Effect of mobilization on ankle mobility and balance performance in diabetic patients

Introduction and Aim: Diabetic Cheiroarthropathy is defined as the condition of restriction joint mobility due to pseudo-sclerodermatous hand, the fibrosis of the elastin connective tissues over the skin. It limits joint mobility especially around Tibia fibular mobility that are interrelated with the flexibility of ankle motion that results in the balance disorder in diabetic population. The aim of the study was to determine the effects of the tibia fibular mobilization technique on ankle joint in diabetes mellitus patients. Materials and Methods: 60 diabetic subjects were randomly assigned into experimental group and control, in which experimental group received Tibia fibular mobilization technique and conventional treatment whereas control group received only conventional treatment 1 time a week for 3 weeks. Results: There is no significant difference in Ankle dorsi flexion range of motion in both extremities but there is significant difference in ankle plantar flexion range of motion in both extremities and functional reach test in both extremities. Conclusion: There is a significant difference in the ankle plantar flexion range of motion and functional reach test, Hence, mobilization of Tibiofibular joint will be beneficial in improving the ankle range of motion and balance factor in the diabetic population.

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Kinesio taping techniques for ankle stabilisation in patients with stroke: a single-blinded randomised controlled study

International Journal of Therapy and Rehabilitation ◽

10.12968/ijtr.2019.0082 ◽

2021 ◽

Vol 28 (2) ◽

pp. 1-12

Author(s):

Ramazan Kurul ◽

Tamer Cankaya ◽

Necmiye Un Yildirim

Keyword(s):

Barthel Index ◽

Intervention Group ◽

Controlled Study ◽

Timed Up And Go ◽

Peroneus Longus ◽

Kinesio Taping ◽

Functional Reach ◽

Significant Difference ◽

Functional Reach Test ◽

Peroneus Brevis

Background/AimsAnkle proprioception and neuromuscular feedback from this region provides the sensory input needed for balance. The aim of this study was to investigate the effects of repeated correction taping applied on the ankle and peroneus longus and peroneus brevis muscles on balance and gait in patients with stroke.MethodsA total of 61 patients with stroke with a mean age of 62.25 ± 7.04 years were included in this study. The patients were randomly divided into two groups. The control group (n=30) received 1 hour of rehabilitation, which took place during weekdays over the course of 2 weeks. The intervention group (n=31) received 1 hour of daily rehabilitation as well as having kinesio tape applied to their ankle. Both groups were assessed with the Balance Evaluating Systems Test, Timed Up and Go Test, Functional Reach Test, Tetrax Balance System and Barthel Index. Clinical assessments were performed at baseline, immediately after the first application, 1 week and 2 weeks later, following the first taping.ResultsThere was a significant improvement in the Balance Evaluating Systems and Functional Reach Tests scores between the first and last measurements in favour of the intervention group (P<0.05). There were no significant changes between baseline and immediately after assessment for all measurements (P>0.05). There was no significant difference in Tetrax scores, Timed Up and Go Test and Barthel Index scores (P>0.05).ConclusionsIn this study, it was found that dynamic balance was improved by taping the peroneus longus and peroneus brevis muscles, but the static balance did not change. One week of kinesio taping would be beneficial; however, prolonged use would not provide further improvement.

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The Effect of Dry Needling on Pain, Range of Motion of Ankle Joint, and Ultrasonographic Changes of Plantar Fascia in Patients With Plantar Fasciitis

Journal of Sport Rehabilitation ◽

10.1123/jsr.2021-0156 ◽

2021 ◽

pp. 1-6

Author(s):

Afsaneh Moosaei Saein ◽

Ziaeddin Safavi-Farokhi ◽

Atefeh Aminianfar ◽

Marzieh Mortezanejad

Keyword(s):

Range Of Motion ◽

Ankle Joint ◽

Visual Analog Scale ◽

Plantar Fasciitis ◽

Plantar Flexion ◽

Plantar Fascia ◽

Trigger Points ◽

Dry Needling ◽

Analog Scale ◽

Significant Difference

Context: Plantar fasciitis (PF) is a common and devastating disease. Despite different treatments, there is no clear evidence for the effect of these treatments on PF. One of the therapy methods used in physiotherapy is dry needling (DN). So the purpose of this study is to investigate the effect of DN on the pain and range of motion of the ankle joint and plantar fascia thickness in subjects with PF who are suffering from the trigger points of the gastrocnemius and soleus muscles. Methods: In this study, 20 volunteer females with PF were randomly assigned into DN treatment and control groups. Measurements were range of motion in dorsiflexion and plantar flexion, plantar fascia thickness, and visual analog scale measured before, immediately, and 1 month after the end of the intervention in both groups. Results: There were significant differences in the plantar fascia thickness and visual analog scale between the 2 groups. Plantar fascia thickness (P = .016) and visual analog scale (P = .03) significantly decreased in the treatment group. However, there was no significant difference in plantar flexion (P = .582) and dorsiflexion range of motion (P = .173) between groups. Conclusion: The result of this study showed that DN can reduce pain and plantar fascia thickness in women with PF who are suffering from trigger points of the gastrocnemius and soleus muscles. Level of evidence: Level 1, randomized controlled trial.

