• 대한족부족관절학회지
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• 제28권1호
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• pp.1-7
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• 2024

Despite the advances in total ankle replacement (TAR), TAR has emerged as a promising alternative to ankle arthrodesis, particularly in severe ankle arthritis. Restoring ankle stability and alignment is the most important technical consideration and the goal of TAR. Hence, additional procedures, such as soft tissue balancing and osteotomies, are often critical parts of surgical planning. This article reviews the basics of joint balancing, offering suggestions on procedure selection for ligamentous balancing and varus and valgus malalignment in TARs.

• The Journal of Korean Physical Therapy
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• 제29권2호
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• pp.95-100
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• 2017

Purpose: This study aimed to evaluate the changes in dorsiflexion and balance following proximal and distal tibiofibular joint manipulation in individuals with a history of lateral ankle sprain (LAS). Methods: Fifteen participants with a history of unilateral LAS, exhibiting a restriction in ankle dorsiflexion were included in this study. LAS ankle received a manipulation to the proximal and distal tibiofibular joint, while the opposite control ankle received no manipulation intervention. The outcome measures included ankle dorsiflexion and balance. Ankle dorsiflexion was measured using weight-bearing lunge test. Static and dynamic balances were measured using the overall, anterioposterior, and mediolateral balance index via the biodex balance system. Measurements were obtained prior to and following manipulation. Results: This study showed that ankle dorsiflexion and dynamic balance were improved following the manipulation compared to those prior to the manipulation (p<0.05). There was no significant change in static balance (p>0.05). Conclusion: The joint manipulation technique applied to the ankle of those with a history of LAS appears to improve ankle dorsiflexion and dynamic balance. This suggest that a manipulation to the proximal and distal tibiofibular joint could be provided as preliminary data regarding the prophylactic effects of recurrent LAS.

• 대한정형도수물리치료학회지
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• 제24권2호
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• pp.59-67
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• 2018

Background: The purpose of this study was to investigate the effects of gluteus medius strength exercise on the ankle stability of high school student with chronic ankle sprains. Methods: A total of 30 participants were divided two groups. Experimental group was 15 participants applied gluteus medius strength exercise. Control group was 15 participants performing ankle strength exercise. This study was performed for 50 minutes per day, three a week for 6 weeks. All measurements were taken to a pre and post test. Strength was measured using Power Track ll. Balance was measured using Biodex balance system for Limits of Stability and Postural Stability. Ankle Stability was measured using Cumberland Ankle Instability Tool (CAIT). Results: In the case of gluteus medius strength, there were statistically significant differences between the experimental group and the control group. For ankle stability were statistically significant differences within the experimental group according to measurements taken by Limits of Stability, Postural Stability, and CAIT. A between group comparison showed a statistically significant difference for CAIT only. Conclusion: According to our measurements it appears that gluteus medius strength training was effective in benefiting muscular strength, balance and ankle stability among the physical education.

• 척추신경추나의학회지
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• 제7권2호
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• pp.109-117
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• 2012

Objectives : The purpose of this study is to compare with the effect of general oriental medical treatment with or without ankle joint Chuna Manual Therapy for acute ankle sprain. Methods : We investigated 36cases of ankle sprain patients, and devided patients into two groups: One was treated general oriental medical treatment(Control Group) and the other was treated ankle joint Chuna Manual Therapy with general oriental medical treatment(Experimental Group). Results : 1. Each Group had significantly decrease in Visual Analogue Scale(VAS) and significantly increase in Ankle-Hind-foot Scale(AHS) after treatment. 2. Experimental Group was significant differences in Visual Analogue Scale(VAS) and Ankle-Hind-foot Scale(AHS) compare to Control Group. Conclusions : In this clinical study, general oriental medical treatment with ankle joint Chuna Manual Therapy was more effective in reduce ankle sprain pain and improve ankle joint function.

