• 대한통합의학회지
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• 제11권1호
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• pp.13-20
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• 2023

Purpose : The purpose of this study is to compare the balance ability between subjects with chronic ankle instability and normal people and the center of pressure displacement during the sit to stand and stand to sit. Methods : The subjects of this study were 63 who met the inclusion criteria and were classified into normal group (n=33) and chronic ankle instability group (n=30). The displacement of the center of pressure during sit to stand and stand to sit was measured. And the limit of stability and Y-balance tests were performed to measure the balance ability. Independent t-test was conducted to compare center of pressure displacement and balance ability between groups, and pearson correlation was conducted to analyze the correlation between the center of pressure displacement and balance ability. Results : In the case of the center of pressure displacement, there was a significant difference between the two groups during sit to stand and stand to sit. In the case of balance, both limit of stability and Y-balance test showed significant differences between the two groups. At the time of sit to stand, the center of pressure displacement showed a significant correlation with balance abilities, and at the time of stand to sit, the center of pressure displacement showed a significant correlation with Y-balance test. Conclusion : Chronic ankle instability shows that there is a lot of sway in the body due to compensation to replace the decrease in ankle joint range of motion when performing sit to stand and stand to sit due to sensory input damage such as decrease in ankle range of motion and decrease in ankle proprioception. Chronic ankle instability is expected to have a negative effect on our daily lives in life. The results of this study will serve as the basis for the dynamic approach to objective evaluation, treatment, and prevention of chronic ankle instability.

• 한국전문물리치료학회지
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• 제31권1호
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• pp.18-28
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• 2024

Background: Lateral instability of the ankle is one of the most common causes of musculoskeletal ankle injuries. The peroneus longus (PL) and peroneus brevis (PB) contribute to ankle stability. In early rehabilitation, isometric exercises have been selected for improvement of ankle stability. To effectively train the peroneal muscles during eversion, it is important to consider ankle and body posture. Objects: This study aimed to compare activation of the PL, PB, and biceps femoris (BF) muscles during eversion in different ankle postures (neutral [N], plantarflexed [PF]) and body postures (sitting and side-lying). Methods: Thirty healthy individuals with no history of lateral ankle sprains within the last 6 months were included in the study. Maximal isometric strength of eversion and muscle activation were measured simultaneously. Muscle activation at submaximal eversion was divided by the highest value obtained from maximal isometric eversion among the four postures (percent maximal voluntary isometric contraction [%MVIC]). To examine the differences in muscle activation depending on posture, a 2 × 2 repeated measures analysis of variance (ANOVA) was conducted. Results: There were significant interaction effects of ankle and body postures on PL muscle activation and evertor strength (p < 0.05). The PL muscle activation showed a significantly greater difference in the side-lying and PF conditions than in the sitting and N conditions (p < 0.05). Evertor strength was greater in the N compared to the PF condition regardless of body posture (p < 0.05). In the case of PB and BF muscle activation, only the main effects of ankle and body posture were observed (p < 0.05). Conclusion: Among the four postures, the side-lying-PF posture produced the highest muscle activation. The side-lying-PF posture may be preferred for effective peroneal muscle exercises, even when considering the BF muscle.

• 대한물리의학회지
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• 제14권3호
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• pp.21-27
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• 2019

PURPOSE: This study examined the changes in the kinematic variables during walking on a downhill ramp according to the shoe heel height. METHODS: The subjects were 10 adult women with no history of musculoskeletal disorders who agreed to participate in the study. Data were collected using a motion analysis system (VICON) consisting of six infrared cameras. The slope was 120 cm in width, 200 cm in length, and 15 in inclination. To confirm the change in gait parameters (stride length, gait speed) and lower extremity joint angle according to the heel heights of the shoes, flat, 5 cm, and 10 cm heel shoes were prepared and walked alternately. RESULTS: As a result, both the stride length and walking speed showed significant differences according to the heel height between flat and 10 cm (p<.05). In the sagittal plane, there was no significant difference in the hip joint and knee joint, but a significant difference was observed in all events in the ankle joint on all heel heights (p<.05). In particular, the heel strike and mid stance events showed significant differences among all height conditions (p<.05). No significant difference was observed in any of the joint angle changes in the frontal plane (p>.05). CONCLUSION: As the shoe heel height increased, the instability increased and efforts to secure the stability were made, leading to a shortened stride length, walking speed, and angle of the ankle joint.

