Passive Ankle Stiffness in Subjects With Diabetes and Peripheral Neuropathy Versus an Age-Matched Comparison Group

Abstract Background and Purpose. Patients with diabetes mellitus and peripheral neuropathy (DM and PN) often complain of joint stiffness. Although stiffness may contribute to some of the impairments and functional limitations found in these patients, it has not been quantified in this population. The purpose of this study was to quantify and compare passive ankle stiffness and dorsiflexion (DF) range of motion in subjects with DM and PN versus an age-matched comparison group. Subjects. Thirty-four subjects were tested (17 subjects with DM and PN and 17 subjects in an age-matched comparison group). There were 10 male subjects and 7 female subjects in each group. Methods. A Kin-Com dynamometer was used to measure passive plantar flexor torque as each subject's ankle was moved from plantar flexion into dorsiflexion at 60°/s. The following variables were compared using a Student t test: initial angle (angle of onset of plantar flexor torque), maximal dorsiflexion angle, plantar flexor muscle excursion (difference between initial angle and maximal dorsiflexion angle), slope of the first half of the plantar flexor torque curve (stiffness 1 measurement), and slope of the second half of the plantar flexor torque curve (stiffness 2 measurement). Results. The subjects with DM and PN group had smaller maximal dorsiflexion angles and less plantar flexor muscle excursion than the comparison group. There was no difference in initial angle, stiffness 1 measurement, or stiffness 2 measurement. Conclusion and Discussion. Although the subjects with DM and PN had less dorsiflexion range of motion than did the comparison group, there was no difference in stiffness between the groups. This finding suggests that people with DM and PN have “short” versus “stiff” plantar flexor muscles.

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Relationships Between Plantar Flexor Muscle Stiffness, Strength, and Range of Motion in Subjects With Diabetes-Peripheral Neuropathy Compared to Age-Matched Controls

Journal of Orthopaedic and Sports Physical Therapy ◽

10.2519/jospt.2000.30.8.473 ◽

2000 ◽

Vol 30 (8) ◽

pp. 473-483 ◽

Cited By ~ 20

Author(s):

Gretchen B. Salsich ◽

Marybeth Brown ◽

Michael J. Mueller

Keyword(s):

Peripheral Neuropathy ◽

Range Of Motion ◽

Muscle Stiffness ◽

Plantar Flexor ◽

Flexor Muscle ◽

Diabetes Peripheral Neuropathy

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A Study of Intrinsic Factors in Patients with Stress Fractures of the Tibia

Foot & Ankle International ◽

10.1177/107110079601700808 ◽

1996 ◽

Vol 17 (8) ◽

pp. 477-482 ◽

Cited By ~ 24

Author(s):

Ingrid Ekenman ◽

Li Tsai-Felländer ◽

Pär Westblad ◽

Ibrahim Turan ◽

Christer Rolf

Keyword(s):

Range Of Motion ◽

Stress Fracture ◽

Reference Group ◽

Intrinsic Factor ◽

Gait Pattern ◽

Stress Fractures ◽

Muscle Performance ◽

Plantar Flexor ◽

Flexor Muscle ◽

Intrinsic Factors

We aimed to study intrinsic factors in 29 consecutive patients with well-documented unilateral stress fractures of the tibia. Anthropometry, range of motion, isokinetic plantar flexor muscle performance, and gait pattern were analyzed. The uninjured leg served as the control. A reference group of 30 uninjured subjects was compared regarding gait pattern. Anterior stress fractures of the tibia (N = 10) were localized in the push-off/ landing leg in 9/10 athletes, but were similarly distributed between legs in posteromedial injuries (N = 19). Ten (30%) of the stress fracture subjects had bilateral high foot arches, similar to those found in the reference group. There were no other systematic differences in anthropometry, range of motion, gait pattern, or isokinetic plantar flexor muscle peak torque and endurance between injured and uninjured legs. No other differences were found between anterior and posteromedial stress fractures. We conclude that anterior stress fractures of the tibia occur mainly in the push-off/landing leg in athletes. Within the limitations of our protocol, no registered intrinsic factor was found to be directly associated with the occurrence of a stress fracture of the tibia.

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Effects of Vibration Rolling with and without Dynamic Muscle Contraction on Ankle Range of Motion, Proprioception, Muscle Strength and Agility in Young Adults: A Crossover Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17010354 ◽

2020 ◽

Vol 17 (1) ◽

pp. 354 ◽

Cited By ~ 2

Author(s):

Bo-Jhang Lyu ◽

Chia-Lun Lee ◽

Wen-Dien Chang ◽

Nai-Jen Chang

Keyword(s):

