• Korean Journal of Applied Biomechanics
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• v.31 no.3
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• pp.168-175
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• 2021

Objective: To investigate the static and dynamic analysis of ankle joint complex between subjects with chronic ankle instability (CAI) and healthy controls. Method: A total of 38 subjects and CAI group (N=19) and healthy control (N=19) participated in this first study. Variables that were measured in this study were as follows: 1) Subtalar joint axis inclination and deviation 2) Rearfoot angle 3) Navicular drop test 4) Heel alignment view in alignment analysis. Intra Correlation Coefficient (ICC) is used for reliability. A secondary 17 subjects are recruited including 9 of CAI and healthy for gait analysis between group. Lower extremity sagittal, frontal, and transverse kinematics were measured. All data were analyzed to ensemble curve analysis. Results: 1) There were statistically significant differences in standing rearfoot, navicular drop, heel alignment view, subtalar joint (STJ) inclination and deviation. 2) Only in sagittal, meaningful difference is showed during walking in gait analysis. Conclusion: Morphological problem can affect ankle sprain in aspect of structure with no relation to compensation of neuromuscular.

• Physical Therapy Korea
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• v.25 no.2
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• pp.22-29
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• 2018

Background: Deficits of both ankle dorsiflexion range of motion (DFROM) and dynamic balance are shown in persons with chronic ankle instability and the elderly, with the risk of falls. Objects: This study aims to investigate the relationship between DFROM and dynamic balance in elderly subjects and young adults. Methods: Fifty-nine subjects were divided into three groups: ankle stability young group (SY), ankle instability young group (IY) and ankle stability older group (SO). We recruited three old subjects with ankle instability, but excluded them during a pilot testing due to the safety issue. DFROM was measured by weight bearing lunge test (WBLT) and dynamic balance was measured via star excursion balance test (SEBT) in anteromedial, medial, and posteromedial directions. The group differences in WBLT and SEBT and each group's correlation between WBLT and SEBT were detected using the R statistical software package. Results: The dorsiflexion range of motion was significantly different between the SY, IY, and SO groups. The SO group showed the highest DFROM and IY group showed the lowest DFROM (SY: $45.88{\pm}.66^{\circ}$, IY: $39.53{\pm}1.63^{\circ}$, SO: $47.94{\pm}.50^{\circ}$; p<.001). However, the SO group showed the lowest dynamic balance score for all SEBT directions (SY: $87.24{\pm}2.05cm$, IY: $83.20{\pm}1.30cm$, SO: $77.23{\pm}2.07cm$; p<.05) and there was no relationship between the dorsiflexion range of motion and dynamic balance in any group. Conclusion: Our findings suggest that ankle DFROM is not a crucial factor for dynamic stability regardless of aging and ankle instability. Other factors such as muscle strength or movement coordination should be considered for training dynamic balance. Therefore, we need to establish the rehabilitation process by measuring and treating ROM, balance, and muscle strength when treating young adults with and without ankle instability as well as elderly people.

• PNF and Movement
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• v.17 no.1
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• pp.81-92
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• 2019

Purpose: This study was an investigation of the effect of unstable supporting exercise in young adults with functional ankle instability. The study tested the use of a jumper and virtual reality (VR) training via a VR-head mounted display (HMD) system to provide functional improvement in proprioception, range of motion (ROM), ankle muscle strength, agility, and balance. Methods: The subjects comprised 61 young adults (in their twenties) with functional ankle instability to decide as less than 24 points using Cumberland ankle instability tool. The subjects were divided into three groups: VUS (VR-HMD and unstable supporting exercise, n = 20), VSS (VR-HMD and stable supporting exercise, n = 19), and NUS (non-VR-HMD and unstable supporting exercise, n = 22). The exercise program was conducted three times per week for three weeks. VR training via a VR-HMD system and a VR application on a smart mobile device were used with the VUS and VSS groups, and unstable supporting exercise was used in the VUS and NUS groups for 30 minutes. Proprioception, ROM, ankle muscle strength, agility, and balance were measured before and after training. Results: The VUS group showed significant differences in most results, including proprioception, ROM, ankle muscle strength, agility, and balance to compare before and after, and the VSS and NUS groups partially. Moreover, the VUS group had significant differences in most results when compared with the other groups. Conclusion: Unstable supporting exercise and VR training via a VR-HMD system improved functional ankle instability in terms of proprioception, ROM, ankle muscle strength, agility, and balance.

