landing biomechanics in persons with CAI. Cross-sectional study. Laboratory. Fifteen physically active persons with CAI (5 men, 10 women; age = 21.9 ± 2.1 years, height = 168.7 ± 9.0 cm, mass = 69.4 ± 13.3 kg) participated. Participants performed dorsiflexion ROM and single-legged landings from a 40-cm height. Sagittal-plane kinematics of the lower extremity and ground reaction forces (GRFs) were captured during landing. Static dorsiflexion was measured using the weight-bearing-lunge test. Kinematics of the ankle, knee, and hip were observed at initial contact, maximum angle, and sagittal displacement. Sagittal displacements of the ankle, knee, and hip were summed to examine overall sagittal displacement. Kinetic variables were maximum posterior and vertical GRFs normalized to body weight. We used Pearson product moment correlations to evaluate the relationships between dorsiflexion ROM and landing biomechanics. Correlations (r) were interpreted as weak (0.00-0.40), moderate (0.41-0.69), or strong (0.70-1.00). The coefficient of determination (r(2)) was used to determine the amount of explained variance among variables. Static dorsiflexion ROM was moderately correlated with maximum dorsiflexion (r = 0.49, r(2) = 0.24), ankle displacement (r = 0.47, r(2) = 0.22), and total displacement (r = 0.67, r(2) = 0.45) during landing. Dorsiflexion ROM measured statically and during landing demonstrated moderate to strong correlations with maximum knee (r = 0.69-0.74, r(2) = 0.47-0.55) and hip (r = 0.50-0.64, r(2) = 0.25-0.40) flexion, hip (r = 0.53-0.55, r(2) = 0.28-0.30) and knee (r = 0.53-0.70, r(2) = 0.28-0.49) displacement, and vertical GRF (-0.47- -0.50, r(2) = 0.22-0.25). Dorsiflexion ROM was moderately to strongly related to sagittal-plane kinematics and maximum vertical GRF during single-legged landing in persons with CAI. Persons with less dorsiflexion ROM demonstrated a more erect landing posture and greater GRF.

Contributing factors to Star Excursion Balance Test performance in individuals with chronic ankle instability

The purpose of this study was to determine the contributions of strength, dorsiflexion range of motion (DFROM), plantar cutaneous sensation (PCS), and static postural control to Star Excursion Balance Test (SEBT) performance in individuals with chronic ankle instability (CAI). Forty individuals with CAI completed isometric strength, weight-bearing DFROM, PCS, static and dynamic balance assessments. Three separate backward multiple linear regression models were calculated to determine how strength, DFROM, PCS, and static postural control contributed to each reach direction of the SEBT. Explanatory variables included dorsiflexion, inversion, and eversion strength, DFROM, PCS, and time-to-boundary mean minima (TTBMM) and standard deviation (TTBSD) in the medial–lateral (ML) and anterior–posterior (AP) directions. Criterion variables included SEBT-anterior, posteromedial, and posterolateral directions. The strength of each model was determined by the R2-value and Cohen's f2 effect size. Regression models with an effect size ≥0.15 were considered clinically relevant. All three SEBT directions produced clinically relevant regression models. DFROM and PCS accounted for 16% of the variance in SEBT-anterior reach (f2=0.19, p=0.04). Eversion strength and TTBMM-ML accounted for 28% of the variance in SEBT-posteromedial reach (f2=0.39, p<0.01). Eversion strength and TTBSD-ML accounted for 14% of the variance in SEBT-posterolateral reach (f2=0.16, p=0.06). DFROM and PCS explained a clinically relevant proportion of the variance associated with SEBT-anterior reach. Eversion strength and TTB ML explained a clinically relevant proportion of the variance in SEBT-posteromedial and posterolateral reach distances. Therefore, rehabilitation strategies should emphasize DFROM, PCS, eversion strength, and static balance to enhance dynamic postural control in patients with CAI.

