• 대한물리의학회지
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• 제6권1호
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• pp.103-108
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• 2011

Purpose : The purposes of this study were to compare the muscle activity ratio of tibialis anterior (TA) / extensor digitorum longus (EDL) during the active ankle dorsiflexion in subjects with the normal toe (NT) and the hammer toe (HT). Methods : Nineteen subjects with the NT group and nineteen subjects with the HT group were recruited for this study. The muscle activities of TA and EDL were measured by using surface electromyography (EMG) and the angles of ankle dorsiflexion and eversion of the subtalar joint were measured by using 3-dementional motion analysis during the active ankle dorsiflexion in prone position. Results : The muscle activity ratio of TA / EDL was significantly lower in the HT group compared to the NT group (p<.05). The angle of ankle dorsiflexion was significantly lower in the HT group compared to the NT group (p<.05). Conclusions : These results suggest that muscle imbalance between TA and EDL muscle and decreased ankle dorsiflexion range of motion may contribute to hammer toe deformity. Further studies are needed to confirm that the correcting of this imbalance and the increasing ankle dorsiflexion could improve toe alignment in the subjects with HT.

• 한국전문물리치료학회지
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• 제31권2호
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• pp.151-158
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• 2024

Background: In Taekwondo athletes, ankle sprain is the most common risk factor for injury. Repeated ankle injuries lead to weakness and imbalance of the ankle muscles, resulting in chronic ankle instability (CAI). Both the ankle and toe muscles contribute to the inversion and eversion of the foot at the subtalar joint. Therefore, it is necessary to consider the ankle and toe joint positions when measuring ankle invertor and evertor strength. Objects: This study aimed to compare the muscle strength and ratio differences of the ankle invertor and evertor muscles in both the toe and ankle positions between the CAI and uninjured sides in Taekwondo athletes. Methods: Fifteen Taekwondo athletes participated in this study. The isometric strengths of both the ankle invertor and evertor were determined in different ankle and toe positions (dorsiflexion with toe extension, dorsiflexion with toe flexion, plantarflexion with toe extension, and plantarflexion with toe flexion). Paired t-tests were used to determine the differences between the ankle invertor and evertor in strength and ratio according to toe and ankle positions between the ankle CAI side and the uninjured side. Results: The results demonstrated that ankle evertor strength significantly decreased in all ankle and toe positions on the CAI side (p < 0.05). In addition, significant differences were observed in the ratios of the ankle invertor and evertor strengths in the dorsiflexion with toe flexion, plantarflexion with toe extension, and plantarflexion with toe flexion positions (p < 0.05). Conclusion: The findings of this study suggest that athletes, trainers, and clinicians should consider ankle and toe positions when measuring invertor and evertor strength and develop ankle rehabilitation protocols for Taekwondo athletes with CAI.

• 대한물리의학회지
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• 제9권4호
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• pp.439-445
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• 2014

PURPOSE: This study was to investigate the effect of direction of gliding in the tibiofibular (TF) joint on angle of active ankle dorsiflexion (AADF). METHODS: Fifteen subjects with no medical history of lower extremities were recruited in this study. The digital dynamometer was used to maintain the same gliding force in each condition. The angle of AADF was measured by using the electronic goniometer. Subjects were instructed to perform the AADF in three trials during the each gliding in the TF joint by the examiner. The conditions were no gliding and four directions of gliding in the proximal (anterior-superior: A-S vs posterior-inferior: P-I) and distal (posterior-superior: P-S vs. anterior-inferior: A-I) TF joint. A repeated measured ANOVA was used to compare angle of the AADF in each TF joint. The paired-sample t tests with Bonferroni correction were used in order to Post hoc pair-wise comparisons. The significant level was set at 0.016 (0.05/3). RESULTS: In distal TF joint, the angle of AADF in the A-I direction of gliding was significantly lower than those in no gliding and P-S direction of gliding (p<0.01). In proximal TF joint, the angle of AADF was significantly lower than those in no gliding and A-S direction of gliding (p<0.01). Although there was no significant differences, angle of AADF were largest in the P-S direction of gliding among four conditions. CONCLUSION: These findings suggest that gliding technique of TF joint would be required to improve the angle of AADF in subjects with limitation of ankle dorsiflexion.

