# Enhancing Ankle Movement in Stroke Patients: The Impact of Joint Mobilization Combined with Active Stretching

## TL;DR

Combining joint mobilization and active stretching improves ankle movement, balance, and walking in stroke patients better than standard therapy.

## Contribution

Demonstrates that joint mobilization plus active stretching is more effective than general physical therapy for stroke patients' ankle issues.

## Key findings

- The experimental group showed significant improvement in muscle tone and stiffness of the gastrocnemius and tibialis anterior muscles.
- The experimental group had increased balance scores and faster TUG test times compared to the control group.
- Combined joint mobilization and active stretching improved ankle movement and gait more effectively than general physical therapy.

## Abstract

Background: The paralyzed ankles of stroke patients show reduced range of motion, muscle tightness, and joint stiffness, further impeding their ability to maintain balance and walk properly. This study aimed to investigate the effects of a combined joint mobilization and active stretching intervention on ankle stiffness, balance, and gait in patients with stroke. Methods: In this study, 24 stroke patients were assigned to two groups of 12 each: the control group (general physical therapy) and the experimental group (joint mobilization technique and active stretching exercise). All interventions were conducted for 30 min a day, 3 times a week, for a total of 4 weeks. Tension and stiffness of the gastrocnemius and tibialis anterior muscles were measured using Myoton®PRO. Balance was evaluated using BioRescue, the Berg Balance Scale (BBS), and the Timed-Up and Go tests (TUG). All measurements were evaluated before the start of the intervention and after four weeks. Results: The muscle tone and stiffness of the medial and lateral gastrocnemius and tibialis anterior muscles of the experimental group were significantly improved compared with those of the control group. The experimental group had significantly increased moving areas in all directions and BBS scores compared with the control group. The experimental group showed a significant decrease in the time spent on the TUG test compared with the control group. Conclusions: We found that joint mobilization combined with active stretching intervention was more effective than general physical therapy in improving ankle joint movement, balance, and gait ability.