• Physical Therapy Rehabilitation Science
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• v.12 no.1
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• pp.26-32
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• 2023

Objective: This study attempted to compare the effects of bridge exercise using a sling according to the angle of the ankle to confirm the effective lower extremity muscle activation posture of patients with patellofemoral pain syndrome(PFPS). Design: Cross-sectional study Methods: Seventeen patients with PFPS were recruited and the muscle activities of the vastus medialis, vastus lateralis, rectus femoris, and gluteus maximus were measured according to the ankle position (dorsiflexion, neutral, plantar flexion). After measuring the maximum number of isometric contractions of vastus medialis, vastus lateralis, rectus femoris, and gluteus maximus, bridging exercise using a sling according to each ankle posture was applied to measure lower extremity muscle activity. The evaluation was performed 3 times for 10 seconds. The three ankle postures were randomly performed and the average values were compared. Results: As a result of this study, the vastus medialis muscle showed high muscle activity in the order of dorsiflexion, plantar flexion, and neutral position bridge exercise (p<0.05). And the vastus lateralis showed high muscle activity in the order of dorsiflexion, neutral, and plantar flexion (p<0.05). However, rectus femoris and gluteus maximus did not show significant muscle activity according to the ankle posture, but muscle activity was highest in the dorsiflexion posture. Conclusions: As a result of this study, muscle activity was high in the order of vastus medialis and vastus lateralis during ankle dorsiflexion. This is thought to be a major factor that can be applied in various ways in clinical practice according to the ankle angle when treating PFPS patients.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.2
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• pp.1791-1796
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• 2019

Background: Vibration exercise after ankle surgery improves proprioception and ankle muscle strength through vibration stimulation. Objective: To examine the effects of vibration exercise on the ankle stability. Design: Randomized controlled clinical trial (single blind) Methods: Twenty soccer players were randomly divided into experimental group and control group. The Vibration exercise program was conducted 12 weeks and 3 times a week. Ankle joint proprioceptive sensory test and Isokinetic muscle strength test were performed using Biodex system pro III to measure plantar flexion / dorsiflexion and eversion / inversion motion. Results: The result of isokinetic test of ankle joint is showed significant improvement in all measurement items, such as leg flexion, lateral flexion, external and internal muscle forces, compared to previous ones by performing vibration movements for 12 weeks. However, in the comparison group, plantar flexor ($30^{\circ}$), eversion muscle ($120^{\circ}$), inversion ($30^{\circ}$) of limb muscle strength were significantly improved compared with the previous phase; was no significant difference in dorsi-flexion. There was no significant difference between groups in all the items. Conclusions: In this study, we analyzed the effects of rehabilitation exercise on soccer players who had reconstructed with an ankle joint ligament injury through vibration exercise device. As a result, we could propose an effective exercise method to improve the ability, and confirmed the applicability as an appropriate exercise program to prevent ankle injuries and help quick return.

• Proceedings of the KSME Conference
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• 2008.11a
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• pp.1575-1579
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• 2008

The purpose of this study was to investigate how maximum-effort eccentric exercise over different contraction ranges affects the characteristics of torque-angle relationship of human ankle plantarflexor in-vivo. Subjects were randomly assigned in two groups. One group (n=6) performed 120 maximum-effort eccentric ankle dorsiflexion contractions at short muscle length (ankle range of motion from -5 to 15 deg) and the other group (n=6) at long (ankle range of motion from 10 to 30 deg) muscle length. Eccentric exercise decreased the maximum isometric ankle plantarflexion torque ${\sim}40%$. It was found that the optimum ankle joint angle changed from 7.5 deg to 11.1 deg and 10.1 deg, shifted toward the longer muscle length, regardless of the exercise range. The results of this study suggest that eccentric exercise alters the characteristics of torqueangle relationship of the muscle but there is no differential effect of the eccentric contraction range.

• The Journal of Korean Physical Therapy
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• v.31 no.1
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• pp.56-61
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• 2019

Purpose: The spasticity of stroke patients decreases the ankle range of motion and increases the gastrocnemius muscle tone. This study examined the effects of stretching exercise and far infrared irradiation on the ankle function in stroke patients with spasticity. Methods: This study was conducted on 20 stroke patients admitted to Jesaeng General Hospital, who were divided into a study group (stretching exercise with far infrared) and control group (stretching exercise only). The dorsiflexion range of motion was measured using a smartphone and the medial gastrocnemius muscle tone and stiffness were measured using a Myoton pro. Results: With the exception of the non-paretic gastrocnemius muscle tone in the control group, the medial gastrocnemius muscle tone and stiffness decreased significantly in both groups. In both groups, the dorsiflexion range of motion increased significantly. In addition, the experimental group had a significantly higher dorsiflexion range of motion than the control group. On the other hand, there was no significant difference between the two groups in terms of the medial gastrocnemius muscle tone and stiffness. Conclusion: For stroke patients with spasticity, stretching exercises increased the ankle's range of motion and decreased the gastrocnemius muscle tone. The addition of heat therapy further increased the ankle's range of motion. On the other hand, as the sample size was small, future studies should include more subjects.