• The Journal of Korean Physical Therapy
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• 제28권2호
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• pp.124-127
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• 2016

Purpose: The flexor hallucis longus stretch test can determine the shortness of the flexor hallucis longus muscle by measuring the angle of extension in the first metatarsophalangeal (MTP) joint at maximum ankle dorsiflexion. Less than 30 degrees of the first MTP joint at the maximal ankle dorsiflexion indicates shortness of the flexor hallucis longus muscle. The purpose of this study was to examine the intra- and inter-reliability of the flexor hallucis longus stretch test in subjects with asymmetric hallux valgus (HV) angles. Methods: Sixteen subjects with asymmetric HV angles participated in this study. In sitting position, dorsiflexion angles of the first MTP joint were measured with maximum ankle dorsiflexion on each side. ICC (3,1) and ICC (3,k) models were used, respectively, to assess the intra-reliability and inter-reliability of the flexor hallucis longus stretch test. The paired-t test was used to compare the dorsiflexion angle of the first MTP joint on the side with the smaller HV angle with that of the side with the larger HV angle. Results: The results of the study showed that both intra- and inter-reliability were more than 0.95 of the coefficient. Dorsiflexion angle of the first MTP joint was higher on the side with the smaller HV angle. Conclusion: Use of the flexor hallucis longus stretch test is acceptable in clinical settings because both intra- and inter-reliability were high in subjects with asymmetric HV angles. In addition, shortness of the flexor hallucis longus muscle is associated with HV angle. This study provides useful information for use in management of HV deformity.

• 한국전문물리치료학회지
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• 제29권2호
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• pp.124-130
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• 2022

Background: During postural control, older adults are more dependent on proprioception than are young adults. Ankle proprioception, which plays an important role in maintaining postural balance, decreases with age. Published studies are insufficient to establish a significant age difference in postural sway resulting from the known age-related decrease in ankle proprioception and do not examine various detailed test conditions. Objects: The present study aimed to compare ankle proprioception between older and younger groups along dimensions of position vs. force proprioception and dorsiflexion vs. plantarflexion. The present study also aimed to compare postural sway between young and older women during quiet standing under two sensory conditions. Methods: We recruited seven young women aged 21-24 and seven older women aged 60-63. Ankle proprioception was assessed as the accuracy of the joint position sense (JPS) and the force sense (FS). Postural sway was assessed using center-of-pressure measurements recorded during quiet standing under two sensory positions: eyes open and eyes closed with head tilted back. Results: Older women had lower JPS in dorsiflexion and lower FS in plantarflexion than did younger women. We found no significant age differences in JPS in plantarflexion or in FS in dorsiflexion. We observed a main effect of group on postural sway in two sway parameters out of three. We observed significant differences in JPS with dorsiflexion, and in FS with plantarflexion. Conclusion: Proprioception for ankle plantar flexor decreased more significantly with aging than did that for ankle dorsiflexor, accounting for the impaired postural balance observed in older women.

• 대한물리의학회지
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• 제13권2호
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• pp.43-51
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• 2018

PURPOSE: Stroke patients have limited ankle range of motion and balance problems. The purpose of this study was to determine the effects of Kaltenborn orthopedic manual therapy, Evjenth-hamberg stretching, and combination of both on ankle dorsiflexion range of motion and dynamic balance ability in stroke patients. METHODS: Thirty patients were placed in three groups, each of which received different treatments: Kaltenborn orthopedic manual therapy (15 mins), Evjenth-hamberg stretching (15 mins), or Kaltenborn orthopedic manual therapy with Evjenth-hamberg stretching (30 mins). Each group received three exercise sessions per week during four weeks. To determine its effectiveness of interventions an evaluation was carried out. ankle dorsiflexion range of motion was gauged using a tiltmeter application, and dynamic balance ability was measured using the Berg balance scale. RESULTS: All groups revealed significant improvements in ankle dorsiflexion range of motion, Berg Balance Scale (BBS) score before and after the intervention, and Kaltenborn orthopedic manual therapy with Evjenth-hamberg stretching group showed a significant improvement in ankle dorsiflexion range of motion and BBS score in comparison to other groups. CONCLUSION: We found out that each individual method was effective in ankle dorsiflexion range of motion, dynamic balance ability in stroke patients, and the combined method was more effective.

• The Journal of Korean Physical Therapy
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• 제34권1호
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• pp.12-17
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• 2022