Increased treatment durations lead to greater improvements in non-weight bearing dorsiflexion range of motion for asymptomatic individuals immediately following an anteroposterior grade IV mobilisation of the talus

Manual therapy aims to minimise pain and restore joint mobility and function. Joint mobilisations are integral to these techniques, with anteroposterior (AP) talocrural joint mobilisations purported to increase dorsiflexion range of motion (DF-ROM). This study aimed to determine whether different treatment durations of single grade IV anteroposterior talocrural joint mobilisations elicit statistically significant differences in DF-ROM. Sixteen asymptomatic male football players (age = 27.1 ± 5.3 years) participated in the study. Non-weight bearing (NWB) and weight bearing (WB) DF-ROM was measured before and after 4 randomised treatment conditions: control treatment, 30 s, 1 min, 2 min. NWB DF-ROM was measured using a universal goniometer, and WB DF-ROM using the weight-bearing lunge test. A within-subjects design was employed so that all participants received each of the treatment conditions. A 4 × 4 balanced Latin square design and 1 week interval between sessions reduced any residual effects. Two-way repeated measures ANOVA revealed a significant improvement in DF-ROM following all AP mobilisation treatments (p < 0.001). The within subjects contrasts showed that increases in treatment duration was associated with statistically significant improvements in DF-ROM (NWB DF-ROM control = 0.01%, 30 s = 14.2%, 1 min = 21.6%, 2 min = 32.8%; WB DF-ROM control = 0.01%, 30 s = 5.0%, 1 min = 7.6%, 2 min = 10.9%; p < 0.05). However, WB DF-ROM improvements were below the minimal detectable change scores needed to conclude that improvements were not a consequence of measurement error. This research shows that single session mobilisations can elicit NWB DF-ROM improvements in asymptomatic individuals in the absence of pain, whilst increases in treatment duration confer greater improvements in NWB DF-ROM within this population.

Factors associated with visually assessed quality of movement during a lateral step-down test among individuals with patellofemoral pain.

Cross-sectional. To determine what physical measures are associated with visually assessed quality of movement among patients with patellofemoral pain (PFP). An altered movement pattern has been implicated as a risk factor for PFP. An understanding of physical measures associated with an altered movement pattern could potentially help guide prevention and management efforts in patients with PFP. Seventy-nine (40 women) Israel Defense Forces soldiers referred to physical therapy with a diagnosis of PFP were included. Movement pattern was assessed visually during a lateral step-down test and rated as "good" or "moderate," based on previously established criteria. Weight-bearing and non-weight-bearing ankle dorsiflexion (DF) range of motion (ROM); hip internal and external rotation ROM; and hip abduction, hip external rotation, and knee extension strength were also assessed. Differences in physical measures between those with good versus moderate quality of movement were assessed. Weight-bearing DF ROM was more limited among participants with a moderate quality of movement compared to those with a good quality of movement (P<.01). Among men, non-weight-bearing DF ROM was more limited in those with a moderate quality of movement as well (P<.01). In addition, quality of movement was associated with weight-bearing DF ROM for both women (r = -0.39, P = .01) and men (r = -0.46, P<.01), and with non-weight-bearing DF ROM for men (r = -0.66, P<.01). When the subgroup of participants who exhibited more than 25° of non-weight-bearing DF ROM was assessed, those with a good quality of movement displayed greater hip external rotator and knee extensor muscle strength compared with those with a moderate quality of movement (P<.01). Ankle DF ROM should be assessed when patients with PFP demonstrate a lower quality of movement during a lateral step-down test. Lower hip muscle strength may be associated with lower quality of movement among patients with relatively greater ankle DF ROM.

Intrinsic Predictive Factors of Noncontact Lateral Ankle Sprain in Collegiate Athletes: A Case-Control Study.

