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Table 2 Comparison of conservative interventions for increasing ankle joint dorsiflexion range of motion

From: Interventions for increasing ankle joint dorsiflexion: a systematic review and meta-analysis

Study ID

Intervention(s)

Sample size

Follow-up period

Measurement method

SMD (95% CI)*

STRETCHING

Bohannon 1994 [31]

A: Control

A: 18

Same day measures taken after 3 sets of stretching

Digital images

Insufficient data

B: Stretch

B: 18

Dinh 2011 [1]

A: WB stretch

A: 14

3 weeks

Goniometer (WB)

B vs A

B: NWB stretch

B: 14

Left: -0.33 (−1.08 to 0.42)

Right: 0.26 (−0.49 to 1)

    

Goniometer (NWB)

B vs A

Left: 0.16 (−0.88 to 0.9)

Right: 0.18 (−0.56 to 0.93)

Christiansen 2008 [12]

A: Control

A: 20

8 weeks

Goniometer (NWB)

B vs A: 0.71 (0.07 to 1.35)

B: Stretch

B: 20

Etnyre 1986 [15]

A: Static stretch

A: 12

3 sessions

Goniometer (active assist)

B vs A: -0.04 (−0.85 to 0.76)

B: Contract-relax PNF stretch

B: 12

C: 12

C vs A: 1.90 (0.92 to 2.88 )

C: Contract-relax-agonist-contract PNF stretch

Gajdosik 2005 [5]

A: Control

A: 9

8 weeks

Electro-goniometer

B vs A: 0.69 (−0.24 to 1.62)

B: WB stretch

B: 10

Gajdosik 2007 [18]

A: Control

A: 4

6 weeks

Electro-goniometer

B vs A: 0.91 (−0.44 to 2.25)

B: WB stretch

B: 6

Johanson 2009 [3]

A: Control

A: 8

3 weeks

Goniometer

B vs A

B: WB stretch

B: 8

Left: 1.19 (0.11 to 2.26)

Right: 0.55 (−0.45 to 1.55)

Kasser 2009 [19]

A: Control

A: 9

6 weeks

Universal goniometer

Insufficient Data

B: WB stretch

B: 9

Knight 2001 [21]

A: Control

A: 18

6 weeks

Goniometer (passive ROM)

B vs A: 0.71 (0.05 to 1.38)

B: Static Stretch

B: 19

Goniometer (active ROM)

B vs A: 0.7 (0.03 to 1.36)

Peres 2002 [23]

A: Control

A: 8

3 weeks

Digital inclinometer

B vs A: 0.85 (−0.10 to 1.81)

B: Stretch

B: 11

Pratt 2003 [32]

A: Control

A: 12

3 days

Digital images

Insufficient data

B: Stretch

B: 12

Rees 2007 [25]

A: Control

A: 10

4 weeks

Goniometer

B vs A

B: PNF stretch

B: 10

Left: 0.82 (−0.1 to 1.74)

Right: 0.84 (−0.08 to 1.76)

Youdas 2003 [29]

A: Control

A: 24

6 weeks

Goniometer (active assist)

B vs A: 0.45 (−0.14 to 1.04)

B: 30 sec stretch

B: 22

C: 1 minute stretch

C: 22

C vs A: 0.24 (−0.34 to 0.83)

D: 2 minute stretch

D: 21

D vs A: 0.46 (−0.14 to 1.05)

STRETCHING COMBINED WITH OTHER INTERVENTIONS

Draper 1998 [14]

A: Stretch

A: 20

10 sessions

Inclinometer

B vs A: 0 (−0.62 to 0.62)

B: Ultrasound + Stretch

B: 20

Kasser 2009 [19]

A: WB stretch

A: 9

6 weeks

Universal goniometer

Insufficient data

C: Tibialis anterior strengthening

C: 9

Knight 2001 [21]

A: Control

A: 18

6 weeks

Goniometer (passive ROM)

C vs A: 0.70 (0.04 to 1.37)

C: Heel raise + static stretch

C: 19

D: 21

D vs A: 0.84 (0.18 to 1.50)

D: Superficial moist heat + static stretch

E: 20

E vs A: 0.95 (0.27 to 1.62)

E: Ultrasound + static stretch

    

Goniometer (active ROM)

C vs A: 0.77 (0.10 to 1.44)

D vs A: 0.65 (0 to 1.30)

E vs A: 0.91 (0.24 to 1.58)

McNair 1996 [22]

A: WB soleus stretch

A: 24

3 sessions

Electro-goniometer

B vs A: 0.05 (−0.52 to 0.62)

B: Aerobic exercise

B: 24

Peres 2002 [23]

A: Control

A: 8

3 weeks

Digital Inclinometer

C vs A: 1.12 (0.05 to 2.18)

C: Stretch +

C: 8

Diathermy

D: 9

D vs A: 1.16 (0.12 to 2.20)

D: Stretch + Diathermy + Ice

Zakas 2006 [30]

A: Warm up

A:18

3 sessions

Flexometer

B vs A: 0.72 (0.04 to 1.39)

B: Stretch

B: 18

C: Warm up + stretch

C: 18

C vs A: 0.87 (0.18 to 1.55)

MANUAL THERAPY

Fryer 2002 [16]

A: Control

A: 41

Immediate

Dynamometer (NWB)

B vs A: 0 (−0.44 to 0.44)

B: Manipulation

B: 40

De Souza 2008 [39]

A: Control

A: 25

Immediate

Biplane goniometer

B vs A: 0.19 (−0.37 to 0.75)

B: Mobilisation

B: 25

SOLEAL TRIGGER POINT THERAPY

Grieve 2011 [2]

A: Control

A: 10

Immediate

Goniometer (NWB assisted)

B vs A: 0.72 (−0.18 to 1.63)

 

B: Soleal trigger point therapy

B: 10

   
  1. Abbreviations: WB weight bearing, NWB non-weight bearing.
  2. *SMDs (95% CIs) were calculated between groups at the longest period of follow-up.