• Journal of the Korean Society of Physical Medicine
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• v.17 no.1
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• pp.109-116
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• 2022

PURPOSE: This study compared the effect of performing gastrocnemius stretching with and without the self-myofascial release of the sole on the active and passive ankle dorsiflexion angles and muscle tone of the gastrocnemius muscle in subjects with short gastrocnemius muscle. METHOD: A total of 23 subjects with short gastrocnemius muscles were included in this study. The study participants were divided into two experimental groups. Group A performed gastrocnemius muscle self-stretching exercises only, while group B performed self-myofascial release of the sole using a massage ball after the gastrocnemius muscle self-stretching exercises. For both groups, the active and passive ankle dorsiflexion angles were measured using a goniometer, and the tone of the gastrocnemius muscle was assessed using the MyotonPRO®. RESULTS: Within-group comparison showed that the participants in both groups A and B had significantly increased active and passive ankle dorsiflexion angles and decreased gastrocnemius muscle tone (p < .05) after performing their respective exercises. However, no significant differences in the said criteria were observed between groups A and B (p>.05). CONCLUSION: The results of this study showed that both methods were effective in increasing active and passive dorsiflexion angles and decreasing muscle tone. Thus, it is recommended to tailor gastrocnemius stretching exercises according to the patient's condition. If the patient does not experience discomfort in the plantar fasciae, it is recommended to perform the gastrocnemius stretching exercise only without myofascial release and use a massage ball afterward.

• Anatomy and Cell Biology
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• v.56 no.1
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• pp.46-53
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• 2023

It is unclear whether forearm and crural muscle fibers extend distally across the wrist and ankle joints, respectively. We hypothesized, in late-term fetuses, an over-production of muscle bellies extending over the joint. Muscle fibers in histological sections from unilateral wrists and ankles of 16 late-term fetuses (30-40 weeks) were examined and compared with 15 adult cadavers. Muscle fibers of the flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) in fetuses, especially muscle bellies to the third and fourth fingers, were found to extend far distally beyond the radiocarpal joint. The extensor digitorum and extensor pollicis longus on the extensor side of the wrist were found to carry distally-extending muscle fibers, but these fibers did not extend beyond the distal end of the radius. In the ankle, most muscle bundles in the flexor hallucis longus (FHL), fibularis brevis (FB) and extensor digitorum longus extended distally beyond the talocrural joint, with most FB muscle fibers reaching the level of the talocalcaneal joint. In adult cadavers, muscle fibers of the FDP and FHL did not reach the levels of the radiocarpal and talocrural joints, respectively, whereas the FB muscle belly always reached the talocalcaneal joint. Similarly, some of the FDS reached the level of the radiocarpal joint. Generally, infants' movements at the wrist and ankle could result in friction injury to over-extended muscle. However, the calcaneal and FDP tendons might protect the FB and FDS tendons, respectively, from friction stress.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.26 no.1
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• pp.55-63
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• 2020

Background: This study was conducted to compare the effects of an incline board, proprioceptive neuromuscular facilitation (PNF) stretching, and joint mobilization on the dorsiflexion of the ankle joint and muscle tone of the plantar flexor and ankle in stroke patients. Methods: Forty-five stroke subjects were randomly divided into three groups: each JMG (Joint Mobilization Group), IBG (Inclined Board Group) and PSG (PNF Stretching Group). The experiment was performed for eight weeks between August 1 and October 31, 2018. Results: The dorsiflexion of the ankle joint was significant between the groups and by period (p<.05). JMG had a significant change by period (p<.05). Differences between groups by period increased after 8 weeks in the PSG and the JMG (p>.05). The gastrocnemius lateral muscle tone was significant between the groups (p<.05), and medial muscle tone was interacted between groups and time (p<.05). Conclusion: An effective intervention method to increase the dorsiflexion of the ankle joint and decrease the muscle tone when performing PNF stretching, and joint mobilization in stroke patients was confirmed. Future studies are recommended to variety research of PNF stretching and joint mobilization.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.1
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• pp.83-92
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• 2021

