• Journal of The Korean Society of Integrative Medicine
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• v.5 no.2
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• pp.43-50
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• 2017

Purpose : There is no validated method for measuring the toe flexor strength that can isolate the intrinsic muscles of the foot from the extrinsic muscles. This study compared the hallux flexion force (HFF) and muscle activity in the foot and ankle according to ankle position [plantarflexion (PF), neutral, and dorsiflexion (DF)]. Method : The study enrolled 17 subjects. In the sitting position, the HFF and activities of the abductor hallucis (AbdH), tibialis anterior (TA), and gastrocnemius (GCM) muscles were measured using a digital dynamometer and a wireless electromyography system, respectively. Subjects were instructed to flex the great toe maximally in three different ankle positions. Three 5-second trials were performed to measure the HFF and muscle activities in each condition. Repeated-measures ANOVA was used to compare the variables and paired t-tests with the Bonferroni correction were used for post-hoc pair-wise comparisons. The significance level was set at .016. Result : The HFF in DF was significantly greater than in any other ankle position (p<.01). The TA activity was greatest in ankle DF and that of the GCM was greatest in PF (both p<.01). However, there was no significant difference in AbdH activity according to ankle position. Conclusion : These results suggest that selective strength measurement of the foot intrinsic muscles in HFF should be performed with the ankle in the neutral position.

• Physical Therapy Korea
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• v.26 no.3
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• pp.84-90
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• 2019

Background: Ankle evertor muscles are important for preventing lateral ankle sprain. Since, the evertor muscles cross the ankle and toe joints, the position at which the ankle evertor muscle strength is measured is important. However, no studies have previously investigated the effect of ankle and toe positions on the strength of the ankle evertor muscle. Objects: This study is aimed to determine the effect of various ankle and toe joint positions on the strength of the ankle evertor muscles in healthy subjects. Methods: Eighteen healthy subjects participated in this study. Isometric ankle evertor strength of the dominant leg was determined in each subject in different ankle and toe positions (dorsiflexion (DF) with toe extension (TE), DF with toe flexion (TF), plantar flexion (PF) with TE, and PF with TF). A 2 by 2 repeated analysis of variance (ANOVA) was used to determine the difference in the evertor strength between the ankle positions (PF and DF) and toe positions (TE and TF). Results: The results indicate that there was no significant ankle position by toe position interaction effect (p=.83). However, the ankle evertor strength was significantly increased in the ankle DF position than in the PF position (p<.01), and the ankle evertor strength during eversion with TE was significantly higher than eversion with TF (p<.01). Conclusion: The findings of this study suggest that clinicians should consider the ankle and toe positions when measuring the muscle strength and during performance of selective muscle strengthening exercises of the ankle evertor muscles.

• The Journal of Korean Physical Therapy
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• v.33 no.2
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• pp.91-96
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• 2021

Purpose: This study investigated the effects of cryotherapy on the ankle joint muscle strength and balance ability in stroke patients with ankle joint muscles. Methods: In this study, 20 patients with chronic stroke were recruited from a rehabilitation hospital. The patients were divided into two groups: a cryotherapy group (10 patients) and a control group (10 patients). The cryotherapy group performed sit-to-stand training for 15 minutes and then cryotherapy for the minutes. In the control group, after sit-to-stand training for 15 minutes, blocked cryotherapy was provided for three minutes. In both groups, the interventions were provided five times a week for three weeks. The strength of the ankle joint muscles was measured before and after the training using the Biodex systems 3. The static balance ability was measured using balancia software, and the dynamic balance ability was measured by performing the sit-to-stand test (FTSST) five times. Results: After the training periods, the cryotherapy group showed significant improvement in the ankle dorsiflexor strength, ankle plantarflexor strength, weight distribution of the affected side, and FTSST compared to the control group (p<0.05). Conclusion: Based on these results, cryotherapy could be considered an effective method to improve the strength of ankle joint muscles. Cryotherapy improves muscle strength as it increases the motor neuron excitability. Therefore, cryotherapy may be considered to improve the strength of the ankle joint muscles of stroke patients.

