Title: Contribution of Ankle Range of Motion to Functional Movement
Name: John Caron
Primary Presenters: John Caron, Gabriel Serafin, Trevor Palm
College of Health Sciences
Clinical Doctorate
Faculty Sponsor(s): Kyle Ebersole
Contribution of Ankle Range of Motion to Functional Movement
John Caron, SPT, Trevor Palm, SPT, Gabriel Serafin, SPT, MS, & Kyle Ebersole, PhD, LAT
Department of Rehabilitation Sciences & Technology
Introduction: Limited ankle range of motion (ROM) has been linked to poor movement ability. However, the contribution of ankle strength to this relationship in firefighter cadets is unknown. The purpose of this study was to examine differences in functional squat movement characteristics and strength between fire cadets with limited ankle (10° dorsiflexion) ROM. Methods: 17 firefighter cadets were split into a limited ankle ROM group (n=7) and a normal ankle ROM group (n=10). A goniometer was used to determine ankle ROM and hamstring (HS) length (90-90 test), and strength was assessed using a hand-held dynamometer (HHD). The FusioneticsTM Movement Efficiency Screen (MES) was used to quantify functional movement. Independent T-tests and bivariate correlations were completed on IBM SPSS 27 software and α = 0.05 was used to determine significant difference. Results: Independent t-tests indicated no differences between groups for any measurement except for right (p=.002) and left ankle (p=.001) ROM. Bivariate Pearson correlations indicated that in the group that lacked ankle ROM, right and left HS length (r=.662 and r=.648, respectively) and right dorsiflexion ROM (r=.752) were related to better functional movement. Conclusion: Results of this study indicated that fire cadets with limited ankle ROM had lower MES performance and greater hamstring and calf strength compared to the group with normal ankle ROM. The trend of increased strength is a possible movement compensation for less available ROM, suggesting that limited ankle ROM leads to maladaptive functional movement characteristics. Thus, in a population of fire cadets, increasing ankle ROM may improve functional movement squat characteristics by optimizing the length tension relationships.
Pretty interesting relationship between ankle ROM and calf/hamstring strength. I am wrapping my head around the idea that this relationship represents a “compensation”. Maybe df > 10 degrees represents a “hypermobile” situation?
Thanks for the insight! The idea that it is a compensation needs to be investigated further, and perhaps future researchers could look at more muscle groups and joints that may contribute to squat performance.
If >10 degrees seems like a lot of dorsiflexion, some authors claim that DF >20 degrees is “normal”! Anecdotally, I have not seem many people with that kind of range, especially in an aging population.
Gabe, John and Trevor – great job! I also am trying to wrap my head around the increased strength with the decreased ankle ROM. Did you happen to videotape the squat motion? Could you go back and see what compensations existed? Super interesting work. For firefighters who I believe can work at max effort at times fighting fires, becoming more efficient by simply increasing ankle ROM has the potential to significantly mitigate risk. Very interesting study!
Hello Dr. Huddleston, thanks for the comment! We don’t have video, but we do have their individual movement compensations (e.g., foot flatten, knee valgus, forward trunk lean) for the 2-leg squat (with and without heel lift) and 1-leg squat. Examining the individual deficits of those with lower scores may show us trends of what exactly is going on, but at this point all we can say is there were “more” compensations. For the larger study, we will go and investigate the individual compensations for each of the 4 time points.
Fascinating work. I am trying to wrap my head around the idea of hamstring length, but assume you mean semimembranosus and semitendinosus, because these would be lengthened across the hip, while plantar flexors would be lengthened across ankle. In addition to Dr. Huddleston asking if you have video data, I am wondering if you have kinetic data? There is an old study that compares heels down squat in children with Down syndrome and children who were swimmers and had quite a bit of range at the ankle. The range in the two populations was the similar, but the kinetic profile was different. Kinetic data may help you consider the compensation proposal.
Hello Dr. Moerchen, thanks for your insights! By HS length, we mean a 90-90 test which would gauge all 3 hamstring muscles, and by ankle ROM, we mean as measured with the Kendall supine gastroc length test. We do not have kinetic data, but we do have the movement compensations (e.g., foot flatten, knee valgus, forward trunk lean) for the 2-leg squat (with and without heel lift) and 1-leg squat. Kinetic data for a future version of this study with a larger population after the proof-of-concept works is an excellent idea, thank you!