• The Journal of Internal Korean Medicine
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• v.38 no.5
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• pp.668-674
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• 2017

Objective: This case report describes the effects of Korean medicine treatment on chronic peroneal nerve palsy. Methods: One patient with peroneal nerve palsy was treated 6 months after onset with various Korean medicine treatments, such as acupuncture, cupping, herbal medicine (Bojungikki-tang and Palmijihwang-tang), and Hominis Placental pharmacopuncture for 14 days. The Manual Muscle Test (MMT), range of motion (ROM) of the ankle, and a numerical rating scale (NRS) were used to evaluate the effectiveness of treatment. Results: After 14 days of treatment, the scores for all 3 scales were improved. The MMT grade increased from 1-3 to 4-4+. The ankle ROM was restored to a nearly normal range. The NRS showed a considerable improvement, decreasing from 7 to 2. No side effects were noted. Conclusions: Korean medicine may be effective for the treatment of chronic peroneal nerve palsy, but further studies are needed.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.2
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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.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.23 no.2
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• pp.27-32
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• 2017

Background: The purpose of this study was to compare the effects of IASTM and static stretching techniques on ankle joint range of motion (ROM), static foot pressure. Methods: Twenty four subjects with gastrocnemius shortness participated in this study. The subjects were assigned randomly to one of two groups: The soft tissue mobilization technique (IASTM) group received intervention using a IASTM instrument for two minutes, and the stactic stretching group performed self stretching for 30 seconds, four times. The ROM of the ankle joint was measured by active ankle dorsi-flexion test, and a TPScan was utilized to collect the plantar foot pressure. This experiment was performed by two physical therapists. The significant level was set at ${\alpha}=.05$. Results: The results were as follows: 1) The ROM of the ankle joint and was significantly increased in both groups. 2) Plantar foot pressure was no significant in both groups. 3) There were no significant differences between the IASTM group and static stretching group for any variable. Conclusions: The results of this study suggest that static stretching is an effective and easy technique for restoring proper muscle length in subjects with gastrocnemius shortness. We recommend that static stretching technique be used for treat gastrocnemius shortness in clinical setting and home program.

• Journal of International Academy of Physical Therapy Research
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• v.12 no.2
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• pp.2359-2364
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• 2021

Background: Patients with stroke have limited ankle range of motion (ROM) due to soft tissue abnormalities around the ankle and thus experience functional impairment. Increased muscle tension and reduced ankle ROM impair gait and hinder the activities of daily living. Joint mobilization and stretching are effective interventions that improve gait performance by enhancing the ankle ROM. Objectives: To investigate the effects of ankle joint mobilization and calf muscle stretching on gait speed and gait performance in patients with stroke. Design: This was a randomized controlled trial. Methods: Twenty patients with stroke patients were randomized into two groups. The joint mobilization group (JMG) underwent anteroposterior mobilization of the talocrural joint and the joint mobilization stretching group (JMSG) underwent calf muscle stretching in addition to joint mobilization. Gait speed and gait parameters were measured using the 10-meter walk test and the GAITRite. Results: Both the JMG and JMSG groups showed significant improvements in gait speed, affected-side step length, and cadence after the intervention (P<.05). Conclusion: Joint mobilization and stretching were effective interventions for improving gait performance by enhancing ankle function in patients with stroke.

• Korean Journal of Applied Biomechanics
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• v.33 no.4
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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.

