• 대한족부족관절학회지
• /
• 제23권1호
• /
• pp.6-11
• /
• 2019

As a result of the increased participation in recreational and competitive sports activity, the incidence of chronic lateral instability has risen. Because chronic ankle instability can cause significant comorbidity and increase the social cost, the interest in this issue is growing. Although there are well-documented and effective surgical treatments for managing this condition, conservative treatments are a viable first option in selected patients. Through conservative treatment, surgical treatments can be reduced or delayed without necessarily affecting the overall outcome, but the failure of conservative treatment results in the need for surgical treatment to reduce the long term complications. Appropriate postoperative rehabilitation is essential for adequate functional recovery, even when surgical treatment is required.

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

• 대한족부족관절학회지
• /
• 제23권1호
• /
• pp.1-5
• /
• 2019

Surgical treatment to restore stability in the ankle and hindfoot and prevent further degenerative changes may be necessary in cases in which conservative treatment has failed. Anatomical direct repair using native ligament remnants with or without reinforcement of the inferior retinaculum is the so-called gold standard operative strategy for the treatment of lateral ankle instability. Non-anatomical lateral ligament reconstruction typically involves the use of the adjacent peroneus brevis tendon and applies only those with poor-quality ligaments. On the other hand, anatomic reconstruction and anatomic repair provide better functional outcomes after the surgical treatment of chronic ankle instability patients compared to a non-anatomic reconstruction. Anatomical reconstruction using an autograft or allograft applies to patients with insufficient ligament remnants to fashion direct repair, failed previous lateral ankle repair, high body mass index, or generalized ligamentous laxity. These procedures can provide good-to-excellent short-term outcomes. Arthroscopic ligament repair is becoming increasingly popular because it is minimally invasive. Good-to-excellent clinical outcomes have been reported after short and long-term follow-up, despite the relatively large number of complications, including nerve damage, reported following the procedure. Therefore, further investigation will be needed before widespread adoption is advocated.

• 대한족부족관절학회지
• /
• 제6권2호
• /
• pp.167-171
• /
• 2002

Purpose: To analyze the result of Modified Brostr$\ddot{O}$m procedure for Chronic ankle lateral instability without associated injury. Materials and Methods: Forty-one patients(Forty-one feet) diagnosed and operated with chronic ankle lateral instability without associated injury were evaluated retrospectively from June 1995 to December 1999. Twenty-three patients were athletes. For the evaluation of clinical outcome, a subjective grading scale of modified Hamilton was used, and pain relief, relief of instability symptom and anterior drawer test were evaluated. Results: Among forty-one operations, there were six excellent, thirty-five good results as a whole. All cases showed over the grade good. The average time to ordinary life in the non-atheletes was 2.5 months and average time to sport activity in the athletes was 4 months postoperatively. Conclusion: The modified Brostr$\ddot{O}$m procedure seems to be effective method for chronic ankle lateral instability without associated injury.

• 대한정형외과스포츠의학회지
• /
• 제12권1호
• /
• pp.37-41
• /
• 2013

목적: 만성 내측 족관절 불안전성을 진단하고, 내측 삼각인대 봉합술로 치료한 단기 결과를 보고하고자 한다. 대상 및 방법: 2007. 5부터 2009. 11까지 만성 족관절 불안정성을 호소하였던 262명의 남자 군인 중 만성 내측 족관절 불안정성으로 진단한 29명을 대상으로 하였다. 진단은 진찰소견과 방사선 소견 및 관절경적 소견에서 족관절 내측 이완 소견이 관찰된 경우로 하였으며, 수술은 손상된 삼각인대의 거골-주상골 인대를 봉합 나사를 이용하여 단축, 봉합하는 방법으로 시행하였다. 수술 전후의 미국 족부 족관절 학회 족관절-후족부 점수(AOFAS), 시각 동통 점수(VAS) 및 수술후 족관절 기능 만족도를 측정하여 임상적인 평가를 시행하였다. 결과: 족관절 불안정성을 가진 환자 중 11.1%에서 만성 내측 족관절 불안정성을 가지고 있었으며, 내측 거골-주상골 인대 봉합술을 시행한 후 AOFAS는 수술전 평균 64.5점(범위: 43~83점)에서 수술후 평균 82.0(범위: 60~100)점으로 증가하였으며, VAS는 수술전 평균 6.0점(범위: 4~10점)에서 수술후 평균 3.2점(범위: 1~7점)으로 감소하였다. 만족도는 우수가 13명 (44.8%), 만족이 11명(37.9%), 불만족이 5명(17.2%)이었다. 재발한 경우가 2례 있었으며, 타가인대(allo-tendinous graft)를 이용한 재수술을 시행하였다. 결론: 만성 내측 족관절 불안정성에 대하여 거골-주상골 인대를 봉합하는 수술을 시행한 후 약 83%에서 만족한 성적을 얻었다.

