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기능적 발목 불안정성시 하지 근피로에 의한 동적균형이 족저압에 미치는 영향

The Effect of the Plantar Pressure on Dynamic Balance by Fatigue of Leg in the Subjects with Functional Ankle Instability

  • 김호성 (을지대학교 물리치료학과)
  • 투고 : 2015.07.15
  • 심사 : 2015.09.01
  • 발행 : 2016.01.28

초록

본 연구는 기능적 발목 불안정성시 하지 근피로도에 따른 동적균형이 족저압에 미치는 영향에 대해 알아보고자 하였다. 본 연구는 설문조사를 통해 기능적 발목 불안정성으로 진단된 14명의 발목불안정집단과 16명의 발목안정집단 총 30명을 대상으로 실시하였다. 하지의 근피로는 Biodex system III, 족저압은 Zebris FDM-S system으로 측정하였고, 한발로 점프 후 착지 검사로 동적균형을 실시하였다. 동적균형시 족저압 분포비율은 발목불안정집단의 전족부(p2, p3, p4)에서 높게 나타났다(p<0.05). 동적균형시 근피로 유발 전후 족저압 분포 비율은 발목 불안정집단에서 발목 안정집단보다 전족부(p2, p3, p4)와 외측 중족부(p6)에서 유의하게 높았으나 종골부(p7)에서는 낮았다(p<0.05). 동적균형시 족저압 중심(CoP)의 전후이동거리(AP)와 좌우이동 폭(ML)은 발목 불안정집단이 발목 안정집단에 비해 근피로 유발 전보다 유발 후 유의하게 길었다(p<0.05). 기능적 발목불안정시 하지 근피로도에 따른 동적균형은 족저압 분포와 족저압 중심이동에 영향을 준 것으로 사료된다. 향후, 기능적 발목 불안정이 있는 다양한 연령대를 대상으로 족저압 차이를 객관화, 척도화 시키는 연구가 이루어져야 할 것으로 사료된다.

Purpose : The present study was aimed at investigating the plantar pressure on dynamic balance of subjects with functional ankle instability following fatigue of lower leg. Methods : The subjects(30 university students) were divided into 2 groups ; functional ankle instability group(7males and 7females) and ankle stable group(9males & 7females) who could evaluate questionnaire. All the participants were evaluated muscle fatigue of lower leg by Biodex system III and distribution of plantar pressure by Zebris FDM-S system, The dynamic balance was tested by single-leg jump landing. This study were to measure of plantar pressure on dynamic balance with the difference between FAIG and control group following muscle fatigue. Results : In functional ankle instability group(FAIG), the post-fatigue was significantly higher than pre-fatigue in forefoot(p2,p3,p4) of plantar pressure on dynamic balance(p<0.05). The FAIG was significantly higher than the ASG in forefoot(p2, p3, p4) & lat midfoot(p6) of plantar pressure after fatigue in dynamic balance(p<0.05). The FAIG was significantly longer than the ASG in anteroposterior(AP) & mediolateral(ML) distance on center of pressure(CoP) after fatigue in dynamic balance(p<0.05). Conclusion : This study showed that FAIG were effected plantar pressure and center of pressure(CoP) by dynamic balance following muscle fatigue. Further study is needed to measure various age & work with ankle instability for clinical application.