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Effectiveness of Hold Relax Proprioceptive Neuromuscular Facilitation Technique in Total Knee Arthroplasty

Bioscience Biotechnology Research Communications ◽

10.21786/bbrc/14.4.80 ◽

2021 ◽

Vol 14 (4) ◽

pp. 1919-1923

Author(s):

Mohammad Miraj

Keyword(s):

Muscle Strength ◽

Range Of Motion ◽

Knee Replacement ◽

Conventional Treatment ◽

Mean Difference ◽

Control Group ◽

Bilateral Knee ◽

Proprioceptive Neuromuscular Facilitation ◽

Total Knee ◽

Experimental Group

Proprioceptive Neuromuscular Facilitation (PNF) is a popular flexibility training, which involves stretching and contraction of the target muscle group. PNF stretching is effective among athletes for improving passive range of motion, flexibility, and performance. Patients who undergo total knee replacement surgeries exhibit pain, swelling, decreased range of motion, muscle weakness, and stiffness. This study aimed to investigate the effect of the hold relax PNF technique to improve the balance and muscle strength in subjects with a bilateral knee replacement. Sixty four patients were selected based on inclusion/exclusion criteria. The patients were allocated into two groups by random allocation. The experimental group A (n=32) received the Hold Relax PNF technique with conventional treatment whereas, the control group B (n=32) received only conventional treatment as a part of the Home Exercise Program (HEP). Outcome measures used for evaluation included the Visual Analogue Scale (VAS), Manual Muscle Testing (MMT), and Berg Balance Scale (BBS) Score for measuring pain, muscle strength, and balance respectively. Students t-test showed significant differences between variables mean scores from two groups after three weeks of intervention. There was a statistical significant (t(32) = 2.38, p = 0.02) change in the mean scores of VAS in the experimental group (mean difference pre-post=3.19) as compared to control group ( mean difference pre -post=3.19) with Cohen’s d = 2.744588. Similarly for MMT(t(32) = 0.415, p = 0.005) and BBS scores (t(32) = 2.628, p = 0.035). The result of the study suggests that the Hold Relax PNF technique is more effective than conventional treatment alone in decreasing pain as well as increasing balance and muscle strength in bilateral knee replacement patients.

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Effectiveness of Low-Frequency Stimulation in Proprioceptive Neuromuscular Facilitation Techniques for Post-Ankle-Sprain Balance and Proprioception in Adults- a Randomized controlled trial

10.21203/rs.3.rs-29932/v1 ◽

2020 ◽

Author(s):

KHALID A ALAHMARI ◽

Paul Silvian Samuel ◽

Irshad Ahmad ◽

Ravi Shankar Reddy ◽

Jaya Shanker Tedla ◽

...

Keyword(s):

