Effects of Homologous instrument assisted mobilization (HIM) on ankle movement, gait-related muscle activation, and plantar pressure distribution in ankle dorsiflexion syndrome: A randomized single control trial

Abstract

BACKGROUND: While the limited ankle dorsiflexion syndrome (ADS) is common in neuro-musculoskeletal conditions, the instrument-assisted mobilization focused on the shortened gastro-soleus myofascial structure (IMI) rather than the homologous structure (both gastrosoleus and tibiliais anterior muscles, HIM). OBJECTIVE: We aimed to compare the immediate therapeutic effects between IMH and IMI treatment groups on the ankle dorsiflexion angle, muscle activation and foot pressure distribution during dynamic gait in ADS. METHODS: Neuromechanical tests including kinematics (ankle mobility), kinetics (center of pressure distribution), and electromyography were used to determine the immediate therapeutic effects between HIM and IMI treatment groups in 24 participants with ADS. RESULTS: The ankle joint angle analysis demonstrated a more improved active DF angle in the group who received HIM intervention when compared to the group who received IMI intervention. (11.26% and 3.58%, respectively) EMG analysis showed more decreased mean and peak TA activation amplitudes in the group who received HIM intervention (9.1% and 9%) when compared to the group who received IMI intervention (11.48% and 1.48%). Plantar pressure distribution analysis showed difference that the forefoot/area decreased in the group who received HIM intervention (8.1%), but rather increased in the group who received IMI intervention (14.3%). CONCLUSIONS: Our neuromechanical results demonstrated promising positive effects on ankle joint mobility, muscle activation and foot pressure distribution during gait in ADS.