• Physical Therapy Korea
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• v.29 no.1
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• pp.19-27
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• 2022

Background: Foot drop is a common symptom in stroke patients. Tape applications are widely used to manage foot drop symptoms. Previous studies have evaluated the effects of static and dynamic balance and gait on foot drop using kinesiology tape; however, only few studies have used dynamic tape application in stroke patients with foot drop. Objects: The purpose of this study was to investigate the immediate effects of dynamic taping, which facilitates the dorsiflexor muscle, on static and dynamic balance and gait speed in stroke patients with foot drop. Methods: The study included 34 voluntary patients (17 men, 17 women) with stroke. The patients were randomly assigned to the experimental group (n = 17), wherein dynamic taping was used to facilitate the dorsiflexor muscle, or the control group (n = 17), wherein kinesiology taping was used. Before the taping application, velocity average, path-length average, Berg balance scale, and timed up and go test (TUG) were recorded to measure static and dynamic balance, whereas the 10-meter walk test (10MWT) was used to measure gait speed. After the taping application, these parameters were re-evaluated in both groups. Repeated measure analysis of variance was used. Statistical significance levels were set to α = 0.05. Results: Except for the 10MWT scores in the control group, significant differences were noted in all the parameters measured for static and dynamic balance and gait speed between the pre and post-test (p < 0.05). However, the parameters showed significant interaction effects between group and time in the TUG and 10MWT (p < 0.01). Conclusion: These results indicate that compared with kinesiology taping, dynamic taping used in chronic stroke patients with foot drop had a more significant effect on dynamic balance and gait speed.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.4
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• pp.63-70
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• 2019

PURPOSE: This study examined the effects of bilateral ankle dorsiflexors-strengthening exercise on the paralytic tibialis anterior activity, balance ability, and gait function of patients with chronic stroke. METHODS: Nineteen patients with chronic stroke were assigned randomly to the experimental and control groups. All participants received general physical therapy for 60-minutes per session, five times a week, for 6 weeks. In addition, the experimental group (n = 9) performed bilateral ankle dorsiflexion muscle-strengthening training three times a week, 30 minutes per session, for six weeks. The control group (n=10) performed the paraplegic ankle dorsiflexion muscle- strengthening training in the same manner. Before and after the intervention, the paralytic tibialis anterior muscle activity, timed up and go test (TUG), and 10m walking test (10 MWT) were performed. RESULTS: Both groups showed significant improvement in the post-intervention muscle activity of the paralytic tibialis anterior, TUG, and 10MWT compared to that before the intervention (p<.05), but the differences between the two groups were not significant (p >.05). CONCLUSION: Bilateral ankle dorsiflexors strengthening exercise is an effective cross-training method to improve the muscle activity of the paraplegic tibialis anterior, balance ability, and walking function in chronic stroke patients.

• Physical Therapy Korea
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• v.1 no.1
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• pp.1-9
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• 1994

This study was performed to determine the inter-rater reliability of manual tests of elbow, knee flexor, and ankle dorsiflexor muscle spasticity graded on the Modified Ashworth Scale. Two raters each independently graded the spasticity of 32 patients with intracranial lesions after moving the paretic limb passively through the available range of motion. The patients were asked to simultaneously squeeze therapeutic putty with their non-paretic hand for reinforcement. The ratings were compared by the Wilcoxon matched pairs signed-rank test and by the Kendall's coefficient of rank(tau) correlation. There was singificant correlation between two raters for spasticity at the elbow, knee flexor, and ankle dorsiflexor. The correlations of the two raters ranged from .6746 to .9308. The highest correlation was for the elbow with reinforcement and the lowest was for the knee without reinforcement. Poorer correlation was evident in the knee joint. The positive results of this study encourage the continued use of manual tests of muscle spasticity, using the Modified Ashworth Scale.

• Korean Journal of Applied Biomechanics
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• v.18 no.4
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• pp.21-30
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• 2008

The purpose of this study was to investigate changes in mechanical properties of human tibialis anterior following eccentric exercise. Healthy subjects (n=12) performed 120 maximum eccentric contraction of ankle dorsiflexor. Before and 1- and 24- hour after the eccentric exercise, ankle dorsiflexion moment-angle relationships were obtained. Along with significant decrease in maximum isometric muscle strength, the shift of the optimum ankle joint angle toward the longer muscle length direction was observed, independent of the ranges of motion of the eccentric exercise. The results of this study demonstrated that eccentric exercise-induced micro muscle damage(Morgan & Allen, 1999) does rut seem to be a sole mechanism of eccentric contraction-induced muscle damage, suggesting further investigation for the better understandings of this phenomenon.

• The Journal of Korean Physical Therapy
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• v.33 no.2
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• pp.91-96
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• 2021

Purpose: This study investigated the effects of cryotherapy on the ankle joint muscle strength and balance ability in stroke patients with ankle joint muscles. Methods: In this study, 20 patients with chronic stroke were recruited from a rehabilitation hospital. The patients were divided into two groups: a cryotherapy group (10 patients) and a control group (10 patients). The cryotherapy group performed sit-to-stand training for 15 minutes and then cryotherapy for the minutes. In the control group, after sit-to-stand training for 15 minutes, blocked cryotherapy was provided for three minutes. In both groups, the interventions were provided five times a week for three weeks. The strength of the ankle joint muscles was measured before and after the training using the Biodex systems 3. The static balance ability was measured using balancia software, and the dynamic balance ability was measured by performing the sit-to-stand test (FTSST) five times. Results: After the training periods, the cryotherapy group showed significant improvement in the ankle dorsiflexor strength, ankle plantarflexor strength, weight distribution of the affected side, and FTSST compared to the control group (p<0.05). Conclusion: Based on these results, cryotherapy could be considered an effective method to improve the strength of ankle joint muscles. Cryotherapy improves muscle strength as it increases the motor neuron excitability. Therefore, cryotherapy may be considered to improve the strength of the ankle joint muscles of stroke patients.