• Archives of Reconstructive Microsurgery
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• v.9 no.2
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• pp.147-153
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• 2000

Soft tissue defects of the dorsum of foot and ankle can be covered from skin graft to free tissue transfer. The extent of injury which may be complex including the exposure of paratenons or bones requires free flap reconstruction. Some of the precautions for reconstruction are providing minimal bulkiness and well conforming to irregular contour thus making normal footwear possible. Though the muscle flap having its advantages and versatility, the fascial flap such as temporoparietal fascial flap has been considered the choice for reconstruction of the dorsum of foot and ankle. The purpose of our study is to utilize the advantages and versatility of the muscle flap as a first choice for reconstruction for the defects involving the dorsum of foot and ankle. The gracilis muscle with its anatomic and donor characteristics, it can be utilized to maximal effect by expanding its slim muscle width removing the epimysium and reducing its bulk by muscle atrophy through denervation. We present our experience with ten cases of reconstruction for the dorsum of foot and ankle using the gracilis muscle free flap. Results were satisfactory without flap loss, skin loss and infection. The contour and aesthetic aspect of the foot was satisfactory. Gait analysis showed near normal gait without limitations from everyday activities. Normal footwear was tolerable in all the cases. The keys to consider in the reconstruction of the dorsum of foot and ankle are appropriate bulkiness, conforming to its contour and able to apply normal footwear. With minimal donor morbidity and satisfying results, the extended gracilis muscle should be considered as the first line for reconstruction of the ankle and dorsum of foot.

• PNF and Movement
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• v.6 no.3
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• pp.29-35
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• 2008

Purpose : To describes the important aspects of the foot and ankle movement and function used when git and balance strategy. Method : The foot and ankle was a very important roles in the lower limb movement and gait. This study summarizes the physiologic movement of knee to the PNF lower extremity patterns. Result : The ankle joint composed of the talocural joint, the subtalarl joint, transverse tarsal joint, talocalcaneonavicular joint. The onset of dorsiflexion muscle activity starts in pre swing gait patterns. First contract muscle is the extensor hallucis. Activity of tibialis anterior and extensor digitorum longus quickly follows in mid swing gait phase. During stance phase, the soleus and gastrocnemius muscle provided plantar flexor torque, which muscle reacts quickly to restrain ankle dorsiflexion, and contributes modulated control of the ankle motion in gait patterns. Conclusions : The understanding of ankle kinematics, could provide a good therapeutic approach for improving gait patterns in patients with various pathological condition.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.28 no.1
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• pp.29-38
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• 2022

Background: Task-oriented training on an unstable support surface is an effective intervention for improving the ankle joint stability and muscle strength in patients with ankle instability. This study examined the effects of balance training on an unstable support surface in patients with ankle sprains with ankle instability. Methods: Forty-four patients with ankle sprains participated in this study. Screening tests were performed and assigned to an experimental group, who performed task-oriented training on an unstable support surface (n=22), and a control group, who performed task-oriented training on a support surface (n=22) using a randomization program. All interventions were applied 3 times per week for 4 weeks. The numeric rating scale (NRS), cumberland ankle instability tool (CAIT), balance ability, muscle activity, and muscle thickness were compared to evaluate the effects of the intervention. Results: Both groups showed significant differences in the NRS, CAIT, balance ability, and muscle activity between before and after the intervention (p<.05). In addition, there were significant differences in balance ability, muscle activity, and muscle thickness between the experimental and control groups (p<.05). Conclusion: Task-oriented training on an unstable support surface is an effective intervention for improving the balance ability, muscle activity, and muscle thickness during contraction.

• The Journal of Korean Physical Therapy
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• v.29 no.1
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• pp.39-43
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• 2017

Purpose: This study was to investigate the effects of unilateral muscle fatigue in knee and ankle joints on balance and gait in healthy adults. Methods: Exercise inducing muscle fatigue in the knee joint consisted of concentric and eccentric contraction of dominant knee extensors in healthy adults by using the Leg Extension Rehap exercise machine (HUR, Finland). Exercise inducing muscle fatigue in the ankle joint was composed of voluntary contractions and forced contractions of the dominant plantar flexors in healthy adults. Exercises to induce muscle fatigue in the knee and ankle joints were performed until the subject complained of fatigue or pain, the occurrence of muscle fatigue was confirmed by electromyography. We measured static and dynamic balance using the Good Balance system and gait performance by RS-scan. Results: Static and dynamic balance ability and spatial-temporal gait decreased significantly after muscle fatigue in knee and ankle joint. Conclusion: These results show that unilateral muscle fatigue of the lower extremities affected postural control and gait. Therefore, therapists and sport trainers should minimize the risks of fall and injuries related to unilateral muscle fatigue.

• The Journal of Korean Physical Therapy
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• v.35 no.2
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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.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.28 no.3
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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.