• Journal of International Academy of Physical Therapy Research
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• v.9 no.3
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• pp.1517-1520
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• 2018

It has been reported that gastrocnemius tightness and posterior talar glide are crucial factors influencing ankle dorsiflexion. However, the relationship of ankle dorsiflexion and these factors is not identified in previous studies. The purpose of this study was to identify the relationship of ankle dorsiflexion passive range of motion and gastrocnemius tightness and posterior talar glide. Twenty-five male subjects participated in this study. Bilateral weight-bearing ankle dorsiflexion passive range of motion and amount posterior talar glide of participants were measured using an inclinometer. Change in myotendinous junction of medial gastrocnemius was measured using ultrasonography to identify gastrocnemius tightness. Pearson product moment correlations were performed to examine correlations between ankle dorsiflexion passive range of motion and gastrocnemius tightness and posterior talar glide. Present findings revealed significant correlation between ankle dorsiflexion passive range of motion and gastrocnemius tightness (p=0.017, r=0.336). Also, ankle dorsiflexion passive range of motion was correlated with posterior talar glide (p=0.001, r=0.470). The present findings provide experimental evidence for factors influencing weight-bearing ankle dorsiflexion.

• Physical Therapy Rehabilitation Science
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• v.10 no.1
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• pp.10-15
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• 2021

Objective: Limited ankle dorsiflexion is related to ankle injuries. There are various exercises to increase the flexibility of the gastrocnemius for improving the passive range of motion in ankle dorsiflexion. However, to performances in daily activities and athletic sports and higher efficiency of walking and running, both ankle dorsiflexion passive and active range of motion are needed. To investigate the effects of combined gastrocnemius stretching and tibialis anterior resistance exercise on ankle kinematics (passive and active range of motion of ankle dorsiflexion) and tibialis anterior muscle activity in subjects with limited ankle dorsiflexion. Design: Cross-sectional single-group repeated measures design. Methods: Fourteen subjects with limited ankle dorsiflexion were recruited (in the right ankle in 7 and the left ankle in 7). All subjects performed gastrocnemius stretching alone and tibialis anterior resistance exercise after gastrocnemius stretching. The passive and active range of motion of ankle dorsiflexion were measured after interventions immediately. The tibialis anterior activity was measured during active range of motion of ankle dorsiflexion measurement. Results: There was no significant difference of ankle dorsiflexion passive range of motion between gastrocnemius stretching alone and the tibialis anterior resistance exercise after gastrocnemius stretching. The tibialis anterior resistance exercise after gastrocnemius stretching significantly increased active range of motion of ankle dorsiflexion compared to gastrocnemius stretching alone (p<0.05). The tibialis anterior resistance exercise after gastrocnemius stretching significantly increased tibialis anterior activity better than did gastrocnemius stretching alone. Conclusions: Thus, subjects with limited ankle dorsiflexion should be encouraged to perform tibialis anterior resistance exercises.

• Journal of the Korean Society of Physical Medicine
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• v.19 no.1
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• pp.69-79
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• 2024

PURPOSE: This study compared the effect of the muscle energy technique (MET) and stretching technique on ankle dorsiflexion passive range of motion, balance, and gait ability of stroke patients with limited ankle dorsiflexion. METHODS: Forty-four post-stroke patients participated. The participants were randomized into the MET group (METG; n = 22) and the stretching group (STG; n = 22). The METG was subjected to the MET to relax the dorsiflexion, while the STG was subjected to the dorsiflexion stretching technique. Both groups completed standard neurological physical therapy for 30 min per session. The intervention was conducted five times a week over 3 weeks for a total of 15 times. All participants underwent ankle dorsiflexion passive range of motion measurement and Berg Balance Scale score determination and completed a 10-m walking test and the timed up and go test before and after the intervention. RESULTS: After the 3-week intervention, both groups showed significant improvement after the intervention (p < .05). METG participants showed greater improvements in ankle dorsiflexion passive range of motion and 10-m walking test results compared to STG participants (p < .05). CONCLUSION: Both interventions improved ankle dorsiflexion passive range of motion, balance, and gait ability in stroke patients with limited ankle dorsiflexion. Moreover, the MET was superior to ankle dorsiflexion passive range of motion on the 10-m walking test.