• 대한족부족관절학회지
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• 제14권1호
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• pp.47-52
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• 2010

Purpose: We report the clinical and radiographic result of ligament reconstruction using plantaris and total ankle replacement in end-stage ankle arthritis with ankle instability. Materials and Methods: The study is based on the 9 cases among total 48 patients of end-stage ankle arthritis that were treated with total ankle prosthesis and ligament reconstruction from 2007 to 2009 at least 12 months follow-up. We evaluated the VAS (Visual analogue scale) pain score, AOFAS (American orthopedic foot and ankle society) score and radiographic measurements. Results: Average age was 59.4 years (53~67 years) old. VAS pain score improved from preoperative average $8.2{\pm}0.9$ (range, 7~10) to $2.7{\pm}1.7$ (range, 0~6) and the AOFAS score improved from $46.4{\pm}14.6$ points (range, 23~69) to $80.1{\pm}9.3$ points (range, 65~95) at final follow-up. Anterior draw test improved $15.2{\pm}3.4$ mm (range, 12~23 mm) to $8.8{\pm}2.6$ mm (range, 6~13mm), varus stress test improved from $13.9{\pm}4.6^{\circ}$ (range, $10-18^{\circ}$) to $6.2{\pm}4.7^{\circ}$ (range, $2-18^{\circ}$) at final follow up. Conclusion: Plantaris ligament reconstruction is good option as part of the management of ankle instability with end-stage ankle arthritis. We achieved good clinical and radiographic results.

• 대한족부족관절학회지
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• 제6권2호
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• pp.261-264
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• 2002

Purpose: To investigate the clinical features of fistulas of the ankle joints. Materials and Methods: Seven fistulas in seven patients were reviewed during Apr. 2000 to Mar. 2002, retrospectively. There are five men and two wemen. Average age was 47.7 years (range, 42-65 years). Average follow-up period was 1.4 years. There were six cystic lesions after ankle sprain and one patient with persistent discharge after excision of bursa over lateral malleolus. Results: Duration from injury to presentation was average 9.8 years. The site of preoperative swelling was mostly over the lateral malleolus in five patients. In one patient, the area of swelling was extended to the anterolateral ankle joint and in another patient there was extensive swelling from Achilles tendon to the anterolateral ankle joint. Concomitant symptoms were instability in three patients, pain and instability in three patients. Methods of surgery were simple repair in one, modified Brostrom in three, augmentation with periosteal flap in addition to modified Brostrom in two and Chrisman-Snook in addition to augmentation with periosteal flap and modified Brostrom in one. There were no recurrence of instability as well as fistula. Conclusion: We think that the fistula of the ankle joint should be included in the differential diagnosis of the cystic lesion over the lateral malleolus and the result of surgical treatment would be satisfactory in most cases.

• 대한정형도수물리치료학회지
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• 제28권3호
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• pp.69-77
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• 2022

Background: Ankle sprains, and the resulting ankle instability worsen to chronic due to recurrent ankle injuries or sprains, 78% of which are accompanied by posture instability and damage due to changes in the position of the talus of the ankle. The purpose of this study is to investigate the immediate effect of applying MWM taping on the patient's muscle strength and balance ability in patients with chronic ankle instability. Methods: 15 people with MWM taping and 15 people with Kinesio taping were applied, and after applying the taping of the ankle, 10 minutes of walking treadmill and 10 times of forward lunge operation, the change in ankle muscle strength and balance ability was confirmed. The strength test of the ankle was performed using a test device called Biodex system 4 (USA) for the movement of the dorsi-flexion and plantar flexion of the foot, and the balance of the two groups was measured using Biodex balance system (USA) to test balance ability. Results: The comparison of muscle strength changes in the ankle does not show a significant increase in the group applying MWM compared to the group applying kinesio taping (p<.05). In the comparison of equilibrium capabilities, the MWM taping group also showed a significant increase in the MWM taping group compared to the kinesio taping group (p<.05). Conclusion: When applying MWM taping and kinesio taping to patients with chronic ankle instability, there was no significant difference in comparison of muscle strength changes, but there was a significant difference in comparison of balance ability.