• 한국체육학회지인문사회과학편
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• 제55권6호
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• pp.749-757
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• 2016

이 연구의 목적은 요가의 한발서기자세를 수련 후 신체안정화에 어떠한 영향을 미치는지를 규명하는 것이다. 요가수련 경험이 없는 20대 여성 13명을 대상으로 24개월간 수련 전·후의 3D동작분석과 근육 생체 신호를 측정하였고 분석 결과는 다음과 같다. 첫째, 댄서포즈에서 왼쪽 무릎의 y축과 오른쪽 발목의 x축, 그리고 트리포즈에서 오른쪽 발목의 x축, 왼쪽 발목 y축의 관절 움직임 범위가 작아지며 통계적으로 유의한 차이를 보였다(p<.05). 둘째, 몸통과 골반의 정렬각은 댄서포즈와 트리포즈 모두에서 유의한 차이가 없었다. 셋째, 질량중심 이동거리는 트리포즈의 Y, Z방향에서 작아지며 유의한 차이를 보였다(p<.05). 넷째, 트리포즈 동작에서 양쪽 척추기립근, 복직근 및 왼쪽 대퇴사두근의 근활성도가 커지면서 유의한 통계적 차이를 보였다(p<.05). 이러한 결과는 요가 훈련이 특히 발목과 질량중심 움직임을 작게하고, 코어근육을 강화시켜 안정적 자세를 만드는데 중요한 역할을 한다고 할 수 있다. 결론적으로 요가 훈련은 자세 안정화에 효과가 있으며, 자세교정에 영향을 미친다고 할 수 있다. 추후 요가훈련을 통해 자세안정화를 볼 수 있는 정렬각의 변인을 통해 얻을 수 있는 정보에 대한 연구가 더 필요할 것으로 사료된다.

• 웰빙융합연구
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• 제5권2호
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• pp.29-32
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• 2022

Purpose: The purpose of this study is to observe the immediate effects of elastic taping and isometric exercises on balance ability in the elderly. Research design, data and methodology: 15 elderlies were participated in this study and randomly assigned into two group. The intervention group was applied elastic taping on ankle joint while the control group performed isometric ankle exercise in three sets for 30 seconds per set. Anterior-posterior and medial-lateral postural sway speed were measured after the experiment. To compare the change in balance ability between groups after the experiment, independent t-test was used. To investigate the change in balance ability between pre- and post-experiment within the groups, paired t-test was used. Results: A significant difference in medial-lateral postural sway speed was found after elastic taping application only in the intervention group (p>0.05). However, there was no significant difference between the groups. Conclusions: In conclusion, this finding supported that elastic taping would be helpful to support ankle stability and increase balance ability for the elderly as well as performance for sports athlete that was demonstrated in previous studies. Further studies will be necessary to confirm the long-term effects of elastic taping application on motor control and the risk of falling.

• The Journal of Korean Physical Therapy
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• 제34권4호
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• pp.161-167
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• 2022

Purpose: The purpose of this study was to investigate the effects of regular training on the uneven surface that stroke patients encounter in their daily life on their ankle joint muscle activity and balance ability. They were divided into two groups: the gait training group on uneven surfaces and the gait training group on normal surfaces. Methods: In this study, 30 patients diagnosed with stroke and undergoing rehabilitation were selected. 15 people in the uneven surface gait training group and 15 people in the flat gait training group were selected. The muscle activation of the ankle muscles was measured when walking again on a even surface after walking on an uneven surface and on a flat ground. After each gait training, the limit of stability and Romberg test were performed to evaluate the balance ability. Results: As a result of the experimental results before and after walking by group, the tibialis anterior muscle activity of the paralyzed side was significantly decreased in the uneven surface walking group. As a result of measuring balance ability after training, the limit of stability in all directions was significantly increased in the uneven surface gait training group, and the area and length moved significantly decreased in the uneven surface gait training group in the Romberg test as well (p<0.05). Conclusion: After walking on uneven surface, it was confirmed that the muscle activity of the ankle joint decreased in normal flat walking, and thus the efficiency of muscle activity was increased. In addition, it was possible to confirm the improvement of the balance ability of the gait training on the uneven surface, and in conclusion, it could be confirmed that it had an effect on the improvement of the walking ability.

• 한국전문물리치료학회지
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• 제21권1호
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• pp.29-36
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• 2014

The purpose of this study was to investigate the immediate effect of fabric ankle-foot orthosis on spatiotemporal gait parameters, compared to a barefoot condition in children with spastic cerebral palsy. Eleven children with spastic cerebral palsy participated in this study. Spatiotemporal gait parameters were measured with the GAITRite system. Fabric ankle-foot orthosis significantly improved Timed Up and Go test time and gait velocity. There was no significant difference in cadence. The step time significantly improved in both the more and less affected foot compared to the barefoot condition. The step length of the affected foot also significantly improved, but there was no significant difference in the step length of the less affected foot. There was significant improvement in the stride length of both the affected and less affected foot, but no significant difference in single stance or double stance. The fabric ankle-foot orthosis could improve stability, and selective control of the joint and promote better walking in children with cerebral palsy. Consequently, the fabric ankle-foot orthosis might be an alternative assistive device for neurological populations as a primary role instead of the typical ankle-foot orthosis.

