• 국제물리치료학회지
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• 제10권3호
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• pp.1823-1829
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• 2019

Background: Stroke patients have leg muscle weakness and impaired balance resulting in compensatory changes. To restore balance in these patients, functional training using postural strategy is needed. Objective: To examine the effects of ankle and hip strategy training on the center of pressure (COP) movement and limits of stability (LOS) in standing posture in stroke patients. Design: The study was an assessor-blinded and randomized-controlled clinical trial. Methods: Thirty patients were randomly assigned to an ankle strategy training group and a ankle/ hip strategy training group. Patients in the ankle strategy training group underwent ankle strategy exercise for 30 min, and those in the ankle/ hip strategy training group underwent 15 min of ankle strategy exercise and 15 min of hip strategy exercise. Both groups underwent training thrice a week for four weeks. Forward, backward, paretic side, and non-paretic side COP movements and LOS were measured using BioRescue. Results: After the intervention, except for the backward area in the ankle strategy training group, the COP movement area and the LOS were significantly improved in both the groups. In addition, these improvements were significantly higher in ankle/ hip strategy training group than that in the ankle strategy training group. Conclusions: Ankle strategy training in addition to hip strategy training improves COP movement (forward-backward, paretic side area, and non-paretic side area) and LOS in stroke patients.

• 대한물리치료과학회지
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• 제17권1_2호
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• pp.67-76
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• 2010

Background: The purpose of this study was to evaluate the influence of ankle strategy exercise on balance ability in the women of octogenarians. Methods: Ankle strategy exercise group(n=14), leg strengthening exercise group(n=14) were measured an balance ability by Berg Balance Scale(BBS) scores and Balance Performance Monitor(BPM) at pre-intervention and post-intervention in 6weeks. Results: This study were summarized as follows : 1. The BBS scores, sway area, sway path length, sway maximum velocity of ankle strategy exercise group and leg strengthening exercise group were significantly different among the intervention period(p<.05). 2. The improvement of BBS scores, sway area, sway path length, sway maximum velocity were significantly different between ankle strategy exercise group and leg strengthening exercise group at in 6weeks(p<.05). Conclusion: Learned from the ankle strategy exercise could improve BBS scores, sway area, sway path length, sway maximum velocity and a balance for the women of octogenarians. Ankle strategy exercise need to be applied clinically for balance ability of the women of octogenarians.

• 대한물리의학회지
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• 제9권1호
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• pp.75-82
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• 2014

PURPOSE: PURPOSE: The purpose of this study was to analyze the effect and examine the feasibility of an intervention of ankle strategy exercise on balance of patients with hemiplegia. METHODS: The subject were randomly allocated to three groups: ankle strategy exercise (group A), balance exercise (group B) and control (group C). Group A was received the conventional physical therapy plus ankle strategy exercises for 20 minutes in one session. Group B was received the same conventional physical therapy plus balance exercises for 20 minutes in one session. Two active groups were performed in the session 3 times a week, for a total of 6 weeks. and Group C was only received the same conventional physical therapy. Balance test was assessed using center of pressure (COP) in the anteroposterior (A-P), mediolateral (M-L) direction, Berg balance scale (BBS) and Timed Up and Go Test (TUG). RESULTS: All groups showed improvements in balance parameters. In especial, the Group A was statistically significant differences in almost part evaluation items and showed more improvements in BBS and TUG parameters than Group B and Group C. and moving distance of M-L COP was more improvements than Group B. CONCLUSION: Ankle strategy exercises had more influence on balance than balance exercises and neurodevelopmental treatment.