Background:Lateral ankle sprain (LAS) is one of the most common injuries in sports. Despite extensive research, intrinsic factors that predict initial and recurrent noncontact LAS remain undefined.Purpose:To identify the predictive factors of initial and recurrent noncontact LAS, focusing on ankle flexibility and/or alignment in collegiate athletes.Study Design:Case-control study; Level of evidence, 3.Methods:A total of 191 athletes were assessed during the preseason for factors predictive of noncontact LAS. The baseline measurements included weightbearing dorsiflexion range of motion (ROM), leg-heel angle, foot internal rotation angle in plantar flexion, classification according to the mortise test, and navicular–medial malleolus (NMM) distance. Occurrence of noncontact LAS and participation in practice and games were prospectively recorded for 11 months.Results:Of the 191 athletes assessed, 169 (145 males, 24 females) completed the study; 125 athletes had a history of ankle sprain. During the observational period, 16 athletes suffered noncontact LAS (0.58 per 1000 athlete-exposures) consisting of 4 initial sprains and 12 recurrences. The hazard ratio estimated by a Cox regression analysis showed that athletes with an NMM distance ≥4.65 cm were 4.14 times more likely to suffer an initial noncontact LAS than were athletes with a shorter NMM distance (95% confidence interval, 1.12-14.30) and that athletes with a weightbearing dorsiflexion ROM >49.5° were 1.12 times as likely to suffer a recurrent noncontact LAS compared with athletes with a lower ROM (95% confidence interval, 1.05-1.20).Conclusion:NMM distance predicts initial noncontact LAS, and weightbearing dorsiflexion ROM predicts recurrent noncontact LAS.

The effects of Mobilization with Movement on dorsiflexion range of motion, dynamic balance, and self-reported function in individuals with chronic ankle instability

Previous studies have examined the effectiveness of a manual therapy intervention known as Mobilization with Movement (MWM) to increase dorsiflexion range of motion (ROM) in individuals with chronic ankle instability (CAI). While a single talocrural MWM treatment has increased dorsiflexion ROM in these individuals, examining the effects of multiple treatments on dorsiflexion ROM, dynamic balance, and self-reported function would enhance the clinical application of this intervention. This study sought to determine if three treatment sessions of talocrural MWM would improve dorsiflexion ROM, Star Excursion Balance Test (SEBT) reach distances, and self-reported function using the Foot and Ankle Ability Measure (FAAM) in individuals with CAI. Eleven participants with CAI (5 Males, 6 Females, age: 21.5 ± 2.2 years, weight: 83.9 ± 15.6 kg, height: 177.7 ± 10.9 cm, Cumberland Ankle Instability Tool: 17.5 ± 4.2) volunteered in this repeated-measures study. Subjects received three MWM treatments over one week. Weight-bearing dorsiflexion ROM (cm), normalized SEBT reach distances (%), and self-reported function (%) were assessed one week before the intervention (baseline), prior to the first MWM treatment (pre-intervention), and 24–48 h following the final treatment (post-intervention). No significant changes were identified in dorsiflexion ROM, SEBT reach distances, or the FAAM-Activities of Daily Living scale (p > 0.05). Significant changes were identified on the FAAM-Sport (p = 0.01). FAAM-Sport scores were significantly greater post-intervention (86.82 ± 9.18%) compared to baseline (77.27 ± 11.09%; p = 0.01) and pre-intervention (79.82 ± 13.45%; p = 0.04). These results indicate the MWM intervention did not improve dorsiflexion ROM, dynamic balance, or patient-centered measures of activities of daily living. However, MWM did improve patient-centered measures of sport-related activities in individuals with CAI.

Passive dorsiflexion stiffness is poorly correlated with passive dorsiflexion range of motion

