Sagittal Plane Range of Motion of the Pediatric Ankle Joint

2006 ◽  
Vol 96 (5) ◽  
pp. 418-422 ◽  
Author(s):  
Angela M. Evans ◽  
Sheila D. Scutter
Keyword(s):  
Range Of Motion ◽  
Ankle Joint ◽  
Interrater Reliability ◽  
Sagittal Plane ◽  
Ankle Dorsiflexion ◽  
Healthy Individuals

Measurement of ankle dorsiflexion is a routine part of the podiatric examination of children, yet the reliability of this measure is largely unknown in healthy individuals. This study assessed the intrarater and interrater reliability of the first and second resistance levels of sagittal ankle range of motion in 4- to 6-year-old children. The results show that measures of ankle dorsiflexion in children are highly variable among examiners, and, in general, gastrocnemius range of motion is more reliable than soleal range of motion. (J Am Podiatr Med Assoc 96(5): 418–422, 2006)

The Reliability of a Smartphone Goniometer Application Compared With a Traditional Goniometer for Measuring Ankle Joint Range of Motion

2019 ◽  
Vol 109 (1) ◽  
pp. 22-29 ◽  
Author(s):  
Motaz Abdalla Alawna ◽  
Bayram H. Unver ◽  
Ertugrul O. Yuksel
Keyword(s):  
Range Of Motion ◽  
Ankle Joint ◽  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Ankle Dorsiflexion ◽  
Data Sets ◽  
Intrarater Reliability ◽  
New Device ◽  
Advantages And Disadvantages

Background: Evaluation of range of motion (ROM) is integral to assessment of the musculoskeletal system, is required in health fitness and pathologic conditions, and is used as an objective outcome measure. Several methods are described to check ROM, each with advantages and disadvantages. Hence, this study introduces a new device using a smartphone goniometer to measure ankle joint ROM. Objective: To test the reliability of smartphone goniometry in the ankle joint by comparing it with the universal goniometer (UG) and to assess interrater and intrarater reliability for the smartphone goniometer record (SGR) application. Methods: Fifty-eight healthy volunteers (29 men and 29 women aged 18–30 years) underwent SGR and UG measurement of ankle joint dorsiflexion and plantarflexion. Two examiners measured ankle joint ROM. Descriptive statistics were calculated for descriptive and anthropometric variables, as were intraclass correlation coefficients (ICCs). Results: There were 58 usable data sets. For measuring ankle dorsiflexion ROM, both instruments showed excellent interrater reliability: UG (ICC = 0.87) and SGR (ICC = 0.89). Intrarater reliability was excellent in both instruments in ankle dorsiflexion: UG and SGR (mean ICC = 0.91). For measuring ankle plantarflexion, both instruments showed excellent interrater reliability: UG (ICC = 0.76) and SGR (ICC = 0.82). Intrarater reliability was excellent in both instruments in ankle plantarflexion: UG (mean ICC = 0.85) and SGR (mean ICC = 0.82). Conclusions: Smartphone-based goniometers can be used to assess active ROM of the ankle joint because they can achieve a high degree of intrarater and interrater reliability.

Effect of prosthetic ankle units on the gait of persons with bilateral trans-femoral amputations

2008 ◽  
Vol 32 (1) ◽  
pp. 111-126 ◽  
Author(s):  
Lexyne L. McNealy ◽  
Steven A. Gard
Keyword(s):  
Power Generation ◽  
Range Of Motion ◽  
Ankle Joint ◽  
Lower Limb ◽  
Stance Phase ◽  
Sagittal Plane ◽  
The Body ◽  
Control Group ◽  
Initial Contact ◽  
Ankle Motion

