• Research in Community and Public Health Nursing
• /
• v.30 no.1
• /
• pp.47-56
• /
• 2019

Purpose: This study was performed to evaluate effects of a stim-up matt walking exercise program on balance and gait of the frail elderly. Methods: A total of 37 elderly people recruited from S city were randomly assigned to the experimental group (n=22) and control group (n=15). The stim-up matt walking exercise program was offered twice a week for 8 weeks. Data were analyzed by SPSS 21.0. Results: The dynamic balance ability Timed Up and Go test of the experimental group was significantly faster than that of the control group (t=21.72, p<.001). The static balance ability open-eye standing test (t=44.15, p<.001) and close-eye standing test (t=9.01, p=.005) also showed increase in effects of the experimental group. In the walking ability, gait cycle (t=2.48, p=.018), cadence (t=-2.21, p=.034) and gait speed (t=-2.78, p=.009), positive effects were on. However, no statistically significant differences were found in stride length and double support. At the ankle joint range left ankle plantar flexion (t=3.92, p<.001) and left ankle dorsal flexion (t=4.51, p<.001) were higher in the experimental group than in the control group, and also right ankle plantar flexion (t=2.79, p=.008) and right ankle dorsal flexion (t=2.92, p=.006) increased in the experimental group. Conclusion: The significance of this study is that the stim-up matt walking exercise program for the frail elderly proves to be useful for improving balance and walking.

• Journal of Korean Foot and Ankle Society
• /
• v.26 no.1
• /
• pp.16-21
• /
• 2022

When an ankle lateral malleolar fracture is accompanied by a deltoid ligament rupture without a medial malleolar fracture, such an injury is called a bimalleolar equivalent fracture. This means that even if there is no bony injury on the medial side, there may be functional instability of the ankle joint due to damage to the deltoid ligament. Manual or gravity external rotational stress radiography is used to differentiate an ankle bimalleolar equivalent fracture from an isolated lateral malleolar fracture. If the medial joint gap is widened on the stress radiography, the deltoid ligament injury can be diagnosed, and surgical treatment for fibula fractures is recommended. After open reduction of the fibula fracture (with syndesmotic fixation if needed), a decision on the repair of the deltoid ligament is taken depending on the surgeons' preference and intraoperative findings. The deltoid ligament repair is performed by inserting a suture anchor (or anchors) in the medial malleolus and fixing the deep and superficial deltoid ligaments to the medial malleolus. The only randomized study to evaluate the utility of deltoid ligament sutures in ankle fractures did not support the deltoid ligament suture, but the study itself had many limitations. An appropriately powered, randomized, controlled trial of the deltoid ligament repair with both patient-reported outcome and radiographic outcome evaluation is needed in the future.

• Journal of Korean Physical Therapy Science
• /
• v.28 no.2
• /
• pp.30-39
• /
• 2021

Background: The purpose of this study was to compare the differences in gait and mobility according to the types of assistive device for ankle joint including ankle foot orthosis (AFO), non-elastic tape, elastic tape, and high ankle shoes in chronic hemiplegic stroke survivors. Design: A cross-over design. Methods: Twelve hemiplegic stroke survivors participated in this study, and they walked under 5 different conditions including bare feet, wearing a AFO, wearing a non-elastic tape, wearing a elastic tape, and wearing a high ankle shoes. During the participants walked, the spatio-temporal gait analysis and mobility examinations were performed. For the spatio-temporal gait analysis (gait velocity and cadence, step length, stride length, and single and double leg support time) and mobility examinations, the gait mat, TUG and TUDS were used. Results: As s results, on the AFO, non-elastic tape, elastic tape, and high ankle shoes, there were significantly differences in the all spatio-temporal gait parameters, TUG, and TUDS compared to barefoot (p<0.05). In particular, all spatio-temporal gait parameters, TUG, TUDS were significantly improved with AFO compared to barefoot. TUG was significantly improved with AFO compared to non-elastic tape, TUG and TUDS were significantly improved with AFO compared to elastic tape, gait velocity was significantly improved with non-elastic tape compared to high ankle shoes, gait velocity and TUG were significantly improved with elastic tape compared to high ankle shoes, and TUDS was significantly improved with non-elastic tape compared to elastic tape. Conclusion: The AFO, non-elastic tape, elastic tape, and high ankle shoes showed a positive effect on gait and mobility compared to barefoot, and among them, wearing AFO was most effective for improving gait and mobility of chronic hemiplegic stroke survivors.

