title: The association between loss of ankle dorsiflexion range of movement, and hip adduction and internal rotation during a step down test.
abstract: A pattern of excessive hip adduction and internal rotation with medial deviation of the knee has been associated with numerous musculo-skeletal dysfunctions. Research into the role that ankle dorsiflexion (DF) range of motion (ROM) play in lower limb kinematics is lacking. The objective of this cross-sectional, observational study was to investigate the relationship between ankle DF ROM, and hip adduction and hip internal rotation during a step-down test with and without heel elevation in a healthy female population. Hip and ankle ROM was measured kinematically using a ten-camera Optitrack motion analysis system. Thirty healthy female participants (mean age = 20.4 years; SD = 0.9 years) first performed a step-down test with the heel of the weight bearing foot flat on the step and then with the heel elevated on a platform. Ankle DF, hip adduction and hip internal rotation were measured kinematically for the supporting leg. Participants who had 17° or less of ankle DF ROM displayed significantly more hip adduction ROM (p = 0.001; Cohen's d effect size = 1.2) than the participants with more than 17° of DF during the step-down test. Participants with limited DF ROM showed a significant reduction in hip adduction ROM during the elevated-heel step-down test (p = 0.008). Hip internal rotation increased in both groups during the EHSD compared to the step-down test (p > 0.05) Reduced ankle DF ROM is associated with increased hip adduction utilised during the step-down test. Ankle DF should be taken into account when assessing patients with aberrant frontal plane lower limb alignment.
authors.affiliation: Physiotherapy Department, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193, Johannesburg, Gauteng, South Africa.
authors.forename: T
authors.initials: T
authors.lastname: Bell-Jenje
authors.affiliation: Physiotherapy Department, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193, Johannesburg, Gauteng, South Africa. Electronic address: benita.olivier@wits.ac.za.
authors.forename: B
authors.initials: B
authors.lastname: Olivier
authors.affiliation: Physiotherapy Department, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193, Johannesburg, Gauteng, South Africa.
authors.forename: W
authors.initials: W
authors.lastname: Wood
authors.affiliation: Physiotherapy Department, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193, Johannesburg, Gauteng, South Africa.
authors.forename: S
authors.initials: S
authors.lastname: Rogers
authors.affiliation: School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193, Johannesburg, Gauteng, South Africa.
authors.forename: A
authors.initials: A
authors.lastname: Green
authors.affiliation: School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193, Johannesburg, Gauteng, South Africa.
authors.forename: W
authors.initials: W
authors.lastname: McKinon
mesh_terms: D000843:Ankle Joint / Q000502:physiology*; D001696:Biomechanical Phenomena / Q000502:physiology*; D003430:Cross-Sectional Studies; D005080:Exercise Test / Q000379:methods*; D005260:Female; D025981:Hip Injuries / Q000503:physiopathology*; D006801:Humans; D016059:Range of Motion, Articular / Q000502:physiology*; D012399:Rotation; D055815:Young Adult
keywords: Alignment; Kinematics; Range of movement