• 한국전문물리치료학회지
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• 제31권1호
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• pp.18-28
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• 2024

Background: Lateral instability of the ankle is one of the most common causes of musculoskeletal ankle injuries. The peroneus longus (PL) and peroneus brevis (PB) contribute to ankle stability. In early rehabilitation, isometric exercises have been selected for improvement of ankle stability. To effectively train the peroneal muscles during eversion, it is important to consider ankle and body posture. Objects: This study aimed to compare activation of the PL, PB, and biceps femoris (BF) muscles during eversion in different ankle postures (neutral [N], plantarflexed [PF]) and body postures (sitting and side-lying). Methods: Thirty healthy individuals with no history of lateral ankle sprains within the last 6 months were included in the study. Maximal isometric strength of eversion and muscle activation were measured simultaneously. Muscle activation at submaximal eversion was divided by the highest value obtained from maximal isometric eversion among the four postures (percent maximal voluntary isometric contraction [%MVIC]). To examine the differences in muscle activation depending on posture, a 2 × 2 repeated measures analysis of variance (ANOVA) was conducted. Results: There were significant interaction effects of ankle and body postures on PL muscle activation and evertor strength (p < 0.05). The PL muscle activation showed a significantly greater difference in the side-lying and PF conditions than in the sitting and N conditions (p < 0.05). Evertor strength was greater in the N compared to the PF condition regardless of body posture (p < 0.05). In the case of PB and BF muscle activation, only the main effects of ankle and body posture were observed (p < 0.05). Conclusion: Among the four postures, the side-lying-PF posture produced the highest muscle activation. The side-lying-PF posture may be preferred for effective peroneal muscle exercises, even when considering the BF muscle.

• The Journal of Korean Physical Therapy
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• 제31권2호
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• pp.129-133
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• 2019

Purpose: This study aimed to investigate effect of ankle instability on peripheral muscle activation among female ballet dancers to provide information on the development of prevention programs for ankle injury rehabilitation. Methods: 32 female ballet dancers were randomly divided into two groups: experience ankle sprain group (n=16, age, $20.7{\pm}0.8years$, BMI $18.6{\pm}1.2kg/m2$) and non-experience ankle sprain group (n=16, $age=21.0{\pm}0.8years$, BMI $19.6{\pm}2.0kg/m2$). Activation of the peroneus longus, tibialis anterior muscle, and gastrocnemius during vertical landing, half pointe, and gait between the two groups were measured. Body composition analyzer was used to examine skeletal muscle mass and body fat mass. Results: A total of 32 patients were included. In the experience ankle sprain group (n=16: left sprain 14, right sprain 2), average ankle sprain injury occurred 7.5 months before the study. The average age of the dancers in the experience ankle sprain group and non-experience ankle sprain group was $20.7{\pm}0.8$ and $21.0{\pm}0.8years$, major period was $64.5{\pm}23.8$ and $71.6{\pm}25.8months$, BMI was $18.6{\pm}1.2$ and $19.5{\pm}2.0kg/m2$, respectively. No significant differences were found on body composition between the two groups (p>0.05). The experience ankle sprain group showed significantly lower tibialis anterior and peroneus longus muscle activation (p<0.5), while gastrocnemius muscle activation appeared to be significantly higher (p<0.05) during landing, half pointe, and normal gait. Conclusion: Ankle sprain can cause a decline in peripheral muscle activation and coordination, which increased the risk for repetitive ankle sprain in the future. Moreover, ankle peripheral muscle selective strength training, coordination program development, and application need to be considered to prevent ankle sprain.

• The Journal of Korean Physical Therapy
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• 제28권3호
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• pp.189-194
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• 2016

Purpose: This study focuses on influence of ankle stabilization training on balance ability and lower limb muscle activation of soccer player with functional ankle instability. Methods: Subjects were grouped into ankle stabilization training group using biofeedback comprised of 15 subjects and general exercise group of 15. The training was conducted for 30 minutes, 3 times a week for 8 weeks in total. All 30 football players conducted plyometric training for 30 minutes before main training. To evaluate balance ability, biorescure was used to measure whole path length and surface area and surface electromyography (EMG) system was used to measure tibialis anterior, tibialis posterior, and soleus to evaluate lower limb muscle activation. Results: The experiment group showed significant difference to the comparison group in regard of whole path length and surface area which represents balancing capability and muscle activation of tibialis anterior, tibialis posterior, and soleus. Conclusion: Therefore, ankle stabilization training using biofeedback is more effective in enhancing balance ability and lower limb muscle activation than general exercise.

