한국운동역학회지 (Korean Journal of Applied Biomechanics)

  • 제31권2호
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  • Pages.79-86
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  • 2021
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  • 1226-2226(pISSN)
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  • 2093-9752(eISSN)
한국운동역학회 (Korean Society of Applied Biomechanics)
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만성 발목 불안정성 환자군과 정상인 군의 발바닥 감각기능 저하에 따른 운동학적 보행 패턴의 변화

Plantar Hypoesthesia Alters Gait Kinematics Pattern in Individuals with and without Chronic Ankle Instability

  • Kang, Tae Kyu (Graduate School of Physical Education, Yonsei University) ;
  • Lee, Sae Yong (Graduate School of Physical Education, Yonsei University) ;
  • Lee, Inje (Graduate School of Physical Education, Yonsei University) ;
  • Kim, Byong Hun (Graduate School of Physical Education, Yonsei University) ;
  • Jeong, Hee Seong (Graduate School of Physical Education, Yonsei University) ;
  • Kim, Chang Young (Division of Sports, Myong-Ji University)
  • 투고 : 2020.08.31
  • 심사 : 2021.05.12
  • 발행 : 2021.06.30
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초록

Objective: The purpose of this study was to identify the effect of reduced plantar cutaneous sensation on gait kinematics during walking with and without CAI. Method: A total of 20 subjects involved in this study and ten healthy subjects and 10 CAI subjects participated underwent ice-immersion of the plantar aspect of the feet before walking test in this study. The gait kinematics were measured before and after ice-immersion. Results: We observed a before ice-immersion on plantar cutaneous sensation, CAI subject were found to reduced ankle dorsiflexion, knee external rotation, hip adduction, and internal rotation compared to control subject. After ice-immersion, CAI subjects were found to reduce knee external rotation, hip adduction. However, no significant ankle joint kinematics. Conclusion: While walking, gait pattern differences were perceived between groups with and without plantar cutaneous sensation. The results of the study may explain the abductions in the hip angle movements in CAI patients at initial contact compared to healthy subjects in the control group when plantar cutaneous sensation was reduced. A change in proximal joint kinematics may be a conservative strategy to promote normal gait patterns in CAI patients.