Young Adults ◽

Muscle Strength ◽

Muscle Contraction ◽

Range Of Motion ◽

Exercise Performance ◽

Plantar Flexion ◽

Ankle Dorsiflexion ◽

Plantar Flexor ◽

Flexor Muscle ◽

Warm Up

Vibration rolling (VR) has emerged as a self-myofascial release (SMR) tool to aid exercise performance when warming up. However, the benefits of VR on exercise performance when combined with dynamic muscle contraction are unclear. The purpose of this study was to investigate the immediate effects of the combination of VR with dynamic muscle contraction (DVR), VR, and static stretching (SS) during warm-up on range of motion (ROM), proprioception, muscle strength of the ankle, and agility in young adults. In this crossover design study, 20 recreationally active adults without musculoskeletal disorders completed three test sessions in a randomized order, with 48 h of rest between each session. Participants completed one warm-up intervention and its measurements on the same day; different warm-up interventions and measurements were performed on each of the three days. The measurements included ankle dorsiflexion and plantarflexion ROM, ankle joint proprioception, muscle strength, and agility. After DVR and VR intervention, ankle dorsiflexion ROM (both DVR and VR, p < 0.001), plantarflexion ROM (both DVR and VR, p < 0.001), plantar flexor muscle strength (DVR, p = 0.007; VR, p < 0.001), and agility (DVR, p = 0.016; VR, p = 0.007) significantly improved; after SS intervention, ankle dorsiflexion and plantar flexion ROM (dorsiflexion, p < 0.001; plantar flexion, p = 0.009) significantly improved, but muscle strength and agility were not enhanced. Compared with SS, DVR and VR significantly improved ankle plantar flexor muscle strength (p = 0.008 and p = 0.001, respectively). Furthermore, DVR significantly improved ankle dorsiflexion compared with VR (p < 0.001) and SS (p < 0.001). In conclusion, either DVR, VR, or SS increased ankle ROM, but only DVR and VR increased muscle strength and agility. In addition, DVR produced considerable increases in ankle dorsiflexion. These findings may have implications for warm-up prescription and implementation in both rehabilitative and athletic practice settings.

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Reliability of Bi-Axial Ankle Stiffness Measurement in Older Adults

Sensors ◽

10.3390/s21041162 ◽

2021 ◽

Vol 21 (4) ◽

pp. 1162

Author(s):

Hogene Kim ◽

Sangwoo Cho ◽

Hwiyoung Lee

Keyword(s):

Older Adults ◽

Range Of Motion ◽

Angular Displacement ◽

Plantar Flexion ◽

Significant Negative Correlation ◽

Talocrural Joint ◽

Ankle Foot Orthosis ◽

Ankle Stiffness ◽

Ankle Movement ◽

Test Retest Reliability

This study involves measurements of bi-axial ankle stiffness in older adults, where the ankle joint is passively moved along the talocrural and subtalar joints using a custom ankle movement trainer. A total of 15 elderly individuals participated in test–retest reliability measurements of bi-axial ankle stiffness at exactly one-week intervals for validation of the angular displacement in the device. The ankle’s range of motion was also compared, along with its stiffness. The kinematic measurements significantly corresponded to results from a marker-based motion capture system (dorsi-/plantar flexion: r = 0.996; inversion/eversion: r = 0.985). Bi-axial ankle stiffness measurements showed significant intra-class correlations (ICCs) between the two visits for all ankle movements at slower (2.14°/s, ICC = 0.712) and faster (9.77°/s, ICC = 0.879) speeds. Stiffness measurements along the talocrural joint were thus shown to have significant negative correlation with active ankle range of motion (r = −0.631, p = 0.012). The ankle movement trainer, based on anatomical characteristics, was thus used to demonstrate valid and reliable bi-axial ankle stiffness measurements for movements along the talocrural and subtalar joint axes. Reliable measurements of ankle stiffness may help clinicians and researchers when designing and fabricating ankle-foot orthosis for people with upper-motor neuron disorders, such as stroke.

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Plantar flexor muscle stretching depresses the soleus late response but not tendon tap reflexes

European Journal of Neuroscience ◽

10.1111/ejn.15178 ◽

2021 ◽

Author(s):

Timothy S. Pulverenti ◽

Gabriel S. Trajano ◽

Benjamin J. C. Kirk ◽

Vanesa Bochkezanian ◽

Anthony J. Blazevich

Keyword(s):

Late Response ◽

Plantar Flexor ◽

Flexor Muscle ◽

Muscle Stretching ◽

Tendon Tap

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Early Childhood Education and Adult Depression: An Attrition Reanalysis With Inverse Propensity Score Weighting

Evaluation Review ◽

10.1177/0193841x20976527 ◽

2020 ◽

pp. 0193841X2097652

Author(s):

Christina F. Mondi ◽

Arthur J. Reynolds ◽

Brandt A. Richardson

Keyword(s):

Early Childhood ◽

Depressive Symptoms ◽

Comparison Group ◽

Practical Significance ◽

Point Estimate ◽

Marginal Effect ◽

Alternative Analysis ◽

Point Reduction ◽

Program Selection ◽

Matched Comparison

In a previous study of the Child-Parent Centers (CPC) education program, preschool participation was linked to a 4.6 percentage point reduction (26%) in depressive symptoms at ages 22–24 over the matched comparison group enrolling the usual programs. The present study reanalyzed these data in the Chicago Longitudinal Study to address potential attrition bias since more than a quarter of the sample was missing on the outcome. Using inverse probability weighting (IPW) involving 32 predictors of sample retention, findings for the 1,142 participants growing up in high-poverty neighborhoods indicated that CPC participation was associated with a 7.1 percentage point reduction (95% CI = [−9.7, −5.4]) in one or more depressive symptoms (39% reduction over the comparison group). Although this marginal effect was within the confidence interval of the original study (95% CI = [−9.5, 0.3]), the 54% increase in the point estimate is substantial and of practical significance, suggesting underestimation in the prior study. Alternative analysis of different predictors and IPW models, including adjustments for program selection and attrition together, yielded similar results. Findings indicate that high-quality early childhood programs continue to be an important strategy for the prevention of depression and its debilitating effects on individuals and families.

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