• Journal of International Academy of Physical Therapy Research
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• v.7 no.1
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• pp.919-924
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• 2016

In this study, 20 men and women in their 20s were divided into a footboard passive stretching group and a manual passive stretching group. After stretching was applied to the soleus for 5 weeks, a comparative analysis was performed on the range of motion(ROM) of the ankle joint to determine changes in the flexibility of the soleus. Both the footboard stretching group and manual stretching group first performed stretching for 15 sec, followed by a 10-sec break. One set consisted of performing the above process twice consecutively, and each group had to perform five sets in total. A goniometer was used as a measuring instrument. The results of the experiment were analyzed using a nonparametric analysis, Wilcoxon signed rank test, and Mann-Whitney test. SPSS WIN 18.0 was employed for the statistical analysis. In terms of the comparison of the flexibility before and after the experiment according to the different interventions, the application of footboard stretching to the soleus for 5 weeks resulted in $3.2^{\circ}$ right dorsiflexion (p=.009), $6.98^{\circ}$ right plantar flexion(p=.008), $4.14^{\circ}$ left dorsiflexion(p=.005), and $10.97^{\circ}$ left plantar flexion(p=.007), which were all statistically significant increases. The application of manual stretching led to $6.04^{\circ}$ right dorsiflexion(p=.005), $12.14^{\circ}$ right plantar flexion(p=.005), $7.00^{\circ}$ left dorsiflexion (p=.008), and $16.38^{\circ}$ left plantar flexion(p=.005). Therefore, both footboard stretching and manual stretching were effective in enhancing the flexibility of the soleus. However, statistically significant larger increases in the ROM of the ankle joint were observed in the manual stretching group.

• The Journal of Korean Physical Therapy
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• v.23 no.5
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• pp.49-56
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• 2011

Purpose: The purpose of this study was to investigate the kinematic characteristics and muscle activities during the following two conditions: transition from half-kneel to standing on the affected leg and non-affected leg. Methods: Twenty-one hemiplegic patients participated in the study. A motion analysis system was used to record the range of motion and angle velocity of the hip, knee and ankle from the half-kneel to the standing position. Electromyography was used to record the activity of 4 muscles. Results: The statistical analysis showed that the minimum ROM of the hip joint was less on the affected leg during transition from half-kneel to standing. However, the minimum ROM of the knee and ankle joints was less on the non-affected leg during transition from half-kneel to standing. The angle velocity of the knee and ankle joints was less during transition from half kneeling to standing on the non-affected leg. Muscle activity of the rectus femoris and tibialis anterior was less while moving from half-kneel to the standing position on the affected leg. Conclusion: These results show that greater active ROM of the knee and ankle was required on the affected leg for transition from half-kneel to the standing position than for normal gait. Muscle activity of the rectus femoris and tibialis anterior is normally required for movement from the half-kneel to the standing position during normal gait. Further studies are needed to investigate the antigravity movement in healthy subjects and hemiplegic patients in order to completely understand the normal and abnormal movement from the half-kneel to the standing position.

• The Journal of Korean Physical Therapy
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• v.16 no.3
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• pp.97-111
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• 2004

This study, adopting the pretest-post test experimental study, is designed to find out how the functional electrical stimulation makes effect on the balance of a patient with spasticity of the ankle plantarflexor muscle caused by hemiplegic after stroke. The 46 subjects for this study were randomly sampled out of the patients who were hospitalized from September 1, 2003 to November 30, 2003 in H sanitarium in Yangpyung. The patients were with spasticity of the ankle plantarflexor muscle caused by hemiplegic after stroke and able to walk without supporting implements. The purpose of the study is firstly to analyze the change of ROM, FRTof a patient with spasticity of the ankle plantarflexor muscle when the functional electrical stimulation is applied and secondly to find out how the sex, age, height, weight, part of the diagnosis, duration of pain, experience of relapse and getting hurt from a fall of a patient make effect on the change. The experimental group for the study is divided into two to compare the differences of the effect. The exercising treatment only was performed for the conrtol group, and the functional electrical stimulation to the ankle dorsiflexor muscle as well as the exercising treatment was applied to the experimental group. The ROM test was performed to check the range of motion of the ankle with a double armed universal goniometer. The test was done 3 times to take an average. FRT were performed to check the balance. The statistical test was conducted using the SPSS 10.0/PC program by means of the following methods: χ2-test and t-test for testing homogeneity between the groups; paired t-test, independent sample t-test, F-test, and two-way ANOVA for analyzing the changes before and after the treatment. The levels of statistical significance of all the data were maintained at p<.05. According to the test, ROM has more decreased in experimental group than in control group when the functional electrical stimulation was applied only to the experimental group. However, the significant statistic difference was not shown (p=.059). FRT showed remarkable differences in the experimental group compared to the control group, showing the significant statistic difference (p=.000). On the one hand, the change of ROM, FRT related with the sex, age, height, weight, part of the diagnosis, and experience relapse was a meaningless minimum value. The change of ROM related to the duration of pain and the experience of falling down was also meaningless. However, FRT showed significant statistic difference (p<.05). According to the test above, the application of functional electrical stimulation to a patient with spasticity of the ankle dorsiflexor muscle caused by hemiplegic after stroke makes significant effect on the balance of a patient, but the result has nothing with the sex, age, height, weight, part of the diagnosis, duration of pain, experience of relapse and getting hurt from a fall of a patient. However, it is regarded to give contribution to the balance improvement of a patient. Therefore, this study expects to be a valuable clinical material for a patient with spasticity.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.3
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• pp.293-299
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• 2014

