The Effect of Joint Mobilization with PNF Stretch Exercise on Ankle Joint Range of Motion, Plantar Pressure, and Balance in Patients with Stroke

Abstract Background High plantar pressures are associated with increased foot ulcer risk in people with diabetes. Identification of high plantar pressures in people with diabetes is clinically challenging due to time and cost constraints of plantar pressure testing. Factors affecting foot biomechanics, including reduced joint range of motion and foot deformity, are implicated in the development of high plantar pressures and may provide a method to clinically identify those at risk of pressure related complications. The aim of this study was to investigate the contribution of joint range of motion and foot deformity measures on plantar pressures in a community dwelling group with diabetes. Methods Barefoot (Tekscan HR Mat™) and in-shoe (Novel Pedar-X®) plantar pressure variables, weight bearing ankle dorsiflexion, hallux range of motion, lesser toe deformities and hallux abductus (HAV) scale were assessed in 136 adults with diabetes (52.2% male; mean age 68.4 years). Multivariate multiple linear regression was used to assess the effect of the four biomechanical factors plus neuropathy and body mass index on plantar pressure variables. Non-parametric bootstrapping was employed to determine the difference in plantar pressure variables for participants with two or more foot biomechanical pathologies compared to those with less than two pathologies. Results Almost one third (32%) of the cohort had two or more foot biomechanical pathologies. Participants with two or more foot biomechanical pathologies displayed significant increases in all barefoot plantar pressure regions (except forefoot), compared to those with less than two pathologies. No significant changes were found for the in-shoe plantar pressure variables. The regression model explains between 9.9% (95%CI: 8.4 to 11.4%) and 29.6% (95% CI: 28.2 to 31%), and between 2.5% (1.0 to 4.0%) and 43.8% (95% CI: 42.5–44.9%), of the variance in the barefoot and in-shoe plantar pressure variables respectively. Conclusions Participants presenting with two or more factors affecting foot biomechanics displayed higher peak pressures and pressure time integrals in all foot regions compared to those with less than two factors. The tests used in this study could help clinicians detect elevated plantar pressures in people with diabetes and present an opportunity for early preventative interventions.

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The Influence of Peripheral Nerve Injury on the Ankle Joint Range of Motion and the Elasticity of the Soleus Muscle in Rats

Rigakuryoho Kagaku ◽

10.1589/rika.19.127 ◽

2004 ◽

Vol 19 (2) ◽

pp. 127-130 ◽

Cited By ~ 1

Author(s):

Takeya ONO ◽

Sadaaki OKI ◽

Junko OCHI ◽

Shusaku KANAI ◽

Michele Eisemann SHIMIZU ◽

...

Keyword(s):

Peripheral Nerve ◽

Range Of Motion ◽

Nerve Injury ◽

Ankle Joint ◽

Soleus Muscle ◽

Peripheral Nerve Injury ◽

Joint Range Of Motion ◽

Joint Range

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Static Ankle Joint Equinus

Journal of the American Podiatric Medical Association ◽

10.7547/1000195 ◽

2010 ◽

Vol 100 (3) ◽

pp. 195-203 ◽

Cited By ~ 21

Author(s):

James Charles ◽

Sheila D. Scutter ◽

Jonathan Buckley

Keyword(s):

Range Of Motion ◽

Ankle Joint ◽

Good Reliability ◽

Future Studies ◽

Second Stage ◽

Joint Range Of Motion ◽

Major Increase ◽

Definition Of ◽

A Minor ◽

Joint Range

Equinus is characterized by reduced dorsiflexion of the ankle joint, but there is a lack of consensus regarding criteria for definition and diagnosis. This review examines the literature relating to the definition, assessment, diagnosis, prevalence, and complications of equinus. Articles on equinus and assessment of ankle joint range of motion were identified by searching the EMBASE, Medline, PubMed, EBSCOhost, Cinahl, and Cochrane databases and by examining the reference lists of the articles found. There is inconsistency regarding the magnitude of reduction in dorsiflexion required to constitute a diagnosis of equinus and no standard method for assessment; hence, the prevalence of equinus is unknown. Goniometric assessment of ankle joint range of motion was shown to be unreliable, whereas purpose-built tools demonstrated good reliability. Reduced dorsiflexion is associated with alterations in gait, increased forefoot pressure, and ankle injury, the magnitude of reduction in range of motion required to predispose to foot or lower-limb abnormalities is not known. In the absence of definitive data, we propose a two-stage definition of equinus: the first stage would reflect dorsiflexion of less than 10° with minor compensation and a minor increase in forefoot pressure, and the second stage would reflect dorsiflexion of less than 5° with major compensation and a major increase in forefoot pressure. This proposed definition of equinus will assist with standardizing the diagnosis and will provide a basis for future studies of the prevalence, causes, and complications of this condition. (J Am Podiatr Med Assoc 100(3): 195–203, 2010)

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First metatarsophalangeal joint range of motion is associated with lower limb kinematics in individuals with first metatarsophalangeal joint osteoarthritis

10.21203/rs.3.rs-21140/v2 ◽

2020 ◽

Author(s):

Jamie J Allan ◽

Jodie A McClelland ◽

Shannon E Munteanu ◽

Andrew K Buldt ◽

Karl B Landorf ◽

...

Keyword(s):

Range Of Motion ◽

Ankle Joint ◽

Sagittal Plane ◽

Metatarsophalangeal Joint ◽

Hip Joints ◽

First Metatarsophalangeal Joint ◽

Clinical Measurement ◽

Joint Range Of Motion ◽

Dynamic Function ◽

Joint Range

Abstract Background Osteoarthritis of the first metatarsophalangeal joint (1st MTP joint OA) is a common and disabling condition that results in pain and limited joint range of motion. There is inconsistent evidence regarding the relationship between clinical measurement of 1st MTP joint maximum dorsiflexion and dynamic function of the joint during level walking. Therefore, the aim of this study was to examine the association between passive non-weightbearing (NWB) 1st MTP joint maximum dorsiflexion and sagittal plane kinematics in individuals with radiographically confirmed 1st MTP joint OA. Methods Forty-eight individuals with radiographically confirmed 1st MTP joint OA (24 males and 24 females; mean age 57.8 years, standard deviation 10.5) underwent clinical measurement of passive NWB 1st MTP joint maximum dorsiflexion and gait analysis during level walking using a 10-camera infrared Vicon motion analysis system. Sagittal plane kinematics of the 1st MTP, ankle, knee, and hip joints were calculated. Associations between passive NWB 1st MTP joint maximum dorsiflexion and kinematic variables were explored using Pearson’s r correlation coefficients. Results Passive NWB 1st MTP joint maximum dorsiflexion was significantly associated with maximum 1st MTPJ dorsiflexion (r=0.486, p<0.001), ankle joint maximum plantarflexion (r=0.383, p=0.007), and ankle joint excursion (r=0.399, p=0.005) during gait. There were no significant associations between passive NWB 1st MTP joint maximum dorsiflexion and sagittal plane kinematics of the knee or hip joints. Conclusions These findings suggest that clinical measurement of 1st MTP joint maximum dorsiflexion provides useful insights into the dynamic function of the foot and ankle during the propulsive phase of gait in this population.

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