Rotating-pulling-poking manipulation in gait analysis for lateral ankle sprain treatment

doi:10.19852/j.cnki.jtcm.2025.03.019

Journal of Traditional Chinese Medicine ›› 2025, Vol. 45 ›› Issue (3): 667-675.DOI: 10.19852/j.cnki.jtcm.2025.03.019

Rotating-pulling-poking manipulation in gait analysis for lateral ankle sprain treatment

FENG Mingshan¹^,², WEN Haibao¹^,²(), ZHAO Wenlong³, HAN Changxiao¹^,², GAO Chunyu¹^,², LI Luguang¹^,², ZOU Jinqiao¹^,², DU Wuyin³, ZHU Liguo¹^,², GAO Jinghua¹^,²()

1 Department of Spine Surgery Ⅱ, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China
2 Beijing Key Laboratory of Digitalized Intelligent Traditional Chinese Medicine for Prevention and Treatment of Bone and Joint Degenerative Diseases, Beijing 100102, China
3 School of Acupuncture and Tuina, Beijing University of Chinese Medicine, Beijing 100102, China

Received:2024-03-18 Accepted:2024-06-29 Online:2025-06-15 Published:2025-05-21
Contact: WEN Haibao, Department of Spine Surgery Ⅱ, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China. Beijing Key Laboratory of Digitalized Intelligent Traditional Chinese Medicine for Prevention and Treatment of Bone and Joint Degenerative Diseases, Beijing 100102, China, 870717325@qq.coom;GAO Jinghua, Department of Spine Surgery II, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China. Beijing Key Laboratory of Digitalized Intelligent Traditional Chinese Medicine for Prevention and Treatment of Bone and Joint Degenerative Diseases, Beijing 100102, China, gaojinghua64@sina.com,Telephone: 84739194
Supported by:
National Traditional Chinese Medicine Inheritance and Innovation Team Project: Traditional Chinese Medicine Innovation Team for Prevention and Treatment of Bone and Joint Degenerative Diseases(ZYYCXTD-C-202003);National Natural Science Foundation of China: the study on the Quantification and Mechanism of the rotating-pulling-poking manipulation in the Treatment of Lateral Ankle Sprain(81473694);China Academy of Chinese Medical Sciences Science and Technology Innovation Project: Establishment and Promotion of a Simulation Operation Evaluation System for Rotating-pulling-poking Manipulation(CI2021A02015)

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Abstract

Abstract:

OBJECTIVE: To compare the changes in gait parameters before and after the treatment of lateral ankle sprain using the rotating-pulling-poking manipulation, and explore the potential bio-mechanical mechanism of this manipulation.
METHODS: Forty patients with lateral ankle sprains were randomly divided into two groups in a 1:1 ratio using a random number table. The experimental group were treated by rotating-pulling-poking manipulation and elastic bandage external fixation, while the control group were treated by ice compress and elastic bandage external fixation. The treatment courses of the two groups were both 2 weeks. We used a three-dimensional motion capture system for kinematic measurements and a Bertec gait analysis force measurement system for mechanical measurements, and compared the changes in gait parameters between the two groups of patients before and after treatment.
RESULTS: Intragroup comparison showed that the support time, swing time, peak of back extension, peak of plantar flexion, peak of toe pedal force, and peak of heel landing force of the affected feet in the experimental group were significantly improved compared to those before treatment (P < 0.05). The swing time of the affected feet in the control group was significantly improved compared to that before treatment (P < 0.05). The inter group comparison showed that the gait speed, stride length, peak of back extension, peak of plantar flexion, peak of toe pedal force, and peak of heel landing force of the affected feet in the experimental group were significantly better than those in the control group (P < 0.05).
CONCLUSIONS: The rotating-pulling-poking manipulation can effectively improve the patient's gait and range of motion of the affected ankle joint, and enhance the negative gravity in the vertical direction of the affected foot, and the braking and driving forces in the front and back directions. This may be the potential biomechanical mechanism of the rotating-pulling-poking manipulation for treating lateral ankle sprain.

Key words: gait analysis, rotating-pulling-poking manipulation, lateral ankle sprain

FENG Mingshan, WEN Haibao, ZHAO Wenlong, HAN Changxiao, GAO Chunyu, LI Luguang, ZOU Jinqiao, DU Wuyin, ZHU Liguo, GAO Jinghua. Rotating-pulling-poking manipulation in gait analysis for lateral ankle sprain treatment[J]. Journal of Traditional Chinese Medicine, 2025, 45(3): 667-675.

Figures/Tables 6

References 31.

