Immediate effect of walking with talus-stabilizing taping on ankle kinematics in subjects with limited ankle dorsiflexion

Effects of peak ankle dorsiflexion angle on lower extremity biomechanics and pelvic motion during walking and jogging

Objective

Ankle dorsiflexion during walking causes the tibia to roll forward relative to the foot to achieve body forward. Individuals with ankle dorsiflexion restriction may present altered movement patterns and cause a series of dysfunction. Therefore, the aim of this research was to clearly determine the effects of peak ankle dorsiflexion angle on lower extremity biomechanics and pelvic motion during walking and jogging.

Method

This study involved 51 subjects tested for both walking and jogging. The motion capture system and force measuring platforms were used to synchronously collect kinematics and kinetics parameters during these activities. Based on the peak ankle dorsiflexion angle during walking, the 51 subjects were divided into a restricted group (RADF group, angle <10°) and an ankle dorsiflexion-unrestricted group (un-RADF group, angle >10°). Independent-Sample T-tests were performed to compare the pelvic and lower limb biomechanics parameters between the groups during walking and jogging test on this cross-sectional study.

Results

The parameters that were significantly smaller in the RADF group than in the un-RADF group at the moment of peak ankle dorsiflexion in the walking test were: ankle plantar flexion moment (p < 0.05), hip extension angle (p < 0.05), internal ground reaction force (p < 0.05), anterior ground reaction force (p < 0.01), pelvic ipsilateral tilt angle (p < 0.05). In contrast, the external knee rotation angle was significantly greater in the RADF group than in the un-RADF group (p < 0.05). The parameters that were significantly smaller in the RADF group than in the un-RADF group at the moment of peak ankle dorsiflexion in the jogging test were: peak ankle dorsiflexion angle (p < 0.01); the anterior ground reaction force (p < 0.01), the angle of pelvic ipsilateral rotation (p < 0.05).

Conclusion

This study shows that individuals with limited ankle dorsiflexion experience varying degrees of altered kinematics and dynamics in the pelvis, hip, knee, and foot during walking and jogging. Limited ankle dorsiflexion alters the movement pattern of the lower extremity during walking and jogging, diminishing the body's ability to propel forward, which may lead to higher injury risks.

Comparison of ankle force, mobility, flexibility, and plantar pressure values in athletes according to foot posture index

Objectives

This study aims to compare ankle force, mobility, flexibility, and plantar pressure distribution of athletes according to foot posture index (FPI).

Patients and methods

Between September 2016 and May 2018, a total of 70 volunteer male athletes (mean age: 21.1±2.3 years; range, 18 to 25 years) were included. The athletes were divided into three groups according to their FPI as follows: having supinated feet (Group 1, n=16), neutral/normal feet (Group 2, n=36), or pronated feet (Group 3, n=18). Ankle range of motion (ROM), muscle flexibility, ankle joint strength, and plantar pressure distribution were measured.

Results

There were significant differences among the three groups in both right and left ankle dorsiflexion ROM (p=0.009 and p=0.003, respectively). Group 1 had significantly smaller dorsiflexion ROM than the other groups. Group 1 also showed significantly less flexibility in the gastrocnemius and soleus muscles than the other foot posture groups. Groups 2 and 3 exhibited significant differences in the maximum torque (p=0.018), maximum work (p=0.008), and total work (p=0.008) of the right plantar flexor muscles at 60°/sec angular velocity. Peak pressure measurements of the right foot were higher in Group 1, compared to Groups 2 and 3 (p<0.001).

Conclusion

The results of this study may help to enhance athletic performance by providing a guide for designing training programs appropriate for athletes with different foot types to address their specific muscle flexibility and strength deficiencies.

Spatial-temporal parameters, pelvic and lower limb movements during gait in individuals with reduced passive ankle dorsiflexion

BACKGROUND

Proper ankle dorsiflexion range of motion (ADF-ROM) allows the anterior roll of the tibia relative to the foot during the midstance phase of gait, which contributes to forward movement of the body. Individuals with reduced passive ADF-ROM may present altered movement patterns during gait due to an inefficient anterior tibial roll over the support foot during the stance phase.

