• 한국운동역학회지
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• 제33권2호
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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.

• 대한족부족관절학회지
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• 제25권1호
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• pp.17-24
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• 2021

Surgical treatments for chronic lateral ankle instability include anatomic repair, anatomic reconstruction using an auto or allograft, non-anatomic reconstruction, and arthroscopic repair. Open anatomic repair using the native ligament with or without reinforcement of the inferior extensor retinaculum is commonly performed in patients with sufficient ligament quality. Non-anatomical reconstruction using the adjacent peroneus brevis tendon is typically used only in patients with poor-quality ligament remnants or when previous repair failed. Anatomical reconstruction can be considered in patients in whom anatomical repair is expected to fail and when performed using auto or allografts can provide good to excellent short-term results, although the long-term outcomes of these methods remain unclear. Arthroscopic repair can provide good to excellent short-term clinical outcomes, but evidence supporting this technique is limited. The advantages and disadvantages of various surgical methods should be compared, and appropriate treatment should be implemented based on patient characteristics.

• 한국운동역학회지
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• 제33권3호
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• pp.94-100
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• 2023

Objective: Few studies have investigated alterations of ground reaction force (GRF) in individuals with chronic ankle instability (CAI) compared with lateral ankle sprain (LAS) copers and healthy controls during walking. This study aimed to investigate differences in GRF variables among the CAI, LAS coper, and control groups. Method: Eighteen individuals with CAI, 18 LAS copers, and 18 healthy controls were recruited for this study. All participants walked on 8-m walkway with a force plate three times. GRF data during stance phase were extracted and analyzed. The analysis of variance and ensemble curve analysis were used for statistical analyses of discrete points and time-series data respectively. Results: The CAI group showed a greater loading rate (LR) and a shorter time to impact peak force than the other groups, as well as decreased vGRF from 56% to 65% in the stance phase than the control group. No significant differences were noted in the other variables. Conclusion: Based on these findings, individuals with CAI should enhance their ability to create propulsion during the push-off phase and spend more time absorbing GRF to decrease the LR, which is considered one of risk factors for overuse injury and ankle osteoarthritis.

• 대한관절경학회지
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• 제15권1호
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• pp.22-27
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• 2011

족관절 인대 봉합수술은 만성 족관절 불안정성의 치료에 많이 사용되는 술기로서 최근에는 족관절의 관절경술을 추가로 시행하여 관절내 병변 등을 확인하고 치료하는 것이 권유되고 있다. 저자들은 연골 손상을 동반한 족관절 중등도 불안전성 환자에서 관절경적 다발성 천공술과 함께 관절경하에 생체 흡수성 나사못을 이용한 전거비 인대 고정술을 시행하고, 그 결과를 문헌 고찰과 함께 보고 하고자 한다.

• 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.

• 대한물리의학회지
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• 제3권2호
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• pp.127-133
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• 2008

Purpose : The purpose of this study was carried out to review the correlation between foot shape(supination foot, pronation foot) and low back pain, hip abduction muscle and ankle lateral sprain. Methods : By using internet, we research the PubMed, Science Direct, KISS, DBpia We selected the article between 1990 and 2007. Key words were supination foot, pronation foot, balance. Results : Normal control balance of human body needs a optimal anatomical alignment and function of musculoskeletal and central nerve system that control continuously to integrate. Especially ankle and foot complex play an important role in postural control because it is located distal part in human body. Supination foot brings to chronic ankle sprain or chronic ankle instability and range of motion limitation due to the weakness of lateral ankle muscle. Pronation foot brings to knee injury because of lower leg internal rotation force. Conclusion : Excessive supination and pronation foot happen to muscle imbalance. Especially weakness of hip abduction or injury of ankle lateral muscle or low back pain are due to abnormal balance and anatomical alignment.

• 대한족부족관절학회:학술대회논문집
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• 대한족부족관절학회 2008년도 추계학술대회 및 총회
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• pp.15-15
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• 2008

• 대한족부족관절학회:학술대회논문집
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• 대한족부족관절학회 2008년도 추계학술대회 및 총회
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• pp.16-16
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• 2008

• 대한정형외과스포츠의학회지
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• 제7권1호
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• pp.19-23
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• 2008

족관절 만성 외측 불안정증을 비해부학적인 방법으로 재건한 후에 발생하는 여러가지 문제점들을 해결하기 위하여 해부학적으로 재건하는 여러가지 방법이 보고되었다. 해부학적인 위치로 재건하는 것이 정상 관절 역학과 안정성을 회복하는데 중요하다. 해부학적인 재건 방법의 가장 큰 문제점은 인대를 정상적인 주행 방향으로 재건하는 것이 매우 어렵다는 점인데, 저자는 전거비 인대와 종비 인대가 서로 인접하여 위치하므로 두 인대의 비골측 부착부에 한 개의 터널을 만드는 것이 각각의 인대가 통과 할 별도의 터널을 만드는 것보다 좀 더 해부학적이라고 생각하였다. 이 논문에서는 외측 인대의 해부학적 재건에 필요한 기초 지식을 알아보고 반건양건을 이용한 재건 수술 방법을 소개하였다.

• 대한족부족관절학회지
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• 제8권1호
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• pp.76-80
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• 2004

Purpose: We assessed the results of open treatment of anterior impingement syndrome of the ankle in elite level soccer players and concomitant injuries were idenfied. Materials and Methods: We retrospectively reviewed twenty one elite level soccer players diagnosed with anterior impingement syndrome who underwent open debridement between January 1997 and January 2002. All were men and the mean age at the operation was 21 years (range 16 to 27). The mean follow-up duration was 31 months (13 to 71). Concomitant abnormalities were idenfied through physical examination, bone scan and MRI. On a preoperative lateral radiograph, patients were classified according to McDermott's stage. Anteromedial or anterolateral approach was used at the operation and osteophyte was removed with osteotome and rongeur. When chronic ankle instability was accompanying, we performed Modified Brostrom-Gould procedure and for osteochondral lesion, multiple drilling was applied. The Ogilvie-Harris scoring system was used as a clinical scale to evaluate pain, swelling, stiffness and limitation of activity. The results were scored as excellent (15 to 16 points), good (13 to 14) and otherwise unsatisfactory. The time to return to full activity including sports activity was determined. Results: Eighteen of twenty one patients had an excellent outcome. Three patients were graded unsatisfactory and two of them abandoned their career due to the persistence of residual pain. Concomitant abnormalities were found including twelve cases of chronic ankle instability, three cases of osteochondral lesion and two cases of flexor hallucis longus tendinitis. Conclusion: Open debridement was successfully applied to the elite level soccer player with anterior impingement syndrome of the ankle. Considerable coexistence of other abnormalities such as chronic ankle instability may encourage us to consider additional operative procedure.