Purpose: This study aims to investigate the effect of Kaltenborn-Evjenth functional glide(KEFG) on the ankle joint's range of motion, as well as the muscle strength, balance ability, and gait ability of chronic stroke patients. Additionally, we seek to examine the effects of passive joint motion(PROM), Kaltenborn-Evjenth glide(KEG), and KEFG.
Methods: The study involved 36 participants who met the inclusion criteria among stroke patients at K University Hospital in Daejeon. After selection, participants were randomly allocated to the KEFG(n = 13), KEG(n = 13), and PROM groups(n = 13). The mediation for the three groups was performed for 40 min/day, five times a week, for 3 weeks.
In the KEFG group, three sets of KEFG were applied three times to the talocrural joint. With 1 min of rest between sets, a total of 10 min of KEFG was applied, followed by 30 min of normal development treatment.
In the KEG group, three sets of KEG were applied three times to the talocrural joint. After 1 min of rest between sets, a total of 10 min of KEG was applied, followed by 30 min of normal development treatment.
The PROM group included three sets of PROM applied three times in the direction of dorsiflexion. After 1 min of rest between sets, a total of 10 min of PROM was applied, followed by 30 min of normal development treatment.
The variation of the dependent variables before and after the intervention was analyzed using a paired t-test and a one-way ANOVA to compare the differences between the three intergroup intervention methods. In the event of significant differences, a post-test was performed with the least significant difference. All statistical significance levels(α) of the data were 0.05.
Results: First, due to the mediation applied to improving the ankle joint's range of motion, there was a significant difference only in the KEFG and KEG groups in the ankle's range of motion. In addition, significant differences existed in the amount of change between the three groups, with the most significant change in the KEFG group.
Second, due to the mediation applied to improving the lower limb's muscle strength, a significant difference was found in the KEFG and KEG groups in terms of ankle dorsiflexion strength. In addition, significant differences existed in the amount of change between the three groups, with the most significant change in the KEFG group.
There was a significant difference only in the KEFG group regarding ankle plantar flexion strength. A significant difference was found in the amount of change between the three groups, with the most significant change in the KEFG group.
Third, as a result of the mediation applied to the promotion of balance capability, there was a significant difference only in the KEFG and KEG groups in terms of biorescue scores. In addition, significant differences existed in the amount of change between the three groups, with the most significant change in the KEFG group.
Regarding the Berg Balance Scale score, significant differences were seen in all groups, and there was no significant difference in the amount of change between the three groups.
Fourth, the interventions applied in improving walking capacity showed significant differences in all groups regarding the Timed Up and Go Test. Significant differences were also found in the amount of change between the three groups, with the most significant change in the KEFG group.
In the 10-Meter Walk Test, significant differences were found in the KEFG and KEG groups. There was no significant difference in the amount of change between the three groups.
Conclusion: Kaltenborn-Evjenth functional joint synchronization applied to the ankle joints in patients with chronic stroke can be said to have a significant effect on the ankle joint's range, lower limb muscle, balance, and gait.
Restrictions on the range of joint movements in the ankle area can be common in treating chronic stroke patients in clinical practice. Among the many interventions were applied to enhance the ankle joint's operating range in this study, the KEFG method showed the most significant effect in improving the ankle joint's range of motion.
Improving the range of ankle joint movement widens the area of the soles that touch the ground, which improves balance and increases walking speed and stability.
Therefore, it is believed that the use of KEFG in clinical trials for therapeutic approaches to improving the ankle joint's range of movement, muscle strength, balance, and gait ability in patients with chronic stroke will have a positive effect.