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Related Concept Videos

Ankle Joint01:10

Ankle Joint

The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...

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Flexibility-enhancing Interventions for Ankle Range of Motion: A Network Meta-analysis.

Jong Mi Park1, Kun Wook Lee1, Seo Yeon Yoon1,2

  • 1Yonsei University College of Medicine, Department and Research Institute of Rehabilitation Medicine, Korea (the Republic of), Seodaemun-gu.

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|May 14, 2026
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Summary

Proprioceptive neuromuscular facilitation (PNF) and foam rolling (FR) best enhance long-term ankle flexibility. Foam rolling also excels in short-term gains, while static stretching aids long-term active range of motion maintenance.

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Area of Science:

  • Sports Medicine
  • Rehabilitation Science
  • Biomechanics

Background:

  • Ankle dorsiflexion range of motion (ROM) is crucial for athletic performance and injury prevention.
  • Various flexibility interventions exist, but their comparative effectiveness on ankle ROM requires synthesis.
  • Understanding optimal methods is key for clinicians and athletes.

Purpose of the Study:

  • To systematically review and network meta-analyze the effectiveness of five flexibility interventions on ankle dorsiflexion ROM.
  • To compare static stretching (SS), dynamic stretching (DS), ballistic stretching (BS), proprioceptive neuromuscular facilitation (PNF), and foam rolling (FR).
  • To rank interventions based on their impact on passive and active ROM.

Main Methods:

  • Systematic review and random-effects network meta-analysis following PRISMA 2020 guidelines.
  • Included 41 RCTs with 1,670 participants.
  • Intervention ranking using surface under the cumulative ranking curve (SUCRA).

Main Results:

  • For passive ROM (PROM), PNF (SUCRA 76.8%) and FR (67.8%) were most effective overall and in long-term protocols (>1 month).
  • For active ROM (AROM), FR (SUCRA 87.2%) showed the largest short-term improvement.
  • Static stretching (SS) demonstrated favorable long-term AROM maintenance (SUCRA 72.4%). No adverse events were reported.

Conclusions:

  • PNF and FR are optimal for long-term flexibility gains in ankle dorsiflexion.
  • FR is recommended for short-term improvements and pre-exercise preparation.
  • SS may be beneficial for sustained AROM maintenance over extended periods.