• Korean Journal of Applied Biomechanics
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• v.33 no.2
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• pp.62-72
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• 2023

Objective: Although balance training has been used as an effective ankle injury rehabilitation program to restore neuromuscular deficits in patients with chronic ankle instability, it is not effectively used in terms of motor learning. Attentional focusing can be an effective method for improving ankle kinematics to prevent recurrent ankle injuries. This study aimed to 1) evaluate the effects of attentional focus, including internal and external focus, and 2) determine a more effective focusing method for patients with chronic ankle instability to learn balance tasks. Method: Twenty-four patients with chronic ankle instability were randomly assigned to three groups (external focus, internal focus, and no feedback) and underwent four weeks of progressive balance training. The three-dimensional ankle kinematics of each patient were measured before and after training as the main outcomes. Ensemble curve analysis, discrete point analysis, and post hoc pairwise comparisons were performed to identify interactions between groups and time. Results: The results showed that (1) the external focus group was more dorsiflexed and everted than the internal focus group; (2) the external focus group was more dorsiflexed than the no feedback group; and (3) the no feedback group was more dorsiflexed than the internal focus group. Conclusion: Because dorsiflexion and eversion are ankle motions that oppose the mechanism of lateral ankle sprain, using the external focus method during balance training may be more effective in modifying these motions, thereby reducing the risk of ankle sprain.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.22 no.2
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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.

• Journal of Korean Physical Therapy Science
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• v.15 no.3
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• pp.19-29
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• 2008

Background : Ankle inversion sprains are one of the most common injuries in sports and activities of daily living that mostly concern physically active individuals. In most researches, proprioceptive deficit, muscle weakness and/or absent coordination have been regarded as a contributing factors. Despite the high incidence of ankle sprain and instability, therapeutic approaches to properly manage the symptoms have rarely been investigated. This study aimed to identify the effect of proprioceptive exercise program that is easy to integrate in normal training program. Methods : Subjects were randomly allocated to control group and experimental group consisting of 11 and 10 patients, respectively. The conservative treatment for the control group consisted of hot packs, ultrasound and TENS. In addition, the experimental group performed 7 exercises to enhance proprioceptive function of ankle joint. The therapeutic intervention of the controland experimental groups was performed a total of 20 exercise sessions, averaging 50 hour each, 5 times per week for 4 weeks. To compare the two groups, the level of ankle disability was assessed by using the ankle injury score scale in pre- and post-treatment. Results : On assessment of post-treatment, there were statistically significant differences in the scores of all sub-items, except for ankle laxity and range of motion, and the total score of ankle injury score scale between the two groups(p<0.05). In comparison between pre- and post-treatments, the significant difference in the scores of all sub-items and total score didn't appear for the control group, while the scores of most sub-items and total score of the experimental group were shown the statistically significant difference(p<0.05). Conclusion : The findings suggest that the proprioceptive exercise program is more effective for relieving ankle disability than conservative treatment therefore, the program to improve proprioceptive function should be recommended for prevention and rehabilitation of recurrent ankle inversion injuries.

• Journal of Korean Foot and Ankle Society
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• v.22 no.4
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• pp.145-150
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• 2018

High ankle sprain (distal tibiofibular syndesmosis injury) occurs from rotational injuries, specifically external rotation, and may be associated with ankle fractures. The prevalence of these injuries may be higher than previously reported because they may be missed in an initial examination. Syndesmosis injury can lead to significant complications in injured ankle joints, so a precise physical examination and radiological evaluation is necessary. The most important treatment goal is to have the tibia and fibula located in the correct position with respect to each other and to heal in that position. The methods to fix these injuries is controversial.

• Journal of Korean Foot and Ankle Society
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• v.23 no.3
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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.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.173-178
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• 2006

Purpose: The purpose of this study is to assess the clinical and radiological results of the early primary repair for acute ankle sprains. Materials and Methods: From October 2002 to September 2005, nine patients with acute ankle sprain were analyzed. Among them, eight patients took the inversion stress X-ray at local clinics, and the mean talar tilting angle was 28 degrees. We observed avulsion fragment near lateral malleolus in the other. The average age at the time of operation was 24 years and average follow-up period was 29 months. We evaluated postoperative symptoms by Hasegawa's clinical rating system, postoperative complications, and compared the talar tilting angle and anterior draw distance between both ankles at the final follow-up X-rays. Results: Anterior talofibular ligament was ruptured at fibula in 4, at midsubstance in 3, at talus in 1 and at fibula and midsubstance simultaneously in 1. Calcaneofibular ligament was ruptured at fibula in 3 including a case of avulsion fracture, at midsubstance in 2, and at calcaneus in 4. And posterior talofibular ligament was ruptured at midsubstance in 2. Clinical results were rated as excellent in all. We did not find major postoperative complications except for one sural nerve irritation. Both (injured ankle/uninjured ankle) talar tilting angle averaged 6.8/8.2 degrees and anterior draw distance averaged 2.9/3.7 mm at final follow-up X-rays. Conclusion: Early primary repair is recommended for treating acute severe ankle sprains and in case found avulsion fracture in X-ray taken after ankle sprain.

