• 한국운동역학회지
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• 제33권4호
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• pp.147-154
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• 2023

Objective: This study aimed 1) to compare the Landing Error Scoring System (LESS) score and movement patterns during landing of the lesser dorsiflexion range of motion (LDFROM) group to that with the greater dorsiflexion range of motion group, and 2) to identify the correlation between the weight-bearing dorsiflexion range of motion (WBDF ROM), LESS score, and movement patterns during landing. Method: Fifty health adults participated in this study. WBDF ROM was measured using the weight bearing lunge test while movement patterns during landing was assessed using the LESS. The joint angles of the ankle, knee and hip joints during landing were analyzed using the 2D video analysis. After mean value of WBDF ROM was calculated, participants were divided into two groups (GDFROM and LDFROM) based on the mean value. The Mann-Whiteny 𝒰 test was used to identify differences in movement strategies during landing between two groups and the Pearson's correlation analysis was performed to determine relationships between WBDF ROM and movement strategies. Results: The LDFROM group showed the poorer LESS score and stiffer landing kinematics during landing compared to the GDFROM group (p<0.05). In addition, DFROM was significantly related to the LESS score and landing kinematics (p<0.05) except for total hip excursion (p=0.228). Conclusion: Our main findings showed that the LDFROM group had poorer landing quality and stiffer landing movements compared to the GDFROM group. In addition, increase of WBDF ROM significantly improved landing quality and soft-landing movements. To reduce shock during landing such as ground reaction forces, individuals need to better utilize WBDF ROM and lower extremity movements based on our findings. Therefore, intervention programs for safer landings should include exercises that increase WBDF ROM and utilize eccentric contraction.

• The Journal of Korean Physical Therapy
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• 제28권5호
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• pp.303-307
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• 2016

Purpose: This study was conducted to determine the effects of Mulligan's mobilization with movement (MWM) on changes in the talofibular interval in the sagittal plane in subjects with chronic ankle instability (CAI). Methods: Sixteen subjects with chronic ankle instability participated in this study. The talofibular intervals were measured from US images, and the weight-bearing lunge test was used to assess dorsiflexion of the ankle joint. Each dependent variable were measured on the both affected side and sound side in three trials in pre- and post-MWM. Dependent variables were examined with a two-way mixed-design analysis of variance (ANOVA). The two factors were side (sound side versus affected side) and intervention (pre- versus post-intervention). For post hoc analysis, paired t-tests were performed to compare the dependent variables. A p<0.05 was considered to indicate significance. Results: Dorsiflexion and talofibular interval differed significantly pre- and post-intervention (p<0.05). Post-hoc analysis revealed that the talofibular interval post-MWM was significantly less than that pre-MWM on the both the affected and sound side (p<0.05). The ankle dorsiflexion in the post-MWM group was significantly greater than that in the pre-MWM group on the affected side and the sound side (p<0.05). Conclusion: The Mulligan's MWM decreased the talofibular interval in subjects with CAI. These findings suggest that the MWM technique can change the position of the talus relative to the fibular in the weight bearing position.

• 한국전문물리치료학회지
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• 제20권4호
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• pp.47-54
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• 2013

The purpose of this study was to investigate the effects of active and passive postural perturbation on ankle dorsiflexor responses in stroke patients. The subjects consisted of 13 stroke patients. Using wireless electromyography, the patients' ankle dorsiflexor muscle responses were measured under the following conditions: active dorsiflexion (AD), active perturbation (AP), and passive perturbation (PP). Tibialis anterior muscle activity increased most significantly during PP of the affected side ($118.64{\pm}56.28$). The most significant increase for the non-affected side was in AD ($72.64{\pm}24.56$). Tibialis anterior muscle activity was compared under each condition. The affected side showed significant differences between PP and AD and between PP and AP (p<.05). The non-affected side showed not significant differences between each condition. The ratios of tibialis anterior muscle activity under AP to that under AD were 1.00 on the affected side and .75 on the non-affected side and the difference was not significant (p>.05). The ratios of tibialis anterior muscle activity under PP to that under AD were 3.30 on the affected side and 1.14 on the non-affected side and the difference was significant (p<.05). Passive perturbation improved tibialis anterior muscle activity on the affected side, and training based on this approach may have the potential to improve the ankle dorsiflexion of people with stroke.