• The Journal of Korean Physical Therapy
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• 제35권2호
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• pp.53-57
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• 2023

Purpose: The purpose of this study was to compare the changes in the muscle activation of the quadriceps muscle (rectus femoris, vastus lateralis, vastus medialis) during the stand-to-sit (StandTS) movement according to the plantar flexion angle of the ankle joint. Methods: A total of 22 healthy young females participated in this study. During the StandTS under the three conditions (plantarflexion angle 0°, 20°, and 45° of the ankle), electromyography (EMG) data (% maximum voluntary iso¬metric contraction) of the rectus femoris, vastus lateralis, and vastus medialis were recorded using a wireless surface EMG system. Results: There was a significant difference in the muscle activation of rectus femoris, vastus lateralis, and vastus medialis according to the plantar flexion angle (0°, 20°, and 45°) of the ankle. The muscle activation of the quadriceps was the highest at a 45° angle of plantarflexion and the lowest at 0°. One-way repeated ANOVA was used to analyze the muscle activation data of the lower extremity muscles according to the angle of the ankle joint. Conclusion: Based on the results of our study, it was confirmed that the muscle activity of the quadriceps can be increased even in the StandTS movement, which involves the eccentric contraction of the quadriceps muscle. This suggests that maintaining a plantar flexion posture for a long time, say by wearing high-heeled shoes, can quickly cause muscle fatigue in the lower-limb muscles, which can cause a decrease in balance ability leading to falls.

• 대한물리의학회지
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• 제9권3호
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• pp.249-253
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• 2014

PURPOSE: This study intends to examine the effects of change of anatomical position of the ankle joint in open kinematic chain, an appropriate position for selective muscle training, on vastus lateralis obliques, rectus femoris, vastus medilais obliques, and rectus abdominalis muscle activation and to present an effective method of muscle training for patients and normal people. METHODS: The participants of this study were Korean healthy adult in their 20s. The 8 channel surface electromyography was used to measure muscle activation while the subjects raised their legs under each condition. Under each condition, while the subjects raised the leg to hip joint flexion at $60^{\circ}$ along the arch. RESULTS: The analysis result of muscle activation by each section and position during leg rising. There were significant differences. CONCLUSION: For independent strengthening of each muscle, muscle activation was measured according to leg raising angles and the result differed according to each section and position. If this study result is applied to muscle training for patients who need selective muscle training, more effective muscle strengthening will be made possible.

• 대한물리의학회지
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• 제14권1호
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• pp.131-138
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• 2019

PURPOSE: This study examined the effects on muscle activation and ankle instability following sudden ankle inversion of the closed kinetic chain exercise using visual feedback to evaluate chronic ankle instability in adult males. METHODS: In this study, 28 subjects with chronic ankle instability were recruited and randomly divided into a closed kinetic chain exercise using a visual feedback group(n=13) and an open kinetic chain exercise group(n=15). Each group underwent 30 minutes of exercise three times a week for 8 weeks. The electromyographic(EMG) values of the rectus femoris, biceps femoris, tibialis anterior, peroneus longus, peroneus brevis, and lateral gastrocnemius muscles were measured to analyze muscle activity. The Cumberland ankle instability tool(CAIT) was used to measure ankle instability. RESULTS: Both groups showed improvements in tibialis anterior, peroneus longus and CAIT score(p<.05). In the experimental group, there were significant improvements in the rectus femoris, biceps femoris, and lateral gastrocnemius muscle activation(p<.05). CONCLUSION: The results suggest that closed kinetic chain exercise using visual feedback can be a useful treatment method for patients with chronic ankle instability.

• 대한물리의학회지
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• 제14권2호
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• pp.41-51
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• 2019

PURPOSE: This study was conducted to investigate the effects of combined Joint Mobilization and Functional Electrical Stimulation on Muscle Activation and Mobility of ankle joints in stroke patients and their Modified Functional Reach Test (MFRT) results. METHODS: A total of 26 patients with stroke were randomly selected for enrollment in this study. (1) Functional Electrical Stimulation (FES) (2) combined Joint Mobilization and FES. An EMG system was used to measure tibialis anterior and gastrocnemius activities. Range Of Motion (ROM) of Ankle Joint and MFRT for Dynamic Balance. Pre and post intervention results were compared by paired-t-tests and differences in changes after intervention between groups were identified by the independent t-test. RESULTS: The muscle activation, ROM, and MFRT differed significantly in the experimental group (p<.05). The ROM was significantly different for the active dorsiflexion pre and post intervention in the group that received FES alone (p<.05). CONCLUSION: The results of this study suggest use of a systematic program of proactive posture control to prevent dysfunction when planning interventions for ankle joints can help stroke patients walk efficiently.

