The modified Brostrom procedure is first considered for the treatment of chronic ankle instability (CAI). Recently, ankle arthroscopy is also recommended for the treatment of concomitant intra-articular lesions during the open repair of the lateral ligaments. We arthroscopically repaired the anterior talofibular ligament with a use of bio suture anchor for CAI as well as performing the multiple drilling procedure for combined osteochondral lesion of talus. We report the cases with a review of the literature.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.28
no.1
/
pp.29-38
/
2022
Background: Task-oriented training on an unstable support surface is an effective intervention for improving the ankle joint stability and muscle strength in patients with ankle instability. This study examined the effects of balance training on an unstable support surface in patients with ankle sprains with ankle instability. Methods: Forty-four patients with ankle sprains participated in this study. Screening tests were performed and assigned to an experimental group, who performed task-oriented training on an unstable support surface (n=22), and a control group, who performed task-oriented training on a support surface (n=22) using a randomization program. All interventions were applied 3 times per week for 4 weeks. The numeric rating scale (NRS), cumberland ankle instability tool (CAIT), balance ability, muscle activity, and muscle thickness were compared to evaluate the effects of the intervention. Results: Both groups showed significant differences in the NRS, CAIT, balance ability, and muscle activity between before and after the intervention (p<.05). In addition, there were significant differences in balance ability, muscle activity, and muscle thickness between the experimental and control groups (p<.05). Conclusion: Task-oriented training on an unstable support surface is an effective intervention for improving the balance ability, muscle activity, and muscle thickness during contraction.
Background: Postural control deficit is a major characteristic in patients with chronic ankle instability (CAI). Elastic ankle tapings are commonly used to facilitate postural control in patients with CAI as well as prevent relapse of a lateral ankle sprain. However, equivocal evidence exists concerning the effect of elastic ankle taping on postural control. Objects: This study aimed to evaluate the effects of elastic ankle tapings using kinesio taping (KT) and dynamic taping (DT) on static and dynamic postural control in patients with CAI. Methods: Fifteen subjects with CAI were participated in this study. The participants performed tests under three conditions (barefoot, KT, and DT). Static postural control was evaluated using the one-leg standing test (OLST) and dynamic postural control using the modified Star Excursion Balance Test (mSEBT). One-way repeated-measures analysis of variance was used to compare center of pressure (CoP) data and normalized mSEBT reach distances among the three conditions (with α = 0.05). Results: The CoP parameters (path length, ellipse area, and mean velocity) of the OLST significantly decreased on applying KT and DT compared with those when barefoot. The normalized reach distances in the anteromedial (AM), medial (M), and posteromedial (PM) directions of the mSEBT significantly increased with DT compared to that in the control condition. Further, the higher reach distances with KT compared with those in the control condition were obtained in the M and PM directions of the mSEBT. No significant differences were identified in any of the OLST and SEBT parameters between the two different taping applications. Conclusion: KT and DT improved static postural control during the OLST compared with the control condition. Moreover, these tapes improved dynamic postural control during the mSEBT compared to the control. Therefore, elastic ankle tapings are useful prophylactic devices for the prevention and treatment of ankle sprain in people with CAI.