RESEARCH QUESTION

What is the influence of reduced passive ADF-ROM on the pelvic and lower limb movements and spatiotemporal parameters during gait?

METHOD

Thirty-two participants divided into two groups according to the degree of passive ADF-ROM-less than 10° (lower ADF-ROM group) or greater than 15° (higher ADF-ROM group) -were subjected to gait assessment using a three-dimensional motion analysis system. Independent t-tests were used to compare the pelvic and lower limb movements and spatiotemporal gait parameters between the groups on this cross-sectional study.

RESULTS

The lower ADF-ROM group had shorter step length, lower peak of pelvic ipsilateral rotation angle, and lower hip and knee maximum flexion angles in the stance phase (p < 0.05). In addition, the peaks of the ankle and forefoot-rearfoot dorsiflexion angles were smaller in the reduced ADF-ROM group (p < 0.05). The between-group differences presented effect sizes varying from moderate to large.

SIGNIFICANCE

Individuals with reduced passive ADF-ROM presented reduced foot and ankle dorsiflexion, knee and hip flexion, and pelvis rotation movements and shorter step length during gait. However, no differences in foot pronation were noted between groups. Therefore, individuals with reduced passive ADF-ROM present alterations in the lower limb and pelvic movements during gait.

Effect of Ankle Joint Mobilization with Movement on Range of Motion, Balance and Gait Function in Chronic Stroke Survivors: Systematic Review of Randomized Controlled Trials

Background

Ankle joint mobilization with movement has been speculated to be an important intervention for enhancing range of motion, balance, and gait functions in chronic stroke survivors. Nonetheless, there is a scarcity of recent conclusive evidence that evaluates its efficacy in chronic stroke patients. The purpose of this review was to synthesize existing evidence on the efficacy of mobilization with movement therapy on range of motion, balance, and gait performance in subjects after stroke.

Methods

A comprehensive systematic search of literature was performed using the following databases: PubMed/Medline, CINAHL, AMED, PEDro, Cochrane Library, and Scopus. Physiotherapy Evidence Database (PEDro) scale was used to evaluate the methodological quality of included trials. The primary outcome measures of this review were dorsiflexion range of motion (DF-ROM), and Berg balance scale (BBS). This review was reported in accordance with PRISMA statement guidelines. Due to variations in relevant trials, meta-analysis was not carried out.

Results and Conclusions

Seven randomized controlled trials with a total of 224 subjects were analyzed. Evidence of overall quality was graded from moderate to high. This review found that mobilization with movement therapy could be an alternative rehabilitative intervention for subjects with chronic stroke to increase range of motion, balance, and gait ability. However, the evidence remains preliminary due to the small number of participants. Large-scale RCTs in the future are warranted to investigate the efficacy of mobilization with movement in subgroups of chronic stroke subjects.

Effects of gastrocnemius stretching with talus-stabilizing taping on ankle dorsiflexion and balance in individuals with limited ankle dorsiflexion: A randomized controlled trial

BACKGROUND: Various interventions have been recommended to increase ankle dorsiflexion range of motion (DFROM); however, few studies have investigated the long-term effects of applying gastrocnemius stretching with talus-stabilizing taping (GSTST). OBJECTIVE: To compare the effects of gastrocnemius stretching (GS) and GSTST on DFROM and balance in subjects with limited DFROM. METHODS: Twenty-six subjects with limited DFROM were randomly allocated to either the GS group (n= 13) or GSTST group (n= 13) for 6 weeks. Maximum DFROM before heel-off during gait, passive DFROM, posterior talar glide, flexibility of the gastrocnemius, and the lower-quarter Y-balance test (YBT-LQ) were assessed pre-intervention and post-intervention. Two-way repeated-measures analysis of variance was used to compare the changes in variables. RESULTS: The GSTST group had greater maximum DFROM before heel-off, passive DFROM, and posterior talar glide than the GS group. Gastrocnemius flexibility and YBT-LQ scores increased significantly post-intervention in both groups; however, there was no significant difference between the groups. CONCLUSIONS: GSTST is recommend for improving ankle DFROM and balance in subjects with limited DFROM.