In able-bodied individuals, the ankle joint functions to provide shock absorption, aid in foot clearance during the swing phase, and provides a rocker mechanism during stance phase to facilitate forward progression of the body. Prosthetic ankles currently used by persons with lower limb amputations provide considerably less function than their anatomical counterparts. However, increased ankle motion in the sagittal plane may improve the gait of persons with lower limb amputations while providing a more versatile prosthesis. The primary aim of this study was to examine and quantify temporal-spatial, kinematic, and kinetic changes in the gait of four male subjects with bilateral trans-femoral amputations who walked with and without prosthetic ankle units. Two prosthesis configurations were examined: (i) Baseline with only two Seattle LightFoot2 prosthetic feet, and (ii) with the addition of Endolite Multiflex Ankle units. Data from the gait analyses were compared between prosthetic configurations and with a control group of able-bodied subjects. The amputee subjects' freely-selected walking speeds, 0.74 ± 0.19 m/s for the Baseline condition and 0.81 ± 0.15 m/s with the ankle units, were much less than that of the control subjects (1.35 ± 0.10 m/s). The amputee subjects demonstrated no difference in walking speed, step length, cadence, or ankle, knee, and hip joint moments and powers between the two prosthesis configurations. Sagittal plane ankle range of motion, however, increased by 3–8° with the addition of the prosthetic ankle units. Compared to the control group, following initial contact the amputee subjects passively increased the rate of energy storage or dissipation at the prosthetic ankle joint, actively increased the power generation at the hip, and increased the extension moment at the hip while wearing the prosthetic ankle configuration. The amputee subjects increased the power generation at their hips, possibly as compensation for the reduced rate of energy return at their prosthetic ankles. Results from subject questionnaires administered following the gait analyses revealed that the prosthetic ankle units provided more comfort during gait and did not increase the perceived effort to walk. The subjects also indicated that they preferred walking with the prosthetic ankle units compared to the Baseline configuration. The results of the study showed that the prosthetic ankle units improved sagittal plane ankle range of motion and increased the comfort and functionality of the amputee subjects’ prostheses by restoring a significant portion of the ankle rocker mechanism during stance phase. Therefore, prosthetic ankle mechanisms should be considered a worthwhile option when prostheses are prescribed for persons with trans-femoral amputations.

Development of a Soft Pneumatic Sock for Robot-Assisted Ankle Exercise

2016 ◽  
Vol 10 (1) ◽  
Author(s):  
Fan-Zhe Low ◽  
Hong Han Tan ◽  
Jeong Hoon Lim ◽  
Chen-Hua Yeow
Keyword(s):  
Range Of Motion ◽  
Ankle Joint ◽  
Medical Condition ◽  
Joint Stiffness ◽  
Intermittent Pneumatic Compression ◽  
Ankle Dorsiflexion ◽  
Compression Stockings ◽  
Robot Assisted ◽  
Pneumatic Actuators ◽  
Prolonged Immobilization

Deep vein thrombosis (DVT) is a severe medical condition that affects many patients around the world, where one of the main causes is commonly associated with prolonged immobilization. Current mechanical prophylaxis systems, such as the compression stockings and intermittent pneumatic compression devices, have yet to show strong efficacy in preventing DVT. The current study aimed to develop a soft pneumatic sock prototype that uses soft extension pneumatic actuators to provide assisted ankle dorsiflexion–plantarflexion motion, so as to prevent the occurrence of DVT. The prototype was evaluated for its efficacy to provide the required dorsiflexion–plantarflexion motion by donning and actuating the prototype on simulated ankle–foot models with various ankle joint stiffness values. Our results showed that the soft extension actuators in the sock prototype provided controllable assisted ankle plantarflexion through actuator extension and ankle dorsiflexion through actuator contraction, where in our study, the actuations extended to 129.9–146.8% of its original length. Furthermore, the sock was able to achieve consistent range of motion at the simulated ankle joint across different joint stiffness values (range of motion: 27.5 ± 6.0 deg). This study demonstrated the feasibility of using soft extension pneumatic actuators to provide robot-assisted ankle dorsiflexion–plantarflexion motion, which will act as an adjunct to physiotherapists to optimize therapy time for bedridden patients and therefore may reduce the risk of developing DVT.