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Characteristic	Experimental group (n = 20)	Control group (n = 20)	P value
Age (years)	32.55±9.67	31.45±8.40	0.914
Gender (male/female)	9/11	12/8	0.752
Affected side (left/right)	15/5	9/11	0.439
Height (cm)	1.68±0.10	1.69±0.10	0.769
Weight (kg)	68.87±17.87	66.45±12.33	0.499
Walking cycle (s)	1.24±0.16	1.32±0.26	0.234
Support time (s)	0.73±0.12	0.80±0.16	0.186
Swing time (s)	0.51±0.09	0.51±0.13	0.969
Stride speed (m/s)	0.78±0.23	0.74±0.22	0.393
Stride frequency (times/s)	0.81±0.09	0.78±0.12	0.253
Stride length (cm)	0.45±0.11	0.43±0.09	0.446
Stride width (cm)	0.14±0.06	0.15±0.04	0.130
Peak of back extension (°)	19.50±9.27	16.61±7.19	0.209
Peak of plantar flexion (°)	24.27±7.82	23.92±6.43	0.547
Heel landing force on vertical axis (N/kg)	10.27±0.63	10.17±1.05	0.753
Heel landing force on sagittal axis (N/kg)	1.30±0.20	1.25±0.22	0.573
Heel landing force on coronal axis (N/kg)	0.90±0.16	0.83±0.13	0.200
Force of foot tip to ground on vertical axis (N/kg)	10.41±0.52	10.50±0.82	0.748
Force of foot tip to ground on sagittal axis (N/kg)	1.23±0.49	1.33±0.39	0.513
Force of foot tip to ground on coronal axis (N/kg)	0.85±0.14	0.81±0.15	0.413

Characteristic	Experimental group (n = 20)	Control group (n = 20)	P value
Age (years)	32.55±9.67	31.45±8.40	0.914
Gender (male/female)	9/11	12/8	0.752
Affected side (left/right)	15/5	9/11	0.439
Height (cm)	1.68±0.10	1.69±0.10	0.769
Weight (kg)	68.87±17.87	66.45±12.33	0.499
Walking cycle (s)	1.24±0.16	1.32±0.26	0.234
Support time (s)	0.73±0.12	0.80±0.16	0.186
Swing time (s)	0.51±0.09	0.51±0.13	0.969
Stride speed (m/s)	0.78±0.23	0.74±0.22	0.393
Stride frequency (times/s)	0.81±0.09	0.78±0.12	0.253
Stride length (cm)	0.45±0.11	0.43±0.09	0.446
Stride width (cm)	0.14±0.06	0.15±0.04	0.130
Peak of back extension (°)	19.50±9.27	16.61±7.19	0.209
Peak of plantar flexion (°)	24.27±7.82	23.92±6.43	0.547
Heel landing force on vertical axis (N/kg)	10.27±0.63	10.17±1.05	0.753
Heel landing force on sagittal axis (N/kg)	1.30±0.20	1.25±0.22	0.573
Heel landing force on coronal axis (N/kg)	0.90±0.16	0.83±0.13	0.200
Force of foot tip to ground on vertical axis (N/kg)	10.41±0.52	10.50±0.82	0.748
Force of foot tip to ground on sagittal axis (N/kg)	1.23±0.49	1.33±0.39	0.513
Force of foot tip to ground on coronal axis (N/kg)	0.85±0.14	0.81±0.15	0.413

Characteristic		Experimental group (n = 20)		P value	Control group (n = 20)		P value
Characteristic		Before treatment	After treatment	P value	Before treatment	After treatment	P value
Kinematic parameters	Walking cycle (s)	1.24±0.16	1.24±0.11	0.919	1.32±0.26	1.33±0.29	0.835
	Support time (s)	0.73±0.12	0.79±0.10	0.021	0.80±0.16	0.89±0.27	0.168
	Swing time (s)	0.51±0.09	0.44±0.06	0.001	0.51±0.13	0.44±0.08	0.015
	Stride speed (m/s)	0.78±0.23	0.83±0.16	0.311	0.74±0.22	0.67±0.27	0.316
	Stride frequency (times/s)	0.81±0.09	0.81±0.07	0.940	0.78±0.12	0.78±0.13	0.990
	Stride length (cm)	0.45±0.11	0.47±0.09	0.282	0.43±0.09	0.39±0.13	0.187
	Stride width (cm)	0.14±0.06	0.14±0.06	0.848	0.15±0.04	0.15±0.12	0.942
	Peak of back extension (°)	19.50±9.27	29.18±4.99	0.001	16.61±7.19	21.00±8.83	0.090
	Peak of plantar flexion (°)	24.27±7.82	34.89±4.24	0.001	23.92±6.43	25.00±10.79	0.661
Mechanical parameters	Heel landing force on vertical axis (N/kg)	10.27±0.63	11.29±0.67	0.003	10.17±1.05	10.70±0.71	0.111
	Heel landing force on sagittal axis (N/kg)	1.30±0.20	1.71±0.49	0.004	1.25±0.22	1.37±0.41	0.420
	Heel landing force on coronal axis (N/kg)	0.90±0.16	0.89±0.29	0.913	0.83±0.13	0.83±0.21	0.917
	Force of foot tip to ground on vertical axis (N/kg)	10.41±0.52	11.40±0.50	0.001	10.50±0.82	10.69±1.00	0.535
	Force of foot tip to ground on sagittal axis (N/kg)	1.23±0.49	1.85±0.37	0.002	1.33±0.39	1.46±0.58	0.589
	Force of foot tip to ground on coronal axis (N/kg)	0.85±0.14	0.87±0.21	0.767	0.81±0.15	0.84±0.19	0.664

