• 대한족부족관절학회지
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• 제8권2호
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• pp.149-152
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• 2004

Purpose: We assessed the clinical results of modified Brostrom procedure as a revision method after failure of a primary reconstruction. Materials and Methods: This is a retrospective study of seven patients treated with Modified Brostrom procedure after failed lateral ankle ligament reconstruction between 1996 and 2002. Instability symptom developed average 4.7 month after the initial reconstruction surgery at other clinics. All patients had significant functional impairment before surgery and not responded to conservative protocols. Modified Brostrom procedure was applied to all patients. Results: The average follow up was 51 months (18 to 84). Seven of eight patients had clinical stability following revision reconstruction, six patients (75%) returned to their previous functional level. American Orthopaedic Foot and Ankle Society ankle-hindfoot scores averaged 87.5. There is no difference in active or passive range of motion of plantar flexion or dorsiflexion when compared to the contralateral ankle. However, three patients were noted to have lost some degree of inversion when compated to contralateral ankle. Two patients had osteochondral lesion and multiple spurs and had pain around the ankle that prevented their full recovery. One patient complained of persistent pain which was considered complex regional pain syndrome. Conclusion: Though the outcome of the Modified Brostrom procedure as a method of revision surgery was less satisfactory compared to the results of primary ankle reconstruction, it would be an appropriate option when concomitant abnormalities were not accompanying.

• 대한족부족관절학회지
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• 제5권1호
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• pp.5-12
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• 2001

Purpose: To find out the priority of which procedure has had a better outcome both clinically and radiographically between the two groups, one is treated by primary repair and the other by modified Brostr$\ddot{o}$m's procedure, by comparing the postoperative ankle joint stability and the patient's degree of satisfaction. Material and methods: 16 cases were taken into consideration whose number of severed ligaments were at least two or more of the lateral collateral ligaments of the ankle, and also were confirmed intraoperatively. Among them, 8 cases were treated with primary repair and the other 8 cases were treated with primary repair and the other 8 cases by modified Brostr$\ddot{o}$m's procedure. Results: There was no distinguishable difference for the patient's degree of satisfaction between the two procedures above mentioned. In 3 cases treated with primary repair, functional instability was observed. In case of postoperative ankle joint stability, 7 of 8 cases treated by modified Brostr$\ddot{o}$m's procedure has revealed increased joint stability. And 3 of 8 cases which were treated by primary repair have showed postoperative residual instability. Conclusion: Actually, the severed ligament can not maintain its normal strength though several months has elapsed, and possible residual instability could be remained. Therefore, it can be expected that modified Brostr$\ddot{o}$m's procedure also would be a .good method in obtaining suitable ankle joint stability as well as subtalar joint stability because of its reinforcement using extensor retinaculum.

• PNF and Movement
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• 제18권2호
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• pp.173-182
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• 2020

Purpose: The purpose of the study was to investigate the effects of visual feedback exercise (VFE), sandal exercise (SE), and thera-band exercise (TE) on people with functional ankle instability. Methods: The 45 study participants were divided into three groups of 15. In the VFE group, participants performed short-foot exercises using visual feedback; the SE group performed sandal exercises, and the TE group performed thera-band exercises. Over a period of 8 consecutive weeks, the experimental groups exercised for 15 minutes per session, four times per week. Balance was measured using the Biodex Balance System for dynamic balance ability (overall balance index [OBI], mediolateral balance index [MBI], and anterioposterior balance index [ABI]). Vibration threshold sense (VTS) was assessed using a vibratory sensory analyzer. Ankle muscular strength was measured using the Biodex 4 Pro. The main outcome measures were assessed at baseline and after 8 weeks of training. Results: Significant improvements in dynamic balance were noted in all three groups (p < 0.05). Significant improvements in VTS and muscular strength were also noted in the VFE and TE groups but not in the SE group (p < 0.05). Conclusion: Appropriate environmental and situational mediation may be of great clinical significance for patients suffering from chronic ankle instability. It is hoped that the findings will inform a program for prevention of ankle instability.

