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At least 577 records · Page 32Linked to original sources
PubMed1990

Prophylactic ankle bracing.

Many choices are available to athletes seeking an ankle support. The time-honored tradition of ankle taping with adhesive tape does offer protection against ankle sprains during activity. Laced stabilizers offer an equal or possibly greater amount of support, are less costly and easier to apply, and can be retightened frequently during activity. The physician should become familiar with one of these two methods and choose one based on availability and feasibility in the community. The air stirrup may be indicated for patients with a history of ankle injury who are undergoing a graduated rehabilitation program. Nevertheless, the air stirrup has not been shown to provide significantly greater inversion restriction than taping or lace-on braces and is not recommended as a first-line method of support for individuals with no history of recent ankle sprain. High-top shoes are better when the ankle is taped, although low-top shoes are better when a laced stabilizer is worn. Elastic guards help reduce ankle edema but do not provide ankle stability.

Ankle Injuries↗
PubMed2001

Time course of stress relaxation and recovery in human ankles.

OBJECTIVE: To characterise the time course of stress relaxation and recovery from stress relaxation in human ankles. DESIGN: Two experiments were conducted. The first used a randomised within-subjects design, and the second used a randomised between-subjects regression design. BACKGROUND: Several studies have described the time course of stress relaxation in human joints, but most have looked only at the effects of short durations of stretch. The time course of recovery from stretch in human ankles has not been documented. METHODS: In the first experiment, one ankle of each of eight subjects was stretched to a fixed dorsiflexion angle for 20 min. The ankle was then released for 2 min (during which time subjects either remained relaxed or performed isometric contractions), then stretched again. In a second experiment, on 24 subjects, the ankle was stretched for 20 min, then released between 0 and 20 min, then stretched again. In both experiments, subjects remain relaxed and ankle torque was measured continuously. RESULTS: When a constant-angle stretch was applied to the ankle, torque declined bi-exponentially towards an asymptote that was 58% of the initial torque. Nearly 5 min of stretch were required to obtain half of the maximal possible stress relaxation. Torque had recovered by 43% within 2 min of the release of stretch, but the degree of recovery did not appear to depend on whether subjects remained relaxed or performed isometric contractions. The time course of recovery was similar to the time course of stress relaxation. CONCLUSIONS: Long duration stretches are required to produce a large proportion of the maximal possible stress relaxation. Recovery is initially rapid when the stretch is released. RELEVANCE: These data provide a description of the time course of the effects of stretch, and of the subsequent relief of stretch, on mechanical properties of human ankles.

Adult↗
PubMed1996

The correlation of ankle oscillometric blood pressures and segmental pulse volumes to Doppler systolic pressures in arterial occlusive disease.

PURPOSE: This study was designed to evaluate the accuracy and failure rates of automatically collected oscillometric ankle systolic pressures (Psys) and pulse volumes (Pvol) using a new algorithm as compared with Psys obtained by standard manual Doppler-and-cuff technique. METHODS: One hundred ten consecutive patients at a vascular laboratory had brachial and ankle Psys measured with the two methods. Pvol at or near the mean arterial pressure was also obtained automatically by the oscillometric device. RESULTS: Both methods showed a 6.6% failure rate when measuring Psys at the ankle. Oscillometric Psys measurement was possible when Doppler Psys failed as a result of nonoccluding arteries. No difference was found between the two methods in occluding limbs with ankle-brachial indexes of 1.30 or more. Sequential brachial Psys values had a mean difference (Doppler-oscillometric) or 2 +/- 10.9 mm Hg and a correlation coefficient (r) of 0.92. Measurements at the ankle had a mean difference of -8.4 +/- 16.8 mm Hg and r = 0.90. These differences were not statistically significant. Mean arterial pressure Pvol recorded at the ankle also correlated with ankle Doppler Psys (r = 0.71) and showed a 1.9% failure rate. CONCLUSION: Both automatic oscillometric plethysmographic Psys and Pvol at the ankle are shown to correlate well with Doppler-and-cuff Psys in patients with vascular disease. Oscillometric measurements can replace Doppler measurements in most clinical situations.

Adult↗
PubMed1997

Arthroscopic treatment of soft-tissue impingement of the ankle in athletes.

