Kinematic and Kinetic Evaluation of the Ankle Joint Before and After Tendo Achilles Lengthening in Patients With Spastic Diplegia

This study aimed to investigate the effects of suboccipital muscle inhibition technique (SMIT) on active range of motion (AROM) of the ankle joint, lunge angle (LA), and balance in healthy adults, according to the duration of its application. A total of 80 participants were randomly allocated to the 4-min suboccipital muscle inhibition (SMI) group (SMI_4M, n = 20), 8-min SMI group (n = 20), 4-min sham-SMI (SSMI) group (n = 20), and 8-min SSMI group (n = 20). Accordingly, the SMIT and sham SMIT were applied for 4 min or 8 min in the respective groups. AROM of dorsiflexion and LA were assessed, and a single leg balance test (SLBT) was performed before and after the intervention. AROM (4 min, p < 0.001; 8 min, p < 0.001), LA (4 min, p < 0.001; 8 min, p < 0.001), and SLBT (4 min, p < 0.001; 8 min, p < 0.001) significantly improved after SMI application. Compared with the SSMI group, the SMI group showed a significant increase in AROM (p < 0.001), LA (p < 0.001), and SLBT (p < 0.001). Except for SLBT (p = 0.016), there were no significant interactions between intervention and application duration. The results suggest that the SMIT, at durations of both 4 and 8 min, could be effective tools for improving AROM, LA, and balance.

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Soft Tissue Release and Osteotomies in the Treatment of Patients with Spastic Diplegic Cerebral Palsy

Journal of Orthopaedics Trauma and Rehabilitation ◽

10.1016/j.jotr.2017.12.004 ◽

2018 ◽

Vol 24 (1) ◽

pp. 80-83

Author(s):

Ng Bobby Kin-Wah ◽

Chau Wai-Wang ◽

Hung Alec Lik-Hang ◽

Lam Tsz-Ping ◽

Cheng Jack Chun-Yiu

Keyword(s):

Cerebral Palsy ◽

Soft Tissue ◽

Soft Tissue Release ◽

Spastic Diplegia ◽

Single Event ◽

Selective Dorsal Rhizotomy ◽

Dorsal Rhizotomy ◽

Surgery Patient ◽

Before And After ◽

Mid Term Results

We aim to study the outcome of soft tissue releases by tendon elongations and osteotomies in fixed joint contractures by clinical examination and patient self-reported assessment on 20 patients (14 males and 6 females) with spastic diplegic cerebral palsy treated with single-event multilevel surgery (SEMLS) between 2000 and 2012. A questionnaire was used to collect information on problems encountered before and after surgery and decision on surgery. Comparing patients with Gross Motor Function Classification System class I/II, (N = 8), III (N = 8) and IV/V, patients of classes IV/V showed much slower mean recovery time than I/II group (14.00 vs. 4.38 months, p < 0.01). SEMLS in the treatment of patients with spastic diplegia had good mid-term results in most patients. The patients who had unfavourable outcomes are associated with mental retardation, general or local complications and previous selective dorsal rhizotomy surgery. Patient selection and good rehabilitations preoperation and postoperation provided the most favourable outcomes of SEMLS.

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Effect of Plantar Flexor and Dorsiflexor Fatigue on Unilateral Postural Control

Journal of Applied Biomechanics ◽

10.1123/jab.9.3.191 ◽

1993 ◽

Vol 9 (3) ◽

pp. 191-201 ◽

Cited By ~ 66

Author(s):

Thomas M. Lundin ◽

Jon W. Feuerbach ◽

Mark D. Grabiner

Keyword(s):

Ankle Joint ◽

Postural Sway ◽

Plantar Flexor ◽

Plantar Flexors ◽

Joint Injury ◽

Balance System ◽

Fatigue Protocol ◽

Before And After ◽

Ankle Muscle ◽

Male Subjects

The purpose of this study was to determine the effect of plantar flexor and dorsiflexor fatigue on postural sway amplitude during unilateral, or one-legged, stance. It was hypothesized that plantar flexor and dorsiflexor fatigue would increase unilateral postural sway amplitude. Eight uninjured male subjects participated in pre- and postfatigue unilateral stability tests. Selected parameters describing medial-lateral (ML) and anterior-posterior (AP) postural sway were measured on a Chattecx Balance System before and after an isokinetic fatigue protocol. The fatigue protocol resulted in a significant increase in ML postural sway amplitude (p< 0.05) and an increase in AP sway amplitude (p= 0.065). Previously, links have been established between increased postural sway amplitude and ankle joint injury. Thus, fatigue of the plantar flexors and dorsiflexors, which increased postural sway amplitude, may render the ankle joint susceptible to injury. Induced ankle muscle fatigue may represent a valid paradigm to study the causes of traumatic ankle joint injury.

