• 제목/요약/키워드: Functional Ankle Instability

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근거에 기반한 급성 발목관절 외측 염좌의 치료 (Evidence-based Treatment of Acute Lateral Ankle Sprain)

  • 조병기
    • 대한족부족관절학회지
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    • 제22권4호
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    • pp.135-144
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    • 2018
  • Acute lateral ankle sprain, which is the most common musculoskeletal injury, can be treated effectively with appropriate evidence-based initial care using PRICE (protection, rest, ice, compression, and elevation) and functional rehabilitation. Many systemic reviews reporting a high-level of evidence supporting the clinical usefulness and necessity of primary surgical repair for acute lateral ankle sprain have been insufficient. Regardless of the severity of ligament complex injuries, the surgical treatment for acute lateral ankle sprain without concomitant pathologies is not recommended and should be considered only in young professional athletes with complete ligament rupture (grade III) and severe instability.

중증 족관절 관절염: 족관절 전치환술 (Severe Ankle Osteoarthritis: Treatment with Total Ankle Arthroplasty)

  • 정비오;정혁
    • 대한족부족관절학회지
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    • 제22권1호
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    • pp.8-15
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    • 2018
  • Ankle osteoarthritis is a debilitating condition that causes severe pain associated with functional impairment and decreased activity. Ankle osteoarthritis, unlike that of the knee or hip joint, is rare in primary arthritis. Most cases are traumatic arthritis that occur after ankle sprain or fractures or chronic ankle instability. Although ankle fusion has been regarded as the standard treatment of ankle osteoarthritis in the past, total ankle arthroplasty (TAA) is increasing due to the development of the implant design and surgical techniques. TAA is biomechanically superior to ankle fusion by preserving the movement of the ankle joint. In particular, it is functionally superior to ankle fusion because it enables normal joint motion during gait. In addition, there is an advantage of preserving the movement of the hindfoot and reducing the abnormal stress applied to the adjacent joints after ankle fusion to prevent the occurrence of long-term adjacent joint arthritis. Although the short-term and mid-term results of TAA have been reported to be excellent, long-term follow-up has a relatively low survival rate and high complication rate compared to total knee or hip arthroplasty. Therefore, continuous and further research is needed.

테이핑과 극초단파를 적용 후 가상현실 운동 프로그램이 기능적 발목 불안정성 균형에 미치는 효과 (Effects of Virtual Reality Exercise Program after Applying Taping and Microwave on Balance with Functional Ankle Instability)

  • 정찬주;김기종;양회송;유영대
    • 대한통합의학회지
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    • 제5권3호
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    • pp.63-70
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    • 2017
  • Purpose : The purpose of this study was to investigate the effects of the virtual reality exercise program on ankle balance with ankle taping or microwave. Methods : This study was performed on 18 subjects. Eighteen subjects were divided into two groups; conducted virtual reality exercises with taping (n=9), and performed virtual reality exercises after microwave application (n=9). Both groups performed the exercise three times a week for four weeks. The data was analyzed by the Wilcoxon signed-rank test for comparing before and after changes of factors in each group and performed the Mann-Whitney test for comparing groups. Result : Taping and microwave groups were increased dynamic balance after virtual reality exercises (p<.05). There was no significant difference in balance after applying taping and microwave for virtual reality exercises (p<.05). Conclusion : Reducing the frequency of recurrent ankle sprain in functional ankle subjects, it is recommended to perform virtual reality exercise after applying taping and microwave.

가상현실 기반 자세조절 융합 훈련이 기능적 발목 불안정성 축구선수들의 균형과 점프에 미치는 영향 (Impact of Virtual Reality Based Neuromuscular Postural Control Fusion Training on Balance Ability and Jump Performance of Soccer Players with Functional Ankle Instability)