• 대한통합의학회지
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• 제11권1호
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• pp.121-130
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• 2023

Purpose : This study aimed to investigate the effect of blood flow restriction exercise on ankle muscle strength and balance ability to achieve maximum efficiency with the same exercise intensity and time. Methods : Twenty-six adults are randomly assigned to experimental group (n=13) and comparison group (n=13). The experimental group performed ankle joint strength exercises with blood flow restriction applied while the comparison group performed ankle joint strength exercises without blood flow restriction applied three times a week for four weeks. The digital muscle measurement, Y-balance test, and Cumberland ankle instability tool were used to evaluate the subject's muscle strength, dynamic balance, and ankle instability index before and after the intervention. Results : In within-group comparison muscle strength, all the two groups showed significant improvements post intervention (p<.05). In between-group comparison, there was significant difference in the change of dorsiflexion, eversion strength pre and post intervention (p<.05). but plantarflexion was no significant difference between pre and post intervention in the group comparison (p>.05). In within-group comparison dynamic balance, all the two groups showed significant improvements post intervention (p<.05). In between-group comparison, there was no significant difference in the change of Y-balance score pre and post intervention (p>.05). In within-group comparison ankle instability index, all the two groups showed significant improvements post intervention (p<.05). In between-group comparison, there was no significant difference in the change of CAIT score pre and post intervention (p>.05). Conclusion : The results of this study show that ankle joint strength exercise improved the strength and balance ability of those complaining of chronic ankle instability, and ankle joint strength exercise applied with blood flow restriction was more effective in dorsiflexion and eversion strength exercise than ankle joint strength exercise without blood flow restriction.

• 한국운동역학회지
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• 제33권2호
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• pp.62-72
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• 2023

Objective: Although balance training has been used as an effective ankle injury rehabilitation program to restore neuromuscular deficits in patients with chronic ankle instability, it is not effectively used in terms of motor learning. Attentional focusing can be an effective method for improving ankle kinematics to prevent recurrent ankle injuries. This study aimed to 1) evaluate the effects of attentional focus, including internal and external focus, and 2) determine a more effective focusing method for patients with chronic ankle instability to learn balance tasks. Method: Twenty-four patients with chronic ankle instability were randomly assigned to three groups (external focus, internal focus, and no feedback) and underwent four weeks of progressive balance training. The three-dimensional ankle kinematics of each patient were measured before and after training as the main outcomes. Ensemble curve analysis, discrete point analysis, and post hoc pairwise comparisons were performed to identify interactions between groups and time. Results: The results showed that (1) the external focus group was more dorsiflexed and everted than the internal focus group; (2) the external focus group was more dorsiflexed than the no feedback group; and (3) the no feedback group was more dorsiflexed than the internal focus group. Conclusion: Because dorsiflexion and eversion are ankle motions that oppose the mechanism of lateral ankle sprain, using the external focus method during balance training may be more effective in modifying these motions, thereby reducing the risk of ankle sprain.

• 한국전문물리치료학회지
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• 제31권2호
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• pp.114-122
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• 2024

Background: The peroneus longus (PL) and peroneus brevis (PB) function as the primary muscles of eversion, a movement closely associated with tibial external rotation for ankle mortise stability. Ankle motion and tibial rotation vary based on different ankle and knee positions. Objects: This study aimed to investigate the PL, PB, and biceps femoris (BF) muscle activation and eversion strength during side-lying isometric eversion exercise based on different ankle positions (neutral [N] and plantarflexion [PF]) and knee positions (90° flexion [KF] and extension [KE]). Methods: Thirty healthy adults with an Ankle Joint Functional Assessment Tool score of ≥ 22 were recruited (mean age = 24.8 ± 3.1 years). Maximal isometric eversion strength and submaximal muscle activation of the PL, PB and BF were measured during isometric eversion exercise in side-lying. A 2 × 2 repeated measures analysis of variance was performed to investigate differences in muscle activation and strength. Results: The PL and PB muscle activation showed significant main effects with the knee and ankle positions (p < 0.05); activation was greater in the KE and PF positions than in the KF and N positions. The BF muscle activation showed a significant interaction effect with knee and ankle positions, which was greater in knee extension and ankle plantarflexed (KEPF) position than in knee flexion and ankle plantarflexed (KFPF) position (p < 0.05). Eversion strength showed a significant main effect only in ankle position (p < 0.05) and was greater in the N position than in the PF position. Conclusion: The results of this study indicate that the KEPF position can be recommended to facilitate contraction of the PL and PB during side-lying eversion exercise. Furthermore, the effects of the knee-ankle positions should be considered for measuring ankle eversion strength and implementing the isometric submaximal side-lying eversion exercise.