Effects of ankle joint mobilizations in adults poststroke: a pilot study.

Abstract

To compare the effect of 2 interventions on ankle mobility, ankle kinematics, and weight-bearing symmetry during functional activities in subjects with hemiparesis after a stroke. Randomized trial. Academic medical center. A convenience sample of 16 subjects with hemiparesis after stroke (mean age, 55.2 y; mean time since stroke, 21.4 mo). Subjects received 8 sessions over 4 weeks of either functional task practice combined with ankle joint mobilizations, or functional task practice only. Changes in ankle range of motion (ROM) (not blinded), ankle kinematics during sit-to-stand (STS) and gait, and lower-extremity weight-bearing symmetry during STS and static standing. The combined intervention group gained 5.7 degrees +/- 3.1 degrees in passive ankle ROM compared with 0.2 degree +/- 2.6 degrees in the functional practice only group (95% confidence interval [CI], 2.5-8.6; P<.01). No significant changes in ankle kinematics or weight bearing during static standing were noted in either group. The functional practice group decreased differences in weight bearing during STS by 9.5% +/- 6.47%, whereas the combined intervention group increased this difference by 3.37% +/- 5.29% (95% CI, 3.26-19.46; P=.01). The increase in ankle motion did not improve joint kinematics and may have prevented improvement in weight-bearing symmetry.