title: Immediate combined effect of gastrocnemius stretching and sustained talocrural joint mobilization in individuals with limited ankle dorsiflexion: A randomized controlled trial.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  The aim of the present study was to compare the effects of gastrocnemius stretching combined with joint mobilization and gastrocnemius stretching alone.
  
  
  METHODS
  A randomized controlled trial.
  
  
  METHODS
  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
  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.
  
  
  CONCLUSIONS
  These findings suggest that gastrocnemius stretching with joint mobilization needs to be considered to improve ankle kinematics during gait.
authors.affiliation: Department of Physical Therapy, Graduate School, INJE University, Gimhae, Gyeongsangnam-do, South Korea. Electronic address: kmhyuk01@naver.com.
authors.forename: Min-Hyeok
authors.initials: MH
authors.lastname: Kang
authors.affiliation: Department of Physical Therapy, College of Biomedical Science and Engineering, INJE University, Gimhae, Gyeongsangnam-do, South Korea. Electronic address: ysrehab@inje.ac.kr.
authors.forename: Jae-Seop
authors.initials: JS
authors.lastname: Oh
authors.affiliation: Laboratory of Kinetic Ergocise based on Movement Analysis, Department of Physical Therapy, YONSEI University, Wonju, Gangwon-do, South Korea. Electronic address: kwonoy@yonsei.ac.kr.
authors.forename: Oh-Yun
authors.initials: OY
authors.lastname: Kwon
authors.affiliation: Department of Physical Therapy, JOONGBU University, Chubu-myeon, Geumsan-gun, Chungcheongnam-do, South Korea. Electronic address: jhweon@joongbu.ac.kr.
authors.forename: Jong-Hyuk
authors.initials: JH
authors.lastname: Weon
authors.affiliation: Department of Physical Therapy, College of Biomedical Science and Engineering, INJE University, Gimhae, Gyeongsangnam-do, South Korea. Electronic address: dhahn@inje.ac.kr.
authors.forename: Duk-Hyun
authors.initials: DH
authors.lastname: An
authors.affiliation: Department of Physical Therapy, College of Biomedical Science and Engineering, INJE University, Gimhae, Gyeongsangnam-do, South Korea. Electronic address: won7y@inje.ac.kr.
authors.forename: Won-Gyu
authors.initials: WG
authors.lastname: Yoo
mesh_terms: D000328:Adult; D000843:Ankle Joint / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D052580:Muscle Stretching Exercises / Q000379:methods*; D018482:Muscle, Skeletal; D026201:Musculoskeletal Manipulations / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D018570:Risk Assessment; D016896:Treatment Outcome
keywords: Ankle; Gait; Kinematics; Manual therapy