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The Immediate Effects of Ankle Joint Mobilization on Ankle Musculotendinous Stiffness in Individuals With Chronic Ankle Instability

International Journal of Athletic Therapy & Training ◽

10.1123/ijatt.2019-0122 ◽

2020 ◽

pp. 1-5

Author(s):

M. Spencer Cain ◽

Kyeongtak Song ◽

J. Troy Blackburn ◽

Kimmery Migel ◽

Erik A. Wikstrom

Keyword(s):

Ankle Joint ◽

Ankle Instability ◽

Change Score ◽

Chronic Ankle Instability ◽

Minimal Detectable Change ◽

Plantar Flexor ◽

Joint Mobilization ◽

Before And After ◽

Damped Oscillation ◽

Musculotendinous Stiffness

Ankle joint mobilization has been shown to be effective at improving outcomes in those with chronic ankle instability (CAI), but the neuromuscular mechanisms are still unknown. We aimed to determine the immediate effect of a single Grade III anterior-to-posterior ankle joint mobilization bout on ankle musculotendinous stiffness (MTS) in those with CAI. Seventeen CAI participants had plantar flexor and fibularis MTS assessed before and after a 5-min joint mobilization treatment. MTS outcomes were estimated using the damped oscillation method. Fibularis (0.25 ± 0.41 N/m/kg, p = .028) but not plantar flexor MTS (−2.18 ± 14.35 N/m/kg, p = .539) changed following mobilization and exceeded the calculated minimal detectable change score (0.12 N/m/kg). Increased fibularis MTS may represent a neuromuscular mechanism by which ankle joint mobilizations improve postural control in those with CAI.

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Mechanical and electromyographic analysis of reciprocal inhibition at the human ankle joint

Journal of Neurophysiology ◽

10.1152/jn.1995.74.2.849 ◽

1995 ◽

Vol 74 (2) ◽

pp. 849-855 ◽

Cited By ~ 16

Author(s):

T. Sinkjaer ◽

J. Nielsen ◽

E. Toft

Keyword(s):

Ankle Joint ◽

Stretch Reflex ◽

Plantar Flexion ◽

Joint Stiffness ◽

Common Peroneal Nerve ◽

Reciprocal Inhibition ◽

Mechanical Effect ◽

Voluntary Contraction ◽

Plantar Flexors ◽

Before And After

1. The purpose of the present study is to investigate how reciprocal inhibition influences the mechanical and electromyographic (EMG) properties of the ankle plantar flexors in humans during a voluntary contraction. 2. At different levels of maintained plantar flexion contractions ranging from 0 to 20 Nm, the size of the soleus EMG stretch reflex and the ankle joint stiffness (ration between the torque increment and the amplitude of the stretch) were measured in response to an imposed dorsiflexion. At matched plantar flexion contraction levels, stretch responses were compared before and after reversible block of the common peroneal nerve (CPN). Stretch responses were also measured during an attempted voluntary fictive dorsiflexion after CPN block. 3. In the preactivated soleus muscles, the phasic EMG response to stretch consisted of two peaks labeled M1 and M2. After CPN block, the M1 short-latency stretch reflex on average increased by 25 +/- 5.7%, mean +/- SD (P < 0.001), and the M2 stretch reflex increased on average by 29 +/- 13.0% (P = 0.002). 4. The total stiffness of the ankle joint during a stretch is the sum of the nonreflex and the reflex mediated stiffness. The total stiffness after CPN block increased on average by 13 +/- 2.7% (P = 0.002) and the estimated reflex stiffness by 33 +/- 6.5% (P < 0.001). 5. When the subjects were asked to make a strong dorsiflexion after CPN block, the soleus stretch reflex was depressed to the extent that the reflex mediated mechanical effect around the ankle joint was abolished.(ABSTRACT TRUNCATED AT 250 WORDS)

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Immediate Effects of Kinesio Taping of Tibialis Anterior and Ankle Joint on Mobility and Balance Ability for Chronic Hemiparesis: Randomized Controlled Cross-Sectional Design

Physikalische Medizin Rehabilitationsmedizin Kurortmedizin ◽

10.1055/a-1126-4616 ◽

2020 ◽

Vol 30 (06) ◽

pp. 350-357

Author(s):

Kyung-Hun Kim ◽

Yang-Jin Lee

Keyword(s):

Ankle Joint ◽

Tibialis Anterior ◽

Timed Up And Go ◽

Cross Sectional ◽

Kinesio Taping ◽

Tibialis Muscle ◽

Before And After ◽

Balance Ability ◽

Hemiparetic Stroke ◽

Chronic Hemiparetic Stroke

Abstract Background Stroke patients with hemiparesis are generally described as being slow and suffering a balance disability. Objective The purpose of this cross-sectional single-blind study was to evaluate the immediate effects of Kinesio taping of tibialis anterior and quadriceps on the mobility and balance ability in individuals with chronic hemiparetic stroke. Methods Thirty-three subjects participated in this study. Participants were divided into 3 groups: Ankle Kinesio taping (AKT) group, a placebo (PKT) group, and a control (NKT) group. The AKT group underwent Kinesio tapping of ankle joint and tibialis muscle, PKT group underwent placebo taping, and NKT group underwent no Kinesio taping. All participants were assessed before and after taping training using timed up and go test (TUG), timed up and down stairs test (TUDS), and balance ability. Results After taping training, the AKT group showed significant improvement in mobility and balance ability compared to the PKT group and NKT group (p < 0.05). The results of this study confirmed that Kinesio taping was effective to the balance and mobility abilities of patients with chronic hemiparetic stroke. Conclusions This study suggested Kinesio taping as an effective intervention to increase the mobility and balance abilities of patients with chronic hemiparetic stroke. Therefore, this study are believed to provide the baseline information to effectively improve the balance and mobility abilities of patients with chronic hemiparetic stroke during the rehabilitation treatment in the future.

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