{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T13:08:41Z","timestamp":1789132121595,"version":"build-2803163510"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,3]],"date-time":"2024-02-03T00:00:00Z","timestamp":1706918400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,3]],"date-time":"2024-02-03T00:00:00Z","timestamp":1706918400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Cooperative Research Grant of Niigata University of Health and Welfare University"},{"name":"Grant-in-Aid for Scientific Research from the Japanese Society for the Promotion of Science","award":["JP23H03258"],"award-info":[{"award-number":["JP23H03258"]}]},{"name":"Grant-in-Aid for Scientific Research from the Japanese Society for the Promotion of Science","award":["JP23H03258"],"award-info":[{"award-number":["JP23H03258"]}]},{"name":"Grant-in-Aid for Scientific Research from the Japanese Society for the Promotion of Science","award":["JP23H03258"],"award-info":[{"award-number":["JP23H03258"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Orthop Surg Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to: (1) identify assessment methods that can detect greater ankle dorsiflexion range of motion (DROM) limitation in the injured limb; (2) determine whether differences in weightbearing measurements exist even in the absence of DROM limitations in the injured limb according to non-weightbearing measurements; and (3) examine associations between DROM in the weightbearing and non-weightbearing positions and compare those between a patient group with foot and ankle injuries and a healthy group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Eighty-two patients with foot and ankle injuries (e.g., fractures, ligament and tendon injuries) and 49 healthy individuals participated in this study. Non-weightbearing DROM was measured under two different conditions: prone position with knee extended and prone position with knee flexed. Weightbearing DROM was measured as the tibia inclination angle (weightbearing angle) and distance between the big toe and wall (weightbearing distance) at maximum dorsiflexion. The effects of side (injured, uninjured) and measurement method on DROM in the patient groups were assessed using two-way repeated-measures ANOVA and\n                      <jats:italic>t<\/jats:italic>\n                      -tests. Pearson correlations between measurements were assessed. In addition, we analyzed whether patients without non-weightbearing DROM limitation (\u2264\u20093 degrees) showed limitations in weightbearing DROM using\n                      <jats:italic>t<\/jats:italic>\n                      -tests with\n                      <jats:italic>Bonferroni<\/jats:italic>\n                      correction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      DROM in patient groups differed significantly between legs with all measurement methods (all:\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), with the largest effect size for weightbearing angle (\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.95). Patients without non-weightbearing DROM limitation (n\u2009=\u200937) displayed significantly smaller weightbearing angle and weightbearing distance on the injured side than on the uninjured side (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001 each), with large effect sizes (\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.97\u20131.06). Correlation coefficients between DROM in non-weightbearing and weightbearing positions were very weak (\n                      <jats:italic>R<\/jats:italic>\n                      \u2009=\u20090.17,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.123) to moderate (\n                      <jats:italic>R<\/jats:italic>\n                      \u2009=\u20090.26\u20130.49,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05) for the patient group, and moderate to strong for the healthy group (\n                      <jats:italic>R<\/jats:italic>\n                      \u2009=\u20090.51\u20130.69,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DROM limitations due to foot and ankle injuries may be overlooked if measurements are only taken in the non-weightbearing position and should also be measured in the weightbearing position. Furthermore, DROM measurements in non-weightbearing and