PURPOSE: This study examined whether ankle joint stabilizing taping and muscle control taping influenced the ankle range of motion (ROM), muscle tone, and balance ability in chronic stroke patients. METHODS: Ten stroke patients were assigned randomly to experimental group 1 (joint stabilization taping n = 5) and experimental group 2 (Muscle control taping n = 5). After general physical therapy in both groups, ankle stabilization taping was applied to experimental group 1, and muscle control taping was applied to experimental group 2 three times a week for a total of six weeks (18 times). RESULTS: The muscle tone and stiffness of the gastrocnemius (GCM) showed significant differences between the experimental 1 and experimental 2 groups (p < .05). The Berg Balance Scale (BBS) and ROM also showed significant differences within the experimental 1 and experimental 2 groups (p < .05). The BBS and ROM also showed no significant differences between the experimental 1 and experimental 2 groups (p > .05). CONCLUSION: This study examined the muscle tone, balance, and ROM on the paraplegic side of stroke patients using kinesio taping, and the effect of the taping application method was confirmed from the preceding study. Therefore, it can decrease the paralysis side muscle tone and improve the ROM and balance ability.

• Physical Therapy Rehabilitation Science
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• v.11 no.2
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• pp.127-135
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• 2022

Objective: The purpose of this study was to investigate the effects of combining Mulligan taping and flossing bands on lower limb muscle activity and static and dynamic balance. Design: A randomized controlled trial. Methods: Sixty-eight patients with chronic ankle instability were randomized into three groups that were treated with Mulligan taping (MT, n=22), flossing band (FB, n=23) and Mulligan taping combined with flossing band (MT+FB, n=23), and various parameters were compared before and after the intervention. The muscle activity of the lower extremities, including the tibialis anterior, peroneus longus and medial of gastrocnemius muscles was measured using BTS FREE EMG 1000, while the static and dynamic balance were measured using the Biorscuue balance measuring equipment. Results: There was a significant difference in muscle activity of the tibialis anterior muscle, before and after the intervention, in the MT group (p<0.01), FB (p<0.001) and MT+FB (p<0.001). There was also a significant difference in the muscle activity of the tibialis anterior muscle in the MT+FB group when compared with that in MT and FB groups (p<0.05). We also observed a significant difference in the dynamic balance all the groups (p<0.001). Conclusions: Therefore, combining Mulligan taping and flossing bands for patients with chronic ankle instability may improve dynamic balance and tibialis anterior muscle activity.

• Physical Therapy Korea
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• v.20 no.4
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• pp.47-54
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• 2013

The purpose of this study was to investigate the effects of active and passive postural perturbation on ankle dorsiflexor responses in stroke patients. The subjects consisted of 13 stroke patients. Using wireless electromyography, the patients' ankle dorsiflexor muscle responses were measured under the following conditions: active dorsiflexion (AD), active perturbation (AP), and passive perturbation (PP). Tibialis anterior muscle activity increased most significantly during PP of the affected side ($118.64{\pm}56.28$). The most significant increase for the non-affected side was in AD ($72.64{\pm}24.56$). Tibialis anterior muscle activity was compared under each condition. The affected side showed significant differences between PP and AD and between PP and AP (p<.05). The non-affected side showed not significant differences between each condition. The ratios of tibialis anterior muscle activity under AP to that under AD were 1.00 on the affected side and .75 on the non-affected side and the difference was not significant (p>.05). The ratios of tibialis anterior muscle activity under PP to that under AD were 3.30 on the affected side and 1.14 on the non-affected side and the difference was significant (p<.05). Passive perturbation improved tibialis anterior muscle activity on the affected side, and training based on this approach may have the potential to improve the ankle dorsiflexion of people with stroke.