Purpose: Ankle dorsiflexion is an essential element of normal functions, including walking, activities of daily living and sport activities. The tibialis anterior (TA) muscle functioned as a dorsiflexor and as a dynamic stabilizer of the ankle joint during walking and jumping. This study aimed to compare TA muscle thickness using ultrasonography according to the four different toe and ankle postures for the selective TA strengthening exercise. Methods: This study were recruited 26 (males: 15, females: 11) aged 20-30 years, with no injury ankle and calf in the medical history, had normal dorsiflexion and inversion range of motion (ROM). The thickness of the TA muscle was measured by ultrasonography in the four different toe and ankle postures: 1. Ankle dorsiflexion with all toe extension and ankle inversion (ITEDF); 2. Ankle dorsiflexion with all toe flexion and ankle inversion (ITFDF); 3. Ankle dorsiflexion with all toe extension and neutral position (NTEDF); 4. Ankle dorsiflexion with all toe flexion and neutral position (NTFDF). One-way repeated analysis of variance (ANOVA) and Bonferroni correction were used to confirm the significant difference among conditions. The level of statistical significance was set at α=0.01. Results: TA muscle thickness with ITFDF was significantly greater than in any other ankle positions, including ITEDF, NTFDF, and NTEDF (p<0.01). Conclusion: Among the four toe and ankle postures, isometric contraction in ITFDF postures showed the greatest increase in thickness of TA rather than ITEDF, NTEDF, and NTFDF postures. Based on these results, ITFDF can be recommended in an efficient way to selectively strengthen TA muscle.

• 재활복지공학회논문지
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• 제8권3호
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• pp.177-185
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• 2014

본 연구에서는 하지마비 장애인의 족하수 방지를 위하여 족배굴곡 보조를 위한 외골격 보조기를 개발하였다. 본 보조기는 인공 근육형 공압 액추에이터를 이용한 동력 전달부, 동력부의 고정을 위한 무릎 관절 착용부 및 보행 신호 검출을 위한 발목 관절 착용부로 구성되었다. 보조기는 무릎 관절 착용부와 발목 관절 착용부에 고정되어 족배굴곡 토크를 발생시켰으며, 발바닥 압력센서를 통해 사용자의 보행 단계를 검출하고, 족배굴곡 보조 타이밍을 감지하도록 하였다. 보행에 이상이 없는 건강한 65세 이상 고령자 7명과 20대 성인 10명을 대상으로 외골격 보조기의 족배굴곡 보조에 대한 성능을 확인한 결과, 인공 근육형 공압 액추에이터의 보조 시 전경골근의 근활성이 감소하는 결과가 나타났다. 향후 연구에서는 하지마비 환자를 대상으로 외골격 보조기의 효과를 검증할 것이다.

• 대한정형도수물리치료학회지
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• 제28권2호
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• pp.57-65
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• 2022

Background: This study examined the effects of adding fibular repositioning taping (FRT) to ankle mobilization with movement taping (AMT) on the ankle range of motion (ROM), balance, and gait performance in patients with chronic stroke with limited ankle dorsiflexion. Methods: The participants were randomized into the control (n=15) and AMT+FRT groups (n=15). The control groups applied only non-elastic taping on the affected ankle, and the AMT+FRT groups also applied non-elastic taping to the inferior tibiofibular joint. Both groups performed treadmill walking for 10 minutes. The ankle dorsiflexion passive ROM, balance, gait velocity, and cadence were measured before and after the intervention. Results: Both groups showed a significant difference after the intervention in the dorsiflexion ROM (p<.01), balance (p<.01), and gait performance (p<.01). On the other hand, no significant difference was observed between the two groups (p>.05). Conclusion: AMT improved ankle dorsiflexion passive ROM, balance, gait velocity, and cadence in patients with chronic stroke, but there was no difference between the two groups. Therefore, the addition of FRT to AMT does not influence the ankle dorsiflexion ROM, balance, and gait performance in patients with chronic stroke.

• 대한물리의학회지
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• 제13권2호
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• pp.129-135
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• 2018

PURPOSE: The imbalance of pretibial muscles can be a factor contributing to the development of pes planus. However, no study has yet compared the muscle activity of the tibials anterior (TA) to that of the extensor digitorum longus (EDL). The purpose of this study was to determine whether there are differences in the electromyographic (EMG) TA and EDL amplitude indexes (AIs) between normal and pes planus feet. METHODS: A total of 14 subjects with normal feet and 15 subjects with bilateral pes planus participated in this study. TA and EDL muscle activities were measured using a wireless EMG system and the angles of ankle dorsiflexion and eversion of the subtalar joint were measured using a universal goniometer during active ankle dorsiflexion in the prone position. AI was calculated as follows: $\text{amplitude_{TA}-amplitude_{EDL}/(amplitude_{TA}+amplitude_{EDL})}/2{\times}100$. RESULTS: The AIs of the TA and EDL were significantly lower in pes planus feet than in normal feet (p<.05). The angle of subtalar eversion was significantly greater in pes planus feet than in normal feet during active ankle dorsiflexon (p<.05). However, there was no significant difference in the angle of ankle dorsiflexion between normal feet and pes planus feet (p>.05). CONCLUSION: This study showed that TA muscle activation was lower in pes planus feet than in normal feet, resulting from greater eversion range of motion during active ankle dorsiflexion. We suggest that the imbalance of ankle dorsiflexors must be considered in pes planus management.