Similarities and differences in manual stretching of physical therapists for equinovarus

For equinovarus, a foot condition commonly suffered as a side effect of stroke, sustained muscle stretching is the primary form of treatment, most of which is manually performed by physical therapists (PTs). It is important to identify variations in the execution of manual stretching techniques by PTs for the standardization of therapeutic techniques. In this study, manual stretching motions performed by three PTs on one stroke survivor were analyzed in terms of foot posture and the force and torque applied to the diseased foot, which were measured through a motion capture system and instrumented foot brace. Statistical analyses based on the principal component analysis showed that many of the stretching motions of the PTs were similar in that they served to control the deformed foot. However, individual differences were observed in the force applied to the heel and the inversion and eversion torque around the ankle, suggesting that individual PTs may stretch different muscle groups. Furthermore, there are potential differences in the efficiency of stretching technique execution among PTs.