Effects of Walking With Talus-Stabilizing Taping on Passive Range of Motion, Timed Up and Go, Temporal Parameters of Gait, and Fall Risk in Individuals With Chronic Stroke: A Cross-sectional Study

OBJECTIVE

The purpose of this study was to determine the effects of walking with talus-stabilizing taping on ankle dorsiflexion passive range of motion, the timed up-and-go test, temporal parameters of gait, and fall risk in individuals with chronic stroke.

METHODS

In this cross-sectional design study, 20 participants with chronic stroke (9 female, 11 male), aged 60.5 ± 8.1 years, were included. Three conditions were evaluated: barefoot, immediately after applying talus-stabilizing taping, and after 5 minutes of walking with talus-stabilizing taping. One-way repeated-measures analysis of variance was used to determine the differences in ankle dorsiflexion passive range of motion, timed up-and-go test results, temporal parameters of gait, and fall risk across the 3 conditions.

RESULTS

Ankle dorsiflexion passive range of motion, walking speed, and single-limb support phase were significantly improved after 5 minutes of walking with talus-stabilizing taping compared to those in the barefoot and immediately-after-taping conditions. The timed up-and-go test, double-limb support phase, and fall-risk results significantly decreased more after 5 minutes of walking with talus-stabilizing taping compared to barefoot and immediately after taping.

CONCLUSION

After the application of talus-stabilizing taping, ankle dorsiflexion passive range of motion, timed up-and-go test results, temporal parameters of gait, and fall risk were reduced in individuals with chronic stroke.

Effects of talus stabilization taping versus ankle kinesio taping in patients with chronic stroke: a randomized controlled trial

Talus stabilization taping (TST) can be utilized to stabilize posteriorly glide of the talus and allows active ankle dorsiflexion movement during walking. The purpose of this study was to compare the effects of ankle kinesio taping with those of TST on ankle dorsiflexion passive range of motion, static balance, the Timed Up and Go test, and the fall risk in patients with chronic stroke and limited ankle dorsiflexion. Participants were randomized into the kinesio taping (n=11) and TST groups (n=11). Both groups were applied the appropriate taping and were asked to walk on the treadmill for 10 min. The ankle dorsiflexion passive range of motion, static balance ability, Timed Up and Go test, and fall risk were assessed in all participants before and after the intervention. The TST group showed greater improvement than the ankle kinesio taping group in all outcomes measured (P<0.05). Furthermore, both groups had significantly decreased in the Timed Up and Go results (P<0.05). This study shows that TST improves functional ability of the ankles of patients with chronic stroke in comparison to the kinesio taping method.

Ankle-Joint Self-Mobilization and CrossFit Training in Patients With Chronic Ankle Instability: A Randomized Controlled Trial

CONTEXT

Ankle-joint mobilization and neuromuscular and strength training have been deemed beneficial in the management of patients with chronic ankle instability (CAI). CrossFit training is a sport modality that involves these techniques.

OBJECTIVE

To determine and compare the influence of adding self-mobilization of the ankle joint to CrossFit training versus CrossFit alone or no intervention in patients with CAI.

DESIGN

Randomized controlled clinical trial.

SETTING

Research laboratory.

PATIENTS OR OTHER PARTICIPANTS

Seventy recreational athletes with CAI were randomly allocated to either self-mobilization plus CrossFit training, CrossFit training alone, or a control group.

INTERVENTION(S)

Participants in the self-mobilization plus CrossFit group and the CrossFit training-alone group pursued a CrossFit training program twice a week for 12 weeks. The self-mobilization plus CrossFit group performed an ankle self-mobilization protocol before their CrossFit training, and the control group received no intervention.