  • 양대중;박승규;엄요한
    • 디지털융복합연구
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    • 제14권11호
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    • pp.357-367
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    • 2016
  • 본 연구에서는 가상현실 기반 신경근 자세조절 융합 훈련을 이용하여 기능적 발목 불안정성을 가진 축구선수들의 균형 능력과 점프 수행력에 미치는 효과에 대하여 알아보고자 하였다. 축구선수는 가상현실 기반 신경근 자세조절 융합 훈련군 15명과 일반적인 트레드밀 훈련군 15명으로 나누어 8주간 주 3회, 30분간 시행하였고, 균형 능력을 평가하기 위해 Biorescue를 이용하여 신체 중심 이동면적, 총 궤적길이, 안정성 한계를 측정하였다. 점프 수행력을 측정하기 위해 Counter movement jump with arm swing과 제자리 멀리 뛰기를 측정하였다. 균형 능력 비교에서는 신체 중심 이동면적과 총 궤적 길이 및 안정선한계에서 통계적으로 유의한 차이를 보였고, 점프 수행력 비교에서는 Counter movement jump with arm swing과 제자리 멀리 뛰기에서 통계적으로 유의한 차이를 보였다. 이에 따라 가상현실 기반 신경근 자세조절 융합 훈련이 일반적인 트레드밀 훈련 보다 균형 능력과 점프 수행력을 향상시키는데 효과적임을 알 수 있었다.

기능적 발목 불안정성 선수들의 드롭랜딩 시 재활 기간이 하지 관절의 운동역학적 특성에 미치는 영향 (Effects of Rehabilitation Duration on Lower Limb Joints Biomechanics dur ing Drop Landing in Athletes with Functional Ankle Instability)

  • 조준행;김경훈;이해동;이성철
    • 한국운동역학회지
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    • 제20권4호
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    • pp.395-406
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    • 2010
  • The purpose of this study was to analyze the changes in kinematic and kinetic parameters of lower extremity joint according to rehabilitation period. Fourteen collegiate male athletes(age: $22.1{\pm}1.35$ years, height: $182.46{\pm}9.45cm$, weight: $88.63{\pm}9.25kg$) and fourteen collegiate athletes on functional ankle instability(age: $21.5{\pm}1.35$ years, height: $184.45{\pm}9.42cm$, weight: $92.85{\pm}10.85kg$) with the right leg as dominant were chosen. The subjects performed drop landing. The date were collected by using VICON with 8 camera to analyze kinematic variables and force platform to analyze kinetic variables. There are two approaches of this study, one is to compare between groups, the other is to find changes of lower extremity joint after rehabilitation. In comparison to the control group, FAI group showed more increased PF & Inversion at IC and decreased full ROM when drop landing. Regarding the peak force and loading rate, it resulted in higher PVGRF and loading. FAI group used more increased knee and hip ROM because of decreased ankle ROM to absorb the shock. And it used sagittal movement to stabilize. In terms of rehabilitation period, FAI group showed that landing patterns were changed and it increased total ankle excursion and used all lower extremity joint close to normal ankle. Regarding the peak force and loading rate, FAI group decreased PVGRF and loading rate. and also showed shock absorption using increased ankle movement. And COP variable showed that proprioception training increased stability during 8 weeks. The results of this study suggest that 8 weeks rehabilitation period is worthwhile to be considered as a way to improve neuromuscular control and to prevent sports injuries.

족관절 염좌에 SSP 전자침 요법을 병행한 동기침법(動氣鍼法)의 효과 (The Effects of Alphabet Exercise with SSP Electrotherapy on Lateral Ankle Sprain)

  • 심우진;류수민;신현대;우경하
    • 대한추나의학회지
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    • 제4권1호
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    • pp.89-98
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    • 2003
  • 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. Methods : 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). Results : 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.

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기능적 족관절 불안정성을 평가할 수 있는 새로운 균형 평가법: 체질량 지수와 성별과의 연관성 (Novel Balance Tests for Assessing Functional Ankle Instability: Relationships with BMI and Gender)

