• Journal of International Academy of Physical Therapy Research
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• v.9 no.4
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• pp.1642-1650
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• 2018

The purpose of this study was to identify the effect of proprioceptive neuromuscular facilitation (PNF) stretching exercise and joint mobilization on ankle joint range of motion (ROM), plantar pressure, and balance in subjects with stroke. Thirty patients (n=30) were organized into three groups, each of which received different treatments: PNF stretching (n=10), joint mobilization (n=10), and joint mobilization and PNF stretching combined (n=10). Each group received three exercise sessions per week for four weeks. The ankle ROM was measured using a goniometer, and plantar pressure and balance ability were measured using BioResque static posturography. In comparison within each group, the joint mobilization group and the joint mobilization with PNF stretching group showed significant improvements in ankle ROM, plantar pressure, and balance ability (p<.05). In comparison between the groups, a statistically significant difference was found in SECS change between the PNF stretching group, joint mobilization group and the joint mobilization with PNF stretching group. This study found demonstrates that the joint mobilization and joint mobilization with the PNF stretching methods were effective in improving ankle ROM, plantar pressure, and balance ability in stroke patients.

• Journal of International Academy of Physical Therapy Research
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• v.9 no.4
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• pp.1651-1656
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• 2018

The purpose of this study was to assess the changes in balance and proprioception of adults with limited ankle joint dorsiflexion, after the application of talocrural joint mobilization. The subjects of this study included 23 college students in their twenties with limited ankle joint dorsiflexion. The students were randomly assigned to the ankle joint mobilization group (AJMG, n=12) and the control group (CG, n=11). After 2 weeks of intervention using grade III talocrural joint mobilization in the anterior-posterior movement, the balance and proprioception of the subjects were assessed. Static/dynamic balance capabilities and ankle proprioception were analyzed using paired t-test and independent t-test. The dynamic balance and proprioception of AJMG were significantly improved after intervention (p<.05), In the comparison between the groups after the intervention, the dynamic balance and proprioceptive sense of AJMG were significantly improved compared to the control group (p<.05). This study suggests that AJMG can help improve the dynamic balance and proprioception.

• Journal of International Academy of Physical Therapy Research
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• v.5 no.2
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• pp.738-742
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• 2014

This study was conducted to investigate the effect of FES and ankle mobilization on the ankle motion and the quality of gait of chronic hemiplegic patients with limited ankle joint motions. As research subjects, 24 chronic hemiplegic patients who could walk independently, regardless of assistive aids, were selected. Then, 8 subjects received mobilization randomly and 8 subjects received FES and 8 subjects received mobilization and FES, at the same time. The dorsiflexion PROM significantly increased in the group of mobilization therapy, mobilization and FES all together(p<.01). There were statistically significant differences among the three groups(p<.01). The 10m walking test significantly decreased in the group of mobilization therapy, mobilization and FES all together(p<.05). There were statistically significant differences among the three groups(p<.01). The gait velocity significantly increased in the group of mobilization therapy, FES therapy, mobilization and FES all together(p<.05). There were statistically significant differences among the three groups(p<.01). The stride length significantly increased in the group of mobilization therapy, mobilization and FES all together(p<.05). There were statistically significant differences among the three groups(p<.05). In conclusion, these findings demonstrate that rather than only using one treatment technique, applying mobilization and FES together brings a more satisfactory result to hemiplegic patients with limited ankle joint motions.

• The Journal of Korean of Orthopedic Manual Physical Therapy
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• v.26 no.1
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• pp.55-63
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• 2020

Background: This study was conducted to compare the effects of an incline board, proprioceptive neuromuscular facilitation (PNF) stretching, and joint mobilization on the dorsiflexion of the ankle joint and muscle tone of the plantar flexor and ankle in stroke patients. Methods: Forty-five stroke subjects were randomly divided into three groups: each JMG (Joint Mobilization Group), IBG (Inclined Board Group) and PSG (PNF Stretching Group). The experiment was performed for eight weeks between August 1 and October 31, 2018. Results: The dorsiflexion of the ankle joint was significant between the groups and by period (p<.05). JMG had a significant change by period (p<.05). Differences between groups by period increased after 8 weeks in the PSG and the JMG (p>.05). The gastrocnemius lateral muscle tone was significant between the groups (p<.05), and medial muscle tone was interacted between groups and time (p<.05). Conclusion: An effective intervention method to increase the dorsiflexion of the ankle joint and decrease the muscle tone when performing PNF stretching, and joint mobilization in stroke patients was confirmed. Future studies are recommended to variety research of PNF stretching and joint mobilization.

• Korean Journal of Sport Biomechanics
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• v.26 no.2
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• pp.153-159
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• 2016

Objective: The purpose of this study was to investigate the effects of joint mobilization on foot pressure, ankle moment, and vertical ground reaction force in subjects with ankle instability. Method: Twenty male subjects (age, $25.38{\pm}3.62yr$; height, $170.92{\pm}5.41cm$; weight, $60.74{\pm}9.63kg$; body mass index (BMI), $19.20{\pm}1.67kg/m^2$) participated and underwent ankle joint mobilization. Weight-bearing distribution, ankle dorsi/plantar flexion moment, and vertical ground reaction force were measured using a GPS 400 and a VICON Motion System (Oxford, UK), and subsequently analyzed. SPSS 20.0 for Windows was used for data processing and paired t-tests were used to compare pre- and post-mobilization measurements. The significance level was set at ${\alpha}$ = .05. Results: The results indicated changes in weight-bearing, ankle dorsi/plantar flexion moment, and vertical ground reaction force. The findings showed changes in weight-bearing distribution on the left (pre $29.51{\pm}6.31kg$, post $29.57{\pm}5.02kg$) and right foot (pre $32.40{\pm}6.30kg$, post $31.18{\pm}5.47kg$). There were significant differences in dorsi/plantar flexion moment (p < .01), and there were significant increases in vertical ground reaction forces at initial stance (Fz1) and terminal stance (Fz2, p < .05). Additionally, there was a significant reduction in vertical ground reaction force at midstance (Fz2, p < .001). Conclusion: Joint mobilization appears to alter weight-bearing distribution in subjects with ankle instability, with resultant improvements in stability.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.2
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• pp.41-51
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• 2019