• 대한의용생체공학회:의공학회지
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• 제24권5호
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• pp.435-442
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• 2003

In this paper, biomechanical aspects of dynamic대학교postural responses against forward perturbations were experimentally determined simultaneous measurements of joint angles, accelerations. EMG activations, center of pressure(CoP) movements and ground reaction forces(GRF), Thirteen young healthy volunteers, stood on a flat platform, were translated into the forward direction by an AC servo-motor at two separate velocities(0.1m and 0.2m/s). In order to recover postural balance against the forward perturbation, joint motions were observed in the sequence of the ankle dorsiflexion, the knee flexion and then the hip flexion during the later acceleration phase. Both acceleration patterns at the heel and the sacrum were shown the forward acceleration pattern during the later acceleration phase and early of constant velocity phase as increasing platform velocity, respectively. Tibialis anterior(TA) for the ankle dorsiflexion and biceps femoris(BF) for the knee flexion. the primary muscle to recover the forward perturbation, was activated during the half of acceleration phase. Ankle strategy was used for slow-velocity perturbation, but mixed strategy of both ankle and hip used for the fast-velocity perturbation. In addition, parameters of perturbation such as timing and magnitude influenced the postural response against the perturbation.

• 한국운동역학회지
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• 제22권2호
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• pp.219-228
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• 2012

The purpose of this study was to investigate how induced fatigue of the ankle joint muscles affects the capability and recovery of postural control during single-leg stance in healthy adults. The study population included 22 randomly recruited men and women. Postural control was performed on single-leg stance with eyes open. Ankle joint muscle was fatigued by repeated heel raises. According to the results of this study, for the anteroposterior variables, both men and women showed significantly increased center of mass velocity and decreased center of pressure 95% edge frequency immediately after fatigue. For the mediolateral variables, both men and women showed significantly increased center of mass velocity and decreased center of pressure 95% edge frequency immediately after fatigue. For the total variables, both men and women showed significantly increased center of mass averaged-velocity immediately after fatigue, and also, the center of pressure 95% confidence ellipse area significantly increased in women. Postural control variables were not significantly different for men and women at any time (Pre, P0, P10, and P20). In conclusion, the gender does not affect the capability and recovery after induced fatigue of ankle joint muscles. The effect of fatigue found for the anteroposterior and the mediolateral variables in both men and women. Furthermore ankle joint muscle fatigue led to change of postural control strategy from an ankle joint strategy towards a hip joint strategy. These changes are believed to damage postural control. The ankle joint muscle recovered from fatigue within 20 min during single-leg stance.

• 한국산학기술학회논문지
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• 제13권12호
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• pp.5909-5919
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• 2012

본 연구는 노인여성들을 대상으로 발목관절 전략 집중 훈련이 근력과 균형능력에 어떠한 영향을 미치는지를 알아보고자 하였다. 연구대상자는 65-80세 사이의 여성노인 30명으로 선정하였다. 대조군(n=10)은 아무런 처치를 하지 않았고, 실험군 I(n=10)은 일반적 하지의 운동만 실시하였다. 실험군 II(n=10)는 세라밴드를 이용한 근력운동과 air cushion, unstable board을 이용한 평형운동을 포함한 발목관절 전략 집중 훈련을 실시하였다. 두 실험군은 6주간 주 3회 1시간 훈련을 실시하였다. 6주간 일반적 하지 운동과 발목관절 전략 집중 훈련을 각각 실시한 후 dynamometer, FRT, SEBT를 측정한 결과 대조군과 실험군 I의 변화는 통계학적으로 유의하지 않았지만, 실험군 II의 변화는 유의하게 증가하였다(p<.05). 더불어 노인 낙상 예방 및 치료적 접근에 있어서 발목관절 전략 집중 훈련을 통한 다양한 변인의 추가적인 연구가 필요하다고 생각된다.

• 한국전문물리치료학회지
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• 제11권1호
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• pp.53-67
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• 2004

