The tester then placed the straight edge of the Dualer IQ Inclinometers parallel to the 2 dots on the calcaneus while keeping the inclinometer in the frontal plane. For consistency, examiner determined subtalar joint neutral position as the moment the medial head of the talus was no longer prominent when moving the subject's foot from a pronated to a supinated position. Subtalar joint neutral was determined when the talar head was felt equally between the thumb and index finger. The subtalar joint neutral position is considered an important reference position from which motion can be measured. Position to measurement of range of motion of ankle dorsiflexion (C, D) and ankle plantarflexion (E, F). Starting position before measurement of range of motion of ankle dorsiflexion & plantarflexion at neutral position of knee joint (A) and ankle dorsiflexion & plantarflexion at knee flexion of 90° (B). There was perfect agreement between the inclinometer and the reference angles. Next, the examiner established a point of reference by placing the inclinometer on the hand and read the angle while the subtalar joint was maintained in a neutral position. Prior to actual testing, the inclinometer was calibrated with computer-generated angles to assess accuracy. The rights of the subjects were protected.ĭualer IQ Inclinometers (J-Tech, Torrance, CA, USA) and Commander Muscle Tester (J-Tech) were used to record the passive ROM of ankle and objective quantify strength ( Fig. Prior to participation, all procedures were explained to each subject, and informed consent was obtained, as approved by the Institutional Review Board at Chungnam National University Hospital (No. Subsequently, the examiner completed the ROM measurements. Prior to measuring ROM of ankle, measures of the body mass index (BMI), blood tests including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid arthritis (RA) factor and radiologic study of knee & ankle joint anteroposterior (AP) and lateral, were conducted in all subjects, in order to rule out any disease that can affect the ROM of ankle joint such as inflammatory arthropathy, prior surgery or trauma involving any joint of either lower extremity. The purpose of our study was to evaluate the effect of gender, pushing force and knee joint position on the normal ROM of ankle joint in healthy young Korean subjects. Korean standard reference for joint ROM and standard and objective method and protocol for measurement of joint ROM are required. Furthermore, the extent to which posture of knee joint influences ROM of ankle joint is not well documented.Ī standardized method for measurement of joint ROM of Koreans has not been presented to date. However, no previous study has assessed adequate pushing force to measure ROM of ankle joint. When the ankle is manually dorsiflexed or plantarflexed, the amount of force applied could influence the amount of ROM achieved. ROM of ankle can be measured differently by measurement posture, pushing force and gender. For this purpose, the digital inclinometer is considered to be a useful instrument due to its cost-effectiveness and ease of use. Visual inspection, goniometric measurements, inclinometer and high-speed cinematography are examples of methods that have been used to quantify the ROM. Reproducible measurements of the ROM are an important prerequisite for the interpretation of study results. Cultural habits, such as squat toilet use, sitting cross-legged, squatting and kneeling on the ground and religious exercises involving kneeling can affect normal ROM of the ankle joints. There are very few studies regarding the normal ROM of lower extremity joints in the Asian population. But, most studies have been conducted on a Western population. Studies have proven that there are variations in the degree of mobility of the ankle related to gender and age, in apparently normal individuals. For clinical applications, joint mobility is often quantified by range of motion (ROM), which is clinically defined as the maximal range of joint angle. Numerous investigations have been carried out to analyze the kinematic characteristics of the ankle joint complex. Because the ankle joint complex is crucial to human locomotion, accurate knowledge on the kinematics of these joints is essential for proper diagnosis and treatment of injuries and diseases in this region. The gross motion between the foot and the shank is the result of the motions at the ankle joint complex. The ankle joint complex consists of the ankle (talocrural) joint and the subtalar (talocalcaneal) joint.
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