• Korean Journal of Applied Biomechanics
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• v.31 no.4
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• pp.276-282
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• 2021

Objective: To investigate effects of Fibular Repositioning Taping (FRT) on lower extremity joint stiffness and angle during drop-landing. Method: Twenty-eight participants (14 healthy, 14 with chronic ankle instability [CAI]) performed drop-landings from a 60 cm box; three were performed prior to tape application and three were performed post-FRT. Three-dimensional kinematic and kinetic data were collected using an infrared optical camera system (Vicon Motion Systems Ltd. Oxford, UK) and force-plate (AMTI, Watertown, MA). Joint stiffness and sagittal angle of the ankle, knee, and hip were analyzed. Results: The hip [Healthy: p<.05; M ± SD: 29.43 ± 11.27 (pre), 33.04 ± 12.03 (post); CAI: p<.05; M ± SD: 31.45 ± 9.70 (pre), 32.29 ± 9.85 (post)] and knee [Healthy: p<.05; M ± SD: 53.44 ± 8.09 (pre), 55.13 ± 8.36 (post); CAI: p<.05; M ± SD: 53.12 ± 8.35 (pre), 55.55 ± 9.81 (post)] joints demonstrated significant increases in sagittal angle after FRT. A significant decrease in joint angle was found at the ankle [Healthy: p<.05; M ± SD: 56.10 ± 3.71 (pre), 54.09 ± 4.31 (post); CAI: p<.05; M ± SD: 52.80 ± 6.04 (pre), 49.86 ± 10.08 (post)]. A significant decrease in hip [Healthy: p<.05; M ± SD: 1549.16 ± 517.53 (pre), 1272.48 ± 646.73 (post); CAI: p<.05; M ± SD: 1300.42 ± 595.55 (pre), 1158.27 ± 550.58 (post)] and knee [Healthy: p<.05; M ± SD: 270.12 ± 54.07 (pre), 239.13 ± 64.70 (post); CAI: p<.05; M ± SD: 241.58 ± 93.48 (pre), 214.63 ± 101.00 (post)] joint stiffness was found post-FRT application, while no difference was found at the ankle [Healthy: p>.05; M ± SD: 57.29 ± 17.04 (pre), 59.37 ± 18.30 (post); CAI: p>.05; M ± SD: 69.15 ± 17.63 (pre), 77.24 ± 35.05 (post)]. Conclusion FRT application decreased joint angle at the ankle without altering ankle joint stiffness. In contrast, decreased joint stiffness and increased joint angle was found at the hip and knee following FRT. Thus, participants utilize an altered shock absorption mechanism during drop-landings following FRT. When compared to previous research, the joint kinematics and stiffness of the lower extremity appear to be different following FRT versus traditional ankle taping.

• Physical Therapy Korea
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• v.28 no.3
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• pp.200-207
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• 2021

Background: Postural control deficit is a major characteristic in patients with chronic ankle instability (CAI). Elastic ankle tapings are commonly used to facilitate postural control in patients with CAI as well as prevent relapse of a lateral ankle sprain. However, equivocal evidence exists concerning the effect of elastic ankle taping on postural control. Objects: This study aimed to evaluate the effects of elastic ankle tapings using kinesio taping (KT) and dynamic taping (DT) on static and dynamic postural control in patients with CAI. Methods: Fifteen subjects with CAI were participated in this study. The participants performed tests under three conditions (barefoot, KT, and DT). Static postural control was evaluated using the one-leg standing test (OLST) and dynamic postural control using the modified Star Excursion Balance Test (mSEBT). One-way repeated-measures analysis of variance was used to compare center of pressure (CoP) data and normalized mSEBT reach distances among the three conditions (with α = 0.05). Results: The CoP parameters (path length, ellipse area, and mean velocity) of the OLST significantly decreased on applying KT and DT compared with those when barefoot. The normalized reach distances in the anteromedial (AM), medial (M), and posteromedial (PM) directions of the mSEBT significantly increased with DT compared to that in the control condition. Further, the higher reach distances with KT compared with those in the control condition were obtained in the M and PM directions of the mSEBT. No significant differences were identified in any of the OLST and SEBT parameters between the two different taping applications. Conclusion: KT and DT improved static postural control during the OLST compared with the control condition. Moreover, these tapes improved dynamic postural control during the mSEBT compared to the control. Therefore, elastic ankle tapings are useful prophylactic devices for the prevention and treatment of ankle sprain in people with CAI.