Physical Activity ◽

Range Of Motion ◽

Outcome Measures ◽

Ankle Sprain ◽

Low Frequency ◽

Control Group ◽

Significant Difference ◽

Proprioceptive Neuromuscular Facilitation ◽

Experimental Group

Abstract BackgroundStretching is an important part of post-ankle-sprain rehabilitation, as well as an effective exercise for improving general ankle-joint performance. But the combination of stretching alongside muscle stimulation has not yet been extensively studied. Therefore the purpose of the present research is to compare the baseline, post- and follow-up effects of the proprioceptive neuromuscular facilitation (PNF) stretching technique combined with transcutaneous electrical nerve stimulation (TENS), as compared against the effects of the PNF stretching technique alone.MethodsSixty subjects with lateral ankle sprains were selected and randomly allocated to three groups: Experimental Group One (EG 1), Experimental Group Two (EG 2), and the Control Group (CG). Subjects in EG 1 received the PNF stretching technique combined with TENS. Subjects in EG2 received the PNF stretching technique alone. Both experimental groups received these treatments for 4 weeks (4 days/week); follow-up assessments were administered in the third and fifth weeks. CG received no treatment; outcome measures alone were assessed. Outcome measures comprised pain, flexibility, proprioception, range of motion, muscle strength, physical activity, and balance. A mixed-model ANOVA was used to analyze the effects of time factors and groups on these outcome measures.ResultsThere was significant interaction (time and group), and the time effect for all the outcome measures (p < 0.05). Physical activity, dorsiflexion, and balance in the medial, lateral, anterolateral, and anteromedial directions did not show a significant difference between the groups. EG 1 showed significant improvement for all the outcome variables between pre- and post-treatment and follow-up when compared to the other groups.ConclusionsThe present study showed that a 12-session treatment program of 3 weeks’ duration that combines PNF stretching with low-frequency TENS for post-ankle sprain subjects, compared against PNF stretching alone, produced significant improvements in balance, proprioception, strength, and range of motion. The study also showed that the treatment effect was sustained even after treatment was ceased after the follow-up assessment in the fifth week.Trial Registration:Human Research Ethics Committee approval for the trial (approval no.: (ECM#2019-26)Clinical trial was also registered in the Clinical Trials Registry – ISRCTN 18013941

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Validity of a Smartphone Application for Measuring Ankle Plantar Flexion

Journal of Sport Rehabilitation ◽

10.1123/jsr.2017-0143 ◽

2018 ◽

Vol 27 (3) ◽

Cited By ~ 4

Author(s):

Robert W. Cox ◽

Rodrigo E. Martinez ◽

Russell T. Baker ◽

Lindsay Warren

Keyword(s):

Range Of Motion ◽

Repeated Measures ◽

Plantar Flexion ◽

Smartphone Application ◽

Convenience Sample ◽

Correlational Design ◽

Valid Instrument ◽

Highly Correlated ◽

Motion Assessment ◽

Ankle Plantar Flexion

Context: Range of motion is a component of a physical examination used in the diagnostic and rehabilitative processes. Following ankle injury and/or during research, it is common to measure plantar flexion with a universal goniometer. The ease and availability of digital inclinometers created as applications for smartphones have led to an increase in using this method of range of motion assessment. Smartphone applications have been validated as alternatives to inclinometer measurements in the knee; however, this application has not been validated for plantar flexion in the ankle. Objectives: The purpose of this study was (1) to assess the validity of the Clinometer Smartphone Application™ produced by Plaincode App Development for use in the ankle (ie, plantar flexion) and (2) to assess the validity of the inclinometer procedures used to measure ankle dorsiflexion for measuring ankle plantar flexion. Design: Blinded repeated measures correlational design. Setting: University-based outpatient rehabilitative clinic. Participants: A convenience sample (N = 50) of participants (27 females and 23 males) who reported to the clinic (mean age = 30.48 y). Intervention: Patients were long seated on a plinth, with the knee in terminal extension. Three plantar flexion measurements were taken with a goniometer on each foot by the primary researcher. The primary researcher then conducted 3 blinded measurements with The Clinometer Smartphone Application™ following the same procedure. A second researcher, who was blinded to the goniometer measurements, recorded the inclinometer measurements. After data were collected, a Pearson’s correlation was calculated to determine the validity of the clinometer app compared with goniometry. Main Outcome Measure: Degrees of motion for ankle plantar flexion. Results: Measurements produced using the Clinometer Smartphone Application™ were highly correlated for right foot (r = .92, P < .001), left foot (r = .92, P < .001), and combined (r = .92, P < .001) with goniometer measurements using a plastic universal goniometer. Conclusion: The Clinometer Smartphone Application™ is a valid instrument for measuring plantar flexion of the ankle.

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Balance Measurement Using Microsoft Kinect v2: Towards Remote Evaluation of Patient with the Functional Reach Test

Applied Sciences ◽

10.3390/app11136073 ◽

2021 ◽

Vol 11 (13) ◽

pp. 6073

Author(s):

Ines Ayed ◽

Antoni Jaume-i-Capó ◽

Pau Martínez-Bueso ◽

Arnau Mir ◽

Gabriel Moyà-Alcover

Keyword(s):