MAIN OUTCOME MEASURE(S)

Ankle-dorsiflexion range of motion (DFROM), subjective feeling of instability, and dynamic postural control were assessed via the weight-bearing lunge test, Cumberland Ankle Instability Tool, and Star Excursion Balance Test (SEBT), respectively.

RESULTS

After 12 weeks of the intervention, both the self-mobilization plus CrossFit and CrossFit training-alone groups improved compared with the control group (P < .001). The self-mobilization plus CrossFit intervention was superior to the CrossFit training-alone intervention regarding ankle DFROM as well as the posterolateral- and posteromedial-reach distances of the SEBT but not for the anterior-reach distance of the SEBT or the Cumberland Ankle Instability Tool.

CONCLUSIONS

Ankle-joint self-mobilization and CrossFit training were effective in improving ankle DFROM, dynamic postural control and self-reported instability in patients with CAI.

The Effects of Posterior Talar Glide and Dorsiflexion of the Ankle Plus Mobilization with Movement on Balance and Gait Function in Patient with Chronic Stroke: A Randomized Controlled Trial

Background:

This study was to evaluate the effects of weight-bearing-based mobilization with movement (WBBMWM) on balance and gait in stroke patients.

Methods:

Thirty stroke patients participated in this study. All individuals were randomly assigned to either WBMWM group (n = 15) or weight-bearing with placebo mobilization with movement group (control, n = 15). Individuals in the WBMWM group were trained for 10 glides of 5 sets a day, 5 times a week during 4 weeks. Furthermore, individuals in the control group were trained for 10 lunges of 5 sets a day, 5 times a week during 4 weeks. All individuals were measured weight-bearing lunge test (WBLT), static balance ability, timed up and go test (TUG), and dynamic gait index (DGI) in before and after intervention.

Results:

The result showed that WBBMWM group and control group had significantly increased in WBLT, postural sway speed, total postural sway path length with eyes open and closed, TUG and DGI (P < 0.05). In particular, the WBMWM group showed significantly greater improvement than control group in WBLT, static balance measures, TUG, and DGI (P < 0.05).

Conclusion:

Therefore, WBMWM improved ankle range of motion, balance, and gait in stroke patients. These results suggest that WBBMWM is feasible and suitable for individuals with a stroke.

The time-course effects of talus taping on ankle dorsiflexion range of motion

Background/Aims

Talus taping may be an effective physiotherapeutic treatment for equinus (passive dorsiflexion range of motion <10°). However, the time-course effects of this intervention are unknown. The aims of this study were to identify the effect that the application of talus tape for 48 hours during normal functional activities has on dorsiflexion range of motion, and to determine whether any changes in dorsiflexion range of motion persisted until 5 days after removal (study day 7).

Methods

A total of 16 healthy participants (mean age 28.3 ± 8 years) were recruited. Participants' were randomly assigned to control and intervention conditions. Baseline measures of dorsiflexion range of motion were taken in both ankles using the weight-bearing lunge test. The intervention ankle had talus tape applied, which remained in place for 48 hours during normal functional activities. To determine the time-course effects, dorsiflexion range of motion was reassessed in the control and intervention ankles immediately following removal of the tape (at 48 hours) and again 5 days later, on day 7.

Findings

Dorsiflexion range of motion in the taped intervention ankle increased significantly between the baseline and 48-hour measures. However, when reassessed at day 7, participants' dorsiflexion range of motion had returned to baseline levels. There were no significant differences in the control ankle across all three measures.

Conclusions

Applying talus tape for 48 hours during normal functional activities results in immediate but not long-lasting changes in dorsiflexion range of motion.

Influence of ankle dorsiflexion range of motion on heel-rise time during gait

[Purpose] The purpose of this study was to examine the correlation between weight-bearing (WB) and non-WB ankle dorsiflexion (DF) range of motion (ROM) and ankle movement during gait, including heel-rise time and ankle DF at heel-rise. [Subjects and Methods] Thirty healthy male subjects were recruited for this study. Ankle DF ROM of both feet was measured under the WB and non-WB conditions. Heel-rise time and ankle DF at heel-rise in both feet during gait were measured using a motion analysis system. Pearson product moment correlations were used to identify correlation ankle DF ROM and ankle movement during gait. [Results] Heel-rise time and ankle DF at heel rise were significantly correlated with WB ankle DF ROM. However, no correlations were found between ankle movement during gait and non-WB ankle DF ROM. [Conclusion] These findings demonstrate that WB ankle DF ROM measurements can be used to predict heel-rise time and ankle DF at heel-rise.

