• 제목/요약/키워드: Ankle instability

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만성 족관절 불안정증에서 건이식을 이용한 외측 인대 재건술의 적응증 (The Indication of Ankle Lateral Ligament Reconstruction Using Tendon Graft in Chronic Ankle Instability)

  • 박재용;최기원;조재호;강찬;최경진;정진화;김학준;배서영;차승도;김기천;한승환;2015 대한족부족관절학회 보험장애판정위원회
    • 대한족부족관절학회지
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    • 제20권1호
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    • pp.12-18
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    • 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.

족관절 급성 염좌의 일차 치료: 석고고정과 기능적 보조기를 이용한 치료의 후향적 비교 (Primary Treatment of Acute Ankle Sprain: Retrospective Comparison of Cast Immobilization and Functional Ankle Brace)

  • 배서영;안수형;정형진;감민철
    • 대한족부족관절학회지
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    • 제23권3호
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    • pp.105-109
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    • 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.

Comparison of the Strength of the Ankle Evertor, Invertor, and Ratio at Different Ankle and Toe Positions Between Sides With and Without Chronic Ankle Instability in Taekwondo Athletes

  • Beom-jun Kim;Ui-jae Hwang;Oh-yun Kwon
    • 한국전문물리치료학회지
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    • 제31권2호
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    • pp.151-158
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    • 2024
  • Background: In Taekwondo athletes, ankle sprain is the most common risk factor for injury. Repeated ankle injuries lead to weakness and imbalance of the ankle muscles, resulting in chronic ankle instability (CAI). Both the ankle and toe muscles contribute to the inversion and eversion of the foot at the subtalar joint. Therefore, it is necessary to consider the ankle and toe joint positions when measuring ankle invertor and evertor strength. Objects: This study aimed to compare the muscle strength and ratio differences of the ankle invertor and evertor muscles in both the toe and ankle positions between the CAI and uninjured sides in Taekwondo athletes. Methods: Fifteen Taekwondo athletes participated in this study. The isometric strengths of both the ankle invertor and evertor were determined in different ankle and toe positions (dorsiflexion with toe extension, dorsiflexion with toe flexion, plantarflexion with toe extension, and plantarflexion with toe flexion). Paired t-tests were used to determine the differences between the ankle invertor and evertor in strength and ratio according to toe and ankle positions between the ankle CAI side and the uninjured side. Results: The results demonstrated that ankle evertor strength significantly decreased in all ankle and toe positions on the CAI side (p < 0.05). In addition, significant differences were observed in the ratios of the ankle invertor and evertor strengths in the dorsiflexion with toe flexion, plantarflexion with toe extension, and plantarflexion with toe flexion positions (p < 0.05). Conclusion: The findings of this study suggest that athletes, trainers, and clinicians should consider ankle and toe positions when measuring invertor and evertor strength and develop ankle rehabilitation protocols for Taekwondo athletes with CAI.

테이핑의 종류가 만성 발목 불안정성을 가진 성인의 정적 및 동적 균형에 미치는 효과 비교 (Comparison of the Effects of Different Types of Taping on Static and Dynamic Balance in Adults with Chronic Ankle Instability)

  • 권오현;김호;신원섭
    • 대한통합의학회지
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    • 제8권1호
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    • pp.27-36
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    • 2020
  • Purpose : The purpose of this study is to apply kinesiology taping and dynamic taping to subjects with ankle instability and to find out the change of static balance and dynamic balance ability and to use it more usefully in daily life. Methods : The subjects were based on 30 Cumberland Ankle Instability Tool questionnaire scores of 24 or less, and were randomly assigned to the kinesiology taping group (n=15) and the dynamic taping group (n=15) to change the static balance and dynamic balance before and after taping Measured. The eyes were closed for 30 seconds and the average balance was measured three times through the Wii balance board in static balance, and the balance ability was evaluated by measuring functional reach test and star excursion balance test in dynamic balance. Results : As a result, the static balance showed significant results in the dynamic speed and the moving distance in the dynamic taping group (p<.05). However, there was no significant difference in the shaking area and the difference in the kinesiology taping group (p<.05) However, both groups showed significant differences in dynamic balance (p<.05). Conclusion : It was confirmed that the application of taping was effective for static and dynamic balance in subjects with ankle instability, and the application of dynamic taping was more effective than kinesiology taping.

