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November 2025

Enhancing Ankle Movement in Stroke Patients: The Impact of Joint Mobilization Combined with Active Stretching

Authors: Shin-Jun Park 1, Kyun-Hee Cho 1, Seunghue Oh 2

Affiliations:

  1. Department of Physical Therapy, Suwon Women’s University, Hwaseong-si 18333, Republic of Korea
  2. Department of Physical Therapy, Uiduk University, Gyeongju-si 38004, Republic of Korea

Journal: Brain Sciences - October 2025, Volume 15, Issue 11, Article no. 1149 (DOI: 10.3390/brainsci15111149)

Background: The paralyzed ankles of stroke patients show reduced range of motion, muscle tightness, and joint stiffness, further impeding their ability to maintain balance and walk properly. This study aimed to investigate the effects of a combined joint mobilization and active stretching intervention on ankle stiffness, balance, and gait in patients with stroke.

Methods: In this study, 24 stroke patients were assigned to two groups of 12 each: the control group (general physical therapy) and the experimental group (joint mobilization technique and active stretching exercise). All interventions were conducted for 30 min a day, 3 times a week, for a total of 4 weeks. Tension and stiffness of the gastrocnemius and tibialis anterior muscles were measured using MyotonPRO®. Balance was evaluated using BioRescue, the Berg Balance Scale (BBS), and the Timed-Up and Go tests (TUG). All measurements were evaluated before the start of the intervention and after four weeks.

Results: The muscle tone and stiffness of the medial and lateral gastrocnemius and tibialis anterior muscles of the experimental group were significantly improved compared with those of the control group. The experimental group had significantly increased moving areas in all directions and BBS scores compared with the control group. The experimental group showed a significant decrease in the time spent on the TUG test compared with the control group.

Conclusions: We found that joint mobilization combined with active stretching intervention was more effective than general physical therapy in improving ankle joint movement, balance, and gait ability.

 

Keywords: stretching exercise, joint mobilization, balance, gait ability, stroke

The present study demonstrated that a four-week intervention combining joint mobilization with active stretching was more effective than general physical therapy in improving ankle muscle tone, stiffness, balance, and gait ability in stroke patients. These results suggest that the integrated approach effectively modulates both mechanical and neurophysiological components of motor control, contributing to enhanced functional mobility. The findings highlight the clinical applicability of combining joint mobilization and active stretching as a feasible and efficient intervention strategy for stroke rehabilitation. Future studies with larger sample sizes and long-term follow-up assessments are warranted to confirm these effects and explore the underlying mechanisms in greater detail.

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