Cho, Byung-Ki;Cho, Jaeho;Lee, Myoungjin;Lee, Jun Young;Bae, Su-Young;The Academic Committee of Korean Foot and Ankle Society,
Journal of Korean Foot and Ankle Society
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v.26
no.1
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pp.22-29
/
2022
Purpose: Despite continuous updates of standard treatment guidelines for acute ankle sprain and chronic ankle instability (CAI), in practice preferred treatment protocols vary widely. Based on a Korean Foot and Ankle Society (KFAS) member survey, this study reports current trends in the management of ankle ligament injuries. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in September 2021. Questions mainly addressed clinical experience and preferences for the diagnosis and treatment of ankle ligament injuries. Answers with a prevalence of ≥50% among respondents were considered to reflect tendencies. Results: Eighty-four of the 550 members (15.3%) responded. Answers that showed a tendency were as follows: commonest additional image study (ultrasound), conservative treatment modality (immobilization, oral medication), frequency of surgical treatment (<5 cases per annum), most important factor when deciding on surgical treatment (activity level, e.g., occupation or sport), and commonest surgical procedure (open ligament repair). Answers that showed a tendency for CAI were as follows: most important symptom (repeated sprain, giving way), radiological factors (talar tilt, osteochondral lesion, anterior talar translation), and patient factors (occupation, sports activities, recurrent instability after surgery, etc.). For decision making regarding surgical treatment and method, the most preferred surgical procedure was the modified Broström procedure, and the most common repair technique was suture anchor technique. The following were considered poor prognostic factors; generalized laxity, failed previous surgery, cavovarus, severe mechanical instability, heavy work, obesity, and dissatisfaction after surgery because of residual pain. Conclusion: This study updates information regarding current trends in the management of ankle ligament injuries in Korea, and reveals consensus opinions and variations in approaches to patients with an acute or chronic injury. The divergence of approaches identified indicates the need for further studies to determine standard guidelines and long-term results.
Purpose: This study was conducted to identify the effects of neuromuscular training performed on badminton club members' to improve muscle activity of the lower extremities and static and dynamic balance tests. Methods: The subjects were 20 badminton club members with chronic ankle instability who were randomly divided into a neuromuscular training group and a balance training group, each with 10 patients. Both exercises ware performed three days per week for 30 minutes a day over six weeks. Results: The neuromuscular training group showed increased muscle activity of the lower extremities compared to the balance training group. Neuromuscular training increased balance ability better than the balance training group, showing a significant difference and better efficiency of neuromuscular training when compared to balance training. Conclusion: This research evaluated neuromuscular training as an intervention for badminton club members with chronic ankle instability and compared the differences in muscle activity of the lower extremities and balance ability; as a result of the effective frequency for improving performance, there was a significant difference in muscle activity of lower extremities and balance ability of the neuromuscular training group and the control group.
Purpose: This study was conducted to identify the effects of dual task training on balance and functional performance in high school soccer players with functional ankle instability. Methods: Twenty high school soccer players with functional ankle instability were randomly assigned to a single task training group and a dual task training group. One participant who did not participate regularly in the training was excluded. The single task training group (n=9) received balance training on an unstable surface. The dual task training group (n=10) received balance training on an unstable surface and had to catch thrown balls during the balance training. Both groups were trained for 4 weeks, 3 days a week. The balance and functional performance of both groups was measured before and after training. Balance was measured using an anterior-posterior and medio-lateral balance. Functional performance was measured based on a figure-of-8 hop test, up-down hop test, and a single hop test. All data were analyzed by repeated two-way ANOVA tests. Results: A time by group interaction effect was not observed in the medio-lateral balance test, figure-of-8 hop test, or single hop test (p>0.05). A time by group interaction effect was observed in the anterior-posterior balance and up-down hop test (p<0.05). Conclusion: These results suggest that dual task training improved balance and functional performance better than single task training for some items.
Purpose: The purpose of this study was to determine the effects of whole body vibration exercise (WBVE) on lower extremity muscle activity and balance ability according to different methods of exercises in football player and use it as basic data for the rehabilitation training of chronic ankle instability. Methods: Thirty subjects were randomly divided into two groups: the two groups, which each group have 15 members, are WBVE group and neuromuscular training (NMT) group according to training method. The exercise program was conducted for six weeks. Subjects were measured on lower extremity muscle activity and balance ability. Results: The muscle activity increasement of the WBVE group was significantly higher than that of the NMT group (p<0.05) and the balance ability decreasement of the WBVE group was significantly higher than that of the NMT group (p<0.05). Conclusion: These findings of this study suggest that WBVE may have a beneficial effect on improvement of lower extremity muscle activity and balance ability in football player with chronic ankle instability.