신경근 훈련이 기능적 발목 불안정성 축구선수의 자세조절과 점프 수행력에 미치는 영향 (Effect of Neuromuscular Training on Postural Control and Jump Performance in Functional Ankle Instability Soccer Player)

  • 양대중;강정일;박승규;이민기;정용식
    • 한국운동역학회지
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    • 제24권3호
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    • pp.295-300
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    • 2014
  • The purpose of this study was to investigate the effects on jump performance and balance in soccer player with functional ankle instability of difference of neuromuscular training. In 33 male college soccer player with functional ankle instability subjects of this study randomization, combined training group (group I, n=11), balance training group (group II, n=11) and control group (group III, n=11) that included in the plyometric training and balance training was classified group. The intervention was conducted three times a week for 8 weeks. Before and after intervention, measured in surface area ellipse and countermovement jump and countermovement jump with arm swing. Showed a significant improvement in postural control and jump performance from the combined training group and balance training group compared to the control group. Showed a significant improvement in countermovement jump from the combined training group compared to the balance training group. Combined training and balance training showed the increased jump performance and postural control in soccer player with functional ankle instability.

멀리건 테이핑과 플로싱 밴드가 만성 발목 불안정성 남성 환자의 Q-각과 하지 근 활성도에 미치는 효과 (Effect of Mulligan Taping and Flossing Bands on Q-angle and Lower Limb Muscular Activity in Men with Chronic Ankle Instability)

  • 정효창;박세진;유성훈
    • 대한정형도수물리치료학회지
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    • 제27권3호
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    • pp.17-24
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    • 2021
  • Background: The study aimed to examine changes in muscle activity by measuring the Q-angle and lower extremity activity when going down the stairs, after the application of either Mulligan taping or flossing bands to patients with chronic ankle instability. Methods: A total of 19 men with chronic ankle instability in their 20s and 30s participated in the study. Participants were randomly divided into two groups: the Mulligan taping group (n = 9) and the flossing band group (n=10). The Mulligan taping group had three sets of Mulligan joint operations repeated 10 times, after which the Mulligan tape was applied. The flossing band group either performed functional activities or exercised for 2 minutes after flossing band application. After the application of either Mulligan taping or flossing bands, changes in the Q-angle and lower limb muscular activity while going down the stairs were measured and compared. Results: In the Mulligan taping group, the Q-angle significantly decreased from 13.63° to 12.7° during the step down. Similarly, the Q-angle of the flossing band group significantly decreased from 15.95° to 15.48° (p<.05). There was no difference in lower limb muscle activity between the two groups when going down the stairs. The muscle activity of the tibialis anterior significantly increased from 34.12% to 40.2%, and the difference between the two groups were statistically significant (p<.05). Conclusions: The study found that the application of Mulligan taping and flossing bands to patients with chronic ankle instability decreased the Q-angle and lower limb muscle activity when going down the stairs.

테이핑이 기능적 발목 불안정성이 있는 선수들의 점프 착지 시 하지에 미치는 영향 (The Effect of Taping on Lower Extremity during lump Landing in Subjects with functional Ankle Instability)

  • 김경훈;조준행;이성철
    • 한국운동역학회지
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    • 제19권2호
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    • pp.265-272
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    • 2009
  • 발목 테이핑은 상해 예방을 위해 임상적으로 이용되어 질 수 있는 보조적 수단으로 여겨지고 있다. 그러나 그동안의 연구들을 살펴보면 발목 자체에 대한 부분만을 언급하였다. 본 연구의 목적은 발목 테이핑의 적용이 기능적 발목 불안정성을 가진 선수들에게서 점프 후 착지 시에 하지 관절에 미치는 영향을 알아보는데 있다. 점프의 거리는 각 대상자 키의 50%로 결정하였으며 높이는 각 대상자 키의 20%로 결정하였다. VICON을 이용하여 하지관절의 데이터를 수집하였고, 점프 착지 동안 시상면, 관상면, 수평면의 관절 움직임의 변화를 측정하였다. 테이핑은 통계적으로 시상면에서 착지순간 저측 굴곡과 최대 저측 굴곡을 제한하는 효과가 있었으며, 반면에 착지순간 무릎 굴곡과 최대 무릎 굴곡, 착지순간 엉덩 굴곡과 최대 엉덩 굴곡을 통계적으로 유의하게 증가시키는 효과가 있었으며, 관상면에서는 최대 발목 내번, 착지순간 무릎 외반과 최대 무릎 외반, 최대 엉덩 외전을 감소시키는 효과가 있었고, 수평면에서는 최대 발목 외전, 최대 엉덩 내회전의 감소를 보였다. 발목 테이핑은 발목 관절 운동범위의 제한과 함께 무릎 관절이나 엉덩 관절에 영향을 미치는 것으로 나타났다.