• 대한물리의학회지
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• 제3권3호
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• pp.151-160
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• 2008

Purpose : The purpose of this study is to know the muscle activation after sub-talar joint mobilition and active exercise, and the low leg muscle activity through the well-balanced interaction of ankle joint around muscle. Methods : For this study 61 experimental subjects are divided into 24 people of supination foot group, pronation foot group 17 people of, 20 people of control group through navicular drop test. Surface EMG was used in order to measure the muscle activities. following is the result of the data analysis about each experiment that has been carried on a week, 2 weeks, 3 weeks, 4 weeks before, and even comparing with pre-experimental state. Results : In electromyogram study, the higher muscle activation there was before the experiment, the more muscle activation increase there was after the experiment in Tibialis Anterior, Peroneus Longus, Peroneus Brevis.(p<.05). Conclusion : This study shows the balanced activation of foot and ankle-around muscle. It shows that foot shape affects the balanced activation recovery of lower leg muscles.

• The Journal of Korean Physical Therapy
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• 제35권5호
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• pp.145-150
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• 2023

Purpose: This study examined the effects of ankle control training using neuromuscular electrical stimulation (NMES), leg muscle activation, and balance in stroke patients. Methods: Thirty-one stroke patients diagnosed with cerebral infarction and cerebral hemorrhage were selected for the study. The experimental group underwent ankle control training using NMES, while the control group applied NMES to the paretic tibialis anterior muscle for 30 minutes per session, five times a week for four weeks. The muscle activity changes were measured using surface electromyography, and balance parameters were evaluated using a functional reach test (FRT). Results: The intra-group comparison of the concentric muscle activity revealed improvements in the experimental group, including paretic tibialis anterior (TA) muscle (p<0.05), medial gastrocnemius muscle (MG) (p<0.01), and lateral gastrocnemius muscle (LG) (p<0.05), as well as MG (p<0.05), LG (p<0.05), soleus muscle (p<0.05) of the non-paretic side, and soleus muscle symmetry index (p<0.05). The intra-group comparison of the eccentric muscle activity showed improvements in the experimental group, including MG (p<0.01) and LG (p<0.01) of the paretic side, as well as MG (p<0.01), LG (p<0.01) of the non-paretic side, and LG symmetry index (p<0.01). The intra-group comparison of the functional reach test revealed significant differences in the test results in the experimental and control groups (p<0.05). Conclusion: Ankle control training using NMES had a positive effect on the changes in muscle activation and improved balance in patients with stroke.

• Physical Therapy Rehabilitation Science
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• 제6권1호
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• pp.39-44
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• 2017

Objective: The purpose of this study is to show the effectiveness of performing squat exercises at various angles to show the maximum muscle activity of the Vastus Medialis Oblique (VMO) and Biceps femoris (BF). Design: Cross-sectional study. Methods: A total of seventeen healthy young adults (8 males and 9 females) voluntarily participated in the study. All subjects randomly performed three different squat variations as follows: A squat performed with the ankle joint at $0^{\circ}$ of incline, a squat performed with the ankle joint at $5^{\circ}$ of incline, and a squat performed with the ankle joint at $10^{\circ}$ incline. Muscle activity was measured using surface electromyography. Electrodes were placed on the VMO and BF to measure the muscle activity on the various ankle angles for comparison analysis. Results: There was a significant increase in bilateral VMO muscle activation at $10^{\circ}$ of incline compared to $0^{\circ}$ and $5^{\circ}$ (p<0.05). Greater increases in muscle activation and exercise effect was observed with increasing incline angles of the board. Changes in bilateral BF muscle activity were found; however, none were found to be significant. Conclusions: Bilateral VMO activity was found to be significant when the squats were performed at an ankle angle of $10^{\circ}$ of incline when compared to at an ankle angle of $0^{\circ}$ and $5^{\circ}$ of incline. Squats performed on an incline can be recommended as an effective method to facilitate lower extremity muscle activities.