PURPOSE: This study was conducted to investigate the effects of combined Joint Mobilization and Functional Electrical Stimulation on Muscle Activation and Mobility of ankle joints in stroke patients and their Modified Functional Reach Test (MFRT) results. METHODS: A total of 26 patients with stroke were randomly selected for enrollment in this study. (1) Functional Electrical Stimulation (FES) (2) combined Joint Mobilization and FES. An EMG system was used to measure tibialis anterior and gastrocnemius activities. Range Of Motion (ROM) of Ankle Joint and MFRT for Dynamic Balance. Pre and post intervention results were compared by paired-t-tests and differences in changes after intervention between groups were identified by the independent t-test. RESULTS: The muscle activation, ROM, and MFRT differed significantly in the experimental group (p<.05). The ROM was significantly different for the active dorsiflexion pre and post intervention in the group that received FES alone (p<.05). CONCLUSION: The results of this study suggest use of a systematic program of proactive posture control to prevent dysfunction when planning interventions for ankle joints can help stroke patients walk efficiently.

• Journal of the Korean Data and Information Science Society
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• v.20 no.3
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• pp.527-539
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• 2009

The purpose of this study was to evaluate the influence of ankle joint mobilization on equilibrium ability of supinated foot. Both Joint mobilization group(n=20) and control group(n=20) were measured an equilibrium ability by Balance performance monitor at pre-test, post-test in 2 weeks, post-test in 4 weeks and follow-up test in 2 weeks. The sway area, sway path length and sway maximum velocity of the joint mobilization group were significantly reduced among the experimental period (p<.05). The reduction of sway area, sway path length and sway maximum velocity were significantly different between the joint mobilization group and the control group at in 2 weeks, 4 weeks and follow-up test(p<.05). In conclusion, we were found that ankle joint mobilization could reduce sway area, sway path length and sway max velocity and improve a balance for the individuals with supinated foot.

• The Journal of Korean of Orthopedic Manual Physical Therapy
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• v.23 no.2
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• pp.9-16
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• 2017

Background: The purpose of this study was to investigate the relationship between the spine and the flat-foot, the stability and the alignment of the posture of the neck to prevent the alignment of the ankle joint operation and the lower back flexibility of the lumbar region according to the type of treatment using active stretching of the triceps, back pain, and to see how they affect weight bearing differences. Methods: The subjects of this study were 24 chronic low back pain patients. They were randomly divided into experimental group and control group. In the experimental group, ankle joint mobilization and active scraping of triceps were performed three times a week for a total of 6 weeks. The control group was performed in the same way without articulation. The range of flexion and extension motion of the lumbar spine and pain degree and difference of weight-bearing were measured before and after the experiment. Results: The model of ankle joint mobilization and calf muscle elongation of flat foot significantly improved the range of flexion and extension motion of the vertebrae (p<.05) and the VAS and distribution of weight-bearing were decreased in both of two groups (p<.05). In other words, the exercise and mobilization help to recover of the balance of the whole musculoskeletal, the vertebrae. Conclusions: The active exercise of the triceps muscle of the lower leg in this study It affects the flexibility of the lumbar spine, the pain and the difference in the weight support of the lower extremities, when we performed ankle joint mobilization for exercise and cramping, pain and the difference in weight support between the two lower limbs.

• Physical Therapy Korea
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• v.19 no.1
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• pp.10-18
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• 2012

The purpose of this study was to determine the effects of weight shift training with joint mobilization on the ankle joint passive range of motion (PROM), balance capacity and gait velocity in hemiplegic patients. Fourteen subjects were randomly assigned to either the experimental group (EG) or the control group (CG), with seven subjects in each group. The EG received weight shift training with joint mobilization in the paretic leg's subtalar joint in order to increase ankle dorsiflexion. The CG received general physical therapy training. Both groups received training five times a week over a period of two consecutive weeks. The figures for PROM of ankle dorsiflexion on the paretic leg, the functional reach test (FRT), the timed up and go (TUG) test, and gait velocity were recorded both before and after the training sessions for both groups. The EG's results in gait velocity, the FRT and the TUG test improved after training (p<.05). The PROM of ankle dorsiflexion improved both in the EG and the CG (p<.05), the EG demonstrated a significantly higher increase (p<.05) than that of the CG. The results of this study suggest that increased joint mobilization positively affects balance and gait velocity of hemiplegic patients. Further studies with a greater sample size are necessary in order further prove the accuracy of the results of this study.

• Journal of Convergence for Information Technology
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• v.9 no.12
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• pp.184-189
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• 2019

The purpose of this study to compare the effect of physical therapy interventions on the improvement of ankle joint range of motion with stroke patients. Total subjects were 45 stroke patients, who were divided into a group using inclined boards(n=15), a group of receiving stretching(n=15), and a group of receiving joint mobilization(n=15). The experiment was performed for 8 weeks. The plantar flexion showed significant differences both groups and by periods. The dorsiflexion showed significant differences between groups and by periods, and the group in changes within groups by periods. This study found that stretching and joint mobilization are effective as an intervention method to increase the range of motion on ankle joint. Future study is expected to investigate other effects of increased ankle range of motion in stroke patients.