Sixty ankle arthroscopies were performed on patients with chronic soft-tissue impingement of the ankle after an ankle sprain between January 1989 and January 1994. Preoperative examination findings featured tenderness localized to the anterolateral aspect of the ankle, no instability, and, with the exception of 2 patients, normal radiographs. A preoperative bone scan was performed on 34 patients and was positive in each case but was not specific. Arthroscopy was performed an average of 23 months after injury. Results were determined by using a new ankle rating score. Hypertrophic synovium, synovitis, or fibrous adhesions were arthroscopically visualized and resected in all cases. The average follow-up was 27 months (range, 6 to 64 months). Thirty-one patients underwent complete evaluation and 29 were evaluated over the telephone. There were 51 excellent, 7 good, 1 fair, and 1 poor results. The diagnosis of chronic soft-tissue impingement of the ankle can be made from an appropriate history, thorough physical examination, and plain radiographs. Ankle arthroscopy with resection of impinging hypertrophic synovium or fibrous bands occurring after an ankle sprain was effective in alleviating pain in athletes.

Adult↗
PubMed1989

In situ bypass to the dorsalis pedis and tibial arteries at the ankle.

Over a three-year period (1984-1987), we performed 98 in situ saphenous vein bypasses to the tibial arteries in 89 patients. In 68 of these grafts, the distal anastomoses were above ankle level. All but one of these grafts were performed for limb salvage indications. Seven (10%) of these grafts were done in patients on chronic renal dialysis. In 30 grafts, the distal anastomoses were to the ankle level. Indications for surgery were risk of limb loss in all these patients, with tissue loss in 29 (97%). Six (20%) were done in patients on chronic renal dialysis. Operative mortality was 3% in both groups. Late mortality was 13% in the above-ankle group, and 27% in the ankle level group. Secondary patency for the above-ankle group was 97%, 85%, 81%, and 81% at 30 days, one year, two years, and three years. Primary patency was 91%, 67%, and 58% at 30 days, one year, and two years, after which the standard error is greater than 10%. Secondary patency for the grafts at the ankle level was 100% and 82% at 30 days and one and one-half years. Primary patency rates were 93% and 68% at 30 days and one year. In situ bypass grafts at the ankle level had patency rates equivalent to grafts with distal anastomoses above the ankle. Patients with distal bypasses usually presented with tissue loss and had a higher late mortality rate. Careful follow-up and operative intervention when changes in graft velocities or indices are recognized, markedly improves the durability of the in situ saphenous vein bypass.

Anastomosis, Surgical↗
PubMed2005

Pulsatility index is better than ankle-brachial doppler index for non-invasive detection of critical limb ischaemia in diabetes.

BACKGROUND: Diabetic polyneuropathy of the feet and legs obscures the diagnosis of critical limb ischaemia (CLI) because of lack of pain sensation. Hence, the Fontaine classification does not apply to these patients. Furthermore, many of them will exhibit medial arterial calcification, which invalidates the application of sphygmomanometry. This study was done to evaluate the pulsatility index (P1) assessed at the ankle arteries by colour Doppler ultrasonography as a non-invasive method to diagnose CLI in diabetic polyneuropathy. PATIENTS AND METHODS: 140 legs of 106 diabetic patients were studied who presented with polyneuropathy and painlessness of the feet; of these, 117 feet displayed an ulcer or gangrene. CLI was defined as the need for arterial revascularisation, as indicated by the physicians in charge on the basis of a) a foot lesion Wagner grade 1-5, and b) a positive arteriography. All patients were subjected to 4 vascular assessment techniques: digital subtraction arteriography, ankle-brachial Doppler index, systolic ankle blood pressure, and PI. RESULTS: Of the 140 legs, 61 (44%) were affected by CLI, and 76 (54%) by medial arterial calcification. A PI < 1.2 indicated CLI with a sensitivity of 0.87 and a specificity of 0.62. The sensitivity and specificity of ankle-brachial index < 0.9, and of systolic ankle pressure < 70 mm Hg to predict CLI was 0.71 and 0.42, and 0.30 and 0.89, respectively. CONCLUSIONS: The pulsatility index is a better noninvasive technique than the ankle-brachial Doppler index or the systolic ankle pressure to assess critical limb ischaemia in diabetic polyneuropathy. A pulsatility index < 1.2 at the ankle arteries is a reliable criterion for diagnosis of CLI in diabetic patients with polyneuropathy.

Aged↗
PubMed2000

A randomized trial assessing the effects of 4 weeks of daily stretching on ankle mobility in patients with spinal cord injuries.