Objective: The purpose of this study was to investigate the effects of combining Mulligan taping and flossing bands on lower limb muscle activity and static and dynamic balance. Design: A randomized controlled trial. Methods: Sixty-eight patients with chronic ankle instability were randomized into three groups that were treated with Mulligan taping (MT, n=22), flossing band (FB, n=23) and Mulligan taping combined with flossing band (MT+FB, n=23), and various parameters were compared before and after the intervention. The muscle activity of the lower extremities, including the tibialis anterior, peroneus longus and medial of gastrocnemius muscles was measured using BTS FREE EMG 1000, while the static and dynamic balance were measured using the Biorscuue balance measuring equipment. Results: There was a significant difference in muscle activity of the tibialis anterior muscle, before and after the intervention, in the MT group (p<0.01), FB (p<0.001) and MT+FB (p<0.001). There was also a significant difference in the muscle activity of the tibialis anterior muscle in the MT+FB group when compared with that in MT and FB groups (p<0.05). We also observed a significant difference in the dynamic balance all the groups (p<0.001). Conclusions: Therefore, combining Mulligan taping and flossing bands for patients with chronic ankle instability may improve dynamic balance and tibialis anterior muscle activity.
Park, Jae Yong;Choi, Gi-Won;Cho, Jae-ho;Kang, Chan;Choi, Kyungjin;Chung, Jin-Wha;Kim, Hak Jun;Bae, Su-Young;Cha, Seung-Do;Kim, Ki Chun;Han, Seung Hwan;The Insurance Committee of Korean Foot and Ankle Society
Journal of Korean Foot and Ankle Society
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v.20
no.1
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pp.12-18
/
2016
Purpose: The purpose of this study is to review the indications of ankle lateral complex reconstruction using tendon graft. Materials and Methods: We searched PubMed using the index, "ankle, instability, lateral ligament, reconstruction" from 1990 to present (September 30, 2015). We excluded 1) modified Brőstrom operation (MBO), 2) conventional tenodesis surgery, 3) review article, 4) technical note, and 5) articles written in another foreign language. We reviewed 24 papers through the publication events, operational method, the indications of surgery, and the specific features of the patient group. Results: There were the indications of 1) previous ligament surgery failure, 2) situation when ligament repair is impossible due to the ligament defect, 3) severe instability (preoperative talar tilt >$15^{\circ}$, anterior draw >10 mm or the difference of contralateral side talar tilt >$5^{\circ}$, anterior draw >3 mm), and 4) overweight (body mass index >$30kg/m^2$). Other considerations included 1) generalized joint laxity and 2) workers, highly-demanded or athlete highly-affected by instability. Conclusion: The ankle lateral complex reconstruction using tendon graft could be indicated in patients with the possibility of MBO failure with several considerations.
Bae, Su-Young;Ahn, Soo Hyung;Chung, Hyung-Jin;Kam, Min-Cheol
Journal of Korean Foot and Ankle Society
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v.23
no.3
/
pp.105-109
/
2019
Purpose: To compare the efficacy between cast immobilization and functional treatment using an ankle brace as a treatment for acute lateral ankle sprain. Materials and Methods: This study reviewed the medical records of 157 acute ankle sprain patients who were treated between 2009 and 2014. A total of 101 cases were included in this study except for cases with a combined injury, and could not be followed up for eight weeks after the first visit. The patients were divided according to the treatment modality: a cast immobilization group (64 cases) and functional treatment group (37 cases). The clinical outcomes were assessed retrospectively based on the medical records of each group. The residual symptoms, such as pain, swelling, and instability, at three weeks after the primary treatment and at the last visit were compared. Results: The residual pain and instability were significantly common in the functional treatment group at three weeks. Five cases (7.8%) of pain and one case (1.6%) of instability were in the cast group whereas nine cases (24.3%) of pain and six cases (16.2%) of instability in functional treatment group (p=0.021, p=0.014). On the other hand, there was no meaningful difference at the last follow-up. Residual pain, swelling, and instability at the last visit were noted in three (4.7%), six (9.4%), and four cases (6.3%) in the cast group, and three (8.1%), three (8.1%), and three (8.1%) were observed in the functional treatment group. Six patients refused cast immobilization. Conclusion: Although there was no significant difference at the last follow-up, cast immobilization appears to be more effective than a functional brace in terms of early pain relief and early restoration of ankle stability as a treatment for acute ankle lateral sprain in this study.
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