fateme khorramroo

This research aims to investigate the effect of instrument-assisted soft tissue mobilization (IASTM) and Faradic electrotherapy (FES) on lower limb coupling during gait in a patient with excessive ankle stiffness.

The study was conducted on a single patient who was diagnosed with ankle stiffness, decreased muscle strength due to 3.5 years of immobilization of the ankle joint, and was experiencing difficulty in walking. The patient underwent a 12-week treatment program that included IASTM and FES. The lower limb kinematics were measured using a motion analysis system before and after the intervention and couplings were calculated for 3-dimensional ankle movement. 

The results of the study changed ankle-knee, ankle-hip sagittal and transverse, and knee-hip frontal and transverse plane coupling during different subphases of gait after the intervention. The observed coordination pattern in the subjects under investigation approached a level of similarity to that of healthy individuals in loading response (LR) and midstance (MS) for the ankle-knee sagittal plane.

The results of this study suggest that IASTM and FES can be used as effective interventions to lower limb coordination during gait in patients with post-operation complications. Further research on more patients is required.

Instrument Assisted Soft Tissue Mobilization (IASTM) and electrotherapy have shown to help alleviating post-operation complications and affect gait kinematics and muscle strength. This case study aimed to manage the post-operative complications in a patient with investigate excessive ankle stiffness with kinetics, kinematics and Electromyography (EMG) approach. A 41-year-old female with post-operation complications including decreased right ankle range of motion (ROM) and strength underwent a 12-week of IASTM and Electrotherapy. Gait analysis was performed before and after the intervention. The results showed notable improvements in ankle 3-dimensional (3D) ROM, power, moment, velocity, cadence, step length, ground reaction force (GRF) and decreased stiffness, muscles activity, single and double support time. Ankle dorsiflexion ROM was not notably increased during gait. Findings suggest that a 12-week intervention of IASTM and electrotherapy can improve gait mechanics and reduce muscle activity in a patient with excessive ankle stiffness.

This case study aims to manage the post-operative complications in a patient with excessive ankle stiffness using Instrument Assisted Soft Tissue Mobilization (IASTM) and Faradic Electrical Stimulation (FES) and investigate the effects on knee and hip kinematics during gait.

Method and Materials: 

A 41-year-old female with post-operation complications including decreased right ankle Range of Motion (ROM) and strength underwent a 12-week of IASTM and FES. Gait analysis was performed before and after the intervention. Knee and hip angles and velocities in 3 dimensions were measured using a motion analysis system before and after the intervention.

Results showed an increased knee adduction, decreased peak knee external rotation at late swing phase, increased peak frontal plane knee velocity, frontal and transverse plane hip excursion, peaks velocities in transverse and frontal plane.

A 12-week IASTM and FES can improve knee and hip gait mechanics in a patient with excessive ankle stiffness.

 Postoperative complications decrease muscle strength and balance. Thus, managing the complications is crucial for optimizing patient outcomes and promoting speedy recovery. This case study explores the use of Instrument-Assisted Soft Tissue Mobilization (IASTM) and electrotherapy in managing postoperative complications in a patient with excessive ankle stiffness, addressing balance and muscle strength, as they are essential components of functional mobility in patients with ankle stiffness.

 A 41-year-old female athlete with Achilles tendon contracture participated in this study. A 12-week IASTM and electrotherapy was implemented. Isokinetic muscle strength, balance, and quality of life were investigated.

 The results showed significant improvement in the stability index, path length and area, dorsiflexion/plantarflexion peak torque, range of motion (ROM), total work, and reduced passive stiffness. The results of all domains of quality of life (SF-36), Foot and Ankle Ability Measure (FAAM), , Achilles Tendon Rupture Score (ATRS), Visual Analog Scale (VAS), and Foot and Ankle Outcome Score (FAOS) improved. The intervention was successful in improving balance, muscle strength, sagittal plane ROM, and quality of life and reduced pain during balance in the patient. Conclusions These findings suggest that the intervention may be an effective treatment option for individuals with excessive ankle stiffness and related balance and strength deficits.

Minimal shoes may alter ankle kinematics while running. This study aimed to systematically review studies investigating ankle kinematics in runners while wearing minimalist shoes versus traditional shoes and barefoot. Four databases including PubMed (128 studies), Web of science (224), Scopus (242 studies) and Embase (148 studies) were searched from inception to Aug 9, 2022. Two reviewers screened studies to identify studies reporting the effects of minimal shoes on ankle kinematics during running. Eleven studies with a total of 203 (wearing minimal shoes) participants and 18 controls (8 participants wearing minimal shoes without gait training and 10 wearing standard shoes) were included. The study design of the included studies were RCTs (2 studies), prospective study (1), cross-sectional study (5), and crossover (3). The Downs and Black appraisal scale was applied to assess the quality of included studies. The results showed that minimal shoe was capable of changing the kinematics of ankle while running. Uncushioned minimal shoes decreased ankle dorsiflexion at initial contact and ankle adduction, and increased plantarflexion moment, strike index, total ROM and joint excursion in stance phase compared to traditional shoes. Standardizing shoes and speeds are needed for reliable comparisons among studies. Because most studies examining the efficacy of minimal shoes, had a low level of evidence, further studies providing valid and high-quality evidence which include RCTs are required to support clinical practice in the use of minimal shoes. Uncushioned minimal shoes are better replicating barefoot running. Therefore, it is recommended for runners since they can change their foot strike pattern to mid-foot or forefoot and consequently reduce peak impact force, resulting in preventing future injuries especially in the knee.