• The Journal of Korean Physical Therapy
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• v.35 no.2
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• pp.43-47
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• 2023

Purpose: This study compared the movement control ability of the ankle joint according to the type of muscle contraction, namely, eccentric or concentric contractions. Methods: Thirty-four healthy adult subjects participated in this study. As a single group, before the experiment, the subjects were trained on achieving the required position of the ankle around the target point by manually controlling the ankle dorsiflexion by 10°. Concentric contraction starts at 0° and continues until the target point of 10° is reached. During an eccentric contraction, the ankle joint starts at 20° ankle dorsiflexion and continues till the target point is reached. Movements using eccentric contraction and concentric contraction were randomly performed 3 times each. Results: The results of comparing the difference in the movement control ability of each type of muscle contraction of ankle dorsiflexion showed that the measurement-remeasurement error was significant in eccentric contraction. Conclusion: In this study, we found a difference in the ability to control movement according to whether the contraction is eccentric or concentric. Therefore, we propose that the ability to control movement is affected by the type of muscle contraction.

• Journal of Korean Foot and Ankle Society
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• v.20 no.4
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• pp.182-186
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• 2016

The tibialis anterior tendon functions as a major dorsiflexor of the ankle. A rupture in this tendon can cause serious problems in the ambulatory function. A closed traumatic rupture without open wound or an atraumatic rupture can delay diagnosis and treatment. There are not enough guidelines for an effective surgical treatment on this chronic condition. Herein, we report two cases of chronic tibialis anterior disruption successfully treated by semitendinosus autograft.

• The Journal of Korean Physical Therapy
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• v.34 no.1
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• pp.12-17
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• 2022

Purpose: Ankle dorsiflexion is an essential element of normal functions, including walking, activities of daily living and sport activities. The tibialis anterior (TA) muscle functioned as a dorsiflexor and as a dynamic stabilizer of the ankle joint during walking and jumping. This study aimed to compare TA muscle thickness using ultrasonography according to the four different toe and ankle postures for the selective TA strengthening exercise. Methods: This study were recruited 26 (males: 15, females: 11) aged 20-30 years, with no injury ankle and calf in the medical history, had normal dorsiflexion and inversion range of motion (ROM). The thickness of the TA muscle was measured by ultrasonography in the four different toe and ankle postures: 1. Ankle dorsiflexion with all toe extension and ankle inversion (ITEDF); 2. Ankle dorsiflexion with all toe flexion and ankle inversion (ITFDF); 3. Ankle dorsiflexion with all toe extension and neutral position (NTEDF); 4. Ankle dorsiflexion with all toe flexion and neutral position (NTFDF). One-way repeated analysis of variance (ANOVA) and Bonferroni correction were used to confirm the significant difference among conditions. The level of statistical significance was set at α=0.01. Results: TA muscle thickness with ITFDF was significantly greater than in any other ankle positions, including ITEDF, NTFDF, and NTEDF (p<0.01). Conclusion: Among the four toe and ankle postures, isometric contraction in ITFDF postures showed the greatest increase in thickness of TA rather than ITEDF, NTEDF, and NTFDF postures. Based on these results, ITFDF can be recommended in an efficient way to selectively strengthen TA muscle.

• Physical Therapy Korea
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• v.12 no.3
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• pp.46-55
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• 2005

The purpose of this study was to evaluate the effect of concurrent and reciprocal isometric contraction and angle of ankle joint on fatigue of concentrically contracting contralateral dorsiflexor and plantar flexor. Seventeen able-bodied subjects participated in the study. Concurrent and reciprocal isometric contraction were performed under three different ankle joint angles (dorsiflexion, neutral position, plantar flexion). During concurrent or reciprocal isometric contraction. fatigue of concentrically contracting contralateral tibialis anterior, gastrocnemius, and soleus was investigated and compared. There was no interaction between different ankle joint angles and direction of isometric contraction (p<.05). No significant differences were found among three different ankle joint angles (p<.05). Contralateral muscle fatigability was lower in reciprocal isometric contraction than that in concurrent isometric contraction (p<.05). Therefore, the findings of this study suggest that reciprocal isometric contraction is more beneficial than concurrent isometric contraction inducing less fatigability during contralateral concentric contraction.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.1
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• pp.1-9
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• 2020

PURPOSE: Many patients with stroke have difficulties in walking with foot-drop. Various types of ankle-foot orthoses (AFOs) have been developed, but their weight needs to be reduced with the assistance of the ankle dorsiflexor. Therefore, an elastic AFO (E-AFO) was devised that not only improves the stability and flexibility of the ankle but also assists with ankle dorsiflexion while walking. This study examined the effects of an E-AFO, on the walking patterns of foot-drop patients with stroke. METHODS: Fourteen patients walked with and without an E-AFO, and the gait parameters were assessed using the GAITRite system. The spatiotemporal data on the gait patterns of stroke patients with foot-drop were compared using paired t-tests; the level of statistical significance was set to α<.05. RESULTS: No significant differences were observed in the velocity (p=.066) and affecte+d step length (p=.980), but the affected and less-affected stance (p=.022, p=.002) and swing time (p=.012, p=.005) were significantly different. The E-AFO produced a significant difference in the less-affected step length (p=.032). CONCLUSION: The E-AFO has a significant effect on the walking patterns of individuals with foot-drop and stroke. The E-AFO could be a useful assistive device for gait training in stroke patients.