• Journal of Korean Foot and Ankle Society
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• v.20 no.2
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• pp.62-66
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• 2016

A modified $Brostr{\ddot{o}}m$ procedure has been widely accepted as a treatment of choice for patients with chronic lateral ankle instability. The procedure is highly reliable and provides successful outcomes in approximately 90% of cases. Severe degree of instability, absence or poor quality of the ligamentous remnant, obesity, and generalized joint hypermobility have been regarded as poor prognostic factors related to the modified $Brostr{\ddot{o}}m$ procedure. However, these perceptions are based on a low level of evidence studies or expert opinions. Therefore, the aim of this article was to search for evidences regarding the poor prognostic factors of the modified $Brostr{\ddot{o}}m$ procedure.

• PNF and Movement
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• v.8 no.1
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• pp.41-50
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• 2010

Pain originating from the sacroiliac joint(SIJ) has been associated with poor performance, yet specific diagnosis of sacroiliac dysfunction(SID) has been difficult to achieve. Clinical presentation of SID appears that pain and poor performance is responsive to local analgesia of periarticular structures with poorly defined pathology, and poor performance with bony pathological changes present as a result of chronic instability. Previous research indicates that physical examination cannot diagnose SIJ pathology. Earlier studies have not reported sensitivities and specificities of composites of provocation tests known to have acceptable inter-examiner reliability. Tests based on mechanics as manual provocation for SIJ pain have formed the basis of tests used to diagnose SIJ dysfunction. In this review summary, the purpose of this study was to describe the sacroiliac tests with a model of examination, diagnosis, and management of SID. Further research is warranted to determine whether SIJ tests is reliable means of evaluating innominate impairments.

• Journal of Korean Foot and Ankle Society
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• v.20 no.1
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• pp.12-18
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• 2016

Purpose: The purpose of this study is to review the indications of ankle lateral complex reconstruction using tendon graft. Materials and Methods: We searched PubMed using the index, "ankle, instability, lateral ligament, reconstruction" from 1990 to present (September 30, 2015). We excluded 1) modified Brőstrom operation (MBO), 2) conventional tenodesis surgery, 3) review article, 4) technical note, and 5) articles written in another foreign language. We reviewed 24 papers through the publication events, operational method, the indications of surgery, and the specific features of the patient group. Results: There were the indications of 1) previous ligament surgery failure, 2) situation when ligament repair is impossible due to the ligament defect, 3) severe instability (preoperative talar tilt >$15^{\circ}$, anterior draw >10 mm or the difference of contralateral side talar tilt >$5^{\circ}$, anterior draw >3 mm), and 4) overweight (body mass index >$30kg/m^2$). Other considerations included 1) generalized joint laxity and 2) workers, highly-demanded or athlete highly-affected by instability. Conclusion: The ankle lateral complex reconstruction using tendon graft could be indicated in patients with the possibility of MBO failure with several considerations.

• Annals of Clinical Neurophysiology
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• v.12 no.1
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• pp.3-6
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• 2010

The British guideline for early management of persistent low back pain, published in 2009, indicated that physicians should offer exercise or medication, rather than radiological interventions or injections, as first choice of treatment in the patients with chronic low back pain (CLBP). However, there had been great controversies regarding the effectiveness of interventional treatment of patients with CLBP. Both somatic (discogenic, instability, etc) and psychosocial factors contribute to the pathophysiology of chronic low back pain (CLBP). Although it can be difficult in many occasions, thorough interview with the patients and specific diagnostic approaches can help us to identify which is the main etiology in individual patient. With the recent progress in medical radiology and development of new therapeutic modalities, some subgroups of patients of CLBP caused by somatic factors appear to be good candidates of interventional therapy. Interventional therapy can be considered in patients with CLBP caused by annulus rupture, facet joint degeneration, disc degeneration, and vertebral column instability. Among other subgroups of CLBP, carefully selected patients with disc degeneration show the most favorable result by interventional therapy. In this regard, discogenic pain, either as a form of CLBP or acute discogenic radiculopathy, seems to be a good indication of interventional therapy. Because many spine specialists generally consider those with radiculopathy are easier to be treated, patients with CLBP tend to be subjects of conventional conservative therapy. For these reasons, clinicians should make their best effort to identify every possible somatic cause in patients with CLBP before regarding them as hypochondriacs. In this review, some of the recent evidence on the role of interventional treatment in patients with CLBP will be discussed, and some of our cases who showed favorable results by interventional therapy will be presented.

