• The Journal of Korean Physical Therapy
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• v.34 no.3
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• pp.91-97
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• 2022

Purpose: This study investigated the short-term effectiveness of extracorporeal shock wave therapy (ESWT) on pain, the ankle instability, the ankle function, dorsiflexion range of motion (ROM), and dynamic balance in patients with chronic ankle instability (CAI). Methods: Eighteen participants were divided into an experimental (n=9) and control group (n=9). The ESWT in the experimental group was applied to the lateral collateral ligament in combination with the tibialis anterior whereas the ESWT was applied to the lateral collateral ligament of the ankle alone in the control group. Pain, the ankle instability, the ankle function, dorsiflexion ROM, and dynamic balance were measured using the Visual analog scale, Cumberland ankle instability tool, American Orthopedic Foot and Ankle Society ankle-hindfoot score, weight-bearing lunge, and Y-balance test, before and after ESWT intervention. Results: Significant interactions (group × time) and time effects were observed in the dorsiflexion ROM and dynamic balance. Bonferroni's post-hoc analysis showed that the experimental group revealed a more significant change in dorsiflexion ROM and dynamic balance than the control group. There was a significant time effect in the pain, the ankle instability, and the ankle function, but no significant interaction (group × time) was observed. Conclusion: The ESWT could improve the pain, ankle instability, ankle function, dorsiflexion ROM, and dynamic balance in patients with CAI. Furthermore, the ESWT combined with lateral ankle ligaments and tibialis anterior more improves the dorsiflexion ROM and dynamic balance.

• PNF and Movement
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• v.20 no.3
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• pp.443-449
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• 2022

Purpose: This study aims to identify the differences in the muscle activity of the ankle joint muscle depending on the type of footwear (sneakers, mule sneakers, slippers) worn while walking on a slope. Methods: The subjects wore each shoe (sneakers, mule sneakers, and slippers) and walked on an 18-degree slope at a speed of 110 beats/min. While walking, the muscle activities of the tibialis anterior and medial gastrocnemius were measured. Of the three walking cycles, the second walking cycle was measured except for the first and third walking cycles, which are the beginning and end, and a three-minute break was taken to prevent muscle fatigue when the type of footwear was changed. Results: When walking on a slope, there was no significant difference in the muscle activity of the tibialis anterior according to the type of footwear. However, when walking on a slope, the difference in muscle medial gastrocnemius muscle activity was significant between sneakers and mule sneakers. There was also a significant difference between sneakers and slippers, but there was no significant difference between slippers and mule sneakers. Conclusion: There was no significant statistical difference between sneakers and mule sneakers, but there was a numerical difference. Therefore, the presence or absence of the shoe collar may affect the muscle activity of the medial gastrocnemius when walking on a slope. This can lead to patellofemoral pain syndrome caused by the excessive use of the quadriceps, so it must be considered that caution is needed.

• The Journal of Korean Physical Therapy
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• v.35 no.1
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• pp.24-30
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• 2023

Purpose: The purpose of this study was to investigate the effectiveness of the elastic compression stockings and Kinesio taping on muscle activity and mechanical properties in healthy women during the heel raise exercise that causes muscle fatigue. Methods: Participants were divided into the elastic compression stockings group (ESG, n=8), Kinesio taping group (KTG, n=8), and control group (CG, n=8). All participants performed the heel raise exercise to cause muscle fatigue. Muscle activity, stiffness, and the muscle tone of the gastrocnemius and tibialis anterior were measured before and after the heel raise exercise. Results: In the gastrocnemius, muscle activity was significantly increased after the heel raise exercise in both the ESG and KTG (p<0.05). There was a significant difference in the change in the gastrocnemius muscle activity between the groups (p<0.05). Post hoc analysis showed that the ESG exhibited a significantly greater change in gastrocnemius muscle activity than the CG (p<0.05). The muscle stiffness of the gastrocnemius was significantly decreased after the heel raise exercise in the ESG (p<0.05). The muscle tone of the gastrocnemius was significantly increased after the heel raise exercise in the control group (p<0.05). There were no significant differences in the change in the gastrocnemius stiffness and muscle tone between the groups (p>0.05). In the tibialis anterior, there were no significant differences in muscle activity, stiffness, and muscle tone between and within the groups (p>0.05). Conclusion: Our findings suggest that the use of elastic compression stockings and Kinesio taping during the heel raise exercise are beneficial and delay muscle fatigue in the gastrocnemius.

