• 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.

• Journal of International Academy of Physical Therapy Research
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• v.7 no.1
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• pp.919-924
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• 2016

In this study, 20 men and women in their 20s were divided into a footboard passive stretching group and a manual passive stretching group. After stretching was applied to the soleus for 5 weeks, a comparative analysis was performed on the range of motion(ROM) of the ankle joint to determine changes in the flexibility of the soleus. Both the footboard stretching group and manual stretching group first performed stretching for 15 sec, followed by a 10-sec break. One set consisted of performing the above process twice consecutively, and each group had to perform five sets in total. A goniometer was used as a measuring instrument. The results of the experiment were analyzed using a nonparametric analysis, Wilcoxon signed rank test, and Mann-Whitney test. SPSS WIN 18.0 was employed for the statistical analysis. In terms of the comparison of the flexibility before and after the experiment according to the different interventions, the application of footboard stretching to the soleus for 5 weeks resulted in $3.2^{\circ}$ right dorsiflexion (p=.009), $6.98^{\circ}$ right plantar flexion(p=.008), $4.14^{\circ}$ left dorsiflexion(p=.005), and $10.97^{\circ}$ left plantar flexion(p=.007), which were all statistically significant increases. The application of manual stretching led to $6.04^{\circ}$ right dorsiflexion(p=.005), $12.14^{\circ}$ right plantar flexion(p=.005), $7.00^{\circ}$ left dorsiflexion (p=.008), and $16.38^{\circ}$ left plantar flexion(p=.005). Therefore, both footboard stretching and manual stretching were effective in enhancing the flexibility of the soleus. However, statistically significant larger increases in the ROM of the ankle joint were observed in the manual stretching group.

• The Journal of Korean Academy 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.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.2
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• pp.43-51
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• 2018

PURPOSE: Stroke patients have limited ankle range of motion and balance problems. The purpose of this study was to determine the effects of Kaltenborn orthopedic manual therapy, Evjenth-hamberg stretching, and combination of both on ankle dorsiflexion range of motion and dynamic balance ability in stroke patients. METHODS: Thirty patients were placed in three groups, each of which received different treatments: Kaltenborn orthopedic manual therapy (15 mins), Evjenth-hamberg stretching (15 mins), or Kaltenborn orthopedic manual therapy with Evjenth-hamberg stretching (30 mins). Each group received three exercise sessions per week during four weeks. To determine its effectiveness of interventions an evaluation was carried out. ankle dorsiflexion range of motion was gauged using a tiltmeter application, and dynamic balance ability was measured using the Berg balance scale. RESULTS: All groups revealed significant improvements in ankle dorsiflexion range of motion, Berg Balance Scale (BBS) score before and after the intervention, and Kaltenborn orthopedic manual therapy with Evjenth-hamberg stretching group showed a significant improvement in ankle dorsiflexion range of motion and BBS score in comparison to other groups. CONCLUSION: We found out that each individual method was effective in ankle dorsiflexion range of motion, dynamic balance ability in stroke patients, and the combined method was more effective.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.23 no.2
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• pp.27-32
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• 2017

Background: The purpose of this study was to compare the effects of IASTM and static stretching techniques on ankle joint range of motion (ROM), static foot pressure. Methods: Twenty four subjects with gastrocnemius shortness participated in this study. The subjects were assigned randomly to one of two groups: The soft tissue mobilization technique (IASTM) group received intervention using a IASTM instrument for two minutes, and the stactic stretching group performed self stretching for 30 seconds, four times. The ROM of the ankle joint was measured by active ankle dorsi-flexion test, and a TPScan was utilized to collect the plantar foot pressure. This experiment was performed by two physical therapists. The significant level was set at ${\alpha}=.05$. Results: The results were as follows: 1) The ROM of the ankle joint and was significantly increased in both groups. 2) Plantar foot pressure was no significant in both groups. 3) There were no significant differences between the IASTM group and static stretching group for any variable. Conclusions: The results of this study suggest that static stretching is an effective and easy technique for restoring proper muscle length in subjects with gastrocnemius shortness. We recommend that static stretching technique be used for treat gastrocnemius shortness in clinical setting and home program.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.1
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• pp.109-116
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• 2022

PURPOSE: This study compared the effect of performing gastrocnemius stretching with and without the self-myofascial release of the sole on the active and passive ankle dorsiflexion angles and muscle tone of the gastrocnemius muscle in subjects with short gastrocnemius muscle. METHOD: A total of 23 subjects with short gastrocnemius muscles were included in this study. The study participants were divided into two experimental groups. Group A performed gastrocnemius muscle self-stretching exercises only, while group B performed self-myofascial release of the sole using a massage ball after the gastrocnemius muscle self-stretching exercises. For both groups, the active and passive ankle dorsiflexion angles were measured using a goniometer, and the tone of the gastrocnemius muscle was assessed using the MyotonPRO®. RESULTS: Within-group comparison showed that the participants in both groups A and B had significantly increased active and passive ankle dorsiflexion angles and decreased gastrocnemius muscle tone (p < .05) after performing their respective exercises. However, no significant differences in the said criteria were observed between groups A and B (p>.05). CONCLUSION: The results of this study showed that both methods were effective in increasing active and passive dorsiflexion angles and decreasing muscle tone. Thus, it is recommended to tailor gastrocnemius stretching exercises according to the patient's condition. If the patient does not experience discomfort in the plantar fasciae, it is recommended to perform the gastrocnemius stretching exercise only without myofascial release and use a massage ball afterward.

