• Title/Summary/Keyword: Anterior instability

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Electromyographic Activity of the Biceps Brachii Muscle in Shoulders With Anterior Instability (전방 불안정성 견관절에서 이두박근의 근전도 활동성)

  • Kim Seung-Ho;Ha Kwon-Ick;Kim Hyeon-Sook;Kim Seon-Woo;Park Jong Hyuk;Kim Young-Min
    • Clinics in Shoulder and Elbow
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    • v.3 no.2
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    • pp.87-94
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    • 2000
  • Purpose : The purpose of this study was to evaluate the activity of the biceps brachii muscle in the vulnerable abduction and external rotation position of the shoulder in patients with anterior instability. Materials and Methods: This experimental study include a prospective analysis of the electromyographic(EMG) data on a group of patients with traumatic unilateral anterior instability of the shoulder. The EMG data of unstable shoulders was compared with those of opposite shoulders as control. The optimal sample size for the case-control study was calculated using an nQuery Advisor program(nQuery Adviser 3.0, Statisticl solutions Ltd., Ireland). The EMG analyses were conducted in 76 shoulders in 38 patients who had a traumatic anterior instability in one shoulder. The EMG records were obtained at different position of shoulder, which included 0° , 45° , 90° and 120° of shoulder abduction. In each angle of shoulder abduction, the arms were placed in an external rotation as tolerated by the anterior apprehension. The paired-sample T test was used to compare the difference of the root mean square(RMS) voltages between the stable and unstable shoulders in each degree of arm position. Results : The RMS voltage of the biceps muscle was significantly greater in the unstable shoulder than opposite stable shoulder in all position of the arm(p<0.001). The RMS voltage of the biceps was maximal at 90° and 120° of external rotation in the unstable shoulder(p<0.05). The RMS voltage of the supraspinatus muscle revealed no differences in any of the test conditions(p=0.904, 0.506, 0.119 and 0.781 in 0° , 45° , 90° and 120° , respectively) Conclusion: In the vulnerable abduction and external rotation position, the biceps muscle plays an active compensatory role in the unstable shoulder while not in the stable shoulder.

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Diagnosis and Comorbidity of Chronic Ankle Instability (만성 족관절 불안정성의 진단 및 동반 질환)

  • Ha, Dongjun;Kim, Duckhee;Gwak, Heuichul
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.2
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    • pp.49-54
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    • 2018
  • Ankle sprains are among the most common injuries sustained during athletic activities and daily life. Acute ankle sprain is usually managed conservatively with functional rehabilitation but the failure of conservative treatment leads to the development of chronic ankle instability. The development of repetitive ankle sprains and persistent symptoms after injury has been termed chronic ankle instability. Acute ankle sprains and chronic ankle instability require a careful evaluation to detect other comorbidities, such as subtalar instability, osteochondral defect, peroneal tendinopathy, tarsal coalition, os trigonum, flexor hallucis longus tendinitis, calcaneus anterior process fracture, and neural injuries. For the successful treatment of acute ankle sprains and chronic ankle instability, the treatment of comorbidity lesions should be performed first.

The Effect of Complex Ankle Exercises on Balance with Functional Ankle Instability in Twenties

  • Kim, Ki Jong;Ji, Sung Ha;Kim, Jin Young
    • Journal of International Academy of Physical Therapy Research
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    • v.8 no.2
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    • pp.1190-1194
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    • 2017
  • The purpose of this study was to investigate the complex ankle exercises on balance. 22 participants (male: 14, female: 8) with functional ankle instability were participated. Functional ankle instability was selected to be less than 24 points using the Cumberland ankle instability tool (CAIT) with people who had severe ankle sprain and then experiencing ankle giving way. A total of 20 minutes performed three times a week for four weeks with muscle strength and balance exercises. Muscle strengthening exercise was performed with Theraband, and balance exercise was performed with unstable support plates. Biodex balance system(R) was used to measure static and dynamic balance. The dynamic balance was selected in grade 2, 4, and 8. The static and dynamic balance (grade: 2, 4,and 8) balance was significantly decreased in anterior-posterior, and medial-lateral directions (p<.05). The instability was significantly increased after exercise (p<.05). These results suggest that complex exercises are beneficial to decreasing the functional ankle instability.

