ankle dorsiflexion passive range of motion ( df prom ) measurements are performed in the 
 field of physical therapy to estimate ankle motion during functional activities1 and to prevent lower extremity injuries2 .
although in the clinical setting , ankle df 
 prom is frequently measured under non - weight - bearing ( non - wb ) conditions1 , 3 , 4 , many researchers have stated that the wb 
 position is more appropriate for estimating the amount of ankle df motion during functional 
 activities5 , 6 . therefore , wb ankle df prom should be measured during interventions 
 focused on increasing ankle df prom .
limited ankle df prom with knee extended may result from gastrocnemius tightness and 
 insufficient posterior talar glide7 .
thus , 
 gastrocnemius stretching and talocrural joint mobilization have been performed as 
 intervention strategies to increase ankle df prom3 , 
 8 , 9 .
previous studies have reported a significant increase in ankle df 
 prom after these interventions3 , 8 , 9 ; however , to our 
 knowledge , no study has demonstrated the combined effect of both interventions on wb ankle 
 df prom .
therefore , the aim of the present study was to examine the influence of 
 gastrocnemius stretching combined with joint mobilization on wb ankle df prom .
in total , 11 male subjects with bilateral limited non - wb ankle df prom with knee extended 
 ( mean age , 22.82  3.09  years ; mean height , 175.91  3.39  cm ; mean weight , 69.55  3.78  kg ; 
 mean non - wb ankle df prom , 4.17  2.48 ) participated in this study .
inclusion criteria were 
 1 ) ankle df prom with knee extension < 10 ; 2 ) ankle df prom with knee flexion > 10 ; 
 and 3 ) > 5 difference in ankle df prom between knee extension and knee flexion 
 conditions on bilateral sides in non - wb positions3 .
subjects with a history of surgery on the lower extremity , 
 fracture , or neurological diseases were excluded from this study .
all participants signed an 
 informed consent form approved by the institutional research review committee of inje 
 university prior to participation in this study .
the study protocol of this study complies 
 with the ethical standard of the declaration of helsinki .
wb ankle df prom with knee extended was measured following the procedures suggested by 
 munteanu et al10 .
subjects stood in front 
 of a wall and placed the leg being tested behind the contralateral leg in a lunge posture . 

subjects were asked to place both hands on the wall and then lean forward without heel - off 
 and knee flexion until maximum stretch was felt in the gastrocnemius on the tested leg .
the 
 force applied to the tested leg was maintained at 60  5% of the subject s weight using 
 scales11 .
an examiner determined the 
 maximum tibial inclination using an inclinometer to measure the wb ankle df prom with knee 
 extended .
measurements of wb ankle df prom were repeated 3 times for each ankle under pre- 
 and post - intervention conditions .
the mean value of 3 trials was used for data analysis . for gastrocnemius stretching combined with joint mobilization , subjects leaned forward 
 against the wall in the same lunge posture as that during measurement of wb ankle df prom 
 with knee extended until the maximum gastrocnemius stretch was felt .
subjects held the 
 end - range posture while an examiner provided the talus of the tested leg with sustained 
 anterior - to - posterior gliding force .
an intervention trial was performed for 30  s , and 10 
 trials were repeated with 30-s rest periods for each ankle . the difference in wb ankle df prom with knee extended between pre- and post - intervention 
 conditions was analyzed using a paired t - test .
wb ankle df prom with knee extended was significantly increased in post - intervention 
 compared with pre - intervention conditions ( 42.60  5.49 versus 38.24  4.69 , p < 
 0.001 ) .
our findings demonstrate that gastrocnemius stretching combined with joint mobilization 
 significantly increases wb ankle df prom with knee extended . stretching exercises
increase 
 tolerance , resulting in increased rom12 . 
 additionally , increased displacement of the myotendinous junction ( mtj ) after gastrocnemius 
 stretching for 5  min was found in a previous study13 .
therefore , the change in tolerance and/or increase in mtj 
 displacement might have influenced our findings .
the addition of talocrural joint 
 mobilization to gastrocnemius stretching is another possible explanation for our findings . 

previous research by dinh et al.3 showed a 
 4.25 increase in wb ankle df prom with knee extended after gastrocnemius stretching alone 
 for 3 weeks . although gastrocnemius stretching combined with joint mobilization
was applied 
 for 5  min in the present study , the amount of increase in wb ankle df prom after 
 intervention ( i.e. , 4.36 ) was similar to that found previously . considering this outcome , 
 despite the relatively short period of intervention in the present study , it may be inferred 
 that the addition of talocrural joint mobilization might maximize the effects of general 
 gastrocnemius stretching .
thus , we 
 conclude that gastrocnemius stretching combined with joint mobilization might decrease 
 gastrocnemius tightness and increase posterior talar gliding movement , which effectively 
 increases wb ankle df prom with the knee extended .
first , although non - wb ankle df prom was used as 
 an inclusion criterion , changes in non - wb ankle df prom after intervention were not 
 measured .
however , we believe that wb ankle df prom is clinically more important because 
 most functional activities are performed under the wb condition .
second , our study included 
 only male subjects , and the results can not be generalized to women .
 [ purpose ] the purpose of this study was to investigate the effect of gastrocnemius 
 stretching combined with talocrural joint mobilization on weight - bearing ankle 
 dorsiflexion passive range of motion . 
 [ subjects ] eleven male subjects with bilateral 
 limited ankle dorsiflexion passive range of motion with knee extended participated in this 
 study . 
 [ methods ] all subjects received talocrural joint mobilization while performing 
 gastrocnemius stretching . 
 ankle dorsiflexion passive range of motion was measured using an 
 inclinometer under weight - bearing conditions before and immediately after intervention . 
 a 
 paired t - test was used to analyze the difference between weight - bearing ankle dorsiflexion 
 passive range of motion pre- and post - intervention . 
 [ results ] a significant increase in 
 weight - bearing ankle dorsiflexion passive range of motion was found post - intervention 
 compared with pre - intervention . 
 [ conclusion ] these findings demonstrate that gastrocnemius 
 stretching combined with joint mobilization is effective for increasing weight - bearing 
 ankle dorsiflexion passive range of motion . 
INTRODUCTION
SUBJECTS AND METHODS
RESULTS
DISCUSSION