• The Journal of Korean Physical Therapy
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• v.29 no.2
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• pp.95-100
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• 2017

Purpose: This study aimed to evaluate the changes in dorsiflexion and balance following proximal and distal tibiofibular joint manipulation in individuals with a history of lateral ankle sprain (LAS). Methods: Fifteen participants with a history of unilateral LAS, exhibiting a restriction in ankle dorsiflexion were included in this study. LAS ankle received a manipulation to the proximal and distal tibiofibular joint, while the opposite control ankle received no manipulation intervention. The outcome measures included ankle dorsiflexion and balance. Ankle dorsiflexion was measured using weight-bearing lunge test. Static and dynamic balances were measured using the overall, anterioposterior, and mediolateral balance index via the biodex balance system. Measurements were obtained prior to and following manipulation. Results: This study showed that ankle dorsiflexion and dynamic balance were improved following the manipulation compared to those prior to the manipulation (p<0.05). There was no significant change in static balance (p>0.05). Conclusion: The joint manipulation technique applied to the ankle of those with a history of LAS appears to improve ankle dorsiflexion and dynamic balance. This suggest that a manipulation to the proximal and distal tibiofibular joint could be provided as preliminary data regarding the prophylactic effects of recurrent LAS.

• PNF and Movement
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• v.19 no.1
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• pp.87-95
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• 2021

Purpose: The purpose of this study was to determine the effects of talus stability taping during gastrocnemius stretching on ankle passive dorsiflexion, talus posterior glide, and balance in subjects with limited ankle dorsiflexion. Methods: Fifteen subjects (eight males and seven females) with limited ankle dorsiflexion participated in this study. Ankle passive dorsiflexion range of motion (ROM), talus posterior glide, and the lower quarter Y-balance test (YBT-LQ) were measured pre-stretching, after applying gastrocnemius stretching (GS), and after applying gastrocnemius stretching with talus stability taping (GSTST). The two types of stretching were performed at random. Results: Ankle passive dorsiflexion ROM was significantly increased by both types of stretching (p < 0.05), and ROM was significantly more increased post-GSTST than post-GS (p < 0.05). In addition, talus posterior glide was significantly increased post-GSTST than pre-stretching and post-GS (p < 0.05). However, there was no significant difference between post-GS and pre-stretching (p > 0.05). YBT-LQ score was significantly increased post-GSTST than pre-stretching (p < 0.05). Conclusion: Gastrocnemius stretching with talus stability taping is an effective method for subjects with limited ankle dorsiflexion to improve ankle passive dorsiflexion, talus posterior gliding, and balance.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.1
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• pp.103-108
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• 2011

Purpose : The purposes of this study were to compare the muscle activity ratio of tibialis anterior (TA) / extensor digitorum longus (EDL) during the active ankle dorsiflexion in subjects with the normal toe (NT) and the hammer toe (HT). Methods : Nineteen subjects with the NT group and nineteen subjects with the HT group were recruited for this study. The muscle activities of TA and EDL were measured by using surface electromyography (EMG) and the angles of ankle dorsiflexion and eversion of the subtalar joint were measured by using 3-dementional motion analysis during the active ankle dorsiflexion in prone position. Results : The muscle activity ratio of TA / EDL was significantly lower in the HT group compared to the NT group (p<.05). The angle of ankle dorsiflexion was significantly lower in the HT group compared to the NT group (p<.05). Conclusions : These results suggest that muscle imbalance between TA and EDL muscle and decreased ankle dorsiflexion range of motion may contribute to hammer toe deformity. Further studies are needed to confirm that the correcting of this imbalance and the increasing ankle dorsiflexion could improve toe alignment in the subjects with HT.

• The Journal of Korean Physical Therapy
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• v.32 no.4
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• pp.233-237
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• 2020

Purpose: This study compared the electromyographic activity of the tibialis anterior (TA) and isometric dorsiflexor strength during dorsiflexion according to the toe postures in individuals with ankle dorsiflexor weakness. Methods: Twenty subjects with ankle dorsiflexor weakness participated in this study. The electromyographic activity of the TA and isometric dorsiflexor strength during dorsiflexion between with toe flexion, extension, and neutral postures were measured using an electromyography device and a hand-held dynamometer in individuals with ankle dorsiflexor weakness. One-way repeated measured analysis of variance, and a Bonferroni post hoc test was used. The level of statistical significance was set to α=0.01. Results: The electromyographic activity of the TA was greater with toe flexion during dorsiflexion than with toe extension and neutral postures (p<0.01). The isometric dorsiflexor strength was smaller with toe flexion during dorsiflexion than with toe extension and neutral postures (p<0.01). Conclusions: In individuals with ankle dorsiflexor weakness, the dorsiflexion with toe flexion can help improve the TA electromyographic activity. The toe posture during dorsiflexion for selective TA activation should be considered, especially in individuals with ankle dorsiflexor weakness.