Immediate effects of talus-stabilizing taping on balance and gait parameters in patients with chronic stroke: a cross-sectional study

BACKGROUND

Talus-stabilizing taping (TST) may improve ankle range of motion and gait performance by providing a posterior-inferior talar glide in a closed-chain dorsiflexion position.

OBJECTIVES

This study aimed to investigate the immediate effects of TST on balance and gait parameters in patients with chronic stroke.

METHODS

Twenty post-stroke patients participated in this study. Each participant performed tests under three conditions (TST, barefoot, and conventional ankle-foot orthosis [AFO]), in random order. Before testing, the patients walked for 10 min under the three conditions, followed by a 5 min rest period. The outcome measures were static balance ability (SBA), timed up-and-go (TUG) test results, and gait parameters evaluated using a 6-m-long gait mat. One-way repeated measures analysis of variance was used to determine the difference in balance and gait parameters under the three conditions.

RESULTS

SBA more significantly improved in the TST condition than in the barefoot condition. SBA more significantly improved in the conventional AFO condition than in the barefoot condition. The TUG test results more significantly improved in the TST condition than in the conventional AFO and barefoot conditions. Walking speed, cadence, and affected side and unaffected side step and stride lengths more significantly improved in the TST condition than in the conventional AFO and barefoot conditions.

CONCLUSIONS

This study used a cross-sectional method and demonstrated that TST improves SBA, TUG, gait speed, cadence, step length, and stride length in patients with chronic stroke.

Relationship Between Weightbearing Ankle Dorsiflexion Passive Range of Motion and Ankle Kinematics During Gait

BACKGROUND

Measurement of weightbearing ankle dorsiflexion (DF) passive range of motion (PROM) has been suggested as a way to estimate ankle kinematics during gait; however, no previous study has demonstrated the relationship between ankle DF during gait and ankle DF PROM with knee extension. We examine the relationship between maximum ankle DF during gait and nonweightbearing and weightbearing ankle DF PROM with knee extension.

METHODS

Forty physically active individuals (mean ± SD age, 21.63 ± 1.73 years) participated in this study. Ankle DF PROM with knee extension was measured in the nonweightbearing and weightbearing conditions; maximum ankle DF during gait was assessed using a three-dimensional motion analysis system. The relationship between each variable was calculated using the Pearson product moment correlation coefficient, and the difference in ankle DF PROM between the nonweightbearing and weightbearing conditions was analyzed using a paired t test.

RESULTS

The weightbearing measurement (r = 0.521; P < .001) for ankle DF PROM showed a greater correlation with maximum ankle DF during gait than did the nonweightbearing measurement (r = 0.245; P = .029). Ankle DF PROM was significantly greater in the weightbearing than in the nonweightbearing condition (P < .001) despite a significant correlation between the two measurements (r = 0.402; P < .001).

CONCLUSIONS

These findings indicate that nonweightbearing and weightbearing measurements of ankle DF PROM with knee extension should not be used interchangeably and that weightbearing ankle DF PROM with the knee extended is more appropriate for estimating ankle DF during gait.

Ankle-Dorsiflexion Range of Motion After Ankle Self-Stretching Using a Strap

CONTEXT

A variety of ankle self-stretching exercises have been recommended to improve ankle-dorsiflexion range of motion (DFROM) in individuals with limited ankle dorsiflexion. A strap can be applied to stabilize the talus and facilitate anterior glide of the distal tibia at the talocrural joint during ankle self-stretching exercises. Novel ankle self-stretching using a strap (SSS) may be a useful method of improving ankle DFROM.

