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

2015 ◽  
Vol 20 (6) ◽  
pp. 827-834 ◽  
Author(s):  
Min-Hyeok Kang ◽  
Jae-Seop Oh ◽  
Oh-Yun Kwon ◽  
Jong-Hyuk Weon ◽  
Duk-Hyun An ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Ankle Dorsiflexion ◽  
Combined Effect ◽  
Talocrural Joint ◽  
Joint Mobilization ◽  
Randomized Controlled

scholarly journals A Randomized Controlled Trial of a Passive Accessory Joint Mobilization on Acute Ankle Inversion Sprains

2001 ◽  
Vol 81 (4) ◽  
pp. 984-994 ◽  
Author(s):  
Toni Green ◽  
Kathryn Refshauge ◽  
Jack Crosbie ◽  
Roger Adams
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Step Length ◽  
Control Group ◽  
Joint Mobilization ◽  
Randomized Controlled ◽  
Ankle Inversion ◽  
Before And After ◽  
Experimental Group ◽  
Support Time

Abstract Background and Purpose. Passive joint mobilization is commonly used by physical therapists as an intervention for acute ankle inversion sprains. A randomized controlled trial with blinded assessors was conducted to investigate the effect of a specific joint mobilization, the anteroposterior glide on the talus, on increasing pain-free dorsiflexion and 3 gait variables: stride speed (gait speed), step length, and single support time. Subjects. Forty-one subjects with acute ankle inversion sprains (<72 hours) and no other injury to the lower limb entered the trial. Methods. Subjects were randomly assigned to 1 of 2 treatment groups. The control group received a protocol of rest, ice, compression, and elevation (RICE). The experimental group received the anteroposterior mobilization, using a force that avoided incurring any increase in pain, in addition to the RICE protocol. Subjects in both groups were treated every second day for a maximum of 2 weeks or until the discharge criteria were met, and all subjects were given a home program of continued RICE application. Outcomes were measured before and after each treatment. Results. The results showed that the experimental group required fewer treatment sessions than the control group to achieve full pain-free dorsiflexion. The experimental group had greater improvement in range of movement before and after each of the first 3 treatment sessions. The experimental group also had greater increases in stride speed during the first and third treatment sessions. Discussion and Conclusion. Addition of a talocrural mobilization to the RICE protocol in the management of ankle inversion injuries necessitated fewer treatments to achieve pain-free dorsiflexion and to improve stride speed more than RICE alone. Improvement in step length symmetry and single support time was similar in both groups.

scholarly journals Treadmill integrated robot-assisted ankle dorsiflexion training for stroke rehabilitation: A randomized controlled trial

2020 ◽  
Author(s):  
Susan Conroy ◽  
Anindo Roy ◽  
Laurence Magder ◽  
Derek Eversley ◽  
Kate Flores ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Motor Control ◽  
Negative Impact ◽  
Controlled Trial ◽  
Ankle Dorsiflexion ◽  
Treadmill Training ◽  
Foot Drop ◽  
Gait Velocity ◽  
Randomized Controlled ◽  
Foot Strike

Abstract Background: Stroke-related ankle dysfunction due to hemiparesis has a profound negative impact on gait biomechanics and walking. Task-oriented treadmill training improves gait velocity but does not lead to restitution of ankle function. Advances in robotic technology have led to the development of an adaptive ankle robot that can be integrated into treadmill walking and provide precisely timed graded assistance consistent with motor learning approaches. The aim of this study was to compare the effectiveness of a 6-week treadmill-integrated adaptive ankle robot (TMR) training to 6-weeks of treadmill training (TM) alone on improved paretic ankle motor control and gait performance. Methods: This was a single-blind (evaluator-blinded) randomized controlled trial. 45 participants received either TMR or TM training 3 times per week for 6 weeks. Primary outcomes were improved peak paretic ankle dorsiflexion (DF) angle at swing, improved DF angle at foot strike (weight acceptance), and increased gait velocity during self-selected over-ground walking. The primary analysis was based on intention-to-treat using a longitudinal regression model. An additional sub-set analysis of subjects with biomechanically defined foot drop was performed. Results: There were no significant post-training ankle dorsiflexion or gait velocity differences between groups. Six-week post-training mean peak paretic DF swing angle was (4.84 ± 6.83; 4.2 ± 6.83 p=0.63) and DF angle at foot strike was (-0.70 ± 6.55; -0.46 ± 5.70 p=0.84) respectively for TMR and TM. Gait velocity gains were similar and TMR had a mean increase of 0.54 m/s ± 0.24 and TM increased 0.56 m/s ±0.32. p=0.48 post-training.Conclusion: Integrating adaptive ankle robotics into task-specific locomotor training was not significantly better than treadmill training alone. Both interventions improved gait velocity. Promising results in ankle motor control were seen in a subset of subjects with biomechanically defined foot drop that warrants further investigation. Clinical Trial Registration: Clinical trials.gov id: NCT02483676. Registered June 29, 2015, https://clinicaltrials.gov/ct2/show/NCT02483676

scholarly journals Complex Versus Simple Ankle Movement Training in Stroke Using Telerehabilitation: A Randomized Controlled Trial