Effects of Joint Mobilization on Foot Pressure, Ankle Moment, and Vertical Ground Reaction Force in Subjects with Ankle Instability

  • Yoon, Na Mi;Seo, Yeon Soon;Kang, Yang-Hoon
    • 한국운동역학회지
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    • 제26권2호
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    • pp.153-159
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    • 2016
  • Objective: The purpose of this study was to investigate the effects of joint mobilization on foot pressure, ankle moment, and vertical ground reaction force in subjects with ankle instability. Method: Twenty male subjects (age, $25.38{\pm}3.62yr$; height, $170.92{\pm}5.41cm$; weight, $60.74{\pm}9.63kg$; body mass index (BMI), $19.20{\pm}1.67kg/m^2$) participated and underwent ankle joint mobilization. Weight-bearing distribution, ankle dorsi/plantar flexion moment, and vertical ground reaction force were measured using a GPS 400 and a VICON Motion System (Oxford, UK), and subsequently analyzed. SPSS 20.0 for Windows was used for data processing and paired t-tests were used to compare pre- and post-mobilization measurements. The significance level was set at ${\alpha}$ = .05. Results: The results indicated changes in weight-bearing, ankle dorsi/plantar flexion moment, and vertical ground reaction force. The findings showed changes in weight-bearing distribution on the left (pre $29.51{\pm}6.31kg$, post $29.57{\pm}5.02kg$) and right foot (pre $32.40{\pm}6.30kg$, post $31.18{\pm}5.47kg$). There were significant differences in dorsi/plantar flexion moment (p < .01), and there were significant increases in vertical ground reaction forces at initial stance (Fz1) and terminal stance (Fz2, p < .05). Additionally, there was a significant reduction in vertical ground reaction force at midstance (Fz2, p < .001). Conclusion: Joint mobilization appears to alter weight-bearing distribution in subjects with ankle instability, with resultant improvements in stability.

축구 선수에서 발생한 족관절 전방 충돌 증후군의 개방적 수술의 치료 결과 (Open Treatment of Anterior Impingement Syndrome of the Ankle in Elite Level Soccer Players)

  • 이경태;양기원;김재영;김응수;차승도
    • 대한족부족관절학회지
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    • 제8권1호
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    • pp.76-80
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    • 2004
  • Purpose: We assessed the results of open treatment of anterior impingement syndrome of the ankle in elite level soccer players and concomitant injuries were idenfied. Materials and Methods: We retrospectively reviewed twenty one elite level soccer players diagnosed with anterior impingement syndrome who underwent open debridement between January 1997 and January 2002. All were men and the mean age at the operation was 21 years (range 16 to 27). The mean follow-up duration was 31 months (13 to 71). Concomitant abnormalities were idenfied through physical examination, bone scan and MRI. On a preoperative lateral radiograph, patients were classified according to McDermott's stage. Anteromedial or anterolateral approach was used at the operation and osteophyte was removed with osteotome and rongeur. When chronic ankle instability was accompanying, we performed Modified Brostrom-Gould procedure and for osteochondral lesion, multiple drilling was applied. The Ogilvie-Harris scoring system was used as a clinical scale to evaluate pain, swelling, stiffness and limitation of activity. The results were scored as excellent (15 to 16 points), good (13 to 14) and otherwise unsatisfactory. The time to return to full activity including sports activity was determined. Results: Eighteen of twenty one patients had an excellent outcome. Three patients were graded unsatisfactory and two of them abandoned their career due to the persistence of residual pain. Concomitant abnormalities were found including twelve cases of chronic ankle instability, three cases of osteochondral lesion and two cases of flexor hallucis longus tendinitis. Conclusion: Open debridement was successfully applied to the elite level soccer player with anterior impingement syndrome of the ankle. Considerable coexistence of other abnormalities such as chronic ankle instability may encourage us to consider additional operative procedure.

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