키워드

참고문헌

  1. G. Lentell, B. Baas, D. Lopez, L McGuire, M. Sarrels, and P. Snyder, "The contributions of proprioceptive deficits, muscle function, and anatomic laxity to functional in stability of the ankle," Orthop Sports Phys Ther, Vol.21, No.4, pp.206-215, 1995. https://doi.org/10.2519/jospt.1995.21.4.206
  2. E. Eils and D. Rosenbaum, "A multi-station proprioceptive exercise program in patients withankle instability," Med Sci Sports Exerc, Vol.33, No.12, pp.1991-1999, 2001. https://doi.org/10.1097/00005768-200112000-00003
  3. T. J. Hubbard, L. C. Kramer, C. R. Denegar, and J. Hertel, "Correlations among multiple measures of functional and mechanical instability in subjects with chronic ankle instability," J Athl Train, Vol.42, No.3, pp.361-366, 2007.
  4. C. L. Docherty, T. C. Valovich McLeod, and S. J. Shultz, "Postural control deficits in participants with functional ankle in stability as measured by the balance error scoring system," Clin J Sport Med, Vol.16, No.3, pp.203-208, 2006. https://doi.org/10.1097/00042752-200605000-00003
  5. C. N. Brown and R. Mynark, "Balance deficits in recreational athletes with chronic ankle in stability," J Athl Train, Vol.42, No.3, pp367-373, 2007.
  6. T. A. McLoda, J. M. Stanek, A. J. Hansen, and S. T. McCaw, "A task failure has no effect on the electro mechanical delay of the peroneus longus," Electromyogr Clin Neurophysiol, Vol.49, No.2-3, pp.109-115, 2009.
  7. R. B. 3rd. Johnston RB 3rd, M. E. Howard, P. W. Cawley, and G. M. Losse, "Effect of lower extremity muscular fatigue on motor control performance," Med Sci Sports Exerc, Vol.30, No.12, pp.1703-1707, 1999. https://doi.org/10.1097/00005768-199812000-00008
  8. J. A. Yaggie and S. J. McGregor, "Effects of iso kinetic ankle fatigue on the maintenance of bal ance and postural limits, "Arch Phys Med Rehabil, Vol.83, No.2, pp.224-228, 2002. https://doi.org/10.1053/apmr.2002.28032
  9. S. Rozzi, P. Yuktanandana, and D. Pincivero, "Role of fatigue on proprioception and neromuscular control. In: Lephart S, Fu F, eds. Proprioception and Neuromuscular Control in Joint Stability," Champaign, IL: Human Kinetics, pp.375-393, 2000.
  10. P. A. Gribble, J. Hertel, and C. R. Denegar, "Chronic ankle instability and fatigue create proximal joint alterations during performance of the Star Excursion Balance Test," Int J Sports Med, Vol.29, No.3, pp.236-242, 2007.
  11. A. Gefen, "Biomechanical analysis of fatigue-related foot injury mechanisms in athletes and recruits during intensive marching," Med Biol Eng Comput," Vol.40, No.3, pp.302-310, 2002. https://doi.org/10.1007/BF02344212
  12. R. Lidor and G. Ziv, "Physical and physiological attributes of female volleyball players a review," J Strength Cond Res, Vol.24, No.7, pp.1963-1973, 2010. https://doi.org/10.1519/JSC.0b013e3181ddf835
  13. F. Mohammadi and A. Roozdar, "Effects of fatigue due to contraction of evertor muscles on the ankle joint position sense in male soccer players," Am J Sports Med, Vol.38, No.4, pp.824-829, 2010. https://doi.org/10.1177/0363546509354056
  14. J. Nyland, S. Smith, K. Beickman, T. Armsey, and D. N. Caborn, "Frontal plane knee angle affects dynamic postural control strategy during unilateral stance," Med Sci Sports Exerc, Vol.34, No.7, pp.1150-1157, 2002. https://doi.org/10.1097/00005768-200207000-00016
  15. M. M. Rodgers, "Dynamic foot biomechanics, J Orthop Sports Phys Ther, Vol.21, No.6, pp.306-316, 1995. https://doi.org/10.2519/jospt.1995.21.6.306
  16. N. M. Stolwijk, J. Duysens, J. W. Louwerens, and N. L. Keijsers, "Plantar Pressure Changes after Long Distance Walking," Med Sci Sports Exerc, Vol.42, No.12, pp.2264-2272, 2010. https://doi.org/10.1249/MSS.0b013e3181e305f4
  17. N. Vuillerme, N. Forestier, and V. Nougier, "Attentional demands and postural sway: the effect of the calf muscles fatigue," Med Sci Sports Exerc, Vol.34, No.12, pp.1907-1912, 2002. https://doi.org/10.1097/00005768-200212000-00008
  18. M Bisiaux and P Moretto, "The effects of fatigue on plantar pressure distribution in walking, Gait Posture," Vol.29, No.4, pp.693-699, 2009.
  19. R. Bizid, E. Margnes, Y. François, J. L. Jully, G. Gonzalez, P. Dupui, and T. Paillard, "Effects of knee and ankle muscle fatigue on postural control in the unipedal stance," Eur J Appl Physiol, Vol.106, No.3, pp.375-380, 2009. https://doi.org/10.1007/s00421-009-1029-2
  20. P. A. Gribble and J. Hertel, "Effect of low er-extremity muscle fatigue on postural control," Arch Phys Med Rehabil, Vol.85, No.4, pp.589-592, 2004. https://doi.org/10.1016/j.apmr.2003.06.031
  21. T. W. Kaminski, B. D. Buckley, M. E. Powers, T. J. Hubbard, and C. Ortiz, "Effect of strength and proprioception training on eversion to inversion strength ratios in subjects with unilateral functional ankle instability," Br J Sports Med, Vol.37, No.5, pp.410-415, 2003. https://doi.org/10.1136/bjsm.37.5.410