weightbearing positions may assess different characteristics, particularly in patient group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>Level IV, cross-sectional study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13018-024-04599-x","type":"journal-article","created":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T23:58:55Z","timestamp":1706918335000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Differences and relationships between weightbearing and non-weightbearing dorsiflexion range of motion in foot and ankle injuries"],"prefix":"10.1186","volume":"19","author":[{"given":"Yuta","family":"Koshino","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoya","family":"Takabayashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Akuzawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Mizota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun","family":"Numasawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takumi","family":"Kobayashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shintarou","family":"Kudo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiki","family":"Hikita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Akiyoshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mutsuaki","family":"Edama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,3]]},"reference":[{"issue":"3","key":"4599_CR1","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.bjpt.2017.03.012","volume":"21","author":"K Hyodo","year":"2017","unstructured":"Hyodo K, Masuda T, Aizawa J, Jinno T, Morita S. Hip, knee, and ankle kinematics during activities of daily living: a cross-sectional study. Braz J Phys Ther. 2017;21(3):159\u201366.","journal-title":"Braz J Phys Ther"},{"issue":"6","key":"4599_CR2","doi-asserted-by":"publisher","first-page":"723","DOI":"10.4085\/1062-6050-49.3.29","volume":"49","author":"KE Dill","year":"2014","unstructured":"Dill KE, Begalle RL, Frank BS, Zinder SM, Padua DA. Altered knee and ankle kinematics during squatting in those with limited weight-bearing-lunge ankle-dorsiflexion range of motion. J Athl Train. 2014;49(6):723\u201332.","journal-title":"J Athl Train"},{"issue":"12","key":"4599_CR3","doi-asserted-by":"publisher","first-page":"786","DOI":"10.2519\/jospt.2005.35.12.786","volume":"35","author":"MJ Hancock","year":"2005","unstructured":"Hancock MJ, Herbert RD, Stewart M. Prediction of outcome after ankle fracture. J Orthop Sports Phys Ther. 2005;35(12):786\u201392.","journal-title":"J Orthop Sports Phys Ther"},{"issue":"1","key":"4599_CR4","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/S0004-9514(09)70058-3","volume":"55","author":"CW Lin","year":"2009","unstructured":"Lin CW, Moseley AM, Herbert RD, Refshauge KM. Pain and dorsiflexion range of motion predict short- and medium-term activity limitation in people receiving physiotherapy intervention after ankle fracture: an observational study. Aust J Physiother. 2009;55(1):31\u20137.","journal-title":"Aust J Physiother"},{"issue":"3","key":"4599_CR5","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1123\/jsr.18.3.358","volume":"18","author":"JW Youdas","year":"2009","unstructured":"Youdas JW, McLean TJ, Krause DA, Hollman JH. Changes in active ankle dorsiflexion range of motion after acute inversion ankle sprain. J Sport Rehabil. 2009;18(3):358\u201374.","journal-title":"J Sport Rehabil"},{"issue":"1","key":"4599_CR6","doi-asserted-by":"publisher","first-page":"5","DOI":"10.3113\/FAI.2011.0005","volume":"32","author":"A Patel","year":"2011","unstructured":"Patel A, DiGiovanni B. Association between plantar fasciitis and isolated contracture of the gastrocnemius. Foot Ankle Int. 2011;32(1):5\u20138.","journal-title":"Foot Ankle Int"},{"issue":"4","key":"4599_CR7","doi-asserted-by":"publisher","first-page":"375","DOI":"10.3113\/FAI.2011.0375","volume":"32","author":"VB Duthon","year":"2011","unstructured":"Duthon VB, L\u00fcbbeke A, Duc SR, Stern R, Assal M. Noninsertional Achilles tendinopathy treated with gastrocnemius lengthening. Foot Ankle Int. 2011;32(4):375\u20139.","journal-title":"Foot Ankle Int"},{"issue":"7","key":"4599_CR8","doi-asserted-by":"publisher","first-page":"1176","DOI":"10.1249\/MSS.0000000000002902","volume":"54","author":"K Song","year":"2022","unstructured":"Song K, Pietrosimone B, Blackburn JT, Padua DA, Tennant JN, Wikstrom EA. Dorsiflexion and hop biomechanics associate with greater talar cartilage deformation in those with chronic ankle instability. Med Sci Sports Exerc. 