Table 2.
Comparison of conservative interventions for increasing ankle joint dorsiflexion range of motion
| Study ID | Intervention(s) | Sample size | Follow-up period | Measurement method | SMD (95% CI)* |
|---|---|---|---|---|---|
|
STRETCHING | |||||
| Bohannon 1994 [31] |
A: Control |
A: 18 |
Same day measures taken after 3 sets of stretching |
Digital images |
Insufficient data |
| B: Stretch |
B: 18 |
||||
| Dinh 2011 [1] |
A: WB stretch |
A: 14 |
3 weeks |
Goniometer (WB) |
B vs A |
| B: NWB stretch |
B: 14 |
Left: -0.33 (−1.08 to 0.42) |
|||
| Right: 0.26 (−0.49 to 1) | |||||
| |
|
|
|
Goniometer (NWB) |
B vs A |
| Left: 0.16 (−0.88 to 0.9) | |||||
| Right: 0.18 (−0.56 to 0.93) | |||||
| Christiansen 2008 [12] |
A: Control |
A: 20 |
8 weeks |
Goniometer (NWB) |
B vs A: 0.71 (0.07 to 1.35) |
| B: Stretch |
B: 20 |
||||
| Etnyre 1986 [15] |
A: Static stretch |
A: 12 |
3 sessions |
Goniometer (active assist) |
B vs A: -0.04 (−0.85 to 0.76) |
| B: Contract-relax PNF stretch |
B: 12 |
||||
| C: 12 |
C vs A: 1.90 (0.92 to 2.88 ) |
||||
| C: Contract-relax-agonist-contract PNF stretch | |||||
| Gajdosik 2005 [5] |
A: Control |
A: 9 |
8 weeks |
Electro-goniometer |
B vs A: 0.69 (−0.24 to 1.62) |
| B: WB stretch |
B: 10 |
||||
| Gajdosik 2007 [18] |
A: Control |
A: 4 |
6 weeks |
Electro-goniometer |
B vs A: 0.91 (−0.44 to 2.25) |
| B: WB stretch |
B: 6 |
||||
| Johanson 2009 [3] |
A: Control |
A: 8 |
3 weeks |
Goniometer |
B vs A |
| B: WB stretch |
B: 8 |
Left: 1.19 (0.11 to 2.26) |
|||
| Right: 0.55 (−0.45 to 1.55) | |||||
| Kasser 2009 [19] |
A: Control |
A: 9 |
6 weeks |
Universal goniometer |
Insufficient Data |
| B: WB stretch |
B: 9 |
||||
| Knight 2001 [21] |
A: Control |
A: 18 |
6 weeks |
Goniometer (passive ROM) |
B vs A: 0.71 (0.05 to 1.38) |
| B: Static Stretch |
B: 19 |
||||
| Goniometer (active ROM) |
B vs A: 0.7 (0.03 to 1.36) |
||||
| Peres 2002 [23] |
A: Control |
A: 8 |
3 weeks |
Digital inclinometer |
B vs A: 0.85 (−0.10 to 1.81) |
| B: Stretch |
B: 11 |
||||
| Pratt 2003 [32] |
A: Control |
A: 12 |
3 days |
Digital images |
Insufficient data |
| B: Stretch |
B: 12 |
||||
| Rees 2007 [25] |
A: Control |
A: 10 |
4 weeks |
Goniometer |
B vs A |
| B: PNF stretch |
B: 10 |
Left: 0.82 (−0.1 to 1.74) |
|||
| Right: 0.84 (−0.08 to 1.76) | |||||
| Youdas 2003 [29] |
A: Control |
A: 24 |
6 weeks |
Goniometer (active assist) |
B vs A: 0.45 (−0.14 to 1.04) |
| B: 30 sec stretch |
B: 22 |
||||
| C: 1 minute stretch |
C: 22 |
C vs A: 0.24 (−0.34 to 0.83) |
|||
| D: 2 minute stretch |
D: 21 |
||||
| D vs A: 0.46 (−0.14 to 1.05) | |||||
|
STRETCHING COMBINED WITH OTHER INTERVENTIONS | |||||
| Draper 1998 [14] |
A: Stretch |
A: 20 |
10 sessions |
Inclinometer |
B vs A: 0 (−0.62 to 0.62) |
| B: Ultrasound + Stretch |
B: 20 |
||||
| Kasser 2009 [19] |
A: WB stretch |
A: 9 |
6 weeks |
Universal goniometer |
Insufficient data |
| C: Tibialis anterior strengthening |
C: 9 |
||||
| Knight 2001 [21] |
A: Control |
A: 18 |
6 weeks |
Goniometer (passive ROM) |
C vs A: 0.70 (0.04 to 1.37) |
| C: Heel raise + static stretch |
C: 19 |
||||
| D: 21 |
D vs A: 0.84 (0.18 to 1.50) |
||||
| D: Superficial moist heat + static stretch |
E: 20 |
||||
| E vs A: 0.95 (0.27 to 1.62) | |||||
| E: Ultrasound + static stretch | |||||
| |
|
|
|
Goniometer (active ROM) |
C vs A: 0.77 (0.10 to 1.44) |
| D vs A: 0.65 (0 to 1.30) | |||||
| E vs A: 0.91 (0.24 to 1.58) | |||||
| McNair 1996 [22] |
A: WB soleus stretch |
A: 24 |
3 sessions |
Electro-goniometer |
B vs A: 0.05 (−0.52 to 0.62) |
| B: Aerobic exercise |
B: 24 |
||||
| Peres 2002 [23] |
A: Control |
A: 8 |
3 weeks |
Digital Inclinometer |
C vs A: 1.12 (0.05 to 2.18) |
| C: Stretch + |
C: 8 |
||||
| Diathermy |
D: 9 |
D vs A: 1.16 (0.12 to 2.20) |
|||
| D: Stretch + Diathermy + Ice | |||||
| Zakas 2006 [30] |
A: Warm up |
A:18 |
3 sessions |
Flexometer |
B vs A: 0.72 (0.04 to 1.39) |
| B: Stretch |
B: 18 |
||||
| C: Warm up + stretch |
C: 18 |
C vs A: 0.87 (0.18 to 1.55) |
|||
|
MANUAL THERAPY | |||||
| Fryer 2002 [16] |
A: Control |
A: 41 |
Immediate |
Dynamometer (NWB) |
B vs A: 0 (−0.44 to 0.44) |
| B: Manipulation |
B: 40 |
||||
| De Souza 2008 [39] |
A: Control |
A: 25 |
Immediate |
Biplane goniometer |
B vs A: 0.19 (−0.37 to 0.75) |
| B: Mobilisation |
B: 25 |
||||
|
SOLEAL TRIGGER POINT THERAPY | |||||
| Grieve 2011 [2] |
A: Control |
A: 10 |
Immediate |
Goniometer (NWB assisted) |
B vs A: 0.72 (−0.18 to 1.63) |
| B: Soleal trigger point therapy | B: 10 | ||||
Abbreviations:WB weight bearing, NWB non-weight bearing.
*SMDs (95% CIs) were calculated between groups at the longest period of follow-up.