OBJECTIVE: To determine the effect of 4 weeks of 30 minutes of daily stretching on ankle mobility in patients with recent spinal cord injuries (SCIs). DESIGN: Assessor-blinded randomized controlled trial. SETTING: Two spinal injury units in Sydney, Australia. PATIENTS: Consecutive sample of 14 recently injured patients with paraplegia and quadriplegia. INTERVENTION: Treated ankles were stretched continuously into dorsiflexion with a torque of 7.5 N x m for 30 minutes each weekday for 4 weeks. Contralateral ankles received no stretches. MAIN OUTCOME MEASURES: Passive torque-angle curves for both ankles were obtained at study commencement, then at weeks 2, 4, and 5 (ie, during, at the end of, and 1 week after the stretching program). Torque-angle measurements were obtained with the knee extended and flexed. Mean values for parameters (baseline angle, angle at 10 N x m, slope) describing the characteristics of the torque-angle curves were derived for each knee position. Changes from pretest to each subsequent test were calculated, as well as 95% confidence intervals (CIs) for differences in these changes between stretched and controlled ankles. RESULTS: The stretching intervention did not significantly change any of the 3 parameters describing the torque-angle curves of the ankle in either knee position. At the beginning of the study, the mean (+/-SD) angles obtained with the application of a standardized torque with the knee extended for the control and stretch ankles were 105 degrees (+/- 10.4 degrees) and 106 degrees (+/- 9.8 degrees), respectively. After 4 weeks, these values were 106 degrees (+/- 10.6 degrees) and 107 degrees (+/- 10.6 degrees) (mean difference in change of angle = 0 degrees; 95% CI, -3.3 degrees to 3.3 degrees). CONCLUSION: Thirty minutes of daily stretching for 4 weeks does not significantly change ankle mobility in recently injured patients with SCIs.

Adult↗
PubMedDate not supplied

The effects of an ankle destabilization device on muscular activity while walking.

Chronic Ankle Instability sprain causes are unclear and many factors or mechanisms may contribute to recurrence of this injury. The aim of the study was to investigate how an ankle destabilization device affects the EMG patterns of the ankle muscles during ankle stabilization against inversion. The left foot was equipped with a mechanical device mounted under the heel of the shoe. This mechanical device induces subtalar joint destabilization necessitating the control of ankle muscles. Surface electrodes were placed over the tibialis anterior, the peroneus longus, the peroneus brevis, the gastrocnemius lateral, and the gastrocnemius medial. Nine healthy subjects (mean age 37+/-12 yr; mean mass 68+/-17 kg; mean height 1.73+/-0.7 m) were instructed to walk normally along a tape fixed on the floor. The ankle destabilization device altered the walking pattern of all subjects. More specifically, the walking pattern is disturbed resulting in higher amplitude of the EMG activity of the peroneal muscles and the Tibialis Anterior and anticipatory reactions in the peroneal muscles. The results suggest that the ankle destabilization device could be beneficial for rehabilitation programs especially during the training of walking. Using this material may help to a specific reinforcement of muscles involved in anti-inversion ankle movement.

Adult↗
PubMed1996

[Proprioceptive reaction in the healthy and chronically unstable ankle joint].

Chronic lateral instability of the ankle, a condition with frequent ankle sprain episodes, difficulties to walk and run on uneven ground and often pain, occurs in 20-30% after acute ankle sprains. The treatment of CLI as well as of acute ankle sprains have more and more in addition to operative reconstructions been focused on proprioceptive training which is in concordance with the results of recent research results. The present study shows that the reaction time after sudden angular displacement of the ankle on a trapdoor is increased by approximately 15 ms in patients with chronic lateral instability compared to control persons. We conclude that delayed proprioceptive response to sudden angular displacement of the ankle can be one of the causes to chronic lateral instability of the ankle and that proprioceptive training should be included in the treatment of acute and chronic ankle disabilities.

Adult↗
PubMedDate not supplied

Magnetic resonance imaging findings of chronic lateral ankle instability.