• Journal of Korean Medicine Rehabilitation
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• v.21 no.2
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• pp.289-297
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• 2011

Objectives : This study was planned to show the influences of acupuncture treatment on peroneus muscles of acute inversion ankle sprain patients. Methods : This study was carried out on the 24 patients who had been treated for their acute inversion ankle sprain from July 1 to December 31, 2010 in the department of oriental rehibilitaion medicine, Dongsuwon oriental medicine hospital. And we divided those 24 patients into 2 groups; group A took near acupuncture point needling treatment on the peroneus muscles along with common treatment, group B took common treatment only. To evaluate the efficiency of each treatment, all patients were examined with visual analogue scale(VAS) and ankle-hindfoot scale(AHS) score before treatment and after the 3rd treatment. Results : On the AHS scores, there's no significant difference between the two groups after the treatment. And on the VAS scores, group A who took near acupuncture point needling treatment on the peroneus muscles along with common treatment showed higher change of VAS than group B who took common treatment only, but it did not show statistical significance in VAS score. Conclusions : In this study, there is no significant effect between common treatment only and near acupuncture point needling treatment on the peroneus muscles along with common treatment for acute ankle sprain.

• PNF and Movement
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• v.18 no.1
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• pp.65-75
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• 2020

Purpose: The purpose of this study was to investigate the differences in muscle thickness and ground reaction force of the vastus medialis oblique and vastus lateral oblique muscles during squats at ankle angles of toe 0°, toe in 10°, and toe out 10°. Methods: In this study, 9 male and 17 female students in their 20s participated in a randomized controlled trial and were compared according to the ankle angles of toe 0°, toe in 10°, and toe out 10°. To determine the reliability and measurement of muscle thickness according to ankle angle using ultrasound equipment and muscle thickness, the participants' ankle angles-toe 0°, toe in 10°, and toe out 10°-were measured three times at the vastus medialis oblique and vastus lateralis oblique muscles during squats. At the same time, the maximum vertical ground reaction force was measured with a force plate. A total of three measurements were taken and averaged, and two minutes of squat movements were assessed between ankle angles to prevent target action. Results: The results of this study illustrated that the reliability of the vastus medialis oblique muscles and vastus lateralis oblique muscles in ankle angle was high. The difference in muscle thickness was significantly greater in comparing the toe out 10° angle with the toe 0° angle than between toe in 10° and toe out 10° in vastus medialis oblique and vastus lateralis oblique (p < 0.05). There was no statistically significant difference between the ankle angle of toe 0° and toe in 10° (p > 0.05). The maximum vertical ground reaction force was significantly greater at toe out 10° than at the ankle angle of toe 0° and toe out 10° and between toe in 10° and toe out 10° (p < 0.05). There was no statistically significant difference in the comparison between toe 0° and toe in 10° (p > 0.05). Conclusion: Squatting at an ankle angle of toe out 10° increases the dorsi flexion; thus, the stability of the ankle and the thickness of both oblique muscles increased to perform more effective squats. In addition, as the base of support widens, it is thought that the stability of the posture increases so that squat training can be performed safely.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.4
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• pp.35-42
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• 2018

PURPOSE: This study was conducted to investigate the effects of Kinesio taping and massage application to the calf muscles on ankle stability. METHODS: The study subjects were 66 healthy adults (male: 32, female: 34) who had no instability in their ankles. Subjects were randomly assigned to a Kinesio taping group or a massage group. The research tool used the Y-balance test to measure instability of the ankle. The distance between the right and left foot was measured from the center in the anterior, posterior-medial, and posterior-lateral directions. Massage was applied to the calf muscles three times over two weeks and Kinesio tape was attached to the calf muscle and tibialis anterior for 10 hours twice during the experimental period. RESULTS: The results showed that application of Kinesio taping resulted in increases in the distance between the feet increased in some directions. After the massage, the distance extended from the anterior and posterior-lateral directions was prolonged, and the ankle stability on the right and left sides was partially improved by massage application. CONCLUSION: Kinesio taping and massage applied to the calf muscles are appropriate interventions for the improvement of ankle stability. Based on the application times of massage, Kinesio taping appears to work more effectively for ankle stability.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.4
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• pp.347-354
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• 2014