• Journal of Korean Physical Therapy Science
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• v.15 no.3
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• pp.19-29
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• 2008

Background : Ankle inversion sprains are one of the most common injuries in sports and activities of daily living that mostly concern physically active individuals. In most researches, proprioceptive deficit, muscle weakness and/or absent coordination have been regarded as a contributing factors. Despite the high incidence of ankle sprain and instability, therapeutic approaches to properly manage the symptoms have rarely been investigated. This study aimed to identify the effect of proprioceptive exercise program that is easy to integrate in normal training program. Methods : Subjects were randomly allocated to control group and experimental group consisting of 11 and 10 patients, respectively. The conservative treatment for the control group consisted of hot packs, ultrasound and TENS. In addition, the experimental group performed 7 exercises to enhance proprioceptive function of ankle joint. The therapeutic intervention of the controland experimental groups was performed a total of 20 exercise sessions, averaging 50 hour each, 5 times per week for 4 weeks. To compare the two groups, the level of ankle disability was assessed by using the ankle injury score scale in pre- and post-treatment. Results : On assessment of post-treatment, there were statistically significant differences in the scores of all sub-items, except for ankle laxity and range of motion, and the total score of ankle injury score scale between the two groups(p<0.05). In comparison between pre- and post-treatments, the significant difference in the scores of all sub-items and total score didn't appear for the control group, while the scores of most sub-items and total score of the experimental group were shown the statistically significant difference(p<0.05). Conclusion : The findings suggest that the proprioceptive exercise program is more effective for relieving ankle disability than conservative treatment therefore, the program to improve proprioceptive function should be recommended for prevention and rehabilitation of recurrent ankle inversion injuries.

• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.127-136
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• 2003

Posterolateral instability of the knee occurs more commonly in association with an injury to anterior and posterior cruciate ligament and combined injuries are severe injuries that result in significant functional instability and articular cartilage degeneration. Reconstruction of the anterior and posterior cruciate ligament without an appropriate treatment of posterolateral corner injury result in failure of the reconstructed cruciate ligaments. Meticulous physical examinations, imaging studies, lower limb alignment and gait pattern should be evaluated. Acute grade III isolated or combined injury of the posterolateral corner is best treated within three weeks by direct repair, or augumentation, or reconstruction. The appropriate surgical method or combined methods are selected among the several methods of posterior and posterolateal reconstruction, and all injuried posterolateral and cruciate ligament structures are anatomically reconstructed simultaneously or by stages. If a varus alignment and varus thrust is disclosed in chronic posterolateral instability of knee, soft tissue reconstructions laterally are highly unlikely to be able to correct tile problem. It is appropriate that valgus osteotomy should be done before soft tissue reconstruction and reevaluate the posterolateral instability about 6 months later.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.4
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• pp.191-200
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• 2021

Purpose : Chronic ankle instability can lead to problems in balance and gait due to weakness of the ankle muscles and decreased proprioceptive sensation. Balance training that stimulates proprioceptors is necessary to improve ankle stability. We aimed to compare the effects of unstable support balance exercises using whole body sonic vibration and an aero-step (TOGU) on proprioception and balance in individuals with unilateral functional ankle instability. Methods : Thirty-six participants with unilateral functional ankle instability were randomly recruited and divided into two groups (group 1 = sonic whole body vibration, group 2= TOGU). Individuals in each group participated in training for 5 weeks, 40 minutes per session, 5 times per week, and performed weight-bearing exercises in five postures on different unstable support surfaces. Proprioception was measured by digital inclinometer (Dualer IQ), and balance was measured by force platform (Biodex balance system). Results : Significant differences were observed in proprioception before and after intervention within both group (p<.05). Significant differences were also observed in the balance index before and after intervention within both groups (p<.05). Conclusion : As a result of this study, it is suggested that for individuals with ankle instability, unstable support surface training using a whole body sonic vibrator and TOGU can have a positive effects on proprioception and balance ability.

• Journal of Korean Foot and Ankle Society
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• v.22 no.1
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• pp.8-15
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• 2018

Ankle osteoarthritis is a debilitating condition that causes severe pain associated with functional impairment and decreased activity. Ankle osteoarthritis, unlike that of the knee or hip joint, is rare in primary arthritis. Most cases are traumatic arthritis that occur after ankle sprain or fractures or chronic ankle instability. Although ankle fusion has been regarded as the standard treatment of ankle osteoarthritis in the past, total ankle arthroplasty (TAA) is increasing due to the development of the implant design and surgical techniques. TAA is biomechanically superior to ankle fusion by preserving the movement of the ankle joint. In particular, it is functionally superior to ankle fusion because it enables normal joint motion during gait. In addition, there is an advantage of preserving the movement of the hindfoot and reducing the abnormal stress applied to the adjacent joints after ankle fusion to prevent the occurrence of long-term adjacent joint arthritis. Although the short-term and mid-term results of TAA have been reported to be excellent, long-term follow-up has a relatively low survival rate and high complication rate compared to total knee or hip arthroplasty. Therefore, continuous and further research is needed.