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참고문헌

  1. Boling, M. C., Padua, D. A., Marshall, S. W., Guskiewicz, K., Pyne, S. & Beutler, A. (2009). A prospective investigation of biomechanical risk factors for patellofemoral pain syndrome: the Joint Undertaking to Monitor and Prevent ACL Injury (JUMP-ACL) cohort. The American Journal of Sports Mediciene, 37(11), 2108-2116. https://doi.org/10.1177/0363546509337934
  2. Bullock-Saxton, J. E. (1994). Local sensation changes and altered hip muscle function following severe ankle sprain. Physical Therapy, 74(1), 17-28. https://doi.org/10.1093/ptj/74.1.17
  3. Carcia, C. R., Martin, R. L. & Drouin, J. M. (2008). Validity of the Foot and Ankle Ability Measure in athletes with chronic ankle instability. Journal of Athletic Training, 43(2), 179-183. https://doi.org/10.4085/1062-6050-43.2.179
  4. Chinn, L., Dicharry, J. & Hertel, J. (2013). Ankle kinematics of individuals with chronic ankle instability while walking and jogging on a treadmill in shoes. Physical Therapy in Sport, 14(4), 232-239. https://doi.org/10.1016/j.ptsp.2012.10.001
  5. Delahunt, E., Monaghan, K. & Caulfield, B. (2006). Altered neuro-muscular control and ankle joint kinematics during walking in subjects with functional instability of the ankle joint. The American Journal of Sports Mediciene, 34(12), 1970-1976. https://doi.org/10.1177/0363546506290989
  6. Denegar, C. R., Hertel, J. & Fonseca, J. (2002). The effect of lateral ankle sprain on dorsiflexion range of motion, posterior talar glide, and joint laxity. Journal of Orthopaedic & Sports Physical Therapy, 32(4), 166-173. https://doi.org/10.2519/jospt.2002.32.4.166
  7. Docherty, C. L., Gansneder, B. M., Arnold, B. L. & Hurwitz, S. R. (2006). Development and reliability of the ankle instability instrument. Journal of Athletic Training, 41(2), 154.
  8. Drewes, L. K., McKeon, P. O., Paolini, G., Riley, P., Kerrigan, D. C., Ingersoll, C. D. & Hertel, J. (2009). Altered ankle kinematics and shank-rear-foot coupling in those with chronic ankle instability. Journal of Sport Rehabilitation, 18(3), 375-388. https://doi.org/10.1123/jsr.18.3.375
  9. Dyck, P. J., O'brien, P., Kosanke, J., Gillen, D. & Karnes, J. (1993). A 4, 2, and 1 stepping algorithm for quick and accurate estimation of cutaneous sensation threshold. Neurology, 43(8), 1508-1508. https://doi.org/10.1212/WNL.43.8.1508
  10. Eils, E., Behrens, S., Mers, O., Thorwesten, L., Volker, K. & Rosenbaum, D. (2004). Reduced plantar sensation causes a cautious walking pattern. Gait & Posture, 20(1), 54-60. https://doi.org/10.1016/S0966-6362(03)00095-X
  11. Feger, M. A., Donovan, L., Hart, J. M. & Hertel, J. (2015). Lower extremity muscle activation in patients with or without chronic ankle instability during walking. Journal of Athletic Training, 50(4), 350-357. https://doi.org/10.4085/1062-6050-50.2.06
  12. Fong, D. T. P., Hong, Y., Chan, L. K., Yung, P. S. H. & Chan, K. M. (2007). A systematic review on ankle injury and ankle sprain in sports. Sports Medicine, 37(1), 73-94. https://doi.org/10.2165/00007256-200737010-00006
  13. Gribble, P., Hertel, J. & Denegar, C. (2007). Chronic ankle instability and fatigue create proximal joint alterations during performance of the Star Excursion Balance Test. International Journal of Sports Medicine, 28(03), 236-242. https://doi.org/10.1055/s-2006-924289
  14. Hertel, J. (2008). Sensorimotor deficits with ankle sprains and chronic ankle instability. Clinics in Sports Medicine, 27(3), 353-370. https://doi.org/10.1016/j.csm.2008.03.006
  15. Hertel, J. & Corbett, R. O. (2019). An updated model of chronic ankle instability. Journal of Athletic Training, 54(6), 572-588. https://doi.org/10.4085/1062-6050-344-18
  16. Hopkins, W., Marshall, S., Batterham, A. & Hanin, J. (2009). Progressive statistics for studies in sports medicine and exercise science. Medicine Science in Sports Exercise, 41(1), 3. https://doi.org/10.1249/MSS.0b013e31818cb278
  17. Kim, B. H., Kim, C. Y., Kang, T. K., Cho, Y. J. & Lee, S. Y. (2018). Immediate Effects of Joint Mobilization Techniques on Clinical Measures in Individuals with CAI. Korean Journal of Sport Biomechanics, 28(4), 219-225. https://doi.org/10.5103/KJSB.2018.28.4.219
  18. Kim, C. Y., Kang, T. K., Kim, B. H. & Lee, S. Y. (2019). The Effect of Diminished Plantar Cutaneous Sensation in Y-balance Test between Chronic Ankle Instability (CAI) Patients versus Healthy Individuals. Korean Journal of Sport Biomechanics, 29(1), 33-41. https://doi.org/10.5103/KJSB.2019.29.1.33
  19. Kim, C. Y., Ryu, J. H., Kang, T. K., Kim, B. H., Lee, S. C. & Lee, S. Y. (2019). The Structural Characteristics of the Ankle Joint Complex and Declination of the Subtalar Joint Rotation Axis between Chronic Ankle Instability (CAI) Patients and Healthy Control. Korean Journal of Sport Biomechanics, 29(2), 61-70. https://doi.org/10.5103/KJSB.2019.29.2.61
  20. Konradsen, L. (2002). Factors contributing to chronic ankle instability: kinesthesia and joint position sense. Journal of Athletic Training, 37(4), 381.
  21. Konradsen, L., Bech, L., Ehrenbjerg, M. & Nickelsen, T. (2002). Seven years follow-up after ankle inversion trauma. Scandinavian Journal of Medicine & Science in Sports, 12(3), 129-135. https://doi.org/10.1034/j.1600-0838.2002.02104.x
  22. Konradsen, L. & Voigt, M. (2002). Inversion injury biomechanics in functional ankle instability: a cadaver study of simulated gait. Scandinavian Journal of Medicine & Science in Sports, 12(6), 329-336. https://doi.org/10.1034/j.1600-0838.2002.00108.x
  23. Li, Z. M. (2006). Functional degrees of freedom. Motor Control, 10(4), 301-310. https://doi.org/10.1123/mcj.10.4.301
  24. Lim, S. G., Oh, D. W. & Shim, J. H. (2008). The Effect of 4-Week Proprioceptive Exercise Program in Patients with Ankle Sprain and Chronic Ankle Instability. Journal of Korean Physical Therapy Science, 15(3), 19-29.
  25. Monaghan, K., Delahunt, E. & Caulfield, B. (2006). Ankle function during gait in patients with chronic ankle instability compared to controls. Clinical Biomechanics, 21(2), 168-174. https://doi.org/10.1016/j.clinbiomech.2005.09.004
  26. Nawata, K., Nishihara, S., Hayashi, I. & Teshima, R. (2005). Plantar pressure distribution during gait in athletes with functional instability of the ankle joint: preliminary report. Journal of Orthopaedic Science, 10(3), 298-301. https://doi.org/10.1007/s00776-005-0898-4
  27. Siegel, N., Erickson, K., Thompson, J., Abraham, K., Telemeco, T. & Hale, S. (2009). Establishing the Foot and Ankle Disability Index as a sensitive, specific, and valid tool for identifying deficits related to chronic ankle instability. Journal of Athletic Training, 44(3S), S100-S101.
  28. Son, S. J., Kim, H., Seeley, M. K. & Hopkins, J. T. (2019). Altered walking neuromechanics in patients with chronic ankle instability. Journal of Athletic Training, 54(6), 684-697. https://doi.org/10.4085/1062-6050-478-17
  29. Van Emmerik, R. E., Hamill, J. & McDermott, W. J. (2005). Variability and coordinative function in human gait. Quest, 57(1), 102-123. https://doi.org/10.1080/00336297.2005.10491845
  30. Vicenzino, B., Branjerdporn, M., Teys, P. & Jordan, K. (2006). Initial changes in posterior talar glide and dorsiflexion of the ankle after mobilization with movement in individuals with recurrent ankle sprain. Journal of Orthopaedic & Sports Physical Therapy, 36(7), 464-471. https://doi.org/10.2519/jospt.2006.2265
  31. Yeung, M., Chan, K. M., So, C. & Yuan, W. (1994). An epidemiological survey on ankle sprain. British Journal of Sports Medicine, 28(2), 112-116. https://doi.org/10.1136/bjsm.28.2.112
  32. Yokoyama, S., Matsusaka, N., Gamada, K., Ozaki, M. & Shindo, H. (2008). Position-specific deficit of joint position sense in ankles with chronic functional instability. Journal of Sports Science & Medicine, 7(4), 480.