2012 ◽  
Vol 92 (2) ◽  
pp. 197-209 ◽  
Author(s):  
Huiqiong Deng ◽  
William K. Durfee ◽  
David J. Nuckley ◽  
Brandon S. Rheude ◽  
Amy E. Severson ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Gait Analysis ◽  
Controlled Trial ◽  
Chronic Stroke ◽  
Ankle Dorsiflexion ◽  
Cortical Activation ◽  
Complex Versus ◽  
Randomized Controlled ◽  
Movement Training ◽  
Brain Reorganization

Background Telerehabilitation allows rehabilitative training to continue remotely after discharge from acute care and can include complex tasks known to create rich conditions for neural change. Objectives The purposes of this study were: (1) to explore the feasibility of using telerehabilitation to improve ankle dorsiflexion during the swing phase of gait in people with stroke and (2) to compare complex versus simple movements of the ankle in promoting behavioral change and brain reorganization. Design This study was a pilot randomized controlled trial. Setting Training was done in the participant’s home. Testing was done in separate research labs involving functional magnetic resonance imaging (fMRI) and multi-camera gait analysis. Patients Sixteen participants with chronic stroke and impaired ankle dorsiflexion were assigned randomly to receive 4 weeks of telerehabilitation of the paretic ankle. Intervention Participants received either computerized complex movement training (track group) or simple movement training (move group). Measurements Behavioral changes were measured with the 10-m walk test and gait analysis using a motion capture system. Brain reorganization was measured with ankle tracking during fMRI. Results Dorsiflexion during gait was significantly larger in the track group compared with the move group. For fMRI, although the volume, percent volume, and intensity of cortical activation failed to show significant changes, the frequency count of the number of participants showing an increase versus a decrease in these values from pretest to posttest measurements was significantly different between the 2 groups, with the track group decreasing and the move group increasing. Limitations Limitations of this study were that no follow-up test was conducted and that a small sample size was used. Conclusions The results suggest that telerehabilitation, emphasizing complex task training with the paretic limb, is feasible and can be effective in promoting further dorsiflexion in people with chronic stroke.

scholarly journals Treadmill integrated robot-assisted ankle dorsiflexion training for stroke rehabilitation: A randomized controlled trial

2020 ◽  
Author(s):  
Susan Conroy ◽  
Anindo Roy ◽  
Laurence Magder ◽  
Derek Eversley ◽  
Kate Flores ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Motor Control ◽  
Controlled Trial ◽  
Ankle Dorsiflexion ◽  
Treadmill Training ◽  
Foot Drop ◽  
Gait Velocity ◽  
Locomotor Training ◽  
Randomized Controlled ◽  
Foot Strike

Abstract Background: Stroke-related ankle dysfunction due to hemiparesis has a profound negative impact on gait biomechanics and walking. Task-oriented treadmill training improves gait velocity but does not lead to restitution of ankle function. Advances in robotic technology have led to the development of an adaptive ankle robot that can be integrated into treadmill walking and provide precisely timed graded assistance consistent with motor learning approaches. The aim of this study was to compare the effectiveness of a 6-week treadmill-integrated adaptive ankle robot (TMR) training to 6-weeks of treadmill training (TM) alone on improved paretic ankle motor control and gait performance. Methods: This was a single-blind (evaluator-blinded) randomized controlled trial. 45 participants received either TMR or TM training 3 times per week for 6 weeks. Primary outcomes were improved peak paretic ankle dorsiflexion (DF) angle at swing, improved DF angle at foot strike (weight acceptance), and increased gait velocity during self-selected over-ground walking. The primary analysis was based on intention-to-treat using a longitudinal regression model. An additional sub-set analysis of subjects with biomechanically defined foot drop was performed. Results: There were no significant post-training ankle dorsiflexion or gait velocity differences between groups. Six-week post-training mean peak paretic DF swing angle was (4.84 ± 6.83; 4.2 ± 6.83 p =0.63) and DF angle at foot strike was (-0.70 ± 6.55; -0.46 ± 5.70 p =0.84) respectively for TMR and TM. Gait velocity gains were similar and TMR had a mean increase of 0.54 m/s ± 0.24 and TM increased 0.56 m/s ±0.32. p =0.48 post-training. Conclusion: Integrating adaptive ankle robotics into task-specific locomotor training was not significantly better than treadmill training alone. Both interventions improved gait velocity. Promising results in ankle motor control were seen in a subset of subjects with biomechanically defined foot drop that warrants further investigation. Keywords: Stroke, hemiparetic gait, ankle robot, locomotor training Clinical trials.gov id: NCT02483676. Registered June 29, 2015, https://clinicaltrials.gov/ct2/show/NCT02483676

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