Microsoft Kinect ◽

Clinical Tests ◽

Kinect V2 ◽

Functional Reach ◽

Significant Difference ◽

Functional Reach Test ◽

Balance Ability ◽

Clinical Tools ◽

Balance Rehabilitation ◽

Remote Evaluation

To prevent falls, it is important to measure periodically the balance ability of an individual using reliable clinical tests. As Red Green Blue Depth (RGBD) devices have been increasingly used for balance rehabilitation at home, they may also be used to assess objectively the balance ability and determine the effectiveness of a therapy. For this, we developed a system based on the Microsoft Kinect v2 for measuring the Functional Reach Test (FRT); one of the most used balance clinical tools to predict falls. Two experiments were conducted to compare the FRT measures computed by our system using the Microsoft Kinect v2 with those obtained by the standard method, i.e., manually. In terms of validity, we found a very strong correlation between the two methods (r = 0.97 and r = 0.99 (p < 0.05), for experiments 1 and 2, respectively). However, we needed to correct the measurements using a linear model to fit the data obtained by the Kinect system. Consequently, a linear regression model has been applied and examining the regression assumptions showed that the model works well for the data. Applying the paired t-test to the data after correction indicated that there is no statistically significant difference between the measurements obtained by both methods. As for the reliability of the test, we obtained good to excellent within repeatability of the FRT measurements tracked by Kinect (ICC = 0.86 and ICC = 0.99, for experiments 1 and 2, respectively). These results suggested that the Microsoft Kinect v2 device is reliable and adequate to calculate the standard FRT.

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Heel Rise and Non–Weight-Bearing Ankle Plantar-Flexion Tasks to Assess Foot and Ankle Function in People With Diabetes Mellitus and Peripheral Neuropathy

Physical Therapy ◽

10.1093/ptj/pzab096 ◽

2021 ◽

Author(s):

H Jeong ◽

M J Mueller ◽

J A Zellers ◽

Y Yan ◽

M K Hastings

Keyword(s):

Diabetes Mellitus ◽

Peripheral Neuropathy ◽

Plantar Flexion ◽

Weight Bearing ◽

Joint Mobility ◽

Foot And Ankle ◽

Control Groups ◽

Limited Joint Mobility ◽

And Control ◽

Ankle Plantar Flexion

Abstract Objective To examine the effects of diabetes mellitus and peripheral neuropathy (DMPN), limited joint mobility, and weight bearing on foot and ankle sagittal movements; and characterize the foot and ankle position during heel rise. Methods Sixty people with DMPN and 22 controls participated. Primary outcomes were foot (forefoot on hindfoot) and ankle (hindfoot on shank) plantar-flexion/dorsiflexion angle during three tasks: unilateral heel rise, bilateral heel rise, and non–weight-bearing ankle plantar flexion. A repeated measures analysis of variance and Fisher exact test were used. Results Main effects of task and group were significant, but not the interaction in both foot and ankle plantar flexion. Foot and ankle plantar flexion were less in people with DMPN compared to controls in all tasks. Both DMPN and control groups had significantly less foot and ankle plantar flexion with greater weight bearing, however, the linear trend across tasks was similar between groups. The DMPN group had a greater percentage of individuals in foot and/or ankle dorsiflexion at peak unilateral heel rise compared to controls, but the foot and ankle position was similar at peak bilateral heel rise between DMPN and control groups. Conclusions Foot and ankle plantar flexion is less in people with DMPN. Less plantar flexion in non–weight bearing suggests that people with DMPN have limited joint mobility. However, peak unilateral and bilateral heel rise is less than the available plantar-flexion range of motion measured in non–weight bearing indicating that limited joint mobility does not limit heel rise performance. A higher frequency of people with DMPN are in foot and ankle dorsiflexion at peak unilateral heel rise compared to controls, but the position improved with lower weight bearing. Impact Proper resistance should be considered with physical therapist interventions utilizing heel rise because foot and ankle plantar-flexion position could be improved by reducing the amount of weight bearing.

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Effects of Wearing High Heels on Ankle Plantarflexion

Pakistan Journal of Physical Therapy (PJPT) ◽

10.52229/pjpt.v4i1.869 ◽

2021 ◽

Vol 4 (1) ◽

pp. 12-16

Author(s):

Nida Waqas ◽

Fareeha Amjad ◽

Fiza Zulfiqar ◽

Saba Illyas

Keyword(s):