The ankle inversion injury is one of the most common types of injury that is encountered in athletes and active individuals. There are a wide variety of acute injuries associated with ankle inversion, including peroneal tendon tears, osteochondritis dessicans of the talus, anterior talofibular ligament avulsion, peroneal retinaculum avulsion, and calcaneofibular ligament tears. Chronic sequelae include impingement, posttraumatic degenerative arthritis, and an attenuated peroneal retinaculum. Most inversion injuries to the ankle have multiple associated injuries and isolated ligament injuries are uncommon. Chronically, the injured ankle usually demonstrates the injuries found at the time of the initial injury. Subsequently, there is a high frequency of these injuries in patients evaluated for symptoms of chronic lateral ankle instability. A high index of suspicion for the specific types of injuries associated with ankle inversions may result in a higher rate of injury detection and more expeditious and accurate diagnoses. Given the persistence of these injuries seen in patients with chronic posterolateral instability, injury patterns of ankle inversion are important to recognize even in the absence of acute trauma. We review the various types of injuries with their associated magnetic resonance (MR) imaging characteristics seen in patients with chronic lateral ankle instability.

Ankle Joint↗
PubMed2004

Non-surgical management of ankle contracture following acquired brain injury.

BACKGROUND AND PURPOSE: The purpose of this study was to document the outcome of non-surgical management of equinovarus ankle contracture in a cohort of patients with acquired brain injury admitted to a specialist Neurosurgical Rehabilitation Unit. METHODS: This prospective descriptive study examined all patients with a new diagnosis of moderate to severe acquired brain injury (Glasgow Coma Scale score </=12) admitted for rehabilitation over a 1 year period. Ankle dorsiflexion range and plantarflexor/invertor muscle activity were evaluated weekly during the period of hospitalization. Contracture was defined as maximal passive range of motion </= 0 degrees dorsiflexion, with the knee extended, on a minimum of two measurement occasions. Patients were retrospectively allocated to one of four treatment outcome categories according to ankle dorsiflexion range, type of intervention required and response to treatment. RESULTS: Ankle contracture was identified in 40 of the 105 patients studied. Contracture resolved with a standard physiotherapy treatment programme, including prolonged weight-bearing stretches and motor re-education, in 23 patients. Contracture persisted or worsened in 17 of 40 cases, all of whom exhibited dystonic muscle overactivity producing sustained equinovarus posturing. Ten of 17 cases required serial plaster casting (+/- injection of botulinum toxin type A) in order to achieve a functional range of ankle motion. Remediation of ankle contracture was not considered a priority in the remaining seven patients due to the severity of their overall disability. CONCLUSION: The incidence of ankle contracture identified in this population was considerably less than previously reported. Reduced dorsiflexion range was remediated with standard physiotherapy treatment in over half of the cases. Additional treatment with serial casting +/- botulinum toxin type-A injection was required to correct persistent or worsening contracture in one quarter of cases. Dystonic extensor muscle overactivity was a major contributor to persistent or progressive ankle contracture.

Adolescent↗
PubMedDate not supplied

Ankle biomechanics of ballet dancers in relevé en pointé dance.

The objective of this study was to study the ankle biomechanics in relevé en pointé of ballet dancers and to investigate the symmetry between dominant and nondominant sides. A three-dimensional motion analysis system and two force platforms were used to collect segmental motion and ground reaction force data during relevé en pointé dancing. Thirteen ballet dancers, each of whom had over 5 years' dance experience (11.37 +/- 3.9 years), were recruited for this study. The results showed that ankle movement patterns were highly correlated (ICC = 0.99) in bilateral comparisons, but only moderate correlation was found in ankle joint moment patterns (ICC = 0.66). The nonldominant ankle showed the same excursion patterns, but different joint moments, when compared to the dominant ankle in relevé en pointé. The indication was that the two ankle joints may play different roles in controlling balance and movements throughout the entire period of the dance movements. Ankle bionmechanical patterns of the fiundamental ballet dance movement, relevé en pointé, also were constructed in this study to help interpret and understand the bilateral ankle joint excursion pattern.

Adult↗
PubMed1988

Goniometric reliability in a clinical setting. Subtalar and ankle joint measurements.

Measurements of the subtalar joint neutral (STJN) position and passive range of motion (PROM) of the ankle joint and the subtalar joint (STJ) are often part of a physical therapy evaluation. These measurements may be used in treatment planning, such as in the prescription of specialized shoes or orthoses. Therefore, reliability of these measurements, as they are obtained clinically, must be determined. The purpose of this study was to examine the reliability of measurements of the STJN position and of ankle and STJ PROM. To determine reliability, repeated measurements of the STJN position and of STJ PROM were taken on the involved feet of 43 patients with neurologic orthopedic disorders (including both feet of 7 patients), and measurements of ankle PROM (dorsiflexion and plantar flexion) were taken on 42 of these patients (including both feet of 7 patients). Intraclass correlation coefficients (ICCs) for intratester reliability ranged from .74 to .90 for ankle and STJ measurements. The ICCs for intertester reliability were .25 for measuring the STJN position, .32 for STJ inversion, and .17 for SJJ eversion. The ICCs for intertester reliability were .50 for ankle dorsiflexion and .72 for ankle plantar flexion. Goniometric measurements of the STJN position and of PROM of the ankle and STJ appear to be moderately reliable if taken by the same therapist over a short period of time. With the exception of ankle plantar flexion, these measurements cannot be considered to be reliable between therapists.

