Kang Min-Hyeok, Oh Jae-Seop, Kwon Oh-Yun, Weon Jong-Hyuk, An Duk-Hyun, Yoo Won-Gyu
Department of Physical Therapy, Graduate School, INJE University, Gimhae, Gyeongsangnam-do, South Korea.
Department of Physical Therapy, College of Biomedical Science and Engineering, INJE University, Gimhae, Gyeongsangnam-do, South Korea.
Man Ther. 2015 Dec;20(6):827-34. doi: 10.1016/j.math.2015.03.016. Epub 2015 Apr 2.
Although gastrocnemius stretching and talocrural joint mobilization have been suggested as effective interventions to address limited ankle dorsiflexion passive range of motion (DF PROM), the effects of a combination of the two interventions have not been identified.
The aim of the present study was to compare the effects of gastrocnemius stretching combined with joint mobilization and gastrocnemius stretching alone.
A randomized controlled trial.
In total, 24 individuals with limited ankle DF PROM were randomized to undergo gastrocnemius stretching combined with joint mobilization (12 feet in 12 individuals) or gastrocnemius stretching alone (12 feet in 12 individuals) for 5 min. Ankle kinematics during gait (time to heel-off and ankle DF before heel-off), ankle DF PROM, posterior talar glide, and displacement of the myotendinous junction (MTJ) of the gastrocnemius were assessed before and after the interventions. The groups were compared using two-way repeated measures analysis of variance.
RESULTS/FINDINGS: Greater increases in the time to heel-off and ankle DF before heel-off during gait and posterior talar glide were observed in the stretching combined with joint mobilization group versus the stretching alone group. Ankle DF PROM and displacement of the MTJ of the gastrocnemius were increased significantly after the interventions in both groups, with no significant difference between them.
These findings suggest that gastrocnemius stretching with joint mobilization needs to be considered to improve ankle kinematics during gait.
尽管已有研究表明，腓肠肌拉伸和距小腿关节松动术是改善踝关节背屈被动活动度（DF PROM）受限的有效干预措施，但尚未明确这两种干预措施联合应用的效果。
本研究旨在比较腓肠肌拉伸联合关节松动术与单纯腓肠肌拉伸的效果。
一项随机对照试验。
总共24名踝关节DF PROM受限的受试者被随机分为两组，一组接受腓肠肌拉伸联合关节松动术（12人，共12只脚），另一组接受单纯腓肠肌拉伸（12人，共12只脚），干预时间均为5分钟。在干预前后，分别评估受试者步态期间的踝关节运动学指标（足跟离地时间和足跟离地前的踝关节背屈角度）、踝关节DF PROM、距骨后移以及腓肠肌肌腱结合部（MTJ）的位移。采用双向重复测量方差分析对两组进行比较。
与单纯拉伸组相比，拉伸联合关节松动术组在步态期间足跟离地时间和足跟离地前踝关节背屈角度以及距骨后移方面的增加更为显著。两组干预后踝关节DF PROM和腓肠肌MTJ的位移均显著增加，但两组之间无显著差异。
这些研究结果表明，为改善步态期间的踝关节运动学，需要考虑采用腓肠肌拉伸联合关节松动术。