• 한국전문물리치료학회지
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• 제23권1호
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• pp.20-30
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• 2016

Background: Total knee arthroplasty (TKA) recovers the alignment of the knee joint, but fails to automatically restore the alignment and function of the hip and ankle joints. It may affect the alignment and stability of the knee joint, therefore therapeutic intervention in hip and ankle joint is necessary for the rehabilitation process after TKA. Objects: The aim of this study was to comparison of the effects of the two exercise methods on the coronal plane alignment after TKA. This study conducted an experiment by dividing subjects into a lower extremity isometric co-contraction group (LEIC) and a quadriceps isolated isometric contraction (QIIC) group. Methods: A total of 37 subjects were randomly assigned to the LEIC ($n_1$=19) or the QIIC ($n_2$=18). Exercise was applied to five times per week for three weeks, starting on the eighth day after surgery. Range of motion exercises were performed as a common intervention and then each group performed quadriceps isometric contraction exercises with 10 sets of 5 repetitions. Radiological imaging was performed prior to surgery, one month and six months after surgery. In addition, the hip-knee-ankle angle (HKA) and tibiotalar angle (TTA) were measured. Results: The HKA was close to neutral in the LEIC rather than the QIIC (p<.05). The LEIC showed varus and the QIIC exhibited valgus TTA (p<.05). In a comparison of HKA and TTA over time, there was no significant change in either group (p>.05). According to the comparison of the TTA before surgery, the LEIC showed significant changes in the varus direction (p<.05), while there was no significant change in the QIIC (p>.05). Conclusion: The LEIC method triggered changes in the TTA and brought the HKA close to the neutral. Thus, LEIC is more effective than QIIC in creating stability in the coronal plane alignment of the knee and ankle joints after TKA.

• 대한정형도수물리치료학회지
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• 제22권2호
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• pp.57-63
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• 2016

Background: Instability due to ankle sprains will be accompanied by a problem of balance and pain change. Balance trainer is used to improve the ankle strength and balance ability. The purpose of this study was to evaluate the change of pain and postural balance ability in ankle joint after balance trainer application in patients with ankle sprain and instability. Methods: Twenty patients in K hospital in Incheon were enrolled. Balance trainer was applied to 10 subjects in the experimental group and 10 subjects in the Balance cushion under the same conditions as the experimental group to compare the pain and balance ability. Results: In the experimental group, there was a significant difference in the change of the pain variation. In the postural balance ability comparison, there was a significant difference in total and post - posterior comparison compared to the control, but there was no significant difference in the postural balance ability comparison. Conclusion: Pain and postural balance ability of patients with instability due to ankle sprain improved the pain and balance ability of the Balance trainer group compared to the Balance cushion training group.

• 대한족부족관절학회지
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• 제19권4호
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• pp.142-150
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• 2015

Purpose: Restoration of ankle stability through the strengthening exercise of peroneus muscles is considered an important factor for achievement of successful outcomes, in the rehabilitation program following ankle ligament injuries. However, there were few definitive data on normal muscle strength, including eversion power by peroneus muscles. This study was conducted to evaluate the muscle strength of ankle joint measured using an isokinetic dynamometer in normal Koreans. Materials and Methods: Sixty adults (120 ankles) were recruited and divided into three groups (20 in their twenties, 20 in thirties, and 20 in forties). Each group consisted of 10 males and 10 females. The selection criteria were no history of ankle injury and no evidence of instability. The peak torque, total work, and deficit ratio were measured using the Biodex$^{TM}$ (Biodex Medical Systems). Differences in muscle strength by age, gender and dominant versus non-dominant side were analyzed. Results: The peak torque of dorsiflexion was average 31.5 Nm at $30^{\circ}/s$ of angular velocity and 18.8 Nm at $90^{\circ}/s$; average 69.3 Nm ($30^{\circ}/s$) and 42.4 Nm ($90^{\circ}/s$) on plantarflexion; average 19.6 Nm ($30^{\circ}/s$) and 10.8 Nm ($90^{\circ}/s$) on inversion; average 12.9 Nm ($30^{\circ}/s$) and 8.0 Nm ($90^{\circ}/s$) on eversion. The deficit ratio of strength in women was average 61.1% of men on dorsiflexion; average 66.2% on plantarflexion; average 48.5% on inversion; average 55.4% on eversion. The deficit ratio in non-dominant foot was average 88.6% of dominant foot on dorsiflexion; average 90.1% on plantarflexion; average 85.1% on inversion; average 85.6% on eversion. Conclusion: The muscle strength of the ankle joint showed a tendency to weaken with age. There were significant differences in muscle strength by gender and dominancy. Further studies for comparison of patients with ankle instability, a comparison between before and after surgery for instability, the correlation between clinical outcomes and the recovery in muscle strength will be needed.