Relationship of Body Mass Index, Ankle Dorsiflexion, and Foot Pronation on Plantar Fascia Thickness in Healthy, Asymptomatic Subjects

2008 ◽  
Vol 98 (5) ◽  
pp. 379-385 ◽  
Author(s):  
Javier Pascual Huerta ◽  
Juan Maria Alarcón García ◽  
Eva Cosin Matamoros ◽  
Julia Cosin Matamoros ◽  
Teresa Díaz Martínez
Keyword(s):  
Body Mass Index ◽  
Range Of Motion ◽  
Ankle Joint ◽  
Body Mass ◽  
Plantar Fasciitis ◽  
Plantar Fascia ◽  
Ankle Dorsiflexion ◽  
Ankle Joint Dorsiflexion ◽  
Foot Pronation ◽  
Asymptomatic Subjects

Background: We sought to investigate the thickness of plantar fascia, measured by means of ultrasonographic evaluation in healthy, asymptomatic subjects, and its relationship to body mass index, ankle joint dorsiflexion range of motion, and foot pronation in static stance. Methods: One hundred two feet of 51 healthy volunteers were examined. Sonographic evaluation with a 10-MHz linear array transducer was performed 1 and 2 cm distal to its insertion. Physical examination was also performed to assess body mass index, ankle joint dorsiflexion, and degree of foot pronation in static stance. Both examinations were performed in a blinded manner. Results: Body mass index showed moderate correlation with plantar fascia thickness at the 1- and 2-cm locations. Ankle dorsiflexion range of motion showed no correlation at either location. Foot pronation showed an inverse correlation with plantar fascia thickness at the 2-cm location and no correlation at the 1-cm location. Conclusion: Body mass index and foot supination at the subtalar joint are related to increased thickness at the plantar fascia in healthy, asymptomatic subjects. Although the changes in thickness were small compared with those in patients with symptomatic plantar fasciitis, they could play a role in the mechanical properties of plantar fascia and in the development of plantar fasciitis. (J Am Podiatr Med Assoc 98(5): 379–385, 2008)

The Effect of Subtalar Arthrodesis Alignment on Ankle Biomechanics

2012 ◽  
Author(s):  
James R. Jastifer ◽  
Peter A. Gustafson ◽  
Robert R. Gorman
Keyword(s):  
Lower Extremity ◽  
Range Of Motion ◽  
Ankle Joint ◽  
Sagittal Plane ◽  
Three Dimensional ◽  
Neutral Position ◽  
Moment Arms ◽  
Subtalar Arthrodesis ◽  
Force Moment ◽  
Ankle Biomechanics

Background: The position, axis, and control of each lower extremity joint intimately affects adjacent joint function as well as whole limb performance. There is little describing the biomechanics of subtalar arthrodesis and none describing the effect that subtalar arthrodesis position has on ankle biomechanics. The purpose of the current study is to establish this effect on sagittal plane ankle biomechanics. Methods: A study was performed utilizing a three-dimensional, validated, computational model of the lower extremity. A subtalar arthrodesis was simulated from 20 degrees of varus to 20 degrees of valgus. For each of these subtalar arthrodesis positions, the ankle dorsiflexor and plantarflexor muscles’ fiber force, moment arm, and moments were calculated throughout a physiologic range of motion. Results: Throughout ankle range of motion, plantarflexion and dorsiflexion strength varies with subtalar arthrodesis position. When the ankle joint is in neutral position, plantarflexion strength is maximized in 10 degrees of subtalar valgus and strength varies by a maximum of 2.6% from the peak 221 Nm. In a similar manner, with the ankle joint in neutral position, dorsiflexion strength is maximized with a subtalar joint arthrodesis in 5 degrees of valgus and strength varies by a maximum of 7.5% from the peak 46.8 Nm. The change in strength is due to affected muscle fiber force generating capacities and muscle moment arms. Conclusion: The clinical significance of this study is that subtalar arthrodesis in a position of 5–10 degrees subtalar valgus has biomechanical advantage. This supports previous clinical outcome studies and offers biomechanical rationale for their generally favorable outcomes.