• PNF and Movement
• /
• v.4 no.1
• /
• pp.45-50
• /
• 2006

Purpose : This study shows the movements of the ankle and the foot in walking stages, and helps to diagnose and treat the problems of the ankle and the foot. The foot in human is a mean of the transportation, body support, and shock absorber. However, the slightest changes in the anatomical position can cause a significant increase of the stress and force in the ankle and the foot. The regular compressive force in the ankle of the normal person is generated by the contraction of the gastrocnemius and popliteus muscles, and transmitted to the achilles tendon. The plantar flexion about 10 degrees occurs immediately after the heel strike, getting ready for the weight acceptance. The shear force about 80 % of the body weight is generated immediately after the heel off of the mid stance phase. In those who have a problem in the ankle, the compression force at the ankle decreased to 1/3 of the body weight, and the shear force decreased, and the compressive force was reached at their maximum level earlier than the normal people. Conclusion : Analysis of the movements at the ankle and the foot in walking phase can make the effort to diagnose and treat the ankle and foot with the problems. However, the further study is necessary.

• Journal of Biomedical Engineering Research
• /
• v.41 no.2
• /
• pp.84-93
• /
• 2020

Despite of a lot of studies about proprioception tests, there are little study results to investigate the relationship between the functional movement and proprioception level. In this study, we tried to perform quantitative analysis for the effect of ankle joint proprioception level on the one leg standing postural control ability. Nine healthy people volunteered for this study. Force and position aspects of proprioception were evaluated using the electromyography system (EMG) and mobile clinometer application, respectively. The center of pressure (COP) trajectories, measured by a pressure mat sensor, were used for quantitative analysis of balance for each subject. We computed indices and errors of force and position aspects of proprioception from the EMG and ankle angle. Mean velocity of total and anterior-posterior direction (Vm and Vm_ap), root mean squared distance in anterior-posterior direction (RDap), travel length (L), and area (A) of COP trajectories were also calculated as indices of postural control ability of subjects. Two aspects of proprioception showed the low correlation from each other as previous studies. However, the EMG error of gastrocnemius lateral activation showed a high correlation coefficient with COP variables such as Vm (ρ=0.817, p=0.007), Vm_ap (ρ=0.883, p=0.002), RDap (ρ=0.854, p=0.003), L (ρ=0.817, 0.007) and A (ρ=0.700, p=0.036). Within our knowledge, this is almost the first study that investigated the relationship between proprioception level and functional movement. These study results could support that the ankle joint proprioception facilitation exercise would have positive effects on functional balance rehabilitation interventions.

• Journal of Korean Academy of Nursing
• /
• v.36 no.5
• /
• pp.853-862
• /
• 2006

Purpose: The purpose of this study was to identify the factors that influence the functional status of patients with heart failure. Method: A descriptive, correlational study design was used. The participants in this study were 260 patients with heart failure who were admitted at Y University and U University in Seoul, Korea. Between September 2005 and December 2005 data was collected by an interview using a questionnaire and from medical records. The Functional status was measured with KASI. Physical factors (dyspnea, ankle edema, chest pain, fatigue, and sleep dysfunction), psychological factors (anxiety and depression), and situational factors (self-management compliance and family support) were examined. Result: In general, the functional status, anxiety, depression, self-management compliance, and family support was relatively not good. The level of fatigue was highest and the level of ankle edema was lowest for physical symptom experiences. In regression analysis, functional status was significantly influenced by dyspnea(23%), age(13%), monthly income(7%), fatigue(3%), ankle edema(2%), depression(1%), and length of stay in the hospital(1%). These factors explained 50% of the variables in the functional status. Conclusion: These results suggest that psycho-physiological symptoms management should be a focus to improve the functional status in patients with heart failure.

• Physical Therapy Korea
• /
• v.24 no.4
• /
• pp.46-53
• /
• 2017

Background: The MLA is supported by both the abductor hallucis (ABH) and the extrinsic muscles. Insufficient muscular support may lower the MLA when the body's weight is applied to the foot. The short foot exercise (SFE) is effective in increasing the height of the MLA for people with flat feet. Most of the research related to the SFE has simply evaluated the efficiency of the exercise using enhanced ABH electromyography (EMG) activation. Since the tibialis anterior (TA), peroneus longus (PER), and ABH are all involved in supporting the MLA, a new experiment design examining the EMG of the selected muscles during SFE should be applied to clarify its effect. Objects: Therefore, this study aimed to clarify the effect of the SFE in different ankle position on the MLA angle and the activation of both the intrinsic and extrinsic muscles and to determine the optimal position. Methods: 20 healthy subjects and 12 subjects with flat feet were recruited from Yonsei University. The surface EMG and camera were used to collect muscle activation amplitude of TA, PER, and ABH and to capture the image of MLA angle during SFE. The subjects performed the SFE while sitting in three different ankle positions-neutral (N), dorsiflexion (DF) at 30 degrees, and plantar flexion (PF) at 30 degrees. Results: ABH EMG amplitudes were significantly greater in N and DF than in PF (p<.05). Muscle activation ratio of TA to ABH was the lowest in PF (p<.05). MLA angle in both groups significantly decreased in PF (p<.01). The TA and ABH was activated at the highest level in DF. However, in PF, subjects significantly activated the ABH and PER with relatively low activation of TA. Conclusion: Therefore, researchers need to discuss which SFE condition most effectively use the arch support muscle for flat foot.