• 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 International Academy of Physical Therapy Research
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• v.12 no.1
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• pp.2272-2278
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• 2021

Background: Vibration stimulation has emerged as a treatment tool to help reduce spasticity during physical therapy. Spasticity includes problems of reduced range of motion (ROM) and stiffness. However, the benefits of vibration rolling (VR) on interventions for stroke patients are unclear. Objectives: This study aimed to investigate the effect of VR intervention on the ankle ROM and ankle stiffness in stroke patients. Design: A randomized crossover study. Methods: Seven stroke patients completed two test sessions (one VR and one non-VR [NVR]) in a randomized order, with 48 hours of rest between each session. Participants completed intervention and its measurements on the same day. The measurements included ankle dorsiflexion and plantarflexion ROM and stiffness of ankle muscles, including the tibialis anterior, medial, and lateral gastrocnemius muscle. Results: After VR, ankle dorsiflexion ROM, lateral gastrocnemius stiffness, and medial gastrocnemius stiffness improved significantly (all P<.05). After NVR, only the lateral gastrocnemius stiffness improved significantly (P<.05). Furthermore, in the cases of changed values for ankle dorsiflexion ROM and lateral gastrocnemius stiffness were compared within groups, VR showed a more significant difference than NVR (P<.05) Conclusion: VR improved ankle ROM and muscle stiffness. Therefore, we suggest that practitioners need to consider VR as an intervention to improve dorsiflexion ROM and gastrocnemius stiffness in stroke patients.

• Physical Therapy Rehabilitation Science
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• v.6 no.1
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• pp.39-44
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• 2017

Objective: The purpose of this study is to show the effectiveness of performing squat exercises at various angles to show the maximum muscle activity of the Vastus Medialis Oblique (VMO) and Biceps femoris (BF). Design: Cross-sectional study. Methods: A total of seventeen healthy young adults (8 males and 9 females) voluntarily participated in the study. All subjects randomly performed three different squat variations as follows: A squat performed with the ankle joint at $0^{\circ}$ of incline, a squat performed with the ankle joint at $5^{\circ}$ of incline, and a squat performed with the ankle joint at $10^{\circ}$ incline. Muscle activity was measured using surface electromyography. Electrodes were placed on the VMO and BF to measure the muscle activity on the various ankle angles for comparison analysis. Results: There was a significant increase in bilateral VMO muscle activation at $10^{\circ}$ of incline compared to $0^{\circ}$ and $5^{\circ}$ (p<0.05). Greater increases in muscle activation and exercise effect was observed with increasing incline angles of the board. Changes in bilateral BF muscle activity were found; however, none were found to be significant. Conclusions: Bilateral VMO activity was found to be significant when the squats were performed at an ankle angle of $10^{\circ}$ of incline when compared to at an ankle angle of $0^{\circ}$ and $5^{\circ}$ of incline. Squats performed on an incline can be recommended as an effective method to facilitate lower extremity muscle activities.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.2
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• pp.83-92
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• 2023

PURPOSE: This study examined the effect of using a smartphone according to the direction of wearing a bag on muscle characteristics and balance ability in adults in their 20s with chronic ankle instability. METHODS: Twelve people with chronic ankle instability were examined for three weeks. The types of carrying a bag were classified into three conditions: to the right, to the left, and on both sides. The muscle characteristics and balance ability were measured and analyzed. The one-way ANOVA was used to obtain a difference between conditions. RESULTS: A significant difference in the muscle tone of medial gastrocnemius was observed between the dominant group and the non-dominant group. The muscle tone and stiffness of the peroneus longus decreased significantly after walking with a smartphone and carrying a bag. The maximum slope of the forward and reverse directions increased and decreased significantly, respectively, after walking with a smartphone and carrying a bag on both sides. CONCLUSION: In this study, muscle fatigue causes a decrease in muscle tone and stiffness with chronic ankle instability when carrying a heavy back while walking, and there were asymmetric changes in the balance ability. Therefore, adults with chronic ankle instability should carefully avoid carrying a heavy bag for extended times, irrespective of the style or type of the bag.