PURPOSE: This study was to examine changes in muscle activity of lower extremity shoes sole form (high heels, shoes with curved out sole, house shoes). METHODS: The subjects of this study were 12 women in their twenties. They put three kinds of shoes (high heels, shoes with curved out sole, house shoes) and walked 5m. The muscles activities of lower extremity muscles (rectus femoris, vastus medialis, tibialis anterior, gastrocnemius medial part) were measured using a wireless electromyogram (EMG). Rectus femoris was attached to 1/2 position at the distance between ASIS and knee bone and vastus medials was attached to 2cm from upper inside of knee bone. Tibialis anterior was attached to 75% position above line connecting knee joint and ankle joint and gastrocnemius medial part was attached to 3 5% position above knee joint and ankle. RESULTS: It was found that there were significant differences in changes of muscles activities of lower extremity muscles (rectus femoris, vastus medialis, tibialis anterior, gastrocnemius medial part) on shoes sole forms (p<.05). All lower extremity muscles were showed high muscles activities, when high heels wear (p<.05). Wearing shoes with curved out sole was showed high muscle activity of tibialis anterior and lower muscle activity of gastrocnemius medial part compared with wearing house shoes (p<.05). CONCLUSION: Shoes sole form should be considered when patients with knee and ankle joint problems choose shoes because muscles were showed different activities according to shoes sole forms.

• Journal of Biomedical Engineering Research
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• v.33 no.4
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• pp.163-168
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• 2012

Elderly women are reported to have greater risk of falls. The purpose of this paper was to investigate the possible gender differences in the reaction performance of ankle joint muscles, which have dominant role in the control of sagittal plane balance. Twenty-six elderly men and women with comparable mean age participated in this study. Reaction times to the audible beeps were measured in the tibialis anterior muscle and gastrocnemius muscle. Reaction time variables included premotor time, electromechanical delay and total reaction time. Gender difference in each reaction time was investigated by independent t-test. In both muscles, premotor time was longer in men but the electromechanical delay was longer in women (p < 0.05). Resulting total reaction time was longer in men in tibialis anterior muscle (p < 0.01) and it tended to be longer in men also in gastrocnemius muscle (p = 0.25). The results demonstrates that the overall reaction performances of elderly women is better than or comparable to those of elderly men in ankle joint muscles. This suggests that the reaction performance of ankle muscles is hardly the cause of the greater risk of falls in elderly women.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.1
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• pp.131-138
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• 2019

PURPOSE: This study examined the effects on muscle activation and ankle instability following sudden ankle inversion of the closed kinetic chain exercise using visual feedback to evaluate chronic ankle instability in adult males. METHODS: In this study, 28 subjects with chronic ankle instability were recruited and randomly divided into a closed kinetic chain exercise using a visual feedback group(n=13) and an open kinetic chain exercise group(n=15). Each group underwent 30 minutes of exercise three times a week for 8 weeks. The electromyographic(EMG) values of the rectus femoris, biceps femoris, tibialis anterior, peroneus longus, peroneus brevis, and lateral gastrocnemius muscles were measured to analyze muscle activity. The Cumberland ankle instability tool(CAIT) was used to measure ankle instability. RESULTS: Both groups showed improvements in tibialis anterior, peroneus longus and CAIT score(p<.05). In the experimental group, there were significant improvements in the rectus femoris, biceps femoris, and lateral gastrocnemius muscle activation(p<.05). CONCLUSION: The results suggest that closed kinetic chain exercise using visual feedback can be a useful treatment method for patients with chronic ankle instability.

• The Journal of Korean Physical Therapy
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• v.31 no.4
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• pp.176-183
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• 2019

Purpose: The purpose of this study was to investigate the short term effects of ASEJ (ankle strengthening with emphasis on jumping) for 3weeks on strength, mechanical properties, and balance and to compare the balance with and without HH(high-heel) condition. Methods: ASEJ (a combined exercise of squat, heel raise up, and jumping) were performed for the subjects in 11 female ankle instability young females ($21.7{\pm}2.0yrs$ Cumberland ankle instability score $19{\pm}6.5$). To investigate the effect of ASEJ, investigator used dynamometer for measuring strength, MyotonPRO for measuring mechanical properties(tone, stiffness, and elasticity of the muscles), I-Balance test for static balance, and Y-balance test for dynamic balance between the condition with and without HH condition. All data were normally distributed and analyzed using the SPSS 22.0 statistical program. Comparing pre- and post-intervention and the condition with and without HH conditions data were examined using the paired t-test. The level of significance was chosen as 0.05 for all the analyses. Results: 3wks of ASEJ would strengthen leg muscles and increasing muscle tone and stiffness in most muscles however there was decreasing muscle elasticity of gastrocnemious. In addition, the ASEJ improves the static balance for ankle instability young females and increases the dynamic balance when wearing the heels especially. Conclusions: the ASEJ could recommend to improve the strength and balance for ankle instability young females. Also, measuring the balance with HH conditions well represents the risk of ankle damage in female.