• Journal of Korean Physical Therapy Science
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• v.15 no.3
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• pp.19-29
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• 2008

Background : Ankle inversion sprains are one of the most common injuries in sports and activities of daily living that mostly concern physically active individuals. In most researches, proprioceptive deficit, muscle weakness and/or absent coordination have been regarded as a contributing factors. Despite the high incidence of ankle sprain and instability, therapeutic approaches to properly manage the symptoms have rarely been investigated. This study aimed to identify the effect of proprioceptive exercise program that is easy to integrate in normal training program. Methods : Subjects were randomly allocated to control group and experimental group consisting of 11 and 10 patients, respectively. The conservative treatment for the control group consisted of hot packs, ultrasound and TENS. In addition, the experimental group performed 7 exercises to enhance proprioceptive function of ankle joint. The therapeutic intervention of the controland experimental groups was performed a total of 20 exercise sessions, averaging 50 hour each, 5 times per week for 4 weeks. To compare the two groups, the level of ankle disability was assessed by using the ankle injury score scale in pre- and post-treatment. Results : On assessment of post-treatment, there were statistically significant differences in the scores of all sub-items, except for ankle laxity and range of motion, and the total score of ankle injury score scale between the two groups(p<0.05). In comparison between pre- and post-treatments, the significant difference in the scores of all sub-items and total score didn't appear for the control group, while the scores of most sub-items and total score of the experimental group were shown the statistically significant difference(p<0.05). Conclusion : The findings suggest that the proprioceptive exercise program is more effective for relieving ankle disability than conservative treatment therefore, the program to improve proprioceptive function should be recommended for prevention and rehabilitation of recurrent ankle inversion injuries.

• Journal of Korean Foot and Ankle Society
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• v.5 no.1
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• pp.5-12
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• 2001

Purpose: To find out the priority of which procedure has had a better outcome both clinically and radiographically between the two groups, one is treated by primary repair and the other by modified Brostr$\ddot{o}$m's procedure, by comparing the postoperative ankle joint stability and the patient's degree of satisfaction. Material and methods: 16 cases were taken into consideration whose number of severed ligaments were at least two or more of the lateral collateral ligaments of the ankle, and also were confirmed intraoperatively. Among them, 8 cases were treated with primary repair and the other 8 cases were treated with primary repair and the other 8 cases by modified Brostr$\ddot{o}$m's procedure. Results: There was no distinguishable difference for the patient's degree of satisfaction between the two procedures above mentioned. In 3 cases treated with primary repair, functional instability was observed. In case of postoperative ankle joint stability, 7 of 8 cases treated by modified Brostr$\ddot{o}$m's procedure has revealed increased joint stability. And 3 of 8 cases which were treated by primary repair have showed postoperative residual instability. Conclusion: Actually, the severed ligament can not maintain its normal strength though several months has elapsed, and possible residual instability could be remained. Therefore, it can be expected that modified Brostr$\ddot{o}$m's procedure also would be a .good method in obtaining suitable ankle joint stability as well as subtalar joint stability because of its reinforcement using extensor retinaculum.

• PNF and Movement
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• v.18 no.2
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• pp.173-182
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• 2020

Purpose: The purpose of the study was to investigate the effects of visual feedback exercise (VFE), sandal exercise (SE), and thera-band exercise (TE) on people with functional ankle instability. Methods: The 45 study participants were divided into three groups of 15. In the VFE group, participants performed short-foot exercises using visual feedback; the SE group performed sandal exercises, and the TE group performed thera-band exercises. Over a period of 8 consecutive weeks, the experimental groups exercised for 15 minutes per session, four times per week. Balance was measured using the Biodex Balance System for dynamic balance ability (overall balance index [OBI], mediolateral balance index [MBI], and anterioposterior balance index [ABI]). Vibration threshold sense (VTS) was assessed using a vibratory sensory analyzer. Ankle muscular strength was measured using the Biodex 4 Pro. The main outcome measures were assessed at baseline and after 8 weeks of training. Results: Significant improvements in dynamic balance were noted in all three groups (p < 0.05). Significant improvements in VTS and muscular strength were also noted in the VFE and TE groups but not in the SE group (p < 0.05). Conclusion: Appropriate environmental and situational mediation may be of great clinical significance for patients suffering from chronic ankle instability. It is hoped that the findings will inform a program for prevention of ankle instability.