This simulation study investigated the characteristics of normal gait, $30^{\circ}$ crouch gait, $30^{\circ}$ crouch/equinus gait, $45^{\circ}$ crouch gait, $45^{\circ}$ crouch/equinus gait. The knee flexion angles were restricted using a specially designed orthosis. This study was carried out in a motion analysis laboratory of the National Rehabilitation Center. Fifteen healthy male subjects were recruited for the study. The purposes of this study were (1) to compare spatiotemporal parameters, kinematics, and kinetic variables in the sagittal plane among the different gait, (2) to investigate the secondary compensatory strategy, and (3) to suggest biomechanical physical therapy treatment methods. The pattern and magnitude observed in each condition were similar to those of normal gait, except the peak knee extension moment of the unrestricted ankle motion-crouch gait. However, the speed of the $45^{\circ}$ crouch gait was half that of a normal gait. The ankle joint moment in the crouch/equinus gait showed the double-bump pattern commonly observed in children with spastic cerebral palsy, and there was no significant difference in gait speed as compared with normal gait. The peak ankle plantar-flexor moment and ankle power generated during the terminal stance in the crouch/equinus conditions were reduced as compared with normal and $45^{\circ}$ crouch gaits (p<.05). The crouch/equinus gait at the ankle joint was an effective compensatory mechanism. Since ankle plantarflexion contracture can be exacerbated secondary to the ankle compensatory strategy in the crouch/equinus gait, it is necessary to increase the range of ankle dorsiflexion and the strength of plantarflexion simultaneously to decrease the abnormal biomechanical advantages of the ankle joint.

• 대한의용생체공학회:의공학회지
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• 제30권6호
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• pp.495-502
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• 2009

This paper investigated the effects of dynamic postural control for maintaining upright standing on a support surface during continuous sinusoidal horizontal translation in anterior-posterior direction. 15 healthy young subjects participated in this experiment. The analysis of body movement was analyzed using Ariel Performance Analysis System. Motion pattern was analyzed by seven markers on subject's body. Position of markers were head, chest, hip, right knee, left knee, right ankle and left ankle. Seven different frequencies of support surface were employed ; 0.1, 0.25, 0.5, 0.75, 1, 1.5 and 2Hz at 2cm of moving path of motionbase. The experiments were performed dynamic postural reponses at the condition of eye open. The results showed that median frequency of the knee, ankle were increased in all frequency bands. Following the frequency of perturbation increased, postural control strategy was changed from ankle strategy to combined strategy. The experiment results could be applied to the dynamic postural training for the elderly and the rehabilitation training for the patients to improving the ability of postural control.

• PNF and Movement
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• 제6권3호
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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.

• 한국응용과학기술학회지
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• 제37권4호
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• pp.839-847
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• 2020

본 연구는 외발 착지 시 신체적 특성 요인들인 발목 유연성, 성별, Q-angle이 발목 관절 상해 요인들에 미치는 영향을 분석하는데 목적이 있었다. 이를 위해 오른발을 주발로 사용하고 체육을 전공하는 20대 남성 16명(나이: 20.19±1.78 years, 체중: 69.54±10.12 kg, 신장: 173.22±4.43 cm), 여성 16명(나이: 21.05±1.53 years, 체중: 61.75±6.97 kg, 신장: 159.34±4.56 cm)을 연구대상자로 선정하였다. 외발 착지 시 신체적 특성 요인들이 발목 관절 상해에 미치는 영향을 확인하기 위하여 첫째, 발목 상해 경험에 따른 하지 관절 움직임과 관절 모멘트의 독립 t-test를 실시하였다(α = .05). 둘째, t-test를 통하여 유의한 차이를 나타낸 변인을 종속변인으로 설정하고 발목 유연성, 성별의 차이, Q-angle을 독립변인으로 지정하여 선형다중회귀분석(Multiple Linear Regression)을 사용하였다(α = .05). 본 연구결과 발목 관절 상해를 경험한 그룹은 상해를 경험하지 않은 그룹과는 다르게 발목 관절의 내전, 무릎 관절의 내측 회전을 통한 착지 전략과 기술을 사용하는 것으로 나타났다. 또한 이러한 움직임은 발목 관절의 신전 모멘트를 증가시키고, 엉덩 관절의 신전 모멘트는 감소시키는 것으로 확인되었다. 특히 발목의 배측굴곡 유연성은 발목과 무릎의 착지전략에 영향을 미치며, 성별의 차이는 발목의 신전 모멘트에 영향을 미치는 것을 알 수 있었다. 따라서 외발 착지 시 신체적 특성 요인들이 발목 관절 상해에 영향을 미치는 요인들임을 확인 할 수 있었다.