• 대한정형외과스포츠의학회지
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• 제3권2호
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• pp.118-127
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• 2004

The foot and ankle are one of the most common sites for acute musculoskeletal injuries related to sports activity. Foot and ankle injury includes ligament injury, tendon injury, bone and osteochondral injury, nerve injuy, heel pain syndrome, phalangeal injury. This is a article about nonoperative management of foot and ankle injury. Therefore, this article includes various exercise technique, range of motion, stretching for muscle relaxation, proprioception training for rehabilitation. We recommend that orthopedic surgeon should discuss with patient and specialist for treatment plan after foot and ankle injury

• 한국콘텐츠학회논문지
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• 제9권9호
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• pp.278-286
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• 2009

본 연구는 스트레칭이 $\alpha$-운동신경원의 흥분도를 변화시키는지의 여부와 이에 따른 유연성의 변화 정도를 알아보고자 시도되었다. 본 연구에서 $\alpha$-운동신경원 흥분도는 비복근 H-반사의 Hmax/Mmax 비로 측정하였으며 근육의 유연성은 족관절의 능동 배측굴곡 가동 범위를 통해 알아보았다. 스트레칭은 10명의 건강한 피검자를 대상으로 총 4분간(2분간의 스트레칭, 1분의 휴식, 2분간의 스트레칭), 각 시기별로 비복근에 적용하였다. $\alpha$-운동신경원 흥분도와 유연성을 분석하기 위해 본 연구에서는 스트레칭 적용 전, 1차 스트레칭 적용 직후, 2차 스트레칭 적용 직후, 그리고 2차 스트레칭 적용 후 48시간 후 Hmax/Hmax와 족관절의 능동 배측굴곡 각도를 측정하였다. 본 연구의 결과 1차와 2차 스트레칭 적용 후 의미 있는 $\alpha$-운동신경원 흥분도의 감소와 족관절 능동 배측굴곡 각도의 증가가 나타났으나 스트레칭을 소거한 48시간 후에는 $\alpha$-운동신경원 흥분도와 족관절의 능동 배측굴곡 가동 범위가 스트레칭 적용전과 비슷한 상태로 되돌아갔다. 이러한 스트레칭에 의한 비복근 $\alpha$-운동신경원 흥분도 감소와 이에 따른 족관절 배측굴곡 유연성 증가는 족관절 주변의 III형 기계적 수용기와 근육에 위치한 골지건 기관의 활성 결과로 사료된다.

• 대한족부족관절학회지
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• 제10권1호
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• pp.88-91
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• 2006

Purpose: To evaluate the effect on clinical course of heterotopic ossification of distal tibiofibular syndesmosis after ankle fractures. Materials and Methods: From June 2001 to May 2004, we found nine cases of heterotopic ossification of distal tibiofibular syndesmosis after ankle fractures. There were 8 male patients and 1 female patient; their mean age was 42 years old. There were 6 Weber type B and 2 Weber type C fractures, and there is 1 case with posterior malleolus fracture only. Among them, 8 ankle fractures were operated. Follow up period was averaged for 14 months. We were able to review radiographs at initial injury and to review clinical menifestation and radiographs at last follow up. We used an ankle-hindfoot scoring system of AOFAS which combined symptom, function and alignment with maximum score of 100 point. Results: In all cases ankle dorsiflexion and plantarflexion were not significantly different from that of the contralateral side. The patients who had developed heterotopic ossification in distal tibiofibular syndesmosis had a similar functional score. The mean ankle-hind foot score was 94 points. Conclusion: We concluded that the heterotopic ossification of distal tibiafibular syndesmosis after ankle fractures had little effect on clinical course and range of motion of ankle joint.