• Journal of The Korean Society of Integrative Medicine
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• v.12 no.3
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• pp.49-59
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• 2024

Purpose : Chronic ankle instability (CAI) can impair strength and balance, leading to activity limitations and restricted participation. Traditionally, ankle stabilization exercises have been applied, and more recently, the effects of hip muscle exercises have been studied. The purpose of this study was to determine the immediate effects of hip exercises (HE) and ankle stabilization exercises (ASE) on dynamic balance, performance and ankle function in subjects with CAI. We also compared the difference in effectiveness between HE and ASE. Methods : A total of 34 subjects with CAI participated, ane were randomly divided into two groups: the HE group and the ASE group. The HE group performed a program consisting of exercises above 70 % MVIC, while the ASE group performed a traditional ankle stabilization exercise program. The subjects in each group completed their respective exercise program for a total of 30 minutes once a day and were assessed before and after the intervention. Dynamic balance was assessed using the Y-balance test (YBT). Performance was assessed using the hop for distance test (HDT), and side-hop test (SHT). Ankle function was assessed using foot and ankle ability measure (FAAM) questionnaires. Results : YBT, HDT, and FAAM values increased significantly in both groups after the intervention (p<.05), and there was no significant difference between the groups. SHT values decreased significantly in both groups after the intervention (p<.05), and there was no significant difference between the groups. Conclusion : Although no significant superiority was observed between HE and ASE in this study, both exercise programs were effective in improving dynamic balance, performance, and ankle function in subjects with CAI. These findings suggest that both HE and ASE can be suitable interventions for CAI, highlighting the need for individualized treatment plans. Future research is warranted to explore the long-term effects of exercise programs on CAI subjects of different ages and occupational characteristics.

• The Journal of Korean Physical Therapy
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• v.28 no.3
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• pp.189-194
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• 2016

Purpose: This study focuses on influence of ankle stabilization training on balance ability and lower limb muscle activation of soccer player with functional ankle instability. Methods: Subjects were grouped into ankle stabilization training group using biofeedback comprised of 15 subjects and general exercise group of 15. The training was conducted for 30 minutes, 3 times a week for 8 weeks in total. All 30 football players conducted plyometric training for 30 minutes before main training. To evaluate balance ability, biorescure was used to measure whole path length and surface area and surface electromyography (EMG) system was used to measure tibialis anterior, tibialis posterior, and soleus to evaluate lower limb muscle activation. Results: The experiment group showed significant difference to the comparison group in regard of whole path length and surface area which represents balancing capability and muscle activation of tibialis anterior, tibialis posterior, and soleus. Conclusion: Therefore, ankle stabilization training using biofeedback is more effective in enhancing balance ability and lower limb muscle activation than general exercise.

• Journal of Korean Foot and Ankle Society
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• v.15 no.4
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• pp.187-194
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• 2011

Ankle injuries may involve the distal tibiofibular syndesmosis and can be associated with a variable degree of trauma to the soft tissue and osseous structures that play an important role in ankle joint stability. Ankle syndesmotic injury may occur solely as a soft tissue injury or in association with variable ankle fractures. Ankle syndesmotic injury does not necessarily lead to ankle instability; however, the coexistence of deltoid ligament injury critically destabilizes the ankle joint. The prevalence of these injuries may be higher than previously reported. The diagnosis of syndesmotic injury as not always easy because isolated ankle sprains may be missed in the absence of a frank diastasis and syndesmotic instability may be unnoticed in the presence of bimalleolar ankle fractures. Controversies arise at almost every phase of treatment includings : type of fixation(screw size, type of implant), number of cortices required for fixation and of need for hardware removal. Regardless of controversies, the most important goal should be restore and maintain the normal tibiofibular relationship to allow for healing of the ligamentous structures of the syndesmosis.

• Journal of Korean Orthopaedic Sports Medicine
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• v.6 no.1
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• pp.13-18
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• 2007

Lateral ankle instability is one of common injury in sports medicine. Already many studies were done with scientific data and clinical relationship. This review article wants to discuss about controversial subject of ankle instability. It will be conducted more precise diagnosis and treatment.