• The Journal of Korean Physical Therapy
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• v.32 no.4
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• pp.238-244
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• 2020

Purpose: This study compared the effects of the fascial distortion model (FDM), foam rolling (FR), and self-stretching (SS) on the ankle dorsiflexion range of motion (ROM). Methods: Thirty subjects who had no more than 30° of ankle dorsiflexion ROM at the weight-bearing lunge test were recruited in this study. They were divided into three groups: (FDM, FR, and SS), and underwent each intervention for five minutes. Before and after the intervention, the ankle dorsiflexion ROM in the supine (the open-) and standing (the closed-kinetic chain) of the subjects were tested. The changes in the ROM between pre- and post-intervention and among the groups were analyzed. Results: All groups showed increased ankle dorsiflexion ROM after the intervention in both positions. In the position of the open kinetic chain, the changes in the ROM between pre- and post-intervention had significant differences among the groups, and the FDM was higher than the FR and SS. In the position of the closed kinetic chain, the ROM after the interventions and the changes in the ROM had significant differences among the groups, and FDM was higher than the FR (ROM after the intervention, the change in ROM) and SS (the change in ROM). Conclusion: These findings showed that FDM had more efficiency than the FR and SS as FDM had a stronger effect on increasing ankle dorsiflexion in a short, limited time. Clinicians who have limited time to treat their patients, particularly trying to increase ankle dorsiflexion ROM, should consider the application of FDM.

• The Journal of Korean Physical Therapy
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• v.34 no.3
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• pp.91-97
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• 2022

Purpose: This study investigated the short-term effectiveness of extracorporeal shock wave therapy (ESWT) on pain, the ankle instability, the ankle function, dorsiflexion range of motion (ROM), and dynamic balance in patients with chronic ankle instability (CAI). Methods: Eighteen participants were divided into an experimental (n=9) and control group (n=9). The ESWT in the experimental group was applied to the lateral collateral ligament in combination with the tibialis anterior whereas the ESWT was applied to the lateral collateral ligament of the ankle alone in the control group. Pain, the ankle instability, the ankle function, dorsiflexion ROM, and dynamic balance were measured using the Visual analog scale, Cumberland ankle instability tool, American Orthopedic Foot and Ankle Society ankle-hindfoot score, weight-bearing lunge, and Y-balance test, before and after ESWT intervention. Results: Significant interactions (group × time) and time effects were observed in the dorsiflexion ROM and dynamic balance. Bonferroni's post-hoc analysis showed that the experimental group revealed a more significant change in dorsiflexion ROM and dynamic balance than the control group. There was a significant time effect in the pain, the ankle instability, and the ankle function, but no significant interaction (group × time) was observed. Conclusion: The ESWT could improve the pain, ankle instability, ankle function, dorsiflexion ROM, and dynamic balance in patients with CAI. Furthermore, the ESWT combined with lateral ankle ligaments and tibialis anterior more improves the dorsiflexion ROM and dynamic balance.

• PNF and Movement
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• v.21 no.1
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• pp.19-25
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• 2023

Purpose: The aim of this study is to determine the effects of gastrocnemius stretching with talus-stabilizing taping on ankle dorsiflexion and subtalar joint pronation during walking. Methods: In total, 26 subjects with limited ankle dorsiflexion were equally divided into two groups: a gastrocnemius stretching with talus-stabilizing taping group (13 subjects) and a gastrocnemius stretching group (13 subjects). They were assessed according to ankle dorsiflexion and subtalar joint pronation during walking before and after an intervention, which involved two types of gastrocnemius stretches performed three times a week for six weeks. Results: Ankle dorsiflexion was significantly increased in both groups (p<0.05), though the gastrocnemius stretching with talus-stabilizing taping group showed a significantly greater improvement in ankle dorsiflexion than the gastrocnemius stretching group (p<0.05). However, subtalar joint pronation showed no difference between the two groups before and after (p>0.05), also between groups (p>0.05). Conclusion: Gastrocnemius stretching with talus-stabilizing taping is a useful stretching exercise that improves ankle dorsiflexion during walking in subjects with limited ankle dorsiflexion movement.