• 제목/요약/키워드: Anterior instability

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Cumberland 발목 불안정성 도구에 의한 안정성과 불안정성 발목의 균형 비교 (The Comparison of Balance using Cumberland Ankle Instability Tool to Stable and Instability Ankle)

  • 김기종;제갈혁;전현주;최범진;최현진;유성훈;김용억
    • 대한물리의학회지
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    • 제8권3호
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    • pp.361-368
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    • 2013
  • PURPOSE: The purpose of this study was to investigate the comparison of balance on Stable Ankle(SA), Instability Ankle(IA) using Cumberland Ankle Instability Tool(CAIT). METHODS: Total 54(SA: 27, IA: 27) subjects were volunteered to participate in the study. SA can be defined CAIT score ${\geq}28$, with no history of injury to ankle. IA can be defined persisting symptoms of giving way and ${\leq}24$ on the CAIT after ankle sprain. the balance measured using Biodex Balance System$^{(R)}$(BBS). BBS instability protocols used static, dynamic balance level less stable(2), moderate stable(4) and level more stable(8). RESULTS: There were significant differences at overall, Anterior-Posterior(AP), Medial-Lateral(ML) of static balance, dynamic balance level 2, 4. The dynamic balance level 8 found significant difference at ML, but not found significant differences at overall, AP. CONCLUSION: We suggest that CAIT is acquired more exact information for IA intervention, as balance measured.

노인 퇴행성디스크 환자의 안정화운동이 척추불안정과 피로도에 미치는 영향 (The Effects of Segmental Instability and Muscle Fatigue after Applying Sabilization Exercise Program In Degenerated Disc Disease Patients of Aged)

  • 김희라
    • 대한정형도수물리치료학회지
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    • 제13권2호
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    • pp.12-20
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    • 2007
  • The purpose of this study was designed to find out the effectiveness of vertebral segment instability, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. In this study, the lumbar spine motion with blind by MedX test machine and the difference of instability to lumbar vertebra segments in flexion, extension test of standing position and spinal load test(Matthiass Test) by Spinal Mouse. The stabilization exercise program was applied 2 times a week for 12 weeks in hospital and 2 times a day for 20 minutes at home. The results of the present study were as follows: 1. Instability test of lumbar vertebra segment is 2 type differential angle test between vertebrae segment and loading test of spine(matthiass) by Spinal Mouse. It appeared to improve stability of segments in sagittal plane after applying program. So lumbar spine curve increased lordosis toward anterior and was improved of the lumbar spine flexibility in flexion and extension. Specially, in matthiass test, (-) value was increased between lumbar vertebra segment when was the load on spine. And so applying stability improved after program. 2. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine vertebra segments stabilization. Spine instability patients will have a risk when in lifting a load or working with slight flexion posture during the daily of living life and it is probably to increase recurrence rate. Thus, not only lumbar extension muscle strength but also stability of vertebra segments in lumbar spine may be very important.

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봉합 나사를 이용한 변형 Br$\ddot{o}$strom 술식 및 관절경 검사를 이용한 족관절 외측 불안정성의 치료 (Treatment of Chronic Ankle Lateral Instability using Modified Br$\ddot{o}$strom Procedure with Anchor suture & Arthroscopy)

  • 이진영;김갑래;이은수;박현진
    • 대한족부족관절학회지
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    • 제13권2호
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    • pp.175-178
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    • 2009
  • Purpose: To evaluate the result of modified Br$\ddot{o}$strom procedure with anchor suture and explore associate lesion under arthroscopy for chronic lateral instability. Materials and Methods: From May 2005 to March 2009, Retrospective analysis of 126 patients with chronic lateral instability who underwent modified Br$\ddot{o}$strom procedure with anchor suture and arthroscopic procedure was done. Mean follow-up period was 13 months. Results: Chronic lateral instability of the ankle almost had local synovitis by arthroscopic examination. There were osteochondral lesion of talus on the anteromedial aspect in 63 cases, on the anterolateral aspect in 25 cases, osteochondral lesion of tibia side in 8 cases, fat hypertrophy of tibiofibular space in 120 cases, anterior fat impingement in 26 cases, intra-articular loose body in 13 cases. Mean Karlsson scoring scale was improve from 53 preoperatively to 91 postoperatively, There were 70 cases excellent, 27 cases good, 26 cases fair, 3 cases poor result according to the Sefton procedure. Conclusion: Modified Br$\ddot{o}$strom procedure with anchor suture and arthroscopic procedure are reliable treatment method for chronic ankle lateral instability which has intraarticular pathology.

