• 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.

• 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.

• PNF and Movement
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• v.22 no.2
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• pp.191-199
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• 2024

Purpose: This study aimed to investigate the effects of ankle stretching with intrinsic muscles on ankle range of motion, static and dynamic balance, and gait speed in chronic stroke patients. Methods: The participants were 20 chronic stroke patients, divided into two groups, 10 in the ankle stretching with intrinsic muscles group and 10 in the slant board exercise group. Both groups performed their respective interventions once daily, with three sets per session, five times a week for four weeks. Ankle range of motion, dynamic and static balance, and gait speed were measured before and after the intervention. An independent t-test was used to compare the results between the two groups before and after the intervention. Results: Both groups showed significant improvements in ankle range of motion, dynamic and static balance, and gait speed after the intervention (p < .05). The ankle stretching with intrinsic muscles group showed more significant improvements in ankle range of motion, dynamic and static balance, and gait speed after the intervention compared to the slant board group (p < .05). These results suggest that ankle stretching with intrinsic muscles may be more effective than the slant board for certain outcomes. Conclusion: Ankle stretching with intrinsic muscles is effective in improving ankle range of motion, dynamic and static balance, and walking speed.

• 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.

• Physical Therapy Korea
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• v.15 no.3
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• pp.8-16
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• 2008

The range of motion (ROM) of ankle dorsiflexion in older women was associated with gait abnormalities and the risk of falls. The purpose of this study was to investigate the effect of self-stretching exercise on the flexibility of the plantar flexors of the ankle and the characteristics of gait in healthy elderly women. Fifteen participants were assigned randomly into an exercise (n=8) or control (n=7) group. The exercise group attended a self-stretching program approximately 30 minutes for 3 days per week for 4 weeks. The active ankle dorsiflexion ROM and gait measurements were taken prior to beginning the stretching program and 1 day after the last stretching day. Results showed that the active ankle dorsiflexion ROM was significantly increased in the exercise group than in the control group after the stretching program (p<.05). However, gait parameters, including gait speed, cadence, and stride length were not significantly different between the two groups (p>.05). The results suggest that a 4-week self-stretching program is capable of provoking a significant increase in ankle dorsiflexion ROM in elderly, community-dwelling women. Additional research is needed to investigate the effect of gait-specific exercise combined with stretching exercise on gait ability.

• 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.

• The Journal of Korean Physical Therapy
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• v.34 no.4
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• pp.181-186
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• 2022

Purpose: This study was to applied to stretching plantar flexor and invertor at the same time to observe the effect of balance and walking ability. Methods: Subjects were instructed patients with ankle limited of motion, 6 months after stroke. We classified 20 subjects into two groups (experimental group: stretching plantar flexor and invertor at the same time, control group: only stretching plantar flexor). each group included 10 subjects and applied ankle stretcher for 20 minutes, 5 times/week during 4 weeks (total 20 times). Results: Both experimental group and control group showed significant increases in static balance, however, the significantly increases in step length and gait speed was observed only in the experimental group. There was no significant increases in step length and gait speed in the control group. Conclusion: Simultaneous stretching of ankle invertor and plantar flexion is effective in improving balance and walking ability in chronic stroke patients.

• Journal of International Academy of Physical Therapy Research
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• v.12 no.2
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• pp.2359-2364
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• 2021

Background: Patients with stroke have limited ankle range of motion (ROM) due to soft tissue abnormalities around the ankle and thus experience functional impairment. Increased muscle tension and reduced ankle ROM impair gait and hinder the activities of daily living. Joint mobilization and stretching are effective interventions that improve gait performance by enhancing the ankle ROM. Objectives: To investigate the effects of ankle joint mobilization and calf muscle stretching on gait speed and gait performance in patients with stroke. Design: This was a randomized controlled trial. Methods: Twenty patients with stroke patients were randomized into two groups. The joint mobilization group (JMG) underwent anteroposterior mobilization of the talocrural joint and the joint mobilization stretching group (JMSG) underwent calf muscle stretching in addition to joint mobilization. Gait speed and gait parameters were measured using the 10-meter walk test and the GAITRite. Results: Both the JMG and JMSG groups showed significant improvements in gait speed, affected-side step length, and cadence after the intervention (P<.05). Conclusion: Joint mobilization and stretching were effective interventions for improving gait performance by enhancing ankle function in patients with stroke.

• PNF and Movement
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• v.22 no.2
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• pp.223-231
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• 2024

Purpose: The aim of this study was to investigate changes in ankle muscle strength, range of motion (ROM) dorsiflexion, and gastrocnemius flexibility following gastrocnemius stretching with talus stability taping in subjects with limited ankle dorsiflexion. Methods: Fifteen subjects (all males) with limited ankle dorsiflexion participated in this study for six weeks. Ankle muscle strength, ankle passive dorsiflexion ROM, and gastrocnemius flexibility were assessed pre- and post-intervention. Results: Ankle dorsiflexion and plantarflexion strength and passive ankle dorsiflexion ROM were significantly increased post-intervention compared to pre-intervention (p < 0.05). Gastrocnemius flexibility was significantly improved post-intervention compared to pre-intervention (p < 0.05). Conclusion: Gastrocnemius stretching with talus stability taping can be recommended for subjects with limited ankle dorsiflexion to increase passive ankle dorsiflexion, flexibility, and ankle muscle strength.

• The Journal of Korean Physical Therapy
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• v.31 no.1
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• pp.56-61
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• 2019

Purpose: The spasticity of stroke patients decreases the ankle range of motion and increases the gastrocnemius muscle tone. This study examined the effects of stretching exercise and far infrared irradiation on the ankle function in stroke patients with spasticity. Methods: This study was conducted on 20 stroke patients admitted to Jesaeng General Hospital, who were divided into a study group (stretching exercise with far infrared) and control group (stretching exercise only). The dorsiflexion range of motion was measured using a smartphone and the medial gastrocnemius muscle tone and stiffness were measured using a Myoton pro. Results: With the exception of the non-paretic gastrocnemius muscle tone in the control group, the medial gastrocnemius muscle tone and stiffness decreased significantly in both groups. In both groups, the dorsiflexion range of motion increased significantly. In addition, the experimental group had a significantly higher dorsiflexion range of motion than the control group. On the other hand, there was no significant difference between the two groups in terms of the medial gastrocnemius muscle tone and stiffness. Conclusion: For stroke patients with spasticity, stretching exercises increased the ankle's range of motion and decreased the gastrocnemius muscle tone. The addition of heat therapy further increased the ankle's range of motion. On the other hand, as the sample size was small, future studies should include more subjects.