• 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.

• Physical Therapy Korea
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• v.31 no.2
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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.

• 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.

• 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.

• Journal of International Academy of Physical Therapy Research
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• v.5 no.2
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• pp.757-763
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• 2014

The purpose of this study is to observe the effect of elasticity of taping on ankle muscles'activity and endurance after plyometric training that easily causes ankle injury, and provide baseline data for physical therapy intervention methods. The study subjects are 24 male students in their 20s who attend N University in Choongnam. They were divided into three groups; 8 subjects in the elastic taping group, 8 in the non-elastic taping group, and 8 in the non-taping group(control group). They had plyometric training for 6 weeks. After the training, this study measured their maximum voluntary isometric contraction(MVIC) and muscle endurance of the muscles around ankle joint. The experiment result is as follows. After the training, all three groups showed improvement in muscle strength and endurance. The elastic taping group showed insignificant improvement in muscle strength but significant increase in muscle endurance in plantarflexion. In dorsiflexion, both muscle strength and endurance increased significantly. The non-elastic taping group showed insignificant improvement in muscle strength but significant increase in muscle endurance in plantarflexion. Taping during plyometric training had a little or insignificant effect on muscle endurance and strength compared to the non-taping group.

• PNF and Movement
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• v.22 no.2
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• pp.223-231
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• 2024

Purpose: The aim of this study was to investigate changes in ankle muscle strength, range of motion (ROM) dorsiflexion, and gastrocnemius flexibility following gastrocnemius stretching with talus stability taping in subjects with limited ankle dorsiflexion. Methods: Fifteen subjects (all males) with limited ankle dorsiflexion participated in this study for six weeks. Ankle muscle strength, ankle passive dorsiflexion ROM, and gastrocnemius flexibility were assessed pre- and post-intervention. Results: Ankle dorsiflexion and plantarflexion strength and passive ankle dorsiflexion ROM were significantly increased post-intervention compared to pre-intervention (p < 0.05). Gastrocnemius flexibility was significantly improved post-intervention compared to pre-intervention (p < 0.05). Conclusion: Gastrocnemius stretching with talus stability taping can be recommended for subjects with limited ankle dorsiflexion to increase passive ankle dorsiflexion, flexibility, and ankle muscle strength.

• Journal of International Academy of Physical Therapy Research
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• v.4 no.2
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• pp.557-561
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• 2013

The purpose of this study to identified the effect of muscle strengthening of ankle joints on postural sway. The subjects of this study were 29 healthy adults aged between 20 and 30 years(male 18, female 11). All subjects received ankle muscle strengthening exercise for 3 times, 3 sessions, 30 minutes per week over 4weeks period. The measured item of muscle strength, postural sway. Data collected from all subjects the result were as follows. The ankle strength showed significant increase(p<.05). One leg stand test with eye close increase in static balance(p<.05), left-right sway distance and anterior-posterior sway distance with eye open and close in static balance(p<.05). The result findings show that strength of the ankle joint muscles is a factor which affects postural sway and the ankle joints are important in static balance.

• The Journal of Korean Physical Therapy
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• v.27 no.6
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• pp.381-385
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• 2015

Purpose: This study was to identify the relationship between the game score and muscle strength in order to elucidate whether the obtained score for the dorsiflexor and plantar flexor muscles in the ankle joint using an EMG-based interactive game system can reflect muscle strength as measured conventionally. Methods: Forty adults were enrolled in the present study. They had no congenital deformities, and no neurological or orthopedic disorders in the 6 months prior to the start of the study. The Biodex were used to measure the isokinetic concentric maximal strength of the plantar flexor and dorsiflexor muscles in the ankle joint. EMG electrodes were attached to the tibialis anterior and gastrocnemius. Results: (1) There was a positive relationship between the obtained game score by the plantar flexor (sPF) and muscle strength of the plantar flexor (tPF) and dorsiflexor (tDF). In addition, the tPF affected the sPF, but the tDF did not. Thus, the higher the tPF, the higher the sPF. (2) There was no relationship between the obtained game score of dorsiflexor (sDF) and tPF or tDF. In addition, neither the tDF or tPF affected the sDF. Conclusion: The game score had a relationship with muscle strength, which is related to ankle instability and re-impairment. Thus we suggest that this game system can be used to predict the degree of weakness of muscle strength.

• Korean Journal of Applied Biomechanics
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• v.25 no.4
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• pp.401-412
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• 2015

Objective : The purpose of this study is to evaluate the effects of hip joint exercises and orthotics on RCSP, ankle's range of motion, and core muscle strength of middle school students with pes planus. Method : Out of the original pool of 200 students, 60 students with pes planus (RCSP < -2) were selected for the study. The selected 60 students were then divided into four groups. The first group was a combined orthotics and exercise group (12 students), the second was the orthotics-only group (9 students), the third was the exercise-only group (8 students), and the last was the control group (10 students). Exercise groups worked out twice a week for 60 minutes per session over 8 weeks. The independent variables were corrective hip joint exercises and orthotics. The dependant variables consisted of kinematic and kinetic variables. The kinematic variables were RCSP, and ankle's range of motion (dorsiflexion and plantarflexion). The kinetic variables were muscles forces that consist in core muscle strength, which are hip joint adduction, abduction, and flexion muscles forces. Statistical analysis was performed via SPSS 18.0 with multivariate analysis of covariance (MANCOVA) and a paired t-test was used. Results : The left foot was more responsive to the treatments, both exercise and orthotics, than the right foot. RCSP improved significantly in the left foot for the first and third groups. Only the first group significantly improved hip joint adduction, abduction, and flexion muscles' strengths. As for the ankle's range of motion of the left foot, plantarflexion showed improvement when treated with exercise, orthotics, or both. Conclusion : This study found that exercise is more effective in correcting RCSP and foot orthotics is more effective in reinforcing core muscle strength. Future studies should expand on these results to examine the relationship between the ankle, hip, and pelvis.