• 한국운동역학회지
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• 제28권2호
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• pp.135-141
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• 2018

Objective: The purpose of this study was to investigate the effect of functional ankle instability (FAI) and surgical treatment (ST) on postural stability and leg stiffness during vertical-drop landing. Method: A total of 21 men participated in this study (normal [NOR]: 7, FAI: 7, ST: 7). We estimated dimensionless leg stiffness as the ratio of the peak vertical ground reaction force and the change in stance-phase leg length. Leg length was calculated as the distance from the center of the pelvis to the center of pressure under the foot. Furthermore, the analyzed variables included the loading rate and the dynamic postural stability index (DPSI; medial-lateral [ML], anterior-posterior [AP], and vertical [V]) in the initial contact phase. Results: The dimensionless leg stiffness in the FAI group was higher than that of the NOR group and the ST group (p = .018). This result may be due to a smaller change in stance-phase leg length (p = .001). DPSI (ML, AP, and V) and loading rate did not show differences according to the types of ankle instability during drop landing (p > .05). Conclusion: This study suggested that the dimensionless leg stiffness was within the normal range in the ST group, whereas it was increased by the stiffness of the legs rather than the peak vertical force during vertical-drop landing in the FAI group. Identifying these potential differences may enable clinicians to assess ankle instability and design rehabilitation protocols specific for the impairment.

• 대한통합의학회지
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• 제8권1호
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• pp.27-36
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• 2020

Purpose : The purpose of this study is to apply kinesiology taping and dynamic taping to subjects with ankle instability and to find out the change of static balance and dynamic balance ability and to use it more usefully in daily life. Methods : The subjects were based on 30 Cumberland Ankle Instability Tool questionnaire scores of 24 or less, and were randomly assigned to the kinesiology taping group (n=15) and the dynamic taping group (n=15) to change the static balance and dynamic balance before and after taping Measured. The eyes were closed for 30 seconds and the average balance was measured three times through the Wii balance board in static balance, and the balance ability was evaluated by measuring functional reach test and star excursion balance test in dynamic balance. Results : As a result, the static balance showed significant results in the dynamic speed and the moving distance in the dynamic taping group (p<.05). However, there was no significant difference in the shaking area and the difference in the kinesiology taping group (p<.05) However, both groups showed significant differences in dynamic balance (p<.05). Conclusion : It was confirmed that the application of taping was effective for static and dynamic balance in subjects with ankle instability, and the application of dynamic taping was more effective than kinesiology taping.

• 대한정형도수물리치료학회지
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• 제27권3호
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• pp.17-24
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• 2021

Background: The study aimed to examine changes in muscle activity by measuring the Q-angle and lower extremity activity when going down the stairs, after the application of either Mulligan taping or flossing bands to patients with chronic ankle instability. Methods: A total of 19 men with chronic ankle instability in their 20s and 30s participated in the study. Participants were randomly divided into two groups: the Mulligan taping group (n = 9) and the flossing band group (n=10). The Mulligan taping group had three sets of Mulligan joint operations repeated 10 times, after which the Mulligan tape was applied. The flossing band group either performed functional activities or exercised for 2 minutes after flossing band application. After the application of either Mulligan taping or flossing bands, changes in the Q-angle and lower limb muscular activity while going down the stairs were measured and compared. Results: In the Mulligan taping group, the Q-angle significantly decreased from 13.63° to 12.7° during the step down. Similarly, the Q-angle of the flossing band group significantly decreased from 15.95° to 15.48° (p<.05). There was no difference in lower limb muscle activity between the two groups when going down the stairs. The muscle activity of the tibialis anterior significantly increased from 34.12% to 40.2%, and the difference between the two groups were statistically significant (p<.05). Conclusions: The study found that the application of Mulligan taping and flossing bands to patients with chronic ankle instability decreased the Q-angle and lower limb muscle activity when going down the stairs.

• 대한족부족관절학회지
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• 제13권1호
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• pp.40-45
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• 2009