Adolescent↗
PubMedDate not supplied

The Scandinavian total ankle replacement (STAR).

Ankle joint arthritis is a condition that affects many people. Initial conservative treatment includes nonsteroidal antiinflammatory drugs, soft bracing, and ankle foot orthosis. When conservative management fails, surgical intervention is often considered. Previously an ankle joint fusion has been considered the "gold standard" to treat disabling ankle joint arthritis because early total ankle joint replacements had unacceptably high complication rates. However, early and midterm data have demonstrated that the Scandinavian Total Ankle Replacement (STAR) or Agility Total Ankle may be a reasonable alternative to an ankle joint fusion.

Ankle Joint↗
PubMed2004

Effects of ankle joint effusion on lower leg function.

BACKGROUND: Inversion ankle sprains are among the most frequently encountered injuries in and outside of sport. Altered feedback from joint damage and/or edema may negatively affect dynamic stabilization, thereby increasing the patients' susceptibility to further injury. In order to understand better how the sensorimotor system responds to the presence of ankle edema during a functional task, further examination is warranted. OBJECTIVE: To quantify muscle activation in the peroneal, tibialis anterior, and soleus musculature as well as to determine ankle joint peak torque, peak power, and root mean square (RMS) power during a closed kinetic chain activity following artificial ankle effusion. DESIGN: Dependent variables were compared within subjects across time intervals and between groups. SETTING: All data were collected in the biomechanics laboratory. PARTICIPANTS: Subjects were 20 healthy, neurologically sound volunteers (age 21.9 +/- 2.1 y, height 174.5 +/- 9.3 cm, mass 79.3 +/- 15.9 kg) with no lower extremity injuries. INTERVENTIONS: Subjects were prepared for surface electrodes on the peroneus longus (PL), tibialis anterior (TA), soleus (Sol), and medial malleolus (ground). Anthropometric measures for the lower extremity were recorded for use by the Omnikinetic closed chain dynamometer. Measurements were taken prior to ankle effusion (baseline), immediately following effusion (post), and again at 30 minutes. MAIN OUTCOME MEASUREMENTS: Testing consisted of 6 repetitions at 35% of 1-repetition max and a constant speed of 1.5 Hz. Separate two-way MANOVAs with repeated measures on time intervals were used to detect differences between groups (effusion and control) over time for torque, power, and RMS power and for peak and average EMG. RESULTS: An overall time x group interaction was detected for EMG (F4,72=3.878; P=0.007) and kinetic variables (F6,70=5.55; P=0.0001). Average and peak PL EMG decreased immediately following effusion (Sidak's; P=0.048), and average EMG remained depressed 30 minutes following effusion (Sidak's; P=0.02). Immediately posteffusion, a decrease in ankle torque was detected (Sidak's; P=0.007). No differences in TA or Sol EMG, power, or RMS power were detected (P>0.05). CONCLUSIONS: Decreases in ankle plantarflexion torque and PL EMG indicate that a neuromuscular deficit exists in the presence of edema that could increase the susceptibility for further ankle injury.

Adult↗
PubMed2006

Evaluation of cuff-wrapping methods for the determination of ankle blood pressure.