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

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.

scholarly journals Comparison of ankle range of motion and functional performance between practitioners of resistance exercise with free-weight vs. Machine

2020 ◽  
Vol 4 (3) ◽  
pp. 81-85
Author(s):  
Alex Souto Maior ◽  
Eduardo Lobo ◽  
Marcos Braz ◽  
José Carlos de Campos Jr ◽  
Gustavo Leporace
Keyword(s):  
Resistance Exercise ◽  
Range Of Motion ◽  
Functional Performance ◽  
Sagittal Plane ◽  
Plantar Flexion ◽  
Ankle Dorsiflexion ◽  
Significant Difference ◽  
Hop Test ◽  
And Performance ◽  
Single Leg Hop Test

The purpose of this investigation was to compare ankle functional performance and ankle range of motion (ROM) between practitioners of resistance exercise (RE) with free-weights versus machines. Twenty-five men participated in this study. They were separated into two groups: (a) Free-weights; and (b) Machines. All subjects practiced regularly RE 5.3±0.7 d∙wk-1 and low aerobic training of 1.2±0.5 d∙wk-1 with a total time volume of 254.9±9.4 min∙wk-1. ROM measurements were taken in both ankles with a digital goniometer. Active ankle-dorsiflexion and plantar flexion range of motion were measured with subjects lying prone with an extended knee on a standard treatment table. The rising on the heel and the rising on toes were used to assess endurance of the ankle dorsiflexor and plantar flexor muscles, respectively. Ankle functional stability was assessed with the Single Leg Hop Test in both limbs. Ankle-dorsiflexion ROM showed a significant difference (Δ% left=21.1%; Δ% right=25.8%; P<0.01) between the Machines Group when compared to the Free-weights Group. Rising on the heel and rising on the toes showed no significant differences between the 2 groups (i.e., free-weights versus machines) (P>0.05). On the other hand, the Single Leg Hop Test (Δ% left=16.3%; Δ% right=15.4%; P<0.05) and number of jumps (Δ% left=27.9 %; Δ% right=26.1 %; P<0.05) recorded were lower in the Free-weights Group compared to the Machines Group. This study found a greater ankle-dorsiflexion ROM and performance during the Single Leg Hop Test in practitioners of RE with free-weights, showing a better control of sagittal plane movements.

Immediate Effects of Ankle Joint Mobilization With Movement on Postural Control, Range of Motion, and Muscle Strength in Healthy Individuals: A Randomized, Sham-Controlled Trial

2020 ◽  
Vol 29 (8) ◽  
pp. 1060-1068
Author(s):  
Murat Tomruk ◽  
Melda Soysal Tomruk ◽  
Emrullah Alkan ◽  
Nihal Gelecek
Keyword(s):  
Muscle Strength ◽  
Postural Control ◽  
Range Of Motion ◽  
Ankle Joint ◽  
Controlled Trial ◽  
Weight Bearing ◽  
Tibialis Anterior Muscle ◽  
Good Health ◽  
Controlled Study ◽  
Healthy Individuals

Context: Ankle proprioception is one of the crucial components contributing to postural control. Although the effects of Mulligan’s mobilization with movement (MWM) on postural control, ankle dorsiflexion range of motion (DFROM), and muscle strength in people with ankle disorders have previously been investigated, it is still unclear whether ankle MWM had ability to change postural control, DFROM, and muscle strength. Objectives: To reveal pure effects of MWM on postural control, ankle DFROM, and muscle strength in healthy individuals. Design: A prospective, randomized, double-blinded, sham-controlled study. Setting: Musculoskeletal laboratory, Dokuz Eylul University, Turkey. Participants: Forty students in good health recruited from a local university. Interventions: Mulligan’s MWM or sham application over ankle joint. Main Outcome Measures: The primary outcome was postural control and measured using limits of stability (LOS) test. The secondary outcomes were tibialis anterior muscle strength and ankle DFROM, which were measured using handheld dynamometer and weight-bearing lunge test, respectively. All outcomes were assessed before and immediately after intervention. Results: Left and right ankle DFROM and LOS overall score showed a statistically significant improvement compared with first measurement in both groups (P < .05). However, LOS time was significantly improved only in the MWM group (P < .05). Statistical analyses of between-group mean differences showed that Mulligan’s MWM provided significant improvement in the LOS in forward–right direction compared with sham application (P = .03). Conclusions: The results of this study suggest that the application of Mulligan’s MWM on ankle joint might be beneficial to improve postural control in forward right direction in individuals with healthy ankles. On the other hand, both MWM and sham application were able to increase overall postural control and DFROM, and MWM had no superiority over sham application for increasing these 2 variables.