Purpose: End-stage ankle arthritis is frequently combined with ankle-hindfoot deformity or ankle instability and therefore additional surgical procedures are often required when performing total ankle arthroplasty. We report the short term clinical and radiographic results of the total ankle arthroplasty with/without the combined adjunctive surgical procedures. Materials and Methods: The study is based on the 17 ankles (16 patients) of end-stage ankle arthritis that were treated with $HINTEGRA^{(R)}$ Total ankle prosthesis (Newdeal, Lyons, France) total ankle arthroplasty (TAA) from 2004 to 2007 with at least 12 months follow-up. The combined adjunctive procedures as well as the VAS pain score, AOFAS score, radiographic measurements and patient satisfactions were evaluated. Results: Average follow-up period was 29 months (13${\sim}$55 months), and the age was average 62 years (39${\sim}$75 years) old. Among total of 17 ankles, varus deformity and lateral ankle instability were found in 4 cases and 3 cases respectively. Twenty additional procedures such as Achilles triple hemisection (9), calcaneal displacement osteotomy (4) and lateral ankle ligament reconstruction (3) were performed in adjunct to TAA in 13 ankles. VAS pain score improved from preoperative average 8.4 (7${\sim}$10) to 2.0 (0${\sim}$5) and the AOFAS functional score improved from 41.8 points (13${\sim}$71 points) to 90.6 (77${\sim}$100 points) at final follow-up. Ninety-four percent of the patients were satisfied with the surgery. Conclusion: We confirmed that many adjunctive combined surgical procedures are often necessary in addressing the end-stage ankle arthritis (74%) with total ankle arthroplasty. We also achieved quite good clinical and radiographic short term results, although the long term follow-up study with larger number of cases are needed in the future.

• 국제물리치료학회지
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• 제9권1호
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• pp.1398-1405
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• 2018

The purpose of this study was to investigate the effect of heel off stairway walking exercise on the increase of muscle activity and balance activity of the ankle joint muscles in university students with functional ankle instability. The conservative treatment for the control group consisted of stairway walking (n=10) and the experimental group consisted of heel off stairway walking (n=11). The therapeutic intervention of the control and experimental groups was performed a total of 12 exercise sessions, 3 times per week for 4 weeks. To compare the two groups, the level of ankle disability was assessed by using the EMG, BT4 and Pedoscan in pre-treatment and post-treatment. Muscle activity increased in both the experimental groups and control groups in each group, however there was no significant difference between the groups. Balance ability did not show any significant difference. This study demonstrates that heel-off stairway walking is effective in significantly increasing muscle activity, however did not significantly improve balance ability.

• 한국전문물리치료학회지
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• 제22권1호
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• pp.1-8
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• 2015

The purpose of this study was to compare the change in electromyography (EMG) activity in the gluteus maximus (G-max) and the gluteus medius (G-med) in subjects with and without chronic ankle instability (CAI) during three functional postures. Twenty four females were recruited for this study. Subjects were assigned into two groups: with CAI ($n_1=12$) and without CAI ($n_2=12$). The assessment postures were rotational squat, one leg stand above a gradient and crossed leg-sway. Electromyographic activities of the G-max and the G-med were recorded using surface EMG and was normalized using the maximal voluntary isometric contraction elicited using a manual muscle testing. Independent t-test was used to determine the statistical differences between two groups during the three functional postures. The comparisons of the three posture between two groups were performed using a one-way repeated analysis of variance. A Bonferroni adjustment used for post hoc analysis. The activation of EMG on G-max performing the one leg stand above a gradient and crossed leg-sway in subjects with CAI is significantly higher than normal group (p<.05). The activation of EMG on the G-max during the rotational squat was significantly increased, compared to those of the one leg stand above a gradient and crossed leg-sway (p<.05). The activation of EMG on G-med performing three exercise at CAI is significantly higher than normal group (p<.05). The activation of EMG on the G-med during the crossed leg-sway was significantly increased, compared to the rotational squat (p<.05). This study provides valuable information for clinician who research CAI.

• The Journal of Korean Physical Therapy
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• 제16권2호
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• pp.33-43
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• 2004

The multiple acupuncture techniques have been used to relieve the pain of lateral ankle sprain. Recently, early functional rehabilitation is emphasized in rehabilitative concepts using active ROM, facilitated proprioception, alphabet exercise and so forth. Similarly, in oriental rehabilition medicine, traditional movement technique called 'Dong-Ki' has been used to relieve pain of ankle sprain. So we used 'Dong-Ki' technique with SSP(silver spike point) electrotherapy transformed from alphabet exercise and evaluated the effects in method of randomized controlled trials. 27 outpatients with lateral ankle sprains were randomized into two groups : 15 samples and 12 controls. Sample group was treated with 'Dong-Ki' technique(writing his name with foot) with SSP electrotherapy to relieve pain during additionally. 'Dong-Ki'. Outcomes were measured by 10cm VAS and ankle circumference(cm). In terms of VAS, Sample group had inclination of pain relieving but not significantly meaningful. In terms of ankle circumference measurement, Sample group showed significantly improved.