OBJECTIVE: The ankle-brachial index, which is calculated by dividing ankle systolic blood pressure by brachial systolic blood pressure, is useful in diagnosing peripheral arterial disease. Consensus has not been reached, however, on a standard method for measuring ankle systolic blood pressure. This study evaluated two cuff-wrapping methods for measuring ankle systolic blood pressure, compared with intra-arterial pressure as a gold standard. METHODS: Study participants were 24 consecutive adult patients who underwent surgery under general anesthesia at Kyoto Prefectural University Hospital in Japan between January and March 2002. Indirect ankle systolic blood pressure was measured in the posterior tibial artery using a Doppler device and two cuff-wrapping methods: spiral, and straight. Direct ankle systolic blood pressure was measured in the dorsalis pedis artery. RESULTS: Mean difference in ankle systolic blood pressure between indirect and direct measurements (indirect minus direct) was 1.4 mmHg [standard deviation of the difference (SDd), 17.6 mmHg] with the straight method and -1.4 mmHg (SDd, 22.2 mmHg) with the spiral method. The limit of agreements (mean difference +/-2 SDd) and intraclass correlation coefficient between two observers were -17.6 to 20.1 mmHg and 0.94, respectively, for the straight method and -39.4 to 40.0 mmHg and 0.78, respectively, for the spiral method. CONCLUSIONS: The straight method, the same cuff-wrapping method used for measuring brachial blood pressure, appears to represent a more suitable wrapping method because of better interobserver reproducibility. Accuracy and reproducibility of indirect ankle systolic blood pressure measurement, however, were not adequately improved by either of the wrapping methods.

Adult↗
PubMed1996

Effect of forward lean on postural ankle dynamics.

Previous studies investigating postural control using platform perturbations demonstrated that forward leaning occurs under certain experimental conditions. This study examined a potential benefit of forward leaning, investigating the hypothesis that forward lean acts to increase the effective stiffness of the postural ankle dynamics. A systems modeling approach was used to evaluate the effect of forward lean (4 degrees ankle flexion beyond normal stance) on dynamic postural responses to continuous random antero-posterior platform acceleration in four healthy young adults. Motion was limited to the ankle joint using a restraint device and responses were characterized in terms of center-of-pressure displacement. Also, EMG and kinematic data were used to partition measured ankle torque into impedance and activation (postural "reflex") components. The results failed to show a consistent effect, due to lean, on the ankle dynamics. A significant increase in phasic ankle torque due to increased muscle impedance during forward lean was counterbalanced by a comparable decrease in net "reflex" ankle torque. The change in "reflex" torque was apparently due to decreased phasic dorsiflexor activity in forward lean, since phasic plantarflexor activity did not change significantly. Functionally, the results suggest that forward lean occurs for reasons other than stiffening of the overall postural ankle dynamics.

Adult↗
PubMed1998

Differences in human antagonistic ankle dorsiflexor coactivation between legs; can they explain the moment deficit in the weaker plantarflexor leg?

The present study examined the hypothesis that the antagonistic ankle dorsiflexor coactivation level during maximum isometric voluntary plantarflexion (MVC) is a function of ankle angle. Six male subjects generated plantarflexion and dorsiflexion MVC trials at ankle angles of -15 deg (dorsiflexed direction), 0 deg (neutral position), +15 deg (plantarflexed direction) and +30 deg having the knee flexed at an angle of 90 deg. In all contractions surface EMG measurements were taken from tibialis anterior and soleus which were considered representative muscles of all dorsiflexors and plantarflexors, respectively. Antagonistic dorsiflexor coactivation was expressed as normalized EMG and moment. Calculations of the antagonistic dorsiflexor moment were based on the tibialis anterior EMG-dorsiflexor moment relationship from contractions at 50, 40, 30, 20 and 10 % of the dorsiflexion MVC moment. In both legs dorsiflexor coactivation level followed an open U-shaped pattern as a function of ankle angle. Differences of 9 and 14 % (P < 0.05) were found in the measured net plantarflexion MVC moment between legs at ankle angles of -15 and +30 deg, respectively. No difference (P > 0.05) was found in the calf circumference between legs. Differences were found in the antagonistic dorsiflexor coactivation between legs at ankle angles of -15 and +30 deg. In the weaker leg the antagonistic EMG measurements were higher by 100 and 45 % (P < 0.01) and the estimated antagonistic moments were higher by 70 and 43 % (P < 0.01) compared with the weaker leg at -15 and +30 deg, respectively. This finding was associated with a decreased range of motion (ROM) in the weaker leg (14 %, P < 0.01), such that no difference (P > 0.05) was found in dorsiflexor antagonistic coactivation between legs at end-range ankle angles. The findings of the study (i) have to be taken into consideration when estimating musculoskeletal loads in the lower extremity, (ii) imply that stretching training can result in a stronger plantarflexion at end-range ankle angles through inhibition of the dorsiflexors, and (iii) imply a neural drive inadequacy during a plantarflexion MVC at end-range angles.

Adult↗