• Physical Therapy Korea
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• v.29 no.1
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• pp.70-78
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• 2022

Background: Individuals with calf muscle shortening may have decreased dynamic balance. Objects: This study aimed to investigate the effect of mobilization with movement (MWM) and myofascial release (MFR) on kinematic changes in dynamic balance in individuals with calf muscle shortening. Methods: Thirteen participants were randomly assigned to the MWM or the mobilization with movement added myofascial release (MWM-MFR) group. The MWM group received treatment with only MWM, whereas the MWM-MFR group was treated with MWM and MFR. Pre- and post-intervention passive range of motion (PROM), maximum reaching lengths, and modified star excursion balance test (MSEBT) results were compared for all participants. Wilcoxon signed-rank test and Mann-Whitney U test were used for statistical analysis. Results: The results showed significant within-group differences in ankle PROM, but no significant between-group differences. The maximum reaching length in the MWM-MFR group in the posterolateral direction was significantly different before and after the intervention (p = 0.005). This group also showed significantly reduced ankle abduction in MSEBT during the posteromedial direction section 3 (p = 0.007) and posterolateral direction section 5 (p = 0.049) compared with the MWM group. Conclusion: Combined MWM and MFR intervention improves ankle stability in the coronal plane during the posteromedial and posterolateral forward movement in dynamic balance compared with only MWM in individuals with calf shortening.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.28 no.1
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• pp.19-27
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• 2022

Background: This study investigated the effects of a single-leg hopping test and Q-angle when applying Mulligan taping, flossing bands, and a combination of Mulligan taping and flossing bands to chronic ankle instability (CAI) patients. Methods: The subjects of the study were 68 patients with chronic ankle instability, randomly divided into three groups receiving the following treatments: Mulligan taping (n=22), flossing bands (n=23), and a combination of Mulligan taping and flossing bands (n=23). The immediate effects of the treatments were evaluated using the single-leg hopping test and Q-angle measurement for functional movement before and after the intervention. Results: All three groups showed significant improvements in the single-leg hopping test after the intervention, and there was a significant difference between the performance of the simultaneous application group and the Mulligan taping group (p<.01). As a result of the post-hoc test, there was a significant difference in the simultaneous application group than in the mulligan taping group (p<.01). When measuring the Q-angle change during the activity of descending stairs, there was also a significant effect in all three groups, with no significant differences when comparing the changes between groups (p>.05). Conclusions: In conclusion, Mulligan taping and flossing bands were confirmed as effective interventions for the functional movement of the lower extremities in patients with CAI. This study can provide basic data on the effectiveness of interventions in patients with CAI.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.20 no.1
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• pp.27-34
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• 2014

Background: The purpose of this clinical case report is to confirm sacroiliac joint misalignment effects on the gait. Methods: A healthy women volunteered to participate in this case report. Measurement of the subject was performed two categories. One is physical examination of the pelvic by inspection, palpation, movement based tests and pain provocation tests. The other one is gait performance measurement by 3 dimentional motion analysis. Results: Diagnosis by physical examination of the subject was Lt. ilium posterior rotation. Pelvic, hip, knee and ankle in the 3 dimensional kinematic data, the most notable result was the ankle. Conclusion: To confirm the effect of the misalignment of the sacroiliac joint on the gait function, it must be evaluated by integrating the movement to the ankle from the lumbar.

• Journal of International Academy of Physical Therapy Research
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• v.5 no.2
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• pp.738-742
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• 2014

This study was conducted to investigate the effect of FES and ankle mobilization on the ankle motion and the quality of gait of chronic hemiplegic patients with limited ankle joint motions. As research subjects, 24 chronic hemiplegic patients who could walk independently, regardless of assistive aids, were selected. Then, 8 subjects received mobilization randomly and 8 subjects received FES and 8 subjects received mobilization and FES, at the same time. The dorsiflexion PROM significantly increased in the group of mobilization therapy, mobilization and FES all together(p<.01). There were statistically significant differences among the three groups(p<.01). The 10m walking test significantly decreased in the group of mobilization therapy, mobilization and FES all together(p<.05). There were statistically significant differences among the three groups(p<.01). The gait velocity significantly increased in the group of mobilization therapy, FES therapy, mobilization and FES all together(p<.05). There were statistically significant differences among the three groups(p<.01). The stride length significantly increased in the group of mobilization therapy, mobilization and FES all together(p<.05). There were statistically significant differences among the three groups(p<.05). In conclusion, these findings demonstrate that rather than only using one treatment technique, applying mobilization and FES together brings a more satisfactory result to hemiplegic patients with limited ankle joint motions.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.24 no.1
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• pp.39-46
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• 2018

Background: In most human lives, 80 percent have problems with the ankle and can be solved with a treatment that is objective in proper assessment. Discrepacts in the ankle are also associated with walking patterns and affect hip and knee joints. An evaluation of hip flexion and extensor muscles was performed to check the strength of hip joints after ankle sprain patients application of arthesis. Methods: In the hospital in Bucheon, 20 outpatients who visited the hospital for treatment with ankle sprain were tested with 10 male and 10 female patients. The criteria for selection of the study subjects were randomly divided into those with joint movement techniques applied to the ankle joints and those with conservative physical therapy. Results: In applying arthrography and preservation physical therapy to patients with ankle sprain, a difference in muscle strength between hip flexion and extensor was noted in post-evaluation comparisons. There were significant differences in the assessment of walking speed and walking time between the two counties in the gait analysis assessment (p<.05). Conclusion: Studies have shown that applying arthrography to people with ankle sprain has a greater therapeutic effect than using conservative physical therapy.