• The Journal of Internal Korean Medicine
• /
• v.41 no.3
• /
• pp.434-446
• /
• 2020

Objectives: The cardio-ankle vascular index (CAVI) and ankle-brachial index (ABI) are non-invasive methods to evaluate cardiovascular disease and arteriosclerosis. This study investigated the relationship between CAVI, ABI, and factors related to arteriosclerosis. Methods: This study included 535 healthy adults who underwent health examinations in 2019. We analyzed the correlation between CAVI, ABI and clinical variables. Multiple regression analysis was performed on the independent clinical variables associated with CAVI and ABI. Results: The correlation analysis of CAVI showed that body mass index (BMI) and HDL-cholesterol (HDL-C) had a negative correlation, and the other variables had a significant positive correlation. The correlation analysis with ABI on the right side showed that age, diastolic blood pressure (DBP), gender, and LDL-cholesterol (LDL-C) had a significant positive correlation, while HDL-C had a significant negative correlation. There was no statistical significance on the left. In the multiple regression analysis, DBP, age, BMI, gender, and HDL-C were proved to be independent factors in CAVI (right) (R²=0.365); DBP, age, gender, BMI, fasting blood sugar, and total cholesterol in CAVI (left) (R²=0.357); and age, gender, DBP, and systolic blood pressure in ABI (right) (R²=0.133). There were no statistically significant factors in ABI (left). It could be inferred that smoking and drinking are determinants that play an important role in CAVI. Conclusion: CAVI showed a high correlation with gender, age, and blood pressure. A significant correlation between CAVI and serum lipid values could be observed, but this showed a low correlation coefficient. ABI showed a high correlation with age and DBP. These results support the use of CAVI and ABI as primary diagnostic devices in medical treatment.

• The Journal of Korean Physical Therapy
• /
• v.18 no.4
• /
• pp.27-40
• /
• 2006

Purpose: This study was to investigate the effect of an arm sling on gait with hemiparesis. Methods: Fifteen patients(8 male, 7 female) with hemiparesis participated in this study and walked self-selected speed over 10m walkway, randomly without arm sling, with Single strap hemisling and Rolyan humeral cuff sling. It were filmed by 5 video camera and used with 3-dimensional motion analyzer system. The following gait variables were analyzed: temporo-spatial parameters, kinematic parameters. Results: In the comparison of temporo-spatial parameters each trial, walking velocity and single support time on affected side was significantly increased and step length on affected side, step length asymmetry ratio, single support time asymmetry ratio was significantly decreased in the Single strap hemisling and Rolyan humeral cuff sling. In the comparison of kinematic parameters each trial, maximal angle of the hip flexion on affected side was significantly increased in the Single strap hemisling and Rolyan humeral cuff sling and maximal angle of the knee flexion on affected side was significantly increased in the Rolyan humeral cuff sling and maximal angle of the ankle dorsiflexion on affected side was significantly increased in the Single strap hemisling. Conclusion: An arm sling improved walking velocity and decreased asymmetry and increased maximal angle of hip, knee, ankle flexion on affected side with hemiparesis caused by stroke.

• Journal of the Korean Society of Physical Medicine
• /
• v.18 no.3
• /
• pp.65-72
• /
• 2023

PURPOSE: This study assessed the influence of bilateral coordination exercises on unstable support surfaces on leg muscle activation and balance in stroke patients. METHODS: Two groups were recruited for comparison: an experimental group of 10 individuals who performed bilateral coordination exercises on unstable surfaces and a control group of 10 individuals who performed the same exercises on stable surfaces. All participants were assigned randomly. Pre-tests were conducted to measure the leg muscle activation and balance levels of the participants prior to the experiment. The intervention was comprised of three 30-minute weekly sessions for four weeks, followed by a post-test after the four-week period. RESULTS: Significant differences were identified within the experimental group in relation to all muscles (p < .01) and balance (p < .05). Within the control group, significant differences were identified in relation to the rectus femoris muscle, biceps femoris muscle, and balance (p < .05). Significant differences between the two groups were only observed in relation to the tibialis anterior and soleus muscles (p < .05). CONCLUSION: Only the tibialis anterior and soleus muscles showed significant differences between the two groups. This effectiveness may be attributed to using an ankle strategy to maintain body balance during exercise on unstable surfaces.