  • ;여의동;김승주;임홍철;황명회;박세현;김학준
    • 대한족부족관절학회지
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    • 제16권2호
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    • pp.128-134
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    • 2012
  • Purpose: To design novel balance tests to assess FAI and evaluate whether these tests are affected by BMI or gender, with the goal of developing reliable FAI assessment tests that are not influenced by these factors. Materials and Methods: Participants included 20 young, healthy volunteers, 12 males and 8 females, with a mean age of $24{\pm}4$ years and a mean BMI of $23{\pm}2.28$. None of the subjects had known ankle instability. The following tests were assessed in each participant: single leg balance (SLB), percentage of leg press (PLP), single leg cycling (SLC), one leg squat (OLS), multiple direction reach-front/back/side (MDR-F/B/S), single leg hop (SLH), two leg jump (TLJ) and side step (SS). Data were analyzed using the SPSS 12.0 software program with ANOVA and t-test used. Results: When grouped by BMI, we found that despite differences in BMI, the performances of all subjects were equivalent except for the one-leg-squat test, for which the mean ratios for underweight ($1.69{\pm}0$), normal weight ($1.05{\pm}0.19$), and overweight ($0.93{\pm}0.30$) individuals were significantly different (p=0.02); ratios for SLB (p=0.273), SLC (p=0.903), PLP (p=0.664), MDR-F/B/S (p=0.498, 0.908, and 0.503, respectively), SLH (p=0.332) were not significantly different. When calculated according to gender, we found that the OLS (p=0.013) and MDRS (p=0.034) were significantly different, while parameters for all the remaining tests were not affected. Conclusion: We found that the SLB, PLP, SLC, MDR-F/B, and SLH ratios were unaffected by BMI or sex and, therefore, are reliable parameters for assessing ankle instability.

만성 족관절 불안정성을 가진 환자군에서 변형 브로스트롬 술식과 봉합 테이프를 추가한 술식 간의 결과 비교 (Comparison of the Modified Brostrom Repair Technique with and without Augmentation Using Suture Tape for Chronic Ankle Instability)

  • 곽희철;정수환;김정한;박대현;추혜정;김대유
    • 대한족부족관절학회지
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    • 제26권1호
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    • pp.40-47
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    • 2022
  • Purpose: The modified Broström repair (BR) technique has yielded good outcomes in patients with chronic ankle instability. This study compared clinical and radiological outcomes between two groups of patients who underwent modified BR or lateral ligament augmentation using suture tapes (ST). Materials and Methods: Seventy-seven patients (ST group [n=47], BR group [n=30]; body mass index <26.61 kg/m2; mean age, 30.7±11.0 years [range, 17~39 years]; mean follow-up, 34.0±12.0 months [range, 24~59 months]) were retrospectively reviewed between January 2014 and July 2017. The Foot and Ankle Outcome Score (FAOS), American Orthopedic Foot and Ankle Score (AOFAS), Foot and Ankle Ability Measure (FAAM), visual analogue scale (VAS) score, and Sefton grading system were used for clinical assessment. The talar tilt angle and anterior talar translation were measured using the Telos stress device (Telos GmbH, Marburg, Germany) at 150 N for radiological evaluation. Results: FAOS, AOFAS, FAAM, and VAS scores improved in both groups at final follow-up (ST, 91.1±5.2, 93±2, 88.1±4.5, 1.5±0.7 vs. BR, 91.3±5.4, 93±3, 83.3±4.8, 1.2±0.7, respectively; p=0.854, 0.971, <0.001, 0.04, respectively). According to the FAOS, mean sports activity scores for the ST and BR groups at the final follow-up were 90.3±3.2 and 76.6±4.2, respectively, reflecting superior outcomes in the ST group (p<0.001). Sefton grading revealed satisfactory functional outcomes (ST, 91.5% vs. BR, 90.0%). There was significant improvement in the talar tilt angle and anterior talar translation in both the ST and BR groups (7.6°±1.2°, 10.5±1.8 mm vs. 4.9°±1.1°, 7.9±1.5 mm, respectively; p<0.001). Conclusion: The ST group demonstrated comparable clinical but better improvement in mechanical stability and FAOS sports scores than the BR group.