• The Journal of Korean Physical Therapy
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• 제31권1호
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• pp.56-61
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• 2019

Purpose: The spasticity of stroke patients decreases the ankle range of motion and increases the gastrocnemius muscle tone. This study examined the effects of stretching exercise and far infrared irradiation on the ankle function in stroke patients with spasticity. Methods: This study was conducted on 20 stroke patients admitted to Jesaeng General Hospital, who were divided into a study group (stretching exercise with far infrared) and control group (stretching exercise only). The dorsiflexion range of motion was measured using a smartphone and the medial gastrocnemius muscle tone and stiffness were measured using a Myoton pro. Results: With the exception of the non-paretic gastrocnemius muscle tone in the control group, the medial gastrocnemius muscle tone and stiffness decreased significantly in both groups. In both groups, the dorsiflexion range of motion increased significantly. In addition, the experimental group had a significantly higher dorsiflexion range of motion than the control group. On the other hand, there was no significant difference between the two groups in terms of the medial gastrocnemius muscle tone and stiffness. Conclusion: For stroke patients with spasticity, stretching exercises increased the ankle's range of motion and decreased the gastrocnemius muscle tone. The addition of heat therapy further increased the ankle's range of motion. On the other hand, as the sample size was small, future studies should include more subjects.

• The Journal of Korean Physical Therapy
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• 제33권1호
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• pp.40-46
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• 2021

Purpose: This study compared the muscle activity of the lower limb according to the three types of fixed angles of the ankle joint during a lunge exercise. Methods: Twenty healthy subjects performed the lunge motion in a trial including the three types of fixed angle. The lunge motion with a neutral, 20° dorsiflexion, and 20° plantarflexion of the ankle joint were randomized and measured repeatedly. The muscle activity of the rectus femoris (RF), vastus medialis (VM), vastus lateralis (VL), biceps femoris (BF), and semitendinosus (ST) was measured by surface electromyography. Results: In the change in ankle joint angle, the RF, VL, BF, and ST muscle activity showed significant differences (p<0.05). In the 20° dorsiflexion position, the muscle activity of VL, BF, and ST showed a significant decrease compared to that in the neutral position (p<0.017). The muscle activity of RF and VL in the neutral position was greater than that in the 20° plantarflexion position (p<0.017). Only the muscle activity of the BF in the 20° plantarflexion position was significantly greater than the 20° dorsiflexion position (p<0.017). Conclusion: These results revealed a difference in the muscle activity of lower extremities in the proximal region according to the angle of the ankle joint during the lunge.

• 한국전문물리치료학회지
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• 제29권3호
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• pp.194-199
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• 2022

Background: Older adults use different ankle muscle activation patterns during difficult static balance conditions. It has been suggested that this is related to a decline in proprioception with age, resulting in reduced postural balance. However, the association between proprioception and ankle muscle activity during quiet standing has not been directly assessed. Objects: This study aimed to investigate the effects of age and sensory condition on ankle muscle activity and the association between ankle proprioception and ankle muscle activity. Methods: We recruited 10 young women and 9 older women. Ankle proprioception was evaluated using joint position sense (JPS) and force sense (FS) divided by dorsiflexion and plantarflexion. The electromyographic activity of the tibialis anterior (TA) and gastrocnemius (GCM) muscles was collected during quiet standing. Results: Older women activated GCM muscle more than young during quiet standing and when performing difficult tasks. Older women had more errors in JPS dorsiflexion and FS plantarflexion than did young. The GCM muscle activity is related to JPS dorsiflexion and FS plantarflexion. Conclusion: Lower proprioception of the GCM with age leads to increased muscle activity, resulting in reduced postural balance. There was no difference in TA proprioception or muscle activity among older women with frequent physical activity.

• The Journal of Korean Physical Therapy
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• 제35권2호
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• pp.43-47
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• 2023

Purpose: This study compared the movement control ability of the ankle joint according to the type of muscle contraction, namely, eccentric or concentric contractions. Methods: Thirty-four healthy adult subjects participated in this study. As a single group, before the experiment, the subjects were trained on achieving the required position of the ankle around the target point by manually controlling the ankle dorsiflexion by 10°. Concentric contraction starts at 0° and continues until the target point of 10° is reached. During an eccentric contraction, the ankle joint starts at 20° ankle dorsiflexion and continues till the target point is reached. Movements using eccentric contraction and concentric contraction were randomly performed 3 times each. Results: The results of comparing the difference in the movement control ability of each type of muscle contraction of ankle dorsiflexion showed that the measurement-remeasurement error was significant in eccentric contraction. Conclusion: In this study, we found a difference in the ability to control movement according to whether the contraction is eccentric or concentric. Therefore, we propose that the ability to control movement is affected by the type of muscle contraction.