2022;54(7):1176\u201382.","journal-title":"Med Sci Sports Exerc"},{"issue":"1","key":"4599_CR9","first-page":"48","volume":"7","author":"A Rabin","year":"2014","unstructured":"Rabin A, Kozol Z, Finestone AS. Limited ankle dorsiflexion increases the risk for mid-portion Achilles tendinopathy in infantry recruits: a prospective cohort study. J Foot Ankle Res. 2014;7(1):48.","journal-title":"J Foot Ankle Res"},{"issue":"10","key":"4599_CR10","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1136\/bjsm.2006.029645","volume":"40","author":"M de Noronha","year":"2006","unstructured":"de Noronha M, Refshauge KM, Herbert RD, Kilbreath SL, Hertel J. Do voluntary strength, proprioception, range of motion, or postural sway predict occurrence of lateral ankle sprain. Br J Sports Med. 2006;40(10):824\u20138 (discussion 8).","journal-title":"Br J Sports Med"},{"issue":"9","key":"4599_CR11","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.1007\/s00402-016-2513-x","volume":"136","author":"SF Baumbach","year":"2016","unstructured":"Baumbach SF, Braunstein M, Seeliger F, Borgmann L, Bocker W, Polzer H. Ankle dorsiflexion: What is normal? Development of a decision pathway for diagnosing impaired ankle dorsiflexion and M gastrocnemius tightness. Arch Orthop Trauma Surg. 2016;136(9):1203\u201311.","journal-title":"Arch Orthop Trauma Surg"},{"issue":"5","key":"4599_CR12","doi-asserted-by":"publisher","first-page":"406","DOI":"10.7547\/1020406","volume":"102","author":"A Rabin","year":"2012","unstructured":"Rabin A, Kozol Z. Weightbearing and nonweightbearing ankle dorsiflexion range of motion: are we measuring the same thing? J Am Podiatr Med Assoc. 2012;102(5):406\u201311.","journal-title":"J Am Podiatr Med Assoc"},{"issue":"1","key":"4599_CR13","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1186\/s12891-018-2113-8","volume":"19","author":"A Searle","year":"2018","unstructured":"Searle A, Spink MJ, Chuter VH. Weight bearing versus non-weight bearing ankle dorsiflexion measurement in people with diabetes: a cross sectional study. BMC Musculoskelet Disord. 2018;19(1):183.","journal-title":"BMC Musculoskelet Disord"},{"issue":"8","key":"4599_CR14","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1177\/107110070602700809","volume":"27","author":"SR Rao","year":"2006","unstructured":"Rao SR, Saltzman CL, Wilken J, Yak HJ. Increased passive ankle stiffness and reduced dorsiflexion range of motion in individuals with diabetes mellitus. Foot Ankle Int. 2006;27(8):617\u201322.","journal-title":"Foot Ankle Int"},{"issue":"1","key":"4599_CR15","doi-asserted-by":"publisher","first-page":"30","DOI":"10.4085\/1062-6050-49.3.40","volume":"50","author":"A Rabin","year":"2015","unstructured":"Rabin A, Kozol Z, Spitzer E, Finestone AS. Weight-bearing ankle dorsiflexion range of motion-can side-to-side symmetry be assumed? J Athl Train. 2015;50(1):30\u20135.","journal-title":"J Athl Train"},{"key":"4599_CR16","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1186\/1471-2474-7-33","volume":"7","author":"SR Piva","year":"2006","unstructured":"Piva SR, Fitzgerald K, Irrgang JJ, Jones S, Hando BR, Browder DA, et al. Reliability of measures of impairments associated with patellofemoral pain syndrome. BMC Musculoskelet Disord. 2006;7:33.","journal-title":"BMC Musculoskelet Disord"},{"issue":"12","key":"4599_CR17","doi-asserted-by":"publisher","first-page":"792","DOI":"10.2519\/jospt.2010.3424","volume":"40","author":"A Rabin","year":"2010","unstructured":"Rabin A, Kozol Z. Measures of range of motion and strength among healthy women with differing quality of lower extremity movement during the lateral step-down test. J Orthop Sports Phys Ther. 2010;40(12):792\u2013800.","journal-title":"J Orthop Sports Phys Ther"},{"issue":"4","key":"4599_CR18","doi-asserted-by":"publisher","first-page":"166","DOI":"10.2519\/jospt.2002.32.4.166","volume":"32","author":"CR Denegar","year":"2002","unstructured":"Denegar CR, Hertel J, Fonseca J. The effect of lateral ankle sprain on dorsiflexion range of motion, posterior talar glide, and joint laxity. J Orthop Sports Phys Ther. 2002;32(4):166\u201373.","journal-title":"J Orthop Sports Phys