• PNF and Movement
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• v.20 no.1
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• pp.135-145
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• 2022

Purpose: The purpose of this study was to investigate the association between cognitive and motor inhibition by comparing muscle activity and ground reaction force during unplanned gait termination according to reaction time measured through the stop-signal task. Methods: Sixteen young adults performed a stop-signal task and an unplanned gait termination separately. The subjects were divided into fast and slow groups based on their stop-signal reaction time (SSRT), as measured by the stop-signal task. Electromyography (EMG) and ground reaction force (GRF) were compared between the groups during unplanned gait termination. The data for gait termination were divided into three phases (Phase 1 to 3). The Mann-Whitney U test was used to compare spatiotemporal gait parameters and EMG and GRF data between groups. Results: The slow group had significantly higher activity of the tibialis anterior in Phase 2 and Phase 3 than the fast group (p <0.05). In Phase 1, the fast group had significantly shorter time to peak amplitude (TPA) of the soleus than the slow group (p <0.05). In Phase 2, the TPA of the tibialis anterior was significantly lower in the fast group than the slow group (p <0.05). In Phase 3, there was no significant difference in the GRF between the two groups (p >0.05). There were no significant difference between the two groups in the spatiotemporal gait parameters (p >0.05). Conclusion: Compared to the slow group, the fast group with cognitive inhibition suppressed muscle activity for unplanned gait termination. The association between SSRT and unplanned gait termination shows that a participant's ability to suppress an incipient finger response is relevant to their ability to construct a corrective gait pattern in a choice-demanding environment.

• The Journal of Korean Physical Therapy
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• v.35 no.5
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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.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.3
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• pp.91-97
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• 2018

PURPOSE: Stroke patients have reduced balance ability due to a lack of motion in the ankle joint. Elastic taping assists movement, and joint mobilization, a form of passive movement, enhances mobility. The purpose of this study was to determine the immediate effects on balance ability after anterior-to-posterior (A-P) talocrural joint mobilization combined with elastic taping in stroke patients. METHODS: Twenty stroke patients were divided into two groups: a joint mobilization with taping group (experimental group, n=10) and an elastic taping only group (control group, n=10). The experimental group underwent anteroposterior mobilization of the talus and elastic tape was applied to the calf and tibialis anterior muscles. The control group had elastic tape applied. Dynamic balanced abilities were assessed by using the BioRescue system. After 30 minutes of intervention, the forward, backward, left side, and right side sway areas ($mm^2$) were measured. RESULTS: Only the experimental group showed a significant increase in forward sway area after intervention. However, no significant differences were detected between the two groups. CONCLUSION: This study shows that A-P talocrural joint mobilization combined with elastic taping has a positive effect, producing an immediate increase in the forward balance ability of stroke patients. However, this study did not examine joint mobilization alone. In subsequent studies, it is necessary to examine the effect of joint mobilization only on balance in stroke patients.

• The Journal of Korean Physical Therapy
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• v.23 no.5
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• pp.1-5
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• 2011

Purpose: This study was designed to investigate the changes of postural sway and muscle activation while standing upright and performing a dual task. Methods: Nine healthy adults were recruited and provided their written informed consent. They performed a balance task with and without a cognitive task on a force flatform (Good balance, Metitur Ltd., Filand). Postural sway was measured as medio-lateral and anterior-posterior distance and the velocity of the center of pressure and muscle activations of the ankle dorsi- and plantar-muscle was measured. The recruits completed three trials and the data was analyzed by a paired t-test. Results: There were significant differences in the medio-lateral and anterior-posterior distance and the velocity of the center of pressure, and significant increases in the muscle activities of the tibialis anterior. Conclusion: These findings revealed that performing a dual task increases postural sway and muscle activation of the ankle when simultaneously maintaining balance and performing another cognitive task. Future studies should focus on balance training with a dual task for patients.