• 대한인간공학회지
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• 제24권4호
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• pp.55-62
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• 2005

This study examined the effect of ergonomic heel rest that was designed for drivers who have physical handicap in the low leg muscles or have to drive prolonged hours with frequent foot pedaling. An experiment was designed to test the ergonomic heel rest with traditional foot pedal. Forty subjects participated in the experiment. Electromyography(EMG) was used to monitor the muscle activity and fatigue of right leg, and Electro-goniometer was used to measure the ranges of motions of the knee and ankle. A simulator of driver's seat was built for the experiment and the heel rest was installed on it. In order to examine the low muscle activity and range of motion, subjects used the foot pedal for 15 minutes repetitively for each experimental condition. Another 15 minutes test without the heel rest was also performed for comparison. The Root Mean Square(RMS) and Mean Power Frequency(MPF) Shift were used to quantify the level of muscle activity and local muscle fatigue. In results, statistically significant decreases of muscle activity and fatigue were found in all the low leg muscles. The range of motion of the knee and ankle joint also decreased when the heel rest was used. The mechanism of the heel rest effect was discussed in this study. This type of heel rest can be applied to real driving situation after ensuring the safety, or overcoming the psychological discomfort possibly due to unfamiliarity.

• Physical Therapy Rehabilitation Science
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• 제10권1호
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• pp.1-9
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• 2021

Objective: Joint mobilization for arthrokinematics altered by the positional fault of chronic ankle instability (CAI) is an effective intervention for stabilization. In this study, we compared the effects of ankle dorsi flexion range of motion (DFROM) and dynamic balance ability (DBA) in CAI patients via passive joint mobilization (PJM), a method traditionally performed in previous studies, and active joint mobilization (AJM), a method that can have a greater effect on cortical excitability with spontaneous movements. Design: Single-blind two-arm randomized controlled trial Methods: A total of 30 participants were registered: 15 each to the PJM and AJM groups. Each participant received a total of 10 intervention sessions, 10 minutes per session, 5 times a week for 2 weeks. PJM used Maitland's mobilization method to apply joint mobilization with talus in the posterior direction and AJM used an angular joint motion to induce patient's voluntary motion of medial malleolus anterior gliding and lateral malleolus posterior gliding, respectively. DFROM of the ankle was measured by using tape and DBA was evaluated by using the balance system. Results: Significant improvement was observed after intervention in both the PJM and AJM groups except for the DBA-anterior and DBA-right variables of the PJM group. There were statistically significant differences between the AJM and PJM groups in the DFROM, DBA-anterior, DBA-posterior, and DBA-right variables. Conclusions: The overall improvement of DFROM and DBA was found to be more effective in joint mobilization including voluntary movement. When it is accompanied by voluntary movement, it further affects the neuromuscular system of the ankle.

• 대한족부족관절학회지
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• 제22권3호
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• pp.91-94
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• 2018

Ankle sprain is one of the most common musculoskeletal injuries. Although most ankle sprains respond well to conservative measures, chronic instability following an acute sprain has been reported to occur in 20% to 40% of patients. Some individuals are eventually indicated for a lateral ankle ligament reconstruction due to persistent ankle instability. More than 80 surgical procedures have been described to address lateral ankle stability. These range from direct repair of the anterior talofibular ligament (ATFL) and of the calcaneofibular ligament (CFL) to reconstructions based on the use of autograft or allograft tissues. However, the best surgical option remains debatable. The modified $Brostr{\ddot{o}}m$ procedure is most widely used for direct ligament repair, but not always possible because of the poor ATFL or CFL quality or deficiency of these ligaments, which prevents effective shortening imbrication. Furthermore, the importance of a CFL reconstruction has been emphasized recently. On the other hand, it is difficult to achieve an efficient CFL reconstruction during the $Brostr{\ddot{o}}m$ procedure. Others have reported that an anatomic reconstruction of injured ligaments restores the normal resistance to anterior translation and inversion without restricting subtalar or ankle motion, and as a result, anatomic reconstructions for lateral ankle instability utilizing an autograft or allograft tendon have gained popularity.