Lower Extremity ◽

University Students ◽

Range Of Motion ◽

Plantar Flexion ◽

P Value ◽

High Heel ◽

Heel Height ◽

Significant Difference ◽

High Heels ◽

Academic Year

Abstract: Wearing High Heels (HH) for prolong period may cause kinetics and kinematics changes of lower extremity. It may lead to musculoskeletal deformities.Objective:To determine the effects of wearing different high heel shoes on ankle joint plantar flexion range.Methadology: 120 healthy university students who habitually wore shoes of different heel heights from 1cm to 10cm for at least 1 academic year, more than 5 days a week were selectively recruited. Participants were grouped according to their heel heights: flat, low, mid and high heels. Ankle plantarflexion was measured using universal goniometer in all 4 groups.Results:Overall plantarflexion range was significantly affected by heel height (p-value <0.001). Wearing high heel s s ignificantly inc reased the plantar flexion range as compared to flat shoe wearers (p-value <0.001). There was statistically significant difference in plantarflexion range according to heel height (p<0.001).Conclusion: Wearing high heels shoes for 1 year enhanced the plantarflexion range of motion in all heel groups and the change was most significant in HH group. Habitually wearing of high heels increases the plantarflexion range of motion in heel wearing groups but it was not seen in flat shoes group (FSG). Increase in range depends on heel height; increasing the heel height results into increase plantarflexion range. Keywords: High heels; Heel height; Plantarflexion ; Range of motion

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Intraobserver and Interobserver Reliability of a Method to Measure Ankle Plantar-Flexion Range of Motion in the Hook-Lying Position

Journal of Sport Rehabilitation ◽

10.1123/jsr.2012.tr4 ◽

2012 ◽

Vol 21 (4) ◽

Cited By ~ 2

Author(s):

Guilherme S. Nunes ◽

Gabriela S. Bayer ◽

Leticia M.R. da Costa ◽

Marcos de Noronha

Keyword(s):

Range Of Motion ◽

Physical Therapists ◽

Interobserver Reliability ◽

Plantar Flexion ◽

Method Of Measurement ◽

Experienced Therapist ◽

Healthy Participants ◽

Ankle Plantar Flexion ◽

Very High ◽

Treatment Table

Context: Physical therapists often have to measure ankle range of motion (ROM) to decide on intervention and investigate improvements. The most common method of measurement is goniometry, but it has been questioned due to its unsatisfactory levels of reliability. Objective: To investigate the intraobserver and interobserver reliability of a new method of measuring plantar-flexion ROM. Design: Prospective and descriptive. Setting: Laboratory. Participants: 20 healthy participants (12 women and 8 men). Main Outcome Measurements: Ankle plantar flexion was measured by 3 observers (A, B, and C) with 3 methods (goniometry, measurement in hook-lying position [MHP], and static-image analysis [SIA]). Observer A was the most experienced therapist, and C, the least. MHP was performed with the participant in the supine position, knees flexed, and first and fifth metatarsals in contact with the treatment table. SIA was recorded and analyzed in the same position. Goniometry was performed with participant seated, lower legs unsupported, and axis positioned on the lateral malleolus. Results: For the interobserver analysis, the ICC2,1 was high for the MHP (.88), high for SIA (.87), and moderate for goniometry (.57). For the intraobserver analysis, the ICC2,1 was high or very high for MHP (.91-.92), high for SIA (.79-.83), and low to moderate for goniometry (.18-.60). Conclusion: MHP is inexpensive, fast, and more reliable than goniometry for measuring plantar-flexion ROM.

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Effects of dual task balance training on dual task performance in elderly people: a randomized controlled trial

Clinical Rehabilitation ◽

10.1177/0269215510394222 ◽

2011 ◽

Vol 26 (1) ◽

pp. 58-67 ◽

Cited By ~ 52

Author(s):

Makoto Hiyamizu ◽

Shu Morioka ◽

Koji Shomoto ◽

Tomoaki Shimada

Keyword(s):

Stroop Task ◽

Dual Task ◽

Controlled Trial ◽

Balance Training ◽

Control Group ◽

Timed Up And Go ◽

Functional Reach ◽

Functional Reach Test ◽

Dual Task Performance ◽

Experimental Group

Objective: To investigate the effects of dual task balance training in the elderly on standing postural control while performing a cognitive task. Design: A randomized two-group parallel controlled trial. Participants: Forty-three subjects (all >65 years old) were enrolled in the study and were assigned randomly to either an experimental group ( n = 21) or a control group ( n = 22). Interventions: Subjects in the experimental group were given strength and balance training while performing cognitive tasks simultaneously. Subjects in the control group were given strength and balance training only. The training was administered twice a week for three months. Measurements: The Chair Stand Test, Functional Reach Test, Timed Up and Go Test and Trail Making Test were measured. The sway length of the centre of gravity was measured during standing while performing the Stroop task. The rate of Stroop task was also measured. All measurements were collected at baseline and after the training period. Results: There were no significant differences in Functional Reach Test, Timed Up and Go Test and sway length at baseline and after training between the two groups. However, the rate of Stroop task ( P < 0.05) was significantly higher after training in the experimental group than in the control group. Conclusions: These results suggest that dual task balance training in elderly people improves their dual task performance during standing postural control.

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