삼각인대 손상 의심 시 진단과 치료방법 (Diagnosis and Management of Suspected Deltoid Injury)

  • 양성훈;이준영
    • 대한족부족관절학회지
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    • 제26권1호
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    • pp.16-21
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    • 2022
  • 도수 또는 중력 외회전 부하 방사선 검사는 족관절 양과 유사 골절과 단독 외과 골절을 구별할 수 있는 기준이 된다. 부하 방사선 검사상 내측 관절 간격이 넓어지면 삼각인대 손상을 진단할 수 있고 비골 골절에 대한 수술적 처치가 권장된다. 비골 골절에 대하여 관혈적 정복술 후 Cotton test를 시행하여 경비원위인대가 벌어질 경우 이에 대한 고정을 시행한 후 삼각인대의 봉합술 시행 여부는 술자의 선호도 및 수술장 내 소견에 의하여 결정된다. 삼각인대 봉합술은 내과에 suture anchor를 삽입하고 심부와 천부 삼각인대에 대하여 중첩술 후 내과에 anchor를 통하여 고정함으로써 시행한다. 유일하게 무작위로 시행된 족관절 골절에서의 삼각인대 봉합술의 유용성 평가 연구에서는 삼각인대 봉합술의 유용성에 대하여 긍정적인 결론을 도출하지 못하였으나 연구 자체의 제한점이 많아 해석을 하는 데 있어 한계가 있었다. 추후 이에 대한 심도 있는 연구가 필요하리라 판단된다.

발목관절 외측 불안정성에서 단일 봉합나사와 이중 봉합나사를 이용한 변형 Brostrom 술식간의 임상결과 비교 (A comparison between the modified Brostrom procedure using single and double suture anchor for chronic lateral ankle instability)

  • 손현철;조병기;김용민;김동수;최의성;박경진;박지강
    • 대한정형외과스포츠의학회지
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    • 제10권2호
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    • pp.69-77
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    • 2011
  • 목적: 만성 발목관절 외측 불안정성 환자에 대한 변형 Brostrom 술식에서 단일 봉합나사와 이중 봉합나사를 이용한 기법간의 임상 결과를 후향적으로 비교하고자 하였다. 대상 및 방법: 본원에서 봉합나사를 이용한 변형 Brostrom 술식을 시행받은 환자들 중 최소 1년 이상 추시가 가능하였던 37례를 대상으로 하였다. 모든 수술은 동일한 술자에 의해 이루어졌으며 단일 봉합나사를 이용한 경우가 17예, 이중 봉합나사를 이용한 경우가 20예 였다. 임상적 결과의 평가는 Karlsson 점수 및 Sefton의 평가법을 이용하였고, 발목관절의 기계적인 안정성에 대한 방사선학적 평가로 Telos 기기를 이용한 전방 전위 및 내반 스트레스 검사가 이용되었다. 결과: Karlsson 점수는 단일 봉합나사군이 술 전 평균 45.2점에서 술 후 89.4점으로, 이중 봉합나사군이 술 전 평균 46.4점에서 90.5점으로 각각 호전되었다. Sefton 평가법상 단일 봉합나사군은 우수가 7예, 양호가 8예, 보통이 2예 였고, 이중 봉합나사군은 우수 8예, 양호 10예, 보통 2예로 나타나 각각 15례(88.2%), 18례(90%)에서 만족스러운 결과를 보였다. 스트레스 방사선검사 상 거골 경사각과 거골 전방전위는 단일 봉합나사군이 술 전 평균 13.6도, 8.6 mm에서 술 후 최종 추시시 5.4도, 4.1 mm로, 이중 봉합나사군이 술 전 평균 14.1도, 8.4 mm에서 술 후 3.9도, 4 mm로 각각 호전되었으며 두 기법간에 술 후 거골 경사각의 유의한 차이를 보였다(p<0.05). 결론: 만성 발목관절 외측 불안정성에 대한 변형 Brostrom 술식에서 단일 봉합나사와 이중 봉합나사를 이용한 기법간에 술 후 임상 결과의 유의한 차이는 없었으나, 발목관절의 기계적인 안정성은 이중 봉합나사군에서 더 우수하였다. 단일 봉합나사와 이중 봉합나사를 이용한 변형 Brostrom 술식 모두 효과적인 치료 방법이라고 생각되며, 향후 운동 선수들을 대상으로 한 치료결과 및 생역학적 분석이 필요할 것으로 생각한다.

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