Background While considerable research has evaluated the effects of joint mobilisation on spinal, pelvic and shoulder biomechanics, there is a paucity of research evaluating the effects of foot mobilisation techniques (FMT) on gait. This pilot study evaluated the immediate effects of FMT on plantar pressures and temporal-spatial gait parameters. Methods Fifteen adults (48±21.4 years) that had no known balance problems or falls history participated. An instrumented treadmill system (Zebris FMD-T, Zebris Medical, Germany) was used to measure plantar pressure and temporal-spatial gait parameters. Data were recorded for 30 seconds of steady state walking immediately before and after intervention using a standardised protocol of FMT. Repeated measures ANOVAs were used to assess the effect of FMT on gait parameters at an alpha level of .05. Results Of the 34 gait parameters measured, only three changed significantly after FMT. Peak pressure beneath the lateral heel (4%) and lateral forefoot (9%) was increased immediately following FMT (p<.05) and was accompanied by a delay (3%) in the time to peak pressure beneath the lateral forefoot (p<.05). Conclusion Changes in plantar pressure following FMT were small and less than the reported measurement error of the treadmill system. Therefore, in this pilot study the immediate effect of FMT on gait parameters was negligible. Further research evaluating short and long term effects of FMT on specific aspects of the locomotor system are needed.
Abstract Background Ankle joint equinus, or restricted dorsiflexion range of motion (ROM), has been linked to a range of pathologies of relevance to clinical practitioners. This systematic review and meta‐analysis investigated the effects of conservative interventions on ankle joint ROM in healthy individuals and athletic populations. Methods Keyword searches of Embase, Medline, Cochrane and CINAHL databases were performed with the final search being run in August 2013. Studies were eligible for inclusion if they assessed the effect of a non‐surgical intervention on ankle joint dorsiflexion in healthy populations. Studies were quality rated using a standard quality assessment scale. Standardised mean differences (SMDs) and 95% confidence intervals (CIs) were calculated and results were pooled where study methods were homogenous. Results Twenty‐three studies met eligibility criteria, with a total of 734 study participants. Results suggest that there is some evidence to support the efficacy of static stretching alone (SMDs: range 0.70 to 1.69) and static stretching in combination with ultrasound (SMDs: range 0.91 to 0.95), diathermy (SMD 1.12), diathermy and ice (SMD 1.16), heel raise exercises (SMDs: range 0.70 to 0.77), superficial moist heat (SMDs: range 0.65 to 0.84) and warm up (SMD 0.87) in improving ankle joint dorsiflexion ROM. Conclusions Some evidence exists to support the efficacy of stretching alone and stretching in combination with other therapies in increasing ankle joint ROM in healthy individuals. There is a paucity of quality evidence to support the efficacy of other non‐surgical interventions, thus further research in this area is warranted.
Ankle equinus is a limitation in ankle dorsiflexion, which has been clinically associated with impaired balance and lower limb pathology in adults. This thesis investigated the immediate effects of ankle mobilisation on balance performance, plantar pressures, muscle activity and ankle movement in people with ankle equinus. Through a series of carefully controlled studies, this thesis identified considerable variation in the force applied during ankle mobilisation. Although the findings suggest that mobilisation may result in improvements in patient-reported outcomes, it also questions the rationale behind the use of ankle mobilisation as an intervention in ankle equinus.
BackgroundAnkle joint equinus, or restricted dorsiflexion range of motion, has been linked to a range of pathologies of relevance to sports medicine practitioners.This systematic review and meta-analysis investigated the effects of conservative interventions on ankle joint range of motion in healthy individuals and athletic populations. MethodsKeyword searches of Embase, Medline, Cochrane and CINAHL databases were performed.Studies were eligible for inclusion if they assessed the effect of a conservative intervention on ankle joint dorsiflexion in healthy populations.Papers were quality rated using a standard quality assessment scale.Standardised mean differences (SMDs) and 95% confidence intervals (CIs) were calculated and results were pooled where study methods were homogenous.