Ther"},{"issue":"4","key":"4599_CR19","doi-asserted-by":"publisher","first-page":"1158","DOI":"10.26603\/001c.25544","volume":"16","author":"M Abassi","year":"2021","unstructured":"Abassi M, Whiteley R. Serial within-session improvements in ankle dorsiflexion during clinical interventions including mobilization-with-movement and a novel manipulation intervention - a case series. Int J Sports Phys Ther. 2021;16(4):1158\u201368.","journal-title":"Int J Sports Phys Ther"},{"issue":"4","key":"4599_CR20","doi-asserted-by":"publisher","first-page":"347","DOI":"10.3138\/ptc.2011-41","volume":"64","author":"MD Chisholm","year":"2012","unstructured":"Chisholm MD, Birmingham TB, Brown J, Macdermid J, Chesworth BM. Reliability and validity of a weight-bearing measure of ankle dorsiflexion range of motion. Physiother Can. 2012;64(4):347\u201355.","journal-title":"Physiother Can"},{"issue":"3","key":"4599_CR21","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1016\/S0004-9514(14)60377-9","volume":"44","author":"KL Bennell","year":"1998","unstructured":"Bennell KL, Talbot RC, Wajswelner H, Techovanich W, Kelly DH, Hall AJ. Intra-rater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion. Aust J Physiother. 1998;44(3):175\u201380.","journal-title":"Aust J Physiother"},{"key":"4599_CR22","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"J Cohen","year":"1988","unstructured":"Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Hillsdale: Lawrence Erlbaum Associates; 1988.","edition":"2"},{"issue":"4","key":"4599_CR23","doi-asserted-by":"publisher","first-page":"253","DOI":"10.2519\/jospt.1997.25.4.253","volume":"25","author":"SR Jonson","year":"1997","unstructured":"Jonson SR, Gross MT. Intraexaminer reliability, interexaminer reliability, and mean values for nine lower extremity skeletal measures in healthy naval midshipmen. J Orthop Sports Phys Ther. 1997;25(4):253\u201363.","journal-title":"J Orthop Sports Phys Ther"},{"key":"4599_CR24","unstructured":"Campbell MJ, Swinscow TDV. Statistics at Square One, 11th edn. Wiley; 2011."},{"issue":"2","key":"4599_CR25","first-page":"121","volume":"8","author":"CR Basnett","year":"2013","unstructured":"Basnett CR, Hanish MJ, Wheeler TJ, Miriovsky DJ, Danielson EL, Barr JB, et al. Ankle dorsiflexion range of motion influences dynamic balance in individuals with chronic ankle instability. Int J Sports Phys Ther. 2013;8(2):121\u20138.","journal-title":"Int J Sports Phys Ther"},{"issue":"9","key":"4599_CR26","doi-asserted-by":"publisher","first-page":"976","DOI":"10.1016\/j.jsams.2019.05.005","volume":"22","author":"KB Kosik","year":"2019","unstructured":"Kosik KB, Johnson NF, Terada M, Thomas AC, Mattacola CG, Gribble PA. Decreased dynamic balance and dorsiflexion range of motion in young and middle-aged adults with chronic ankle instability. J Sci Med Sport. 2019;22(9):976\u201380.","journal-title":"J Sci Med Sport"}],"container-title":["Journal of Orthopaedic Surgery and Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13018-024-04599-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13018-024-04599-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13018-024-04599-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,3]],"date-time":"2024-02-03T00:00:20Z","timestamp":1706918420000},"score":1,"resource":{"primary":{"URL":"https:\/\/josr-online.biomedcentral.com\/articles\/10.1186\/s13018-024-04599-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,3]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["4599"],"URL":"https:\/\/doi.org\/10.1186\/s13018-024-04599-x","relation":{},"ISSN":["1749-799X"],"issn-type":[{"value":"1749-799X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,3]]},"assertion":[{"value":"12 December 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 January 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 February 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethics approval for this study was obtained from the ethics committee at Niigata University of Health and Welfare (approval no. 18892\u2013220829). All methods were carried out in accordance with relevant guidelines and regulations. All participants provided informed consent before participating in this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not Applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"115"}}