• Journal of Korean Foot and Ankle Society
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• v.19 no.3
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• pp.81-85
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• 2015

Acute sprain of the ankle requires comprehensive history taking and physical examination in diagnosing the type of severity and deciding on the plan of treatment. Literature supports functional treatment as the treatment of choice for grade I and II injuries. During the acute phase, the goal of treatment focuses on controlling pain and swelling. PRICE (protection, rest, ice, compression, and elevation) is a well-established protocol at this phase. There is some evidence that application of ice and use of nonsteroidal anti-inflammatory drugs improves healing and speeds recovery. Then the functional treatment (motion restoration and strengthening exercises) is administered to progress the rehabilitation appropriately in order to facilitate healing and restore the mechanical strength and proprioception. Early mobilization has been shown to result in more rapid return to work and daily activities than immobilization. Grade III injuries still generate controversy in terms of the best management available, and more studies on early mobilization, cast immobilization, or surgery are needed. Even the Cochrane reviews published to date are not conclusive.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.3
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• pp.141-151
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• 2022

Objectives The purpose of this study is to improve the accessibility of Korean medicine by standardizing managements, improving quality of medical services, and reducing medical costs in ankle sprain by develop clinical pathway (CP). Methods The development of CP in this study is based on clinical practice guideline (CPG) for ankle sprain, and aims to maximize the quality of treatment, such as reducing treatment time and medical costs, and increasing patient satisfaction through standardized pathway. The CP was revised after consultation and review by the advisory committee. The advisory committee is consisted of a stakeholder group applying the CP. Results In previous research studies, there were no Korean medicine CP studies on ankle sprain. Based on CPG for ankle sprain and analysis of medical records, 6 types of time task matrix type CP (for Korean medicine doctors, medical assistant, patients) and 4 types of algorithm type CP (for Korean medicine clinics, Korean medicine hospitals, and cooperative practicing hospitals, public medical centers) were derived as a result. Conclusions Ankle sprain CP is expected to not only increase patient satisfaction and maximize the quality of treatment, but also reduce the financial burden of health insurance by reducing medical costs.

• Journal of Acupuncture Research
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• v.31 no.2
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• pp.11-19
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• 2014

Objectives : This study was aimed to determine which pharmacopuncture was effective in relieving pain in standard pain model, acute grade 3 ankle sprain rat model. Methods : Percentage changes of weight bearing ratio(WBR), as pain indicator, were measured after anti-inflammation, neutro Eohyul, Hwangryunhaedock-decoction pharmacopuncture were injected to Guheo ($GB_{40}$). Results : In three kinds of pharmacopuncture, neutro Eohyul and Hwangryunhaedock-decoction pharmacopuncture represented more effect in percentage changes of WBR than surgical(non treatment), needling group. Conclusions : Comparing of pharmacopuncture in grade 3 ankle sprain rat model, these results provide basis to select pharmacopuncture in sprain disease. Furthermore, mechanism of pharmacopuncture's analgesia, anti-inflammation should be progressed.

• Physical Therapy Rehabilitation Science
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• v.5 no.2
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• pp.78-83
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• 2016

Objective: The purpose of this study was to investigate whether the intrinsic foot muscle training method can improve the medial longitudinal arch in patients with chronic ankle injury and with pronated feet, as well as to investigate for the most effective exercise method for these patients. Design: Randomized controlled trial. Methods: Thirty men and women with pronated feet had participated in this study and were allocated to either the short foot exercise group (SFEG) or the towel curl exercise group (TCEG) randomly. SFEG and TCEG underwent exercises three times a week for 8 weeks, with three sets per day, totalling up to 5 minutes per day. The navicular drop test (NDT) was used in order to assess for changes in the medial longitudinal arch and the Cumberland ankle instability tool (CAIT) was used to assess for ankle instability of the chronic ankle sprain patients. Results: There was a significant increase in CAIT scores in the SFEG (p<0.05) and a significant difference between groups was presented (p<0.05). The NDT scores were significantly decreased in both groups (p<0.05). In the SFEG, the NDT scores were more decreased than in the TCEG (p<0.05). Conclusions: These results suggest that short foot exercises are more effective in providing intrinsic foot muscle training for patients with pronated feet among chronic ankle sprain patients. Furthermore, short foot exercises may be used to provide ankle stability.