Changes in Active Ankle Dorsiflexion Range of Motion after Acute Inversion Ankle Sprain

2009 ◽  
Vol 18 (3) ◽  
pp. 358-374 ◽  
Author(s):  
James W. Youdas ◽  
Timothy J. McLean ◽  
David A. Krause ◽  
John H. Hollman
Keyword(s):  
Range Of Motion ◽  
Outcome Measure ◽  
Sagittal Plane ◽  
Plantar Flexion ◽  
Exercise Program ◽  
Plane Motion ◽  
Ankle Dorsiflexion ◽  
Home Exercise ◽  
Main Outcome Measure ◽  
Ankle Inversion

Context:Posterior calf stretching is believed to improve active ankle dorsiflexion range of motion (AADFROM) after acute ankle-inversion sprain.Objective:To describe AADFROM at baseline (postinjury) and at 2-wk time periods for 6 wk after acute inversion sprain.Design:Randomized trial.Setting:Sports clinic.Participants:11 men and 11 women (age range 11–54 y) with acute inversion sprain.Intervention:Standardized home exercise program for acute inversion sprain.Main Outcome Measure:AADFROM with the knee extended.Results:Time main effect on AADFROM was significant (F3,57 = 108, P < .001). At baseline, mean active sagittal-plane motion of the ankle was 6° of plantar flexion, whereas at 2, 4, and 6 wk AADFROM was 7°, 11°, and 11°, respectively.Conclusions:AADFROM increased significantly from baseline to week 2 and from week 2 to week 4. Normal AADFROM was restored within 4 wk after acute inversion sprain.

Role of spasticity severity on the balance of post-stroke patients (Preprint)

2021 ◽  
Author(s):  
Ashraf Mahmoudzadeh ◽  
Noureddin Nakhostin Ansari ◽  
Soofia Naghdi ◽  
Ehsan Ghasemi ◽  
Brandon S Shaw ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Ankle Joint ◽  
Postural Sway ◽  
Dynamic Balance ◽  
Ankle Dorsiflexion ◽  
Plantar Flexor ◽  
Stroke Patients ◽  
Timed Up And Go ◽  
Balance Confidence ◽  
Post Stroke

BACKGROUND Lower limb spasticity, as is common following a cerebrovascular attack (CVA) or stroke, can affect the balance and gait of patients. This then not only affects independence, and quality of life, but also increases the risk for other concerns, such as falling and an increased sedentariness, which could further affect health outcomes. OBJECTIVE We aimed to evaluate the effect of ankle plantar flexor spasticity severity on balance and to determine the relationship between the spasticity severity with ankle proprioception, passive range of motion (ROM), and balance confidence in post-stroke patients. METHODS Twenty-eight post-stroke patients were divided into two groups based on the level of ankle plantar flexor spasticity according to the Modified Modified Ashworth Scale (MMAS) as a High Spasticity Group (HSG) (MMAS>2) (n=14) or a Low Spasticity Group (LSG) (MMAS≤2) (n=14). The MMAS scores, Activities-Specific Balance Confidence Questionnaire, postural sway in the open and closed eyes conditions, timed up and go (TUG) test, ankle dorsiflexion passive range of motion (ROM), and ankle joint proprioception were measured. RESULTS No significant (p>0.05) differences were found between the LSG and HSG in terms of balance confidence, dynamic balance, and ankle dorsiflexion ROM. In addition, postural sway in the open and closed eye conditions was not significantly different in both the LSG and HSG for both the less affected and affected limbs. Similarly, posturography indicators in the open and closed eye conditions were not significantly different in both the LSG and HSG for both the less affected and affected limbs. However, ankle joint proprioception in terms of repositioning error angle was significantly (p≤0.05) better in the LSG compared to the HSG (p=0.01). There was also a significant relationship between TUG scores and balance confidence in the HSG(r=-0.55, p=0.04) CONCLUSIONS Our data suggests that several aspects of balance needs to be considered in the assessment and rehabilitation of post-stroke patients and there is a need to monitor entire patterns of activities to support wider engagement in rehabilitation activities. INTERNATIONAL REGISTERED REPORT RR2-10.2196/16045

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