Purpose : The purpose of this study was to compare the effect of ankle joint mobilization with movement (MWM) and weight-bearing exercise (WBE) on the lower extremities muscle strength, range of motion (ROM), position sense, postural control, and gait in stroke patients.
Method : Thirty subjects with chronic stroke were recruited by convenience sampling from Chonbuk National University Hospital. The subjects were divided into three groups: an MWM group (12 subjects), a WBE group (8 subjects), and a control group (10 subjects). All groups attended three physical therapy sessions each week. The MWM group and WBE group also attended additional MWM and WBE sessions, respectively, three times a week for five weeks. For the three groups, the ROM of the ankle, peak torque, and joint position sense of the affected lower extremities, affected side limit of stability (LOS), and spatiotemporal gait parameters were evaluated before and after the intervention. The data was examined using a one-way analysis of variance (ANOVA) to compare changes between groups. The post-hoc test was conducted according to the least significant difference (LSD).
Result : The results of this study, the MWM group and the WBE group saw a significant increased in knee extensor peak torque (p<.05). Only the MWM group exhibited a significant increased in knee flexor and ankle plantarflexor peak torque (p<.05). Moreover, only the MWM group showed a significant increased in the passive and active ROM of the ankle (p<.05). The MWM group and WBE group exhibited a significant increased in forward and affected side LOS, and only the MWM group showed a significant increased in forward-affected side LOS (p<.05). The MWM group and WBE group showed a significant increased in gait velocity (p<.05).
Conclusion : It was also found that both the MWM and the WBE interventions resulted in increasesd in knee extensor strength and forward and affected side LOS and gait velocity. Particularly, the MWM proved to be a more effective intervention than the WBE, because MWM intervention has the ability to improved knee flexor strength, ankle plantarflexor strength, and ankle ROM, as well as forward-affected side LOS, it also increasesd the step length and decreased the cycle time of the unaffected side. Furthermore, it would be more effective if applied in conjunction with direct gait training, such as using a treadmill. Key Words: Ankle joint, Gait, Mobilization with Movement, Storke, Weight-bearing exercise.