• 대한족부족관절학회지
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• 제4권2호
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• pp.61-66
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• 2000

Purpose: To evaluate the clinical validity of percutaneous screw fixation in Maisonneuve fracture. Material and Methods: Out of 5 Maisonneuve fracture patients hospitalized in the department of orthopedic surgery of Seigang hospital from February 1995 to May 1998, 4 patients were treated with percutaneous screw fixation and 1 patient was treated with percutaneous screw fixation and repair of deltoid ligament altogether. The results were evaluated on the clinical and radiological finding. Results: In all cases, the range of motion of ankle joint was normal, the complication such as postoperative pain and post-traumatic arthritis were not found. Widening of medial clear space or talar shift were not found in the follow up X-ray and tibiofibular distance, compared with normal ankle joint was same on follow up CT. Conclusion: Percutaneous screw fixation is simple, less invasive and more effective method in the treatment of Maisonneuve fracture.

• 대한정형도수물리치료학회지
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• 제23권2호
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• pp.9-16
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• 2017

Background: The purpose of this study was to investigate the relationship between the spine and the flat-foot, the stability and the alignment of the posture of the neck to prevent the alignment of the ankle joint operation and the lower back flexibility of the lumbar region according to the type of treatment using active stretching of the triceps, back pain, and to see how they affect weight bearing differences. Methods: The subjects of this study were 24 chronic low back pain patients. They were randomly divided into experimental group and control group. In the experimental group, ankle joint mobilization and active scraping of triceps were performed three times a week for a total of 6 weeks. The control group was performed in the same way without articulation. The range of flexion and extension motion of the lumbar spine and pain degree and difference of weight-bearing were measured before and after the experiment. Results: The model of ankle joint mobilization and calf muscle elongation of flat foot significantly improved the range of flexion and extension motion of the vertebrae (p<.05) and the VAS and distribution of weight-bearing were decreased in both of two groups (p<.05). In other words, the exercise and mobilization help to recover of the balance of the whole musculoskeletal, the vertebrae. Conclusions: The active exercise of the triceps muscle of the lower leg in this study It affects the flexibility of the lumbar spine, the pain and the difference in the weight support of the lower extremities, when we performed ankle joint mobilization for exercise and cramping, pain and the difference in weight support between the two lower limbs.

• 대한정형도수물리치료학회지
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• 제23권2호
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• pp.27-32
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• 2017

Background: The purpose of this study was to compare the effects of IASTM and static stretching techniques on ankle joint range of motion (ROM), static foot pressure. Methods: Twenty four subjects with gastrocnemius shortness participated in this study. The subjects were assigned randomly to one of two groups: The soft tissue mobilization technique (IASTM) group received intervention using a IASTM instrument for two minutes, and the stactic stretching group performed self stretching for 30 seconds, four times. The ROM of the ankle joint was measured by active ankle dorsi-flexion test, and a TPScan was utilized to collect the plantar foot pressure. This experiment was performed by two physical therapists. The significant level was set at ${\alpha}=.05$. Results: The results were as follows: 1) The ROM of the ankle joint and was significantly increased in both groups. 2) Plantar foot pressure was no significant in both groups. 3) There were no significant differences between the IASTM group and static stretching group for any variable. Conclusions: The results of this study suggest that static stretching is an effective and easy technique for restoring proper muscle length in subjects with gastrocnemius shortness. We recommend that static stretching technique be used for treat gastrocnemius shortness in clinical setting and home program.

• 융합정보논문지
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• 제9권10호
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• pp.220-226
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• 2019

본 연구는 발바닥 굽힘근에 저주파 치료인 경피신경전기자극과 중주파 치료인 간섭전류가 뇌졸중 환자의 보행 및 발목 관절가동범위에 즉각적인 영향을 미치는지 알고자 한다. 30명의 연구대상자는 경피신경전기자극군과 간섭전류군으로 동일하게 나누어 마비측 장딴지근에 각각 통전하였다. 60분 통전 직후 스마트폰을 이용한 보행 평가와 발등 굽힘 관절가동범위를 측정하였다. 연구결과 두 전기치료 방법 모두 보행속도, 분속수, 발목 관절가동범위에 유의한 증가를 보였다. 두 전기치료 방법 모두 뇌졸중 환자의 보행 및 발목 관절가동범위를 증가시킬 수 있는 중재 방법이었지만 두 전기치료방법 간의 차이는 더 많은 대상자 모집을 통해 확인되어야 할 것이다.