• 근관절건강학회지
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• 제16권2호
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• pp.165-173
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• 2009

Purpose: The aim of this study was to examine the effects of sling exercise on fall risk score, ankle dorsiflexion and balance in community-dwelling elderly women. Method: A 6-week prospective study was conducted to examine the effects of sling exercise. Participants were required to attend their assigned exercise classes three times a week for 6 weeks. Result: After the 6 week study period, PPA fall-risk scores were reduced by 0.90 for the exercise group, which was a significant change (p<.001). Dorsiflexion strength increased significantly (p<.01) by 1.56 kg after the sling exercise. There was a 2.0 cm-increase (p<.05) in FRT and 0.38 second-improvement (p<.01) in TUGT. A 7.88 second-increase in One-leg standing with Eyes Open and a 3.12 second-increase in One-leg standing with Eyes Closed were reported during the 6-week intervention period. Conclusion: The 6-week sling exercise reduced falls risk score significantly (p<=.001) in community-dwelling elderly women by improving fall risk related factors such as reaction time, balance and strength.

• Physical Therapy Rehabilitation Science
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• 제12권3호
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• pp.340-345
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• 2023

Objective: The purpose of this study was to investigate the effect of thoracic spine and ankle joint alignment on trunk and upper limb muscle activity during trunk forward lean exercise using a sling. Methods: 25 subjects participated in this study. All subjects performed trunk forward lean exercise using a sling under four conditions according to the alignment of the thoracic spine and ankle joints. Trials were performed 3 times in each condition. Muscle activity of the trunk and upper extremity was measured using electromyography. Results: In the dorsiflexion, the thoracic kyphosis condition showed significantly higher muscle activity in the pectoralis major, rectus abdominis, latissimus dorsi, transverse abdominis than dorsiflexion(p<0.05). In the plantar flexion, thoracic kyphosis condition showed significantly higher muscle activity in pectoralis major, transverse abdominis, latissimus dorsi muscle activity than dorsiflexion(p<0.05). Conclusions: Regardless of ankle alignment, thoracic kyphosis condition increased the activity of the pectoralis major, transverse abdominis, latissimus dorsi. Therefore, regardless of the alignment of the ankle, it is recommended to perform the trunk forward lean exercise using a sling in thoracic kyphosis.

• 한국콘텐츠학회논문지
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• 제9권9호
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• pp.278-286
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• 2009

본 연구는 스트레칭이 $\alpha$-운동신경원의 흥분도를 변화시키는지의 여부와 이에 따른 유연성의 변화 정도를 알아보고자 시도되었다. 본 연구에서 $\alpha$-운동신경원 흥분도는 비복근 H-반사의 Hmax/Mmax 비로 측정하였으며 근육의 유연성은 족관절의 능동 배측굴곡 가동 범위를 통해 알아보았다. 스트레칭은 10명의 건강한 피검자를 대상으로 총 4분간(2분간의 스트레칭, 1분의 휴식, 2분간의 스트레칭), 각 시기별로 비복근에 적용하였다. $\alpha$-운동신경원 흥분도와 유연성을 분석하기 위해 본 연구에서는 스트레칭 적용 전, 1차 스트레칭 적용 직후, 2차 스트레칭 적용 직후, 그리고 2차 스트레칭 적용 후 48시간 후 Hmax/Hmax와 족관절의 능동 배측굴곡 각도를 측정하였다. 본 연구의 결과 1차와 2차 스트레칭 적용 후 의미 있는 $\alpha$-운동신경원 흥분도의 감소와 족관절 능동 배측굴곡 각도의 증가가 나타났으나 스트레칭을 소거한 48시간 후에는 $\alpha$-운동신경원 흥분도와 족관절의 능동 배측굴곡 가동 범위가 스트레칭 적용전과 비슷한 상태로 되돌아갔다. 이러한 스트레칭에 의한 비복근 $\alpha$-운동신경원 흥분도 감소와 이에 따른 족관절 배측굴곡 유연성 증가는 족관절 주변의 III형 기계적 수용기와 근육에 위치한 골지건 기관의 활성 결과로 사료된다.