背景及目的：探討護理之家住民六個月期間踝背屈被動角度的改變情形，尋找可預測改變之預測因子。方法：共徵召51名住民參與研究，完成六個月後測者僅17名，其平均年齡為74.2歲，年齡範圍在55至93歲之間的11位男性和6位女性護理之家住民參與完成本研究。由同一位施測者收集住民基本資料、活動情形、物理檢查及物理治療介入與踝背屈被動關節角度，並於六個月後再測量其踝背屈被動關節角度。以成對樣本t檢定來描述六個月當中踝背屈被動角度的改變情形，再以邏輯廻歸分析來找出可能影響其改變之預測因子。結果：17名住民之34隻腳數中，12隻腳(35.3%)有惡化的現象，而成對樣本t檢定顯示在六個月當中，護理之家住民的踝背屈被動關節角度前測平均為－9.4度，六個月後平均為－13.7度，顯示前後兩次測量角度，有明顯的差異(t=2.535, P<0.05)。邏輯迴歸分析顯示，造成踝背屈被動關節角度下降的預測因子主要為踝蹠屈肌張力正常與否。結論：本研究發現踝蹠屈肌張力正常與否是護理之家住民六個月期間踝背屈被動關節角度是否惡化的重要預測因子，這個發現的臨床意義是提醒臨床工作者，能早期警覺關節角度的惡化及篩檢出會產生角度惡化的關節，以早期介入治療達到預防惡化的目的。

Purpose: The aims of this study were to describe the changes of passive range of motion (PROM, measured in degrees) over 6-month period for ankle dorsiflexion and to identify potential prognostic factors in nursing home residents. Methods: Fifty-one subjects were recruited among the residents of a nursing home during the pretest, but only 17 subjects completed the 6-month posttest (mean age=74.2 years old; 11 males, 6 females). The following data were collected from each resident: demographic characteristics; mobility status (Postural Assessment Scale for Stroke patients, PASS); physical examination (pain status, muscle tone, strength, timed up and go test, Barthel Index, etc.); duration of physical therapy interventions (min); passive joint ranges motion of bilateral ankle dorsiflexion and plantarfiexion. The passive ranges of motion were measured again after 6 months. One sample t test was used to determine the effects of time on the changes of ankle PROMs. Binary logistic regression models were used to analyze the prognostic factors for ankle dorsiflexion deterioration. Results: Deterioration was evident in 12 of 34 (35.3%) PROM of ankle dorsiflexion. Mean of the first-time measure of PROM of ankle dorsiflexion was-9.4 degrees, and Mean of the second-time measure of PROM of ankle dorsiflexion was -13.7 degrees. One sample t-test revealed that the PROM of the ankle dorsiflexion decreased significantly over 6 months (t=2.535, p<0.05). Longer length of stay and onset of diseases, worse mobility status (lesser PASS scores and both L/E weight bearing ability), weaker ankle dorsiflexor and higher muscle tone over ankle plantarfiexor were correlated to contracture of ankle PROMs. Binary logistic regression model revealed that the occurrence of ankle dorsiflexion range deterioration is higher if abnonnal muscle tone over ankle plantarflexor was detected (odds ratior6.329; 95%CI 1.202 to 33.333), Conclusions: Nursing home residents demonstrated significant deteriorations in ankle dorsiflexion in 6 months duration. Higher muscle tone over ankle plantarflexor was the main prognostic factors for ankle joint range deteriorations. Thus we should screen and detect the residents with the prognostic factor and provide appropriate intervention early to prevent the occurrence of contracture in nursing home residents.