[Purpose] This study aimed to ascertain whether ankle stretching combined with arm cycling compared with that without arm cycling results in greater improvement in maximum dorsiflexion range of motion (ROM), calf muscle stiffness, and gait velocity in the affected limb of patients with stroke. [Participants and Methods] Random ABAB reversal design was used in this study involving nine patients with stroke. Participants performed 10 min of ankle plantar flexor stretching through weight bearing using the tilt table under the following 2 conditions: with or without arm cycling at 60 revolutions per minute. Pre- and post-stretching maximum ROM and passive plantar flexion torque were measured using a custom-made passive torque indicator. Stiffness was calculated based on passive torque-angle relationships. [Results] Maximum ROM and stiffness significantly improved after stretching in both conditions, whereas no changes in gait velocity were found. The difference in pre- and post-stretching stiffness was significantly greater in the stretching with arm cycling group. Change in maximum ROM showed no difference between both stretching conditions. [Conclusion] This study indicates that ankle plantar flexor stretching combined with arm cycling was more effective than that without cycling in improving calf muscle stiffness in the affected limb of patients with stroke.
Purpose] To confirm the criterion-related validity and reliability of surae muscle tendon unit stiffness measured using a custom-made passive torque indicator (CPTI), a portable device composed of an angle-adjustable foot plate and strain gauge. The data were compared to readings obtained using an isokinetic dynamometer. [Subjects and Methods] Fourteen healthy young adults participated in this study. Torques at four angles of dorsiflexion of the ankle joint of the subjects were recorded using the CPTI and a dynamometer. The slope of the portion of the passive torque-angle curve was defined as stiffness. Three measurements were performed with each device.[Results] The intra-class correlation coefficients (ICC) (1, 3) were 0.81 and 0.86 for the CPTI and dynamometer, respectively. The degree of stiffness determined using the CPTI was significantly less than that determined using the dynamometer. A Bland-Altman plot revealed there was a fixed error between the CPTI and dynamometer.[Conclusion] The results of this study indicate that three measurements with the CPTI are as reliable as those made with an isokinetic dynamometer. However, the degree of stiffness determined using the CPTI tended to be less than that determined using the dynamometer.
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