  22. L. Lauttamus, O. Korkala, and P. Tanskanen, "Lateral ligament injuries of the ankle," Surgical treatment of late cases, Ann Chir Gynaecol, Vol.71, No.3, pp.164-167, 1992.
  23. R. L. Brand, H. M. Black, and J. S. Cox, "The natural history of inadequately treated ankle sprain," Am J Sports Med, Vol.5, No.6, pp.248-249, 1997. https://doi.org/10.1177/036354657700500609
  24. H. F. Riegler, "Reconstruction for lateral in stability of the ankle," J Bone Joint Surg Am, Vol.66, No.3, pp.336-339, 1984. https://doi.org/10.2106/00004623-198466030-00003
  25. J. R. Cass, B. F. Morrey, Y. Katoh, and E. Y. Chao, "Ankle instability: comparison of primary repair and delayed reconstruction after long-term follow-up study," Clin Orthop Relat Res, Vol.198, pp110-110, 1985.
  26. S. E. Ross, K. M. Guskiewicz, and B. Yu, "Single-leg jump-landing stabilization times in subjects with functionally unstable ankles," J Athl Train, Vol.40, No.4, pp.299-304, 2005.
  27. S. L. Yniguez, The effects of fatigue on plantar pressure distribution in subjects with chronic ankle instability after jump landing task, Masters of Science degree in Exercise Science in the University of Toledo, 2011.
  28. E. Kellis, "Plantar pressure distribution during bare foot standing, walking and landing in pre school boys," Gait Posture, Vol.14, No.2, pp.92-97, 2001. https://doi.org/10.1016/S0966-6362(01)00129-1
  29. J. T. Han and G. Whangbo, "Analysis of plantar foot pressure and pathway of COP depending on in clination of descending ramp," International Journal of Contents, Vol.10, No.8, pp.92-97, 2010.
  30. M. Beaulieu, P. Allard, M Simoneau, G. Dalleau, F. A. Hazime, and C. H. Rivard, "Relationship between oscillations about the vertical axis and center of pressure displacements in single and double leg upright stance," Am J Phys Med Rehabil, Vol.89, No.10, pp.809-816, 2010. https://doi.org/10.1097/PHM.0b013e3181f1b4af
  31. H. S. Zhu, J. J. Wertsch, G. F. Harris, J. D. Loftsgaarden, and M. B. Price, "Foot pres sure distribution during walking and shuffling," Arch Phys Med Rehabil, Vol.72, No.6, pp.390-397, 1991.
  32. D. C. Dickin and J. B. Doan, "Postural stability in altered and unaltered sensory environments following fatiguing exercise of lower extremity joints," Scand J Med Sci Sports. Vol.18, No.6, pp.765-772, 2009.
  33. S. Khamis and Z. Yizhar, "Effect of feet hypepro nation on pelvic alignment in a standing position," Gait & Posture, Vol.25, No.25, pp.127-134, 2007. https://doi.org/10.1016/j.gaitpost.2006.02.005
  34. A. Nagel, F. Fernholz, C. Kibele, and D. Rosenbaum, "Long distance running increases plantar pressures beneath the metatarsal heads: a barefoot walking investigation of 200 marathon runners," Gait Posture, Vol.27, No.1, pp.152-155, 2008. https://doi.org/10.1016/j.gaitpost.2006.12.012
  35. P. F. Meyer, L. I. Oddsson, and C. J. De Luca, "Reduced plantar sensitivity alters postural responses to lateral perturbations of balance," Exp Brain Res, Vol.157, No.4, pp.526-536, 2004. https://doi.org/10.1007/s00221-004-1868-3
  36. C. J. L. Sneyers, R. Lysens, H. Feys, and R. Andries, "Influence of malalignment of feet on the plantar pressure pattern in running," Foot Ankle Int, Vol.16, No.10, pp.624-632, 1995. https://doi.org/10.1177/107110079501601008
  37. M. N. Orlin and T. G. McPoil, "Plantar pressure assessment," Phys Ther, Vol.80, No.4, pp.399-409, 2000. https://doi.org/10.1093/ptj/80.4.399
  38. K. Davids, P. Glazier, and D. Araujo, and R. Bartlett, "Movement systems as dynamical systems: the functional role of variability and its implications for sports medicine," Sports Med, Vol.33, No.4, pp.245-260, 2003. https://doi.org/10.2165/00007256-200333040-00001
  39. E. Coventry, K. M. O'Connor, B. A. Hart, J. E. Earl, and K. T. Ebersole, "The effect of lower extremity fatigue on shock attenuation during single-leg landing," Clin Biomech(Bristol, Avon), Vol.21, No.10, pp.1090-1097, 2006. https://doi.org/10.1016/j.clinbiomech.2006.07.004
  40. J. Augustsson, R. Thomee, C. Linden, M. Folkesson, R. Tranberg, and J. Karlsson, "Single-leg hop testing following fatiguing exercise: reliability and biomechanical analysis," Scand J Med Sci Sports, Vol.16, No.2, pp.111-120, 2006. https://doi.org/10.1111/j.1600-0838.2005.00446.x
  41. C. R. Young, "The F-SCAN system of foot pressure analysis," Clin Podiatr Med Surg, Vol.10, No.3, pp.455-461, 1993.
  42. C. N. Brown, B. Bowser, and K. Simpson, "Movement variability during single leg jump landings in individuals with and without chronic ankle instability," Clin Biomech(Bristol, Avon), Vol.27, No.1, pp.52-63, 2011. https://doi.org/10.1016/j.clinbiomech.2011.07.012
  43. T. Willems, E. Witvrouw, J. Verstuyft, P. Vaes and D. De Clercq, "Proprioception and Muscle Strength in Subjects With a History of Ankle Sprains and Chronic Instability," J Athl Train, Vol.37, No.4, pp.487-493, 2002.