• The Journal of Korean Physical Therapy
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• v.33 no.6
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• pp.272-277
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• 2021

Purpose: The purpose of this study is to confirm the effect of static stretching of the plantar flexor for 5 minutes on balance and ankle muscle activity when walking in young adults. Methods: This study experimented on 20 healthy college students without vestibular and musculoskeletal diseases. Subjects performed static stretching intervention of plantar flexor for 5 minutes on a stretch board set at 15° to 25° Balance was measured four times before intervention (pre), after intervention (post), 5 minutes after intervention (post 5 min), 10 minutes after intervention (post 10 min), and ankle muscle activity was measured during walking. For the analysis and post hoc analysis, one-way Repeated Measure ANOVA and Fisher's LSD (Last Significant Difference) was performed to find out the change in balance and the activity of ankle muscles before static stretching, pre, post, post 5 minutes rest, post 10 minutes rest. Results: There was no significant difference in weight distribution index (WDI) in balance, but stability index (ST) showed a significant difference, and there was also a significant difference in correlation pre, post, post 5min rest, post 10 minutes rest (p<0.05). There was no significant difference in ankle muscle activity during walking in Tibialis anterior (TA), Medial gastrocnemius (GM), and Lateral gastrocnemius (GL) (p>0.05). Conclusion: The stability index (ST) increased significantly immediately after static stretching and decreased after 5 minutes. After static stretching, at least 5 minutes of rest are required to restore balance.

• The Journal of Korean Physical Therapy
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• v.32 no.4
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• pp.245-249
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• 2020

Purpose: This study examined the effects of local vibration using a massage gun on the triceps surae flexibility by measuring the ankle dorsiflexion range of motion (ROM) compared to static stretching in healthy adults. Methods: Twenty healthy subjects were instructed in this study. They were allocated randomly to two groups: local vibration (LV) and static stretching (SS). The ankle dorsiflexion ROM was measured before and after the intervention in supine (open kinetic chain, OKC) and standing (closed kinetic chain, CKC). The LV group received local vibration using a massage gun for five minutes on their triceps surae, and the SS group stood on the Q board with a dorsiflexed ankle for five minutes. The ROM between pre- and post-intervention and the change in ROM between two groups were analyzed. A paired t-test was used to compare the ROM between pre- and post-intervention, while an independent t-test was used to compare the change in ROM between the two groups. Results: Both groups showed a significant difference between pre- and post-intervention in the position of both the OKC and CKC. The change in ROM, however, was not significantly different between the two groups. Conclusion: The application of local vibration using a massage gun for five minutes on the triceps surae could improve its flexibility as much as the application of static stretching. A massage gun for the application of a local vibration stimulus may be effective, simple, portable, and comfortable.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.3
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• pp.47-55
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• 2021

Background: Plantar fasciitis is one of the most common conditions of the lower limbs. The present study aimed to compare the effect of hip muscle strengthening exercise and stretching of lower extremity in plantar fasciitis, with regard to pain, navicular drop and foot and ankle functional ability. Methods: A total of 42 patients diagnosed with plantar fasciitis were randomly assigned to the experimental group (n=21) that applied the hip muscle strengthening exercise and the control group(n=21) that applied the general lower limb stretching. The intervention period was 6 weeks. Results: The results of the experiment showed that the exercises for strengthening the hip muscle had significant effects on pain, navicular drop and foot and ankle functional ability In addition, lower extremity stretching showed improvement effects in pain, navicular drop and foot and ankle functional ability, however, the difference between the groups except navicular drop did not reach statistical significance Conclusion: Both interventions tested in this study were confirmed to be effective treatment options for patients with plantar fasciitis.

• The Journal of the Korea Contents Association
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• v.9 no.9
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• pp.278-286
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• 2009

The aims of this study were to determined whether excitability of the $\alpha$-motor neuron is modulated by stretching and this changes were associated with flexibility of the muscle. In this study, $\alpha$-motor neuron excitability was measured by using the Hmax/Mmax ratio of the gastrocnemius H-reflex, and muscle flexibility was measured with the range of motion of the ankle dorsiflexion. The gastrocnemii of 10 healthy volunteers were stretched for 4 minutes(2 minutes stretching, 1 minute rest, and 2 minutes stretching) in each session by manual force. The Hmax/Mmax ratio of the H-reflex, as well as the range of motion of the ankle dosiflexion was measured through four different conditions: before stretching, as soon as after $1^{st}$ stretching, as soon as after $2^{nd}$ stretching and at 48 hours after $2^{nd}$ stretching. Excitability of the $\alpha$-motor neuron was decreased significantly after $1^{st}$ and $2^{nd}$ stretching(p<0.05). Furthermore, the range of the dorsiflexion was increased significantly after $1^{st}$ and $2^{nd}$ stretching(p<0.05). However, the excitability of the $\alpha$-motor neuron and range of the dorsiflexion at 48 hours after $2^{nd}$ stretching were not different from those of before stretching. These results suggest that reduced $\alpha$-motor neuron excitability of the gastrocnemius and increased flexibility of the ankle dorsiflexion would be followed by activation of the type III mechanoreceptor which around the ankle joint and the Golgi tendon organ in the gastrocnemius.