ObjectivesThe purpose of this study was to determine the relationships among passive measures of weight-bearing dorsiflexion range of motion, non-weight-bearing dorsiflexion range of motion and dorsiflexion stiffness, thereby establishing whether they assess similar mechanical characteristics, as each measure has been implicated in injury risk during landings. DesignCross-sectional study. MethodsPassive weight-bearing dorsiflexion range of motion, non-weight-bearing dorsiflexion range of motion and dorsiflexion stiffness were quantified for 42 males (22.8±5.0 years). The relationship between each data set was calculated using Pearson product-moment correlation coefficients. ResultsAlthough weight-bearing dorsiflexion range of motion and non-weight-bearing dorsiflexion range of motion were significantly correlated, the strength of the relationship was poor (r2=0.18; p=0.004). Weight-bearing dorsiflexion range of motion (mean=43.0±5.0°) was significantly greater than non-weight-bearing dorsiflexion range of motion (29.8±5.9°; p<0.001) and weight-bearing dorsiflexion range of motion and non-weight-bearing dorsiflexion range of motion were also poorly correlated with passive dorsiflexion stiffness (1.48±0.55Nm°−1; r2=0.04 and r2=0.14, respectively), despite the latter relationship being significant (p=0.017). ConclusionsPassive dorsiflexion stiffness was not strongly associated with dorsiflexion range of motion, despite the significant correlation in the non-weight-bearing condition. It must be acknowledged that passive dorsiflexion stiffness was weakly associated with dorsiflexion range of motion, although the strength of the association suggests that it may not necessarily determine dorsiflexion range of motion. Furthermore, the functional dorsiflexion limits of the ankle during weight-bearing tasks may be underestimated or misrepresented by non-weight-bearing measures of dorsiflexion range of motion. Therefore, although ankle dorsiflexion range of motion and dorsiflexion stiffness have been implicated in injury risk during weight-bearing tasks such as landings, it may be due to different mechanisms.

Two‐week joint mobilization intervention improves self‐reported function, range of motion, and dynamic balance in those with chronic ankle instability

We examined the effect of a 2-week anterior-to-posterior ankle joint mobilization intervention on weight-bearing dorsiflexion range of motion (ROM), dynamic balance, and self-reported function in subjects with chronic ankle instability (CAI). In this prospective cohort study, subjects received six Maitland Grade III anterior-to-posterior joint mobilization treatments over 2 weeks. Weight-bearing dorsiflexion ROM, the anterior, posteromedial, and posterolateral reach directions of the Star Excursion Balance Test (SEBT), and self-reported function on the Foot and Ankle Ability Measure (FAAM) were assessed 1 week before the intervention (baseline), prior to the first treatment (pre-intervention), 24-48 h following the final treatment (post-intervention), and 1 week later (1-week follow-up) in 12 adults (6 males and 6 females) with CAI. The results indicate that dorsiflexion ROM, reach distance in all directions of the SEBT, and the FAAM improved (p < 0.05 for all) in all measures following the intervention compared to those prior to the intervention. No differences were observed in any assessments between the baseline and pre-intervention measures or between the post-intervention and 1-week follow-up measures (p > 0.05). These results indicate that the joint mobilization intervention that targeted posterior talar glide was able to improve measures of function in adults with CAI for at least 1 week.

Effects of passive ankle dorsiflexion stiffness on ankle mechanics during drop landings

ObjectivesVertical landing tasks strain the Achilles tendon and plantar-flexors, increasing acute and overuse strain injury risk. This study aimed to determine how passive ankle dorsiflexion stiffness affected ankle mechanics during single limb drop landings at different vertical descent velocities. DesignCross-sectional study. MethodsPassive ankle dorsiflexion stiffness and passive weight-bearing dorsiflexion range of motion (DROM) were quantified for 42 men. Participants were then grouped as having low (LPS: 0.94±0.15Nm°−1; n=16) or high (HPS: 2.05±0.36Nm°−1; n=16; p<0.001) passive ankle dorsiflexion stiffness. Three-dimensional ankle joint kinematics was quantified while participants performed drop landings onto a force platform at two vertical descent velocities (slow: 2.25±0.16ms−1; fast: 3.21±0.17ms−1). ResultsAlthough affected by landing velocity, there were no significant effects of passive ankle dorsiflexion stiffness, nor any significant ankle dorsiflexion stiffness×vertical descent velocity interactions on any outcome variables characterising ankle mechanics during drop landings. Furthermore, there was no significant difference between the groups for passive weight-bearing DROM (LPS: 43.9±4.1°; HPS: 42.5±5.7°), indicating that the results were not confounded by between-group differences in ankle range of motion. ConclusionsNeither high nor low passive ankle dorsiflexion stiffness was found to influence ankle biomechanics during drop landings at different descent velocities. Landing strategies were moderated more by the demands of the task than by passive ankle dorsiflexion stiffness, indicating that passive ankle dorsiflexion stiffness may not affect plantar-flexor strain during a drop landing.