Swipe om te navigeren naar een ander artikel
The online version of this article (doi:10.1186/1757-1146-6-46) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
RY performed the data searches, performed all quality assessments and data extractions and drafted the manuscript. SN was involved with study design, performed meta-analysis and data calculations and revised the manuscript. AW performed quality assessments and assisted with manuscript revisions. LR was involved with study conception and design, and assisted with manuscript revisions. RB was involved with the study conception and design and assisted with manuscript revisions. All authors read and approved the final manuscript.
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.
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.
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.
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.
Johanson MA, Cuda BJ, Koontz JE, Stell JC, Abelew TA: Effect of stretching on ankle and knee angles and gastrocnemius activity during the stance phase of gait. J Sport Rehabil. 2009, 18: 521-534. PubMed
Gajdosik RL, Vander Linden DW, McNair PJ, Williams AK, Riggin TJ: Effects of an eight-week stretching program on the passive-elastic properties and function of the calf muscles of older women. Clin Biomech (Bristol, Avon). 2005, 20: 973-983. CrossRef
Macklin K, Healy A, Chockalingam N: The effect of calf muscle stretching exercises on ankle joint dorsiflexion and dynamic foot pressures, force and related temporal parameters. Foot (Edinb). 2012, 22: 10-17. CrossRef
Root M, Orien W, Weed J: Normal and Abnormal Function of the Foot. 1977, Los Angeles: Clinical Biomechanics Corp
Orendurff MS, Rohr ES, Sangeorzan BJ, Weaver K, Czerniecki JM: An equinus deformity of the ankle accounts for only a small amount of the increased forefoot plantar pressure in patients with diabetes. J Bone Joint Surg Br. 2006, 88-B: 65-68. CrossRef
Valmassy R: Clinical biomechanics of the lower extremity. 1996, St. Louis, Mosby, 6
Etnyre BR, Abraham LD: Gains in range of ankle dorsiflexion using three popular stretching techniques. Am J Phys Med. 1986, 65: 189-196. PubMed
Fujii M, Suzuki D, Uchiyama E, Muraki T, Teramoto A, Aoki M, Miyamoto S: Does distal tibiofibular joint mobilization decrease limitation of ankle dorsiflexion?. Manual Ther. 2010, 15: 117-121. CrossRef
Kasser RJ, Pridmore K, Hoctor K, Loyd L, Wortman FA: Comparison of stretching versus strengthening for increasing active ankle dorsiflexion range of motion. Top Geriatr Rehabil. 2009, 25: 211-221. CrossRef
Kirsch RF, Weiss PL, Dannenbaum RM, Kearney RE: Effect of maintained stretch on the range of motion of the human ankle joint. Clin Biomech (Bristol, Avon). 1995, 10: 166-168. CrossRef
Knight CARC, Cox ME, Acosta M, Hall SJ: Effect of superficial heat, deep heat, and active exercise warm-up on the extensibility of the plantar flexors. Phys Ther. 2001, 81: 1206-1213. PubMed
Rees SS, Murphy AJ, Watsford ML, McLachlan KA, Coutts AJ: Effects of proprioceptive neuromuscular facilitation stretching on stiffness and force-producing characteristics of the ankle in active women. J Strength Cond Res. 2007, 21: 572-577. PubMed
Samukawa M, Hattori M, Sugama N, Takeda N: The effects of dynamic stretching on plantar flexor muscle-tendon tissue properties. Manual Ther. 2011, 16: 618-622. CrossRef
Zakas A, Grammatikopoulou MG, Zakas N, Zahariadis P, Vamvakoudis E: The effect of active warm-up and stretching on the flexibility of adolescent soccer players. J Sports Med Phys Fitness. 2006, 46: 57-61. PubMed
Bohannon RW, Tiberio D, Zirro M: Effect of 5 minute stretch on ankle dorsiflexion range of motion. J Physical Ther Sci. 1994, 6: 1-8.
Pratt K, Bohannon R: Effects of a 3-minute standing stretch on ankle-dorsiflexion range of motion. J Sport Rehabil. 2003, 12: 162-173.
Wikstrom E, McKeon PO: Manipulative therapy effectiveness following acute lateral ankle sprains. Athl Train Sports Health Care. 2011, 3: 271-279. CrossRef
Rose KJ, Burns J, Wheeler DM, North KN: Interventions for increasing ankle range of motion in patients with neuromuscular disease. Cochrane Database Syst Rev. 2010, 1-54. Issue 2
PEDro Scale. [ http://www.pedro.org.au/english/downloads/pedro-scale/]
Law M, Stewart D, Pollock N, Letts L, Bosch J, Westmorland M: Guidelines for critical review form - Quantitative studies, 1998. McMaster University Occupational Therapy Evidence-based Practice Research Group. 2003, [www.srs-mcmaster.ca/Portals/20/pdf/ebp/quanguidelines.pdf].
de Souza M, Ventunni C, Teixeira L, Chagas M, de Resende M: Force-displacement relationship during anteroposterior mobilization of the ankle joint. J Manipulative Physiol Ther. 2008, 31: p285-p292. CrossRef
Tiberio D, Bohanon RW, Zito M: Effects of subtalar joint position on the measurement of maximum ankle dorsiflexion. Clin Biomech (Bristol, Avon). 1989, 4: 189-191. CrossRef
- Interventions for increasing ankle joint dorsiflexion: a systematic review and meta-analysis
- BioMed Central