Effects of Dual Task Training on Balance and Functional Performance in High School Soccer Players with Functional Ankle Instability

  • Kwak, Kwang-Il;Choi, Bum-Jin
    • The Journal of Korean Physical Therapy
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    • v.28 no.4
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    • pp.254-258
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    • 2016
  • Purpose: This study was conducted to identify the effects of dual task training on balance and functional performance in high school soccer players with functional ankle instability. Methods: Twenty high school soccer players with functional ankle instability were randomly assigned to a single task training group and a dual task training group. One participant who did not participate regularly in the training was excluded. The single task training group (n=9) received balance training on an unstable surface. The dual task training group (n=10) received balance training on an unstable surface and had to catch thrown balls during the balance training. Both groups were trained for 4 weeks, 3 days a week. The balance and functional performance of both groups was measured before and after training. Balance was measured using an anterior-posterior and medio-lateral balance. Functional performance was measured based on a figure-of-8 hop test, up-down hop test, and a single hop test. All data were analyzed by repeated two-way ANOVA tests. Results: A time by group interaction effect was not observed in the medio-lateral balance test, figure-of-8 hop test, or single hop test (p>0.05). A time by group interaction effect was observed in the anterior-posterior balance and up-down hop test (p<0.05). Conclusion: These results suggest that dual task training improved balance and functional performance better than single task training for some items.

Indications of Lateral Ankle Ligament Reconstruction with a Free Tendon and Associated Evidence (유리건을 이용한 족관절 외측 인대 재건술의 적응증과 근거)

  • Kang, Hwa-Jun;Jung, Hong-Geun
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.3
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    • pp.91-94
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    • 2018
  • Ankle sprain is one of the most common musculoskeletal injuries. Although most ankle sprains respond well to conservative measures, chronic instability following an acute sprain has been reported to occur in 20% to 40% of patients. Some individuals are eventually indicated for a lateral ankle ligament reconstruction due to persistent ankle instability. More than 80 surgical procedures have been described to address lateral ankle stability. These range from direct repair of the anterior talofibular ligament (ATFL) and of the calcaneofibular ligament (CFL) to reconstructions based on the use of autograft or allograft tissues. However, the best surgical option remains debatable. The modified $Brostr{\ddot{o}}m$ procedure is most widely used for direct ligament repair, but not always possible because of the poor ATFL or CFL quality or deficiency of these ligaments, which prevents effective shortening imbrication. Furthermore, the importance of a CFL reconstruction has been emphasized recently. On the other hand, it is difficult to achieve an efficient CFL reconstruction during the $Brostr{\ddot{o}}m$ procedure. Others have reported that an anatomic reconstruction of injured ligaments restores the normal resistance to anterior translation and inversion without restricting subtalar or ankle motion, and as a result, anatomic reconstructions for lateral ankle instability utilizing an autograft or allograft tendon have gained popularity.

A Comparative Evaluation of Closed and Open Kinetic Exercises in the Management of Chronic Ankle Instability

  • Jung, Namjin
    • Journal of International Academy of Physical Therapy Research
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    • v.11 no.4
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    • pp.2212-2220
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    • 2020
  • Background: Repetitive damage to the ankle joint causes chronic ankle instability, and studies comparing the effects of exercise in open and closed chains as a treatment method are very rare. Objectives: To investigate the effects of open and closed kinetic exercises on muscle activity and dynamic balance of ankle joint in adults with chronic ankle instability. Design: Single-blind randomized controlled trial. Methods: The selected 30 subjects are randomly divided into open kinetic chain exercise experimental group (EGI, n=10), closed kinetic chain exercise experimental group (EGII, n=10), and stretching control group (CG, n=10). Open and closed kinetic exercises lasted 30 minutes three times a week for six weeks and stretching exercises performed four actions for 20 seconds and five sets. The measurement tools using surface electromyography to measure muscle activity in the ankle joint. The dynamic balance of the ankle was evaluated using the Y-Balance test. Results: Following the intervention, closed and open kinetic chain exercise group showed significant difference in tibialis anterior and gastrocnemius muscle activity and dynamic balance (P<.05). However, no significant difference in tibialis anterior and gastrocnemius muscle activity and dynamic balance between closed and open kinetic chain exercise group (P<.05). Conclusion: This study provides evidence that closed and open kinetic chain exercise can be presented as an effective exercise for the muscle activity of ankle muscle and dynamic balance of the subject with chronic ankle instability.