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노인 퇴행성디스크 환자의 안정화운동이 척추불안정과 피로도에 미치는 영향 (The Effects of Segmental Instability and Muscle Fatigue after Stabilization Exercise Program in Degenerated Disc Disease Patients of Aged)

  • 김희라
    • 대한물리치료과학회지
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    • 제13권4호
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    • pp.7-16
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    • 2006
  • The purpose of this study was designed to find out the effectiveness of vertebral segment instability, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. In this study, the lumbar spine motion with blind by MedX test machine and the difference of instability to lumbar vertebra segments in flexion, extension test of standing position and spinal load test(Matthiass Test) by Spinal Mouse. The stabilization exercise program was applied 2 times a week for 12 weeks in hospital and 2 times a day for 20 minutes at home. The results of the present study were as follows: 1. Instability test of lumbar vertebra segment is 2 type differential angle test between vertebrae segment and loading test of spine(matthiass) by Spinal Mouse. It appeared to improve stability of segments in sagittal plane after program. So lumbar spine curve increased lordosis toward anterior and was improved of the lumbar spine flexibility in flexion and extension. Specially, in matthiass test, ( - ) value was increased between lumbar vertebra segment when was the load on spine. And so stability improved after program. 2. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine vertebra segments stabilization. Spine instability patients will have a risk when in lifting a load or working with slight flexion posture during the daily of living life and it is probably to increase recurrence rate. Thus, not only lumbar extension muscle strength but also stability of vertebra segments in lumbar spine may be very important.

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동반 손상이 없는 만성 족관절 불안정성 환자에 대한 변형 Brostr$\ddot{O}$m 술식 (The Modified Brostr$\ddot{O}$m Procedure for Chronic Ankle Lateral Instability without associated injury)

  • 이경태;최성이;양기원;배상원;이승환
    • 대한족부족관절학회지
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    • 제6권2호
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    • pp.167-171
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    • 2002
  • Purpose: To analyze the result of Modified Brostr$\ddot{O}$m procedure for Chronic ankle lateral instability without associated injury. Materials and Methods: Forty-one patients(Forty-one feet) diagnosed and operated with chronic ankle lateral instability without associated injury were evaluated retrospectively from June 1995 to December 1999. Twenty-three patients were athletes. For the evaluation of clinical outcome, a subjective grading scale of modified Hamilton was used, and pain relief, relief of instability symptom and anterior drawer test were evaluated. Results: Among forty-one operations, there were six excellent, thirty-five good results as a whole. All cases showed over the grade good. The average time to ordinary life in the non-atheletes was 2.5 months and average time to sport activity in the athletes was 4 months postoperatively. Conclusion: The modified Brostr$\ddot{O}$m procedure seems to be effective method for chronic ankle lateral instability without associated injury.

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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.

Craniovertebral Junction Tuberculosis with Atlantoaxial Dislocation : A Case Report and Review of the Literature

  • Lee, Dae-Kyu;Cho, Keun-Tae;Im, So-Hyang;Hong, Seung-Koan
    • Journal of Korean Neurosurgical Society
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    • 제42권5호
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    • pp.406-409
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    • 2007
  • Craniovertebral junction (CVJ) tuberculosis is a rare disease, potentially causing severe instability and neurological deficits. The authors present a case of CVJ tuberculosis with atlantoaxial dislocation and retropharyngeal abscess in a 28-year-old man with neck pain and quadriparesis. Radiological evaluations showed a widespread extradural lesion around the clivus, C1, and C2. Two stage operations with transoral decompression and posterior occipitocervical fusion were performed. The pathological findings confirmed the diagnosis of tuberculosis. Treatment options in CVJ tuberculosis are controversial without well-defined guidelines. But radical operation (anterior decompression and posterior fusion and fixation) is necessary in patient with neurological deficit due to cord compression, extensive bone destruction, and instability or dislocation. The diagnosis and treatment options are discussed.

Effect of Taping Technique Applied to Adults with Knee Instability on Landing Error Scoring System, Lower Extremity Joint Angle

  • Son, Jin-Kyu;Park, Sam-Ho;Lee, Myung-Mo
    • Physical Therapy Rehabilitation Science
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    • 제10권4호
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    • pp.406-413
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    • 2021
  • Objective: The purpose of this study was to investigate effects of taping technique applied to knee instability. Design: Cross sectional study. Methods: Twenty-six participants with knee instabilityparticipated in this study. They were randomly assigned to the Kinesio taping (KT) group (n=13) and the dynamic taping (DT) group (n=13). Both groups applied knee stabilization taping techniques. In order to compare the effects of each taping technique, the change in the landing error scoring system (LESS) and lower extremity joint angle wasrecorded before and after the intervention. Results: Both groups significantly decreased in the change before and after the LESS (p<0.05). At the joint angle of the lower extremities, KT group significantly reduced the valgus angle at the max knee flexion (p<0.05). In DT group knee joint flexion and hip joint flexion angles were significantly increased at foot contact (p<0.05). In max knee flexion, the knee joint flexion angle was significantly increased (p<0.05). In foot contact, max knee flexion, the knee joint valgus angle was significantly increased (p<0.05). DT group showed more significant changes in knee joint flexion angle at foot contact and hip joint flexion angle at max knee flexion. Conclusions: Dynamic taping is a clinically applicable intervention method for lowering the risk of non-contact injury in participants with knee instability and for knee stability during rehabilitation exercises.

