Association ankle function and balance in community-dwelling older adults

Abstract

Background and purpose Ankle function declines with age. The objective of this study was to investigate the association between ankle function and balance in older adults, with a focus on range of motion (ROM) and strength. Methods This was a cross-sectional study that included 88 healthy community-dwelling older adults. Ankle mobility was measured while bearing weight (lunge test) and not bearing weight. The plantar-flexor muscle strength was assessed using a hand-held dynamometer. Balance was measured in terms of dynamic balance and mobility (timed up and go test), monopodal and bipodal static balance with open and closed eyes (single-leg stand test and platform measures), and margins of stability (functional reach test). Linear correlation and multiple regression analyses were conducted with a 95% CI. Results and discussion Most participants had limited ankle mobility (n = 75, 86%). Weight-bearing ankle dorsiflexion ROM was the strongest predictor of dynamic balance and included general mobility and stability (Radj2 = [0.34]; β = [-0.50]). In contrast, plantar-flexor muscle strength was a significant predictor of static standing balance with open eyes (Radj2 = [0.16–0.2]; β = [0.29–0.34]). Overall, weight-bearing ankle dorsiflexion ROM was a more representative measure of balance and functional performance; however, a non-weight-bearing mobility assessment provides complementary information. Therefore, both measures can be used in clinical practice. Conclusion This study supports the concept that ankle mobility contributes to the performance of dynamic tasks, while the plantar-flexor muscle strength helps to develop a standing static balance. Identification of alterations in ankle function is warranted and may assist in the design of tailored interventions. These interventions can be used in isolation or to augment conventional balance training in order to improve balance performance in community-dwelling older adults.

The Efficacy of Virtual Reality Training in the Rehabilitation of Orthopedic Ankle Injuries: A Systematic Review and Meta-analysis

“…31 These inconsistencies could also be attributable to other biomechanical factors that impact dynamic balance, such as muscle strength, ankle mobility, and functionality of synovial structures that may enhance joint stiffness and thus limit dynamic balance. [36][37][38] This assumption was also confirmed by Hoch et al 39 in their investigation, where they concluded that a loss of ankle range of motion could negatively affect dynamic balance.…”

Ankle Proprioception Deficit Is the Strongest Factor Predicting Balance Impairment in Patients With Chronic Stroke

“… 34 Therefore, studies regarding ankle function in patients with stroke have mainly reported that ankle dorsiflexion ROM and plantar flexor strength were effective in the performance of functional activities rather than ankle proprioception. 35 However, another study suggested that uncertainty regarding the foot position due to impaired ankle proprioception during walking could alter the step length and affect walking speed. 36 Depending on the lesion location, strokes can damage both motor and sensory neural systems, thereby leading to neurologic impairment.…”

Measures of attributes of locomotor capacity in older people: a systematic literature review following the COSMIN methodology

“…However, the goniometer, which seems to have been used in clinical practice as ‘a proxy’ for joint function assessment may be a useful tool in assessing locomotor capacity. In fact, in clinical research, this tool has rather been used to assess range of motion [ 148 ], even if there seems to be a confusion between range of motion and joint function in some publications [ 149 , 150 ].…”