OBJECTIVE

To compare the effects of 2 ankle-stretching techniques (static stretching versus SSS) on ankle DFROM.

DESIGN

Randomized controlled clinical trial.

SETTING

University research laboratory.

PATIENTS OR OTHER PARTICIPANTS

Thirty-two participants with limited active dorsiflexion (<20°) while sitting (14 women and 18 men) were recruited.

MAIN OUTCOME MEASURE(S)

The participants performed 2 ankle self-stretching techniques (static stretching and SSS) for 3 weeks. Active DFROM (ADFROM), passive DFROM (PDFROM), and the lunge angle were measured. An independent t test was used to compare the improvements in these values before and after the 2 stretching interventions. The level of statistical significance was set at α = .05.

RESULTS

Active DFROM and PDFROM were greater in both stretching groups after the 3-week interventions. However, ADFROM, PDFROM, and the lunge angle were greater in the SSS group than in the static-stretching group (P < .05).

CONCLUSIONS

Ankle SSS is recommended to improve ADFROM, PDFROM, and the lunge angle in individuals with limited DFROM.

Effect of treadmill walking with ankle stretching orthosis on ankle flexibility and gait

[Purpose] The purpose of this study was to evaluate the kinematics of the ankle in the lunge to estabilish effectiveness of an ankle stretching orthosis (ASO) on the ankle dorsiflexion range of motion (ROM) of individuals with limited dorsiflexion ROM. [Subjects and Methods] Forty ankles with decreased dorsiflexion ROM of 20 participants were evaluated in this study. After wearing the ASO, participants walked on a treadmill for 15 minutes. Participants walked on the treadmill at a self-selected comfortable speed. Ankle dorsiflexion ROM, maximum dorsiflexion ROM before heel-off, and time to heel-off during the stance phase of gait were measured before and after 15 minutes of treadmill walking with the ASO. The differences in all variables between before and after treadmill walking with ASO were analyzed using the paired t-test. [Results] Ankle active and passive ROM, and dorsiflexion ROM during lunge increased significantly after treadmill walking with ASO. Treadmill walking with the ASO significantly increased the angle of maximal dorsiflexion before heel-off and time to heel-off during the stance phase. [Conclusion] The results of this study show that treadmill walking with the ASO effectively improved ankle flexibility and restored the normal gait pattern of the ankle joint by increasing dorsiflexion ROM, maximal angle of dorsiflexion, and time to heel-off in the stance phase.

Immediate combined effect of gastrocnemius stretching and sustained talocrural joint mobilization in individuals with limited ankle dorsiflexion: A randomized controlled trial

BACKGROUND

Although gastrocnemius stretching and talocrural joint mobilization have been suggested as effective interventions to address limited ankle dorsiflexion passive range of motion (DF PROM), the effects of a combination of the two interventions have not been identified.

OBJECTIVE

The aim of the present study was to compare the effects of gastrocnemius stretching combined with joint mobilization and gastrocnemius stretching alone.

DESIGN

A randomized controlled trial.

METHODS

In total, 24 individuals with limited ankle DF PROM were randomized to undergo gastrocnemius stretching combined with joint mobilization (12 feet in 12 individuals) or gastrocnemius stretching alone (12 feet in 12 individuals) for 5 min. Ankle kinematics during gait (time to heel-off and ankle DF before heel-off), ankle DF PROM, posterior talar glide, and displacement of the myotendinous junction (MTJ) of the gastrocnemius were assessed before and after the interventions. The groups were compared using two-way repeated measures analysis of variance.

RESULTS/FINDINGS

Greater increases in the time to heel-off and ankle DF before heel-off during gait and posterior talar glide were observed in the stretching combined with joint mobilization group versus the stretching alone group. Ankle DF PROM and displacement of the MTJ of the gastrocnemius were increased significantly after the interventions in both groups, with no significant difference between them.

CONCLUSIONS

These findings suggest that gastrocnemius stretching with joint mobilization needs to be considered to improve ankle kinematics during gait.