• 대한족부족관절학회지
• /
• 제13권2호
• /
• pp.175-178
• /
• 2009

Purpose: To evaluate the result of modified Br$\ddot{o}$strom procedure with anchor suture and explore associate lesion under arthroscopy for chronic lateral instability. Materials and Methods: From May 2005 to March 2009, Retrospective analysis of 126 patients with chronic lateral instability who underwent modified Br$\ddot{o}$strom procedure with anchor suture and arthroscopic procedure was done. Mean follow-up period was 13 months. Results: Chronic lateral instability of the ankle almost had local synovitis by arthroscopic examination. There were osteochondral lesion of talus on the anteromedial aspect in 63 cases, on the anterolateral aspect in 25 cases, osteochondral lesion of tibia side in 8 cases, fat hypertrophy of tibiofibular space in 120 cases, anterior fat impingement in 26 cases, intra-articular loose body in 13 cases. Mean Karlsson scoring scale was improve from 53 preoperatively to 91 postoperatively, There were 70 cases excellent, 27 cases good, 26 cases fair, 3 cases poor result according to the Sefton procedure. Conclusion: Modified Br$\ddot{o}$strom procedure with anchor suture and arthroscopic procedure are reliable treatment method for chronic ankle lateral instability which has intraarticular pathology.

• 대한물리의학회지
• /
• 제18권2호
• /
• pp.83-92
• /
• 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.

• 대한물리치료과학회지
• /
• 제31권1호
• /
• pp.70-87
• /
• 2024

Background: This study aimed to investigate the effect of Y-balance exercise on spatio-temporal gait parameters in subjects with chronic ankle instability. Design: Randomized Controlled Trial. Method: A study was conducted on 43 people with chronic ankle instability. Subjects performed modified Y-balance exercise 3 times a week for 50 minutes, 4 weeks. Gait parameters were measured using a gait analysis treadmill before exercise, 2 weeks after exercise, and 4 weeks after exercise. A gait analysis treadmill (FDM-T AP1171, Zebris, Germany) was used to measure gait parameters. Mean values were compared using Repeated measured two-way ANOVA. Result:: When comparing the results of three measurements taken before exercise, 2 weeks after exercise, and 4 weeks after exercise, there were significant differences in the qualitative and quantitative aspects of gait in gait variables such as step distance, step time, step ratio, and sway ratio. Conclusions: These results suggest that the Y-balance exercise and various exercises combining balance and proprioception are effective for subjects with chronic ankle instability.

• The Journal of Korean Physical Therapy
• /
• 제28권5호
• /
• pp.303-307
• /
• 2016

Purpose: This study was conducted to determine the effects of Mulligan's mobilization with movement (MWM) on changes in the talofibular interval in the sagittal plane in subjects with chronic ankle instability (CAI). Methods: Sixteen subjects with chronic ankle instability participated in this study. The talofibular intervals were measured from US images, and the weight-bearing lunge test was used to assess dorsiflexion of the ankle joint. Each dependent variable were measured on the both affected side and sound side in three trials in pre- and post-MWM. Dependent variables were examined with a two-way mixed-design analysis of variance (ANOVA). The two factors were side (sound side versus affected side) and intervention (pre- versus post-intervention). For post hoc analysis, paired t-tests were performed to compare the dependent variables. A p<0.05 was considered to indicate significance. Results: Dorsiflexion and talofibular interval differed significantly pre- and post-intervention (p<0.05). Post-hoc analysis revealed that the talofibular interval post-MWM was significantly less than that pre-MWM on the both the affected and sound side (p<0.05). The ankle dorsiflexion in the post-MWM group was significantly greater than that in the pre-MWM group on the affected side and the sound side (p<0.05). Conclusion: The Mulligan's MWM decreased the talofibular interval in subjects with CAI. These findings suggest that the MWM technique can change the position of the talus relative to the fibular in the weight bearing position.

• 대한족부족관절학회지
• /
• 제14권1호
• /
• pp.53-57
• /
• 2010

Purpose: This study was designed to evaluate the clinical and radiographical results of anatomical reconstruction by Chen method for chronic lateral ankle instability. Materials and Methods: Fifteen patients with chronic lateral ankle instability who had undergone anatomical reconstruction of anterior talofibular and calcaneofibular ligaments by Chen method were evaluated retrospectively. Average age of the patients was 31.3 years, and average follow-up period was 15.5 months. Preoperative and postoperative radiographs including varus stress view and magnetic resonance imaging (MRI) were analyzed. The clinical evaluation was performed according to the American Orthopaedic Foot and Ankle Society (AOFAS) scale. Results: Radiographically average talar tilt angle was $15.3^{\circ}$ preoperatively, and the difference with contralateral normal side was $10.1^{\circ}$. At last follow up, talar tile angle and the difference with contralateral side improved to $5.9^{\circ}$ and $1.3^{\circ}$ respectively. AOFAS scale was 66.6 preoperatively and 87.3 postoperatively. In MRI findings, four patients had associated intra-articular lesion such as articular cartilage defect, synovitis and osteoarthritis. The talar tilt angle improvement and AOFAS scale of patients without intra-articular lesion was better than those of four patients with intra-articular lesions. Surgical wound pain occurred in six patients and sural neuropathy in three patients. Conclusion: The anatomical reconstruction by Chen method was an easy and effective procedure for symptomatic chronic lateral ankle instability. Careful operative technique may prevent the surgical wound pain and sural neuropathy.