Radiographic Measurement of Ankle Lateral Stability in Normal Korean Adults (정상 한국 성인에서 발목관절 외측 안정성의 방사선학적 계측)

  • Shon, Hyun-Chul;Kim, Yong-Min;Kim, Dong-Soo;Choi, Eui-Sung;Park, Kyoung-Jin;Cho, Byung-Ki;Park, Ji-Kang;Hong, Kyung-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.1
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    • pp.41-46
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    • 2010
  • Purpose: Anterior drawer and varus stress test are commonly used for radiologic evaluation of chronic lateral ankle instability. However, there are controversies regarding the method of measurement and the normal value. This study was performed to investigate radiologic normal values in normal Korean adults and to analyze differences by age and gender. Materials and Methods: Sixty Korean adults were recruited and divided in three groups (20 in their twenties, 20 in their thirties, 20 in their forties). There were 10 males and 10 females in each group. The selection criteria were no history of ankle injury and no evidence of instability on physical examination. Radiologic measurement of varus talar tilt and anterior talar translation were performed through anterior and varus stress radiographs using Telos device (150N force). The measurement was repeated twice by three researchers, and intraobserver reproducibility and interobserver reliability were analyzed. The average talar tilt and anterior talar translation were obtained. Results: Talar tilt and anterior talar translation on ankle stress radiographs had good intraobserver reproducibility and interobserver reliability. Talar tilt was average $3.7^{\circ}$ and $5.1^{\circ}$ in male and female of twenties of age, $3.9^{\circ}$ and $4.8^{\circ}$ in their thirties, $3.4^{\circ}$ and $4.5^{\circ}$ in their forties. Anterior talar translation was average 3.5 mm and 4.2 mm in their twenties, 4.1 mm and 3.8 mm in their thirties, 3.6 mm and 4.1 mm in their forties. There was no significant difference in talar tilt and anterior talar translation by age. However, there was significant difference in talar tilt by gender. Conclusion: Normal range of talar tilt angle in Korean adults was below $8.3^{\circ}$, and normal range of anterior talar translation was below 7.6 mm. It seems to be able to serve as a good reference for radiologic evaluation and for treatment of chronic lateral ankle instability.

Alteration of Trabecular Bone Microarchitecure at Tibial Epiphysis due to Knee Joint Instability by Anterior Cruciate Ligament Rupture: Difference between Medial and Lateral Part (전방십자인대 손상으로 인한 슬관절 불안정성에 따른 경골 골단 해면골 미세구조 변화 : 내방과 외방에서의 해면골 미세구조 패턴 변화)

  • Lee, Joo-Hyung;Chun, Keyoung-Jin;Kim, Han-Sung;Lim, Do-Hyung
    • Journal of Biomedical Engineering Research
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    • v.33 no.2
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    • pp.78-88
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    • 2012
  • Knee joint instability by anterior cruciate ligament(ACL) rupture is allowing the abnormal loading condition at the tibial epiphysis locally, resulting in producing locally different bone bruise. The study examined difference between local alteration patterns of trabecular bone microarchitecture at medial and lateral parts of the tibial epiphysis by ACL rupture. Fourteen SD rats were divided into Control(CON; n = 7) and Anterior Cruciate Ligament Transection(ACLT; n = 7) groups. The tibial joints were then scanned by in vivo ${\mu}$-CT at 0, 4, and 8 weeks post-surgery. The results showed that alteration pattern on trabecular bone microarchitecture at medial part was significantly higher than that at lateral part of the tibial epiphysis in ACLT group from 0 to 8 weeks(P < 0.05). Tb.Th and Tb.Sp distributions were well corresponded with differences between aforementioned trabecular bone microarchitectural alteration pattens at medial and lateral parts of the tibial epiphysis in ACLT group from 0 to 8 weeks(P < 0.05). These findings suggest that the alteration patterns of trabecular bone microarchitecture should be locally and periodically considered, particularly with respect to the prediction of bone fracture risk by ACL rupture. Improved understanding of the alteration patterns at medial and lateral trabecular bone microarchitectures at the tibial epiphysis may assist in developing more targeted treatment interventions for knee joint instability secondary to ACL rupture.