• PNF and Movement
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• v.15 no.1
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• pp.85-96
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• 2017

Purpose: Peripheral neuropathy accompanied by sensory disturbance, such as limb paralysis and hemiplegia, is mainly caused by acute disseminated encephalomyelitis (ADEM). This case study aimed to determine the effect of ankle strengthening exercises that use proprioceptive neuromuscular facilitation (PNF) on the gait, balance, ankle-control ability, and sit-to-stand ability on a patient with ADEM. Methods: A 10-year-old male with quadriplegia and ankle-control impairment participated in this 4-week training intervention. The patient, diagnosed with ADEM, was treated with ankle strengthening exercises that used PNF. Results: The patient demonstrated improvements in balance, ankle-control ability, sit-to-stand ability, and gait performance. Outcome measures (manual muscle test, modified Ashworth scale, sensory assessment, coordination assessment, Berg balance scale, 5 time sit-to-stand test, and 10 m walk test) were taken before and after the training program. Conclusion: The results of this case suggest that an ankle strengthening exercise that uses PNF can improve the gait, balance, ankle-control ability, and sit-to-stand ability in patients with ADEM. In ADEM, the initial treatment is important, and the use of ankle strengthening exercises with PNF could lead to meaningful results. However, there is limited research due to an insufficient number of cases. In the future, more patients will need to be studied.

• Physical Therapy Korea
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• v.26 no.3
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• pp.84-90
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• 2019

Background: Ankle evertor muscles are important for preventing lateral ankle sprain. Since, the evertor muscles cross the ankle and toe joints, the position at which the ankle evertor muscle strength is measured is important. However, no studies have previously investigated the effect of ankle and toe positions on the strength of the ankle evertor muscle. Objects: This study is aimed to determine the effect of various ankle and toe joint positions on the strength of the ankle evertor muscles in healthy subjects. Methods: Eighteen healthy subjects participated in this study. Isometric ankle evertor strength of the dominant leg was determined in each subject in different ankle and toe positions (dorsiflexion (DF) with toe extension (TE), DF with toe flexion (TF), plantar flexion (PF) with TE, and PF with TF). A 2 by 2 repeated analysis of variance (ANOVA) was used to determine the difference in the evertor strength between the ankle positions (PF and DF) and toe positions (TE and TF). Results: The results indicate that there was no significant ankle position by toe position interaction effect (p=.83). However, the ankle evertor strength was significantly increased in the ankle DF position than in the PF position (p<.01), and the ankle evertor strength during eversion with TE was significantly higher than eversion with TF (p<.01). Conclusion: The findings of this study suggest that clinicians should consider the ankle and toe positions when measuring the muscle strength and during performance of selective muscle strengthening exercises of the ankle evertor muscles.

• Proceedings of the IEEK Conference
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• 2003.07c
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• pp.2887-2890
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• 2003

This paper describes the possibility of analyzing gait pattern from the variation of the lower leg electrical impedance. This impedance is measured by the four-electrode method. Two current electrodes are applied to the thigh, knee, and foot, and two potential electrodes are applied to the lateral, medial, and posterior position of lower leg. The correlation coefficients of the joint angle and the impedance change from human leg movement was obtained using electrogoniometer and 4ch impedance measurement system developed in this study. We found the optimal electrode position for ankle, knee and hipjoint movements based on high correlation coefficient, least interference, and maximum magnitude of impedance change. The correlation coefficients of the ankle, knee, and the hip movements -0.87, 0.957 and 0.80. respectively. From such features of the lower leg impedance, it has been made clear that different movement patterns exhibit different impedance patterns and impedance level. This system showed possibility that lower leg movement could be easily measured by impedance measurement system with a few skin-electrodes.

• Journal of the Korean Applied Science and Technology
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• v.37 no.3
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• pp.509-515
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• 2020

The purpose of this study was to analyze the correlation between passive ankle movement range and knee joint kinetic variables during squat movement. In this study, a total of 27 subjects participated in this study, 19 men and 8 women, who had no history of the musculoskeletal system of the lower extremity. To verify the correlation between the ankle joint flexibility and the knee joint kinetic variables during deep squat, it was performed pearson's correlation coefficient and variables showing statistically significant correlation were performed by simple regression analysis at a significant level of α .05. Through this study, the relationship between the peak joint moment and joint reaction force factors that determine ankle joint flexibility and knee joint pressure was confirmed. Therefore, when applying an exercise that can generate a lot of load on the knee joint such as deep squats during strength training, checking the degree of flexibility of the ankle joint among physical characteristics to the individual may reduce the stability of the body and the risk of injury to the knee joint. It is expected to be helpful in setting the intensity of exercise that can be done.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.28 no.1
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• pp.61-69
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• 2022

Background: This study aimed to investigate the effect of maitland mobilization and mobilization with movement (MWM) applied to the ankle joint on ankle dorsiflexion range of motion (ROM), static and dynamic balance, plantar pressure, and gait ability. Methods: A total of 24 individuals were assigned to either the maitland mobilization group (n=12) or the MWM group (n=12). Dorsiflexion ROM, static and dynamic balance, plantar pressure, 10-meter walk test were measured before and 4 weeks after the intervention. Results: Both groups showed a significant difference in the evaluation after 4 weeks as the dorsiflexion ROM of the ankle increased (p<.05), and the sway length and sway area indicating static balance decreased (p<.05). Furthermore, the movement area showing dynamic balance showed a significant increase (p<.05), the plantar pressure difference between both feet significantly decreased (p<.05). In the 10-meter walk test, there was a significant difference as the time decreased (p<.05). However, no significant difference between the two groups was observed (p>.05). Conclusion: According to the results of this study where, maitland mobilization and MWM were applied to the ankle joint of hemiplegic patients for 4 weeks, we found no difference between the two groups. However, each technique was found to be effective for dorsiflexion ROM, static and dynamic balance, plantar pressure, and gait.