Effect of Jumping Exercise on Supporting Surface on Ankle Muscle Thickness, Proprioception and Balance in Adults with Functional Ankle Instability

  • Park, Chibok;Kim, Byeonggeun
    • 국제물리치료학회지
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    • 제10권2호
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    • pp.1756-1762
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    • 2019
  • Background: Functional ankle instability (FAI) indicating a decrease in muscle strength, proprioception, neuromuscular control, balance and postural control function. Objective: To investigate the effect of jumping exercise on the supporting surface on the ankle muscle thickness, proprioceptive sensation, and balance in adults with FAI. Design: Randomized Controlled Trial. Methods: Twenty young people with FAI were randomly assigned to the unstable supporting surface jump group (N=10) and the stable supporting surface jump group (N=10). The intervention was conducted three times a week for eight weeks, and for 30 minutes per session. Trampoline was used as an unstable support surface and the stable support surface was carried out on a regular floor. The thickness of the tibialis anterior muscle and medial gastrocnemius muscle was measured by ultrasonography, and the proprioception of dorsiflexion and plantarflexion was measured using an electrogoniometer. The dynamic balance was also measured with a balance meter. Results: The the muscle thickness of the medial gastrocnemius muscle was significantly higher in the stable supporting surface jump group than in the unstable supporting surface jump group (p<.05). Furthermore, the plantar flexion proprioception and dynamic balance were significantly improved in the unstable supporting surface jump group than in the stable supporting surface jump group in the intergroup comparison (p<.05). Conclusions: The conclusion has been reached in this study that the jumping exercise on the unstable supporting surface could be a more effective in improving FAI than the regular surface.

관절경하 생체흡수형 Knotless Anchor를 이용한 견관절 전방 불안정성의 치료 (Arthroscopic Treatment using Bioabsorbable Knotless Anchor for Anterior Instability of Shoulder)

  • 이용재;이동주;임광열;김명구
    • 대한관절경학회지
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    • 제8권2호
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    • pp.103-108
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    • 2004
  • 목적: 견관절의 전방 불안정성이 있는 환자에서 관절경하 생체흡수형 knotless anchor를 이용한 치료 결과를 객관적 및 주관적 평가를 통하여 알아보는데 있다. 대상 및 방법: 2003년 1월부터 2003년 6월까지 본원에서 외상성 견관절 전방 불안정성에 대하여 관절경하 생체흡수형 knotless anchor를 이용하여 Bankart복원술을 시행하고 평균 12개월 추시된 15예를 대상으로 하였다. 환자 구성은 남자가 14명, 여자가 1명이었으며, 평균 연령은 24세 (16세${\sim}$42세)였다. 평균 추시 기간은 14개월(12개월${\sim}$18개월)이었다. 수술시간은 같은 저자에 의해 2002년 1월부터 2002년 10월까지 suture anchor 술기를 이용하여 관절경하 Bankart 복원술을 시행한 20예와 비교하였다. 결과: 수술 후 탈구의 재발이나 아탈구의 발생은 없었으며 Rowe등에 의한 기능적 평가에서 평균 89.4점이었고 환자의 주관적 만족도는 평균 87.5였다. 최종 추시시의 견관절 운동 범위는 각각 굴곡이 평균 171도, 외회전이 평균 54도로 측정되었고 전 예에서 결과에 만족하였으나 3예에서 운동시 불안감각이 남아 있었다. 수술시간은 suture anchor 술기를 이용한 Bankart 복원술에서 1개의 매듭 당 평균 25.5분이 소요되었지만, 생체흡수형 knotless anchor를 이용시 1개의 anchor당 소요 시간은 평균 16.5분으로 의미 있게 감소됨을 알 수 있었다(P<0.05).결론: 견관절 전방 불안정성의 원인인 Bankart병변의 치료에 있어 knotless anchor 술식은 관절낭의 적절한 긴장을 획득하고 수술 시간을 단축하는 장점이 있으며 탈구나 아탈구의 재발없이 견관절 불안정성을 치료할 수 있는 유용한 방법으로 사료된다.

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