PURPOSE: The purpose of this study was to investigate the effect of functional training using a sliding rehabilitation machine (SRM) on the mobility of the ankle joint and balance in children with cerebral palsy (CP). METHODS: The subjects consisted of 11 children who were diagnosed with spastic CP. They carried out the functional training using the SRM for 30 minutes, three times a week, for 8 weeks. Before and after all of the training sessions, the subjects were tested using the Pediatric Balance Scale (PBS) and Gross Motor Function Measurement (GMFM), range of motion (ROM) in the ankle joint, the pennation angle of the gastrocnemius muscle and the fascicle length of gastrocnemius muscle were measured to determine the mobility of the ankle joint and balance ability. RESULTS: There were significant differences between the pre-test and post-test in the PBS and GMFM. The ROM of the ankle joint was significantly increased after the functional training using the SRM. Moreover, the fascicle length was increased and the pennation angle was decreased after the functional training using the SRM, but the difference was not significant. CONCLUSION: These results suggest that functional training using the SRM may have some effect on the mobility of ankle joint and balance in children with CP. According to the results, this study could present an approach to the rehabilitation or treatment of children with CP.

• The Transactions of The Korean Institute of Electrical Engineers
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• v.58 no.1
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• pp.203-209
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• 2009

The purpose of this study is to develop a minimally constraint joint angle measurement system for the feedback control of FES (functional electrical stimulation) locomotion. Feedback control is desirable for the efficient FES locomotion, however, the simple on-off control schemes are mainly used in clinic because the currently available angle measurement systems are heavily constraint or cosmetically poor. We designed a new angle measurement system consisting of a magnet and magnetic sensors located below and above the ankle joint, respectively, in the rear side of ipsilateral leg. Two magnetic sensors are arranged so that the sensing axes are perpendicular each other. Multiple positions of sensors attachment on the shank part of the ankle joint model and also human ankle joint were selected and the accuracy of the measured angle at each position was investigated. The reference ankle joint angle was measured by potentiometer and motion capture system. The ankle joint angle was determined from the fitting curve of the reference angle and magnetic flux density relationship. The errors of the measured angle were calculated at each sensor position for the ankle range of motion (ROM) $-20{\sim}15$ degrees (dorsiflexion as positive) which covers the ankle ROM of both stroke patients and normal subjects during locomotion. The error was the smallest with the sensor at the position 1 which was the nearest position to the ankle joint. In case of human experiment, the RMS (root mean square) errors were $0.51{\pm}1.78(0.31{\sim}0.64)$ degrees and the maximum errors were $1.19{\pm}0.46(0.68{\sim}1.58)$ degrees. The proposed system is less constraint and cosmetically better than the existing angle measurement system because the wires are not needed.