• Journal of Korean Physical Therapy Science
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• v.17 no.3_4
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• pp.29-39
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• 2010

Purpose: The purpose of this study was to examine the effect of foot position and lifting an object on muscle activity and foot pressure during sit to stand(STS) in hemiparetic patients. Methods: Fourteen patients participated in this study. Surface electromyography was used to collect muscle activity and foot pressure measurement system was used to analyze foot pressure in hemiparetic side. Three different foot position was assumed(anterior, neutral, posterior) in hemiparetic side. The repeated two-way analysis of variance and multiple comparisons were conducted to determine statistical significance with a significance level of 0.05. Results: The results were as follows. 1) Lower extremity muscle activity was significantly higher(p<0.05) in biceps femoris and tibialis anterior muscle during STS without holding an object. With changing positions of the affected foot, muscle activity was significantly increased (p<0.05) in vastus medialis and lateral gastrocnemius when the foot was positioned in posterior. 2) There was no significant difference(p>0.05) in foot pressure during STS with object holding and foot positioning. Conclusion: Muscle activity showed a significant increase when the foot was positioned in posterior in comparison to the muscle activity when the foot was in neutral or anterior position.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.4
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• pp.35-42
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• 2018

PURPOSE: This study was conducted to investigate the effects of Kinesio taping and massage application to the calf muscles on ankle stability. METHODS: The study subjects were 66 healthy adults (male: 32, female: 34) who had no instability in their ankles. Subjects were randomly assigned to a Kinesio taping group or a massage group. The research tool used the Y-balance test to measure instability of the ankle. The distance between the right and left foot was measured from the center in the anterior, posterior-medial, and posterior-lateral directions. Massage was applied to the calf muscles three times over two weeks and Kinesio tape was attached to the calf muscle and tibialis anterior for 10 hours twice during the experimental period. RESULTS: The results showed that application of Kinesio taping resulted in increases in the distance between the feet increased in some directions. After the massage, the distance extended from the anterior and posterior-lateral directions was prolonged, and the ankle stability on the right and left sides was partially improved by massage application. CONCLUSION: Kinesio taping and massage applied to the calf muscles are appropriate interventions for the improvement of ankle stability. Based on the application times of massage, Kinesio taping appears to work more effectively for ankle stability.

• Journal of the Korean Arthroscopy Society
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• v.8 no.2
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• pp.89-93
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• 2004

Purpose: To evaluate the clinical stability and function after arthroscopic anterior cruciate ligament(ACL) reconstruction using fresh-frozen tibialis tendon allograft. Materials and Methods: Of the patients who underwent ACL reconstruction using tibialis tendon allograft from July 2002 to June 2003, thirty-one patients could be evaluated and the mean follow-up period was 19 months. Evaluations included were Lysholm knee score, 2000 International knee Documentation Committee (IKDC) subjective knee score, Lachman test, pivot shift test, KT-1000 arthrometer measurement and 2000 IKDC knee examination. Results: The mean Lysholm score was 88. Twenty-eight patients (90.3%) were good or exellent for the measured parameters. Twenty-seven patients(87.1%) was over 70 in IKDC subjective knee score. Thirty patients (96.8%) had 1+ firm end or negative Lachman test. 27 patients (87.1%) had a negative pivot shift. Thirty patients (96.8%) had less than 5mm difference of maximal manual difference by KT-1000 arthrometer. Twenty -nine patients (93.5%) were nearly normal or normal grade by 2000 IKDC knee examination. Complications were 1 case of failure and 1 case of infection. Conclusion: ACL reconstruction with the double-stranded fresh-frozen tibialis tendon allograft resulted in a reliable and predictable outcome after short-term follow-up.