How does the stretching exercise of ankle joint affect gait balance in the elderly? : A clinical trial

Research Objectives: To investigate the effects of the stretching exercise of ankle joint on gait of elderly person through gait analysis and footscan system, and to elucidate the underlying mechanisms of gait stability.

Design: Before-After trial.

Setting: Institutional practice

Participants: A total of 22 participants through volunteer sampling, aged between 65 and 75 years, who could walk independently were involved in the study. Individuals who with musculoskeletal or neurological disorders and impaired cognitive function and those who had undergone foot and ankle surgical procedures within the past 6 months were excluded.

Interventions: Participants undergo ankle joint stretching exercise training using the ‘Ankle Stretcher’, an electric exercise device, a total of 15 sessions, for 30 minutes each session, five times a week. Starting from a low dorsiflexion angle (10°) and an eversion angle(5°) to the maximum joint range where participants feel a stretching sensation without pain. Hold this position for 20 seconds and afterward resting position for 10 seconds.

Main Outcome Measures: Ankle range of motion, Berg Balance Scale, Timed Up and Go test , Step cadence, Step length, Step velocity, Double support phase proportion, Total heel contact time, and Center of pressure range were assessed before and after training.

Results: Ankle dorsiflexion and eversion ROM (P < 0.001), BBS score (P=0.046), TUG test (P < 0.001), Step cadence (P=0.038), Step length (P=0.046) and Step velocity (P=0.04) showed a significant improvement at post-intervention compared with pre-intervention. Double limb support phase proportion (P=0.004) and COP range (P=0.043) showed a significant decrease. Total heel contact time (P=0.78) did not show a significant decrease.

Conclusions: This study shows promising results in improving balance and gait abilities of elderly. These are believed to be attributed to the enhancement of dynamic balance control during gait, which is expected to reduce the risk of falls in the elderly. An experimental-control group study is required to warrant these results.

Author(s) Disclosures: This study was conducted with the support of the Ministry of Trade, Industry and Energy's orthopedic and rehabilitation medical device commercialization certification and demonstration support project.