Characteristic		Experimental group (n = 20)		P value	Control group (n = 20)		P value
Characteristic		Before treatment	After treatment	P value	Before treatment	After treatment	P value
Kinematic parameters	Walking cycle (s)	1.24±0.16	1.24±0.11	0.919	1.32±0.26	1.33±0.29	0.835
	Support time (s)	0.73±0.12	0.79±0.10	0.021	0.80±0.16	0.89±0.27	0.168
	Swing time (s)	0.51±0.09	0.44±0.06	0.001	0.51±0.13	0.44±0.08	0.015
	Stride speed (m/s)	0.78±0.23	0.83±0.16	0.311	0.74±0.22	0.67±0.27	0.316
	Stride frequency (times/s)	0.81±0.09	0.81±0.07	0.940	0.78±0.12	0.78±0.13	0.990
	Stride length (cm)	0.45±0.11	0.47±0.09	0.282	0.43±0.09	0.39±0.13	0.187
	Stride width (cm)	0.14±0.06	0.14±0.06	0.848	0.15±0.04	0.15±0.12	0.942
	Peak of back extension (°)	19.50±9.27	29.18±4.99	0.001	16.61±7.19	21.00±8.83	0.090
	Peak of plantar flexion (°)	24.27±7.82	34.89±4.24	0.001	23.92±6.43	25.00±10.79	0.661
Mechanical parameters	Heel landing force on vertical axis (N/kg)	10.27±0.63	11.29±0.67	0.003	10.17±1.05	10.70±0.71	0.111
	Heel landing force on sagittal axis (N/kg)	1.30±0.20	1.71±0.49	0.004	1.25±0.22	1.37±0.41	0.420
	Heel landing force on coronal axis (N/kg)	0.90±0.16	0.89±0.29	0.913	0.83±0.13	0.83±0.21	0.917
	Force of foot tip to ground on vertical axis (N/kg)	10.41±0.52	11.40±0.50	0.001	10.50±0.82	10.69±1.00	0.535
	Force of foot tip to ground on sagittal axis (N/kg)	1.23±0.49	1.85±0.37	0.002	1.33±0.39	1.46±0.58	0.589
	Force of foot tip to ground on coronal axis (N/kg)	0.85±0.14	0.87±0.21	0.767	0.81±0.15	0.84±0.19	0.664

Characteristic		Experimental group (n = 20)	Control group (n = 20)	P value
Kinematic parameters	Walking cycle (s)	1.24±0.11	1.33±0.29	0.994
	Support time (s)	0.79±0.10	0.89±0.27	0.938
	Swing time (s)	0.44±0.06	0.44±0.08	0.891
	Stride speed (m/s)	0.83±0.16	0.67±0.27	0.030
	Stride frequency (times/s)	0.81±0.07	0.78±0.13	0.981
	Stride length (cm)	0.47±0.09	0.39±0.13	0.010
	Stride width (cm)	0.14±0.06	0.15±0.12	0.816
	Peak of back extension (°)	29.18±4.99	21.00±8.83	0.001
	Peak of plantar flexion (°)	34.89±4.24	25.00±10.79	0.001
Mechanical parameters	Heel landing force on vertical axis (N/kg)	11.29±0.67	10.70±0.71	0.026
	Heel landing force on sagittal axis (N/kg)	1.71±0.49	1.37±0.41	0.043
	Heel landing force on coronal axis (N/kg)	0.89±0.29	0.83±0.21	0.561
	Force of foot tip to ground on vertical axis (N/kg)	11.40±0.50	10.69±1.00	0.027
	Force of foot tip to ground on sagittal axis (N/kg)	1.85±0.37	1.46±0.58	0.041
	Force of foot tip to ground on coronal axis (N/kg)	0.89±0.24	0.83±0.18	0.676

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References 31.

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