• 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 Korean Foot and Ankle Society
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• v.8 no.2
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• pp.199-203
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• 2004

Purpose: We report a case that iatrogenic dorsiflexion deformity after hallux valgus surgery treated successfully with crescenteric plantar flexion metatarsal osteotomy. Materials and Methods: 43 years old female who suffered from left fore foot pain and deformity after hallux valgus surgery was evaluated. Results: Preoperatively she did not put on ordinary shoes and had had persistent pain and discomfort on 1st metatarsal area. She also had a callus on plantar surface of 2nd metatarsal head. Simple AP and Lateral x-ray identified that 1st metatarsal bone had a 23 degree dorsiflexion deformity. For correction of deformity, plantarflexion crescenteric osteotomy was performed on proximal 1st metatarsal area. After operation, All of symptom eliciting patient was gone and 43 points of AOFAS scale preoperatively improve 100 points and the patient very satisfied. Post operative x-ray was showing complete correction of deformity. Conclusion: As a treatment of iatrogenic dorsiflexion deformity after hallux valgus surgery, the crescenteric plantar flexion osteotomy can be good and safe modality for correction.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.3
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• pp.263-270
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• 2014

PURPOSE: The purpose of this study was to examine the immediate changes in the weight-bearing ankle dorsiflexion range of motion (ROM) and the dynamic balance in asymptomatic subjects using the modified Star Excursion Balance Test (SEBT) after ankle balance taping (ABT) and placebo ABT with kinesiology tape METHODS: A total of 23 active participants (11 men, 12 women) volunteered for this study. Ankle flexibility was assessed using the weight-bearing lunge test, and dynamic balance was assessed using the modified SEBT. Participants were asked to respond to questions regarding their perception of stability, reassurance, and confidence when performing modified SEBT. RESULTS: The weight-bearing ankle dorsiflexion ROM did not show a significant decrease after real ABT or placebo ABT compared to the ROM prior to ABT. The anterior, posterolateral, and posteromedial reach distances of SEBT did not increase significantly after real ABT or placebo ABT compared to the distances prior to ABT. However, the participants' perception of stability, reassurance, and confidence, when performing SEBT with real ABT, was increased compared to that during the control trial. CONCLUSION: This study showed that although real ABT did not immediately improve the reach distances in the 3 directions during modified SEBT, it improved the participants' perception of stability, reassurance, and confidence without decreasing weight-bearing ankle dorsiflexion ROM.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.2
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• pp.43-51
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• 2018

PURPOSE: Stroke patients have limited ankle range of motion and balance problems. The purpose of this study was to determine the effects of Kaltenborn orthopedic manual therapy, Evjenth-hamberg stretching, and combination of both on ankle dorsiflexion range of motion and dynamic balance ability in stroke patients. METHODS: Thirty patients were placed in three groups, each of which received different treatments: Kaltenborn orthopedic manual therapy (15 mins), Evjenth-hamberg stretching (15 mins), or Kaltenborn orthopedic manual therapy with Evjenth-hamberg stretching (30 mins). Each group received three exercise sessions per week during four weeks. To determine its effectiveness of interventions an evaluation was carried out. ankle dorsiflexion range of motion was gauged using a tiltmeter application, and dynamic balance ability was measured using the Berg balance scale. RESULTS: All groups revealed significant improvements in ankle dorsiflexion range of motion, Berg Balance Scale (BBS) score before and after the intervention, and Kaltenborn orthopedic manual therapy with Evjenth-hamberg stretching group showed a significant improvement in ankle dorsiflexion range of motion and BBS score in comparison to other groups. CONCLUSION: We found out that each individual method was effective in ankle dorsiflexion range of motion, dynamic balance ability in stroke patients, and the combined method was more effective.

• The Journal of Korean Physical Therapy
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• v.32 no.2
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• pp.88-93
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• 2020

Purpose: This study examined the inter-rater reliability of cervical proprioception, dynamic balance ability, and ankle dorsiflexion range of motion using STARmat^®, which is a practical clinical tool that can provide practitioners and patients with quantitative and qualitative results. Methods: Thirty healthy young subjects were enrolled in this study, and two well-trained physical therapists participated as a tester. Two testers measured the cervical joint position error at the starting position after neck flexion, extension, side bending, and rotation; three dynamic balance tests, including anterior excursion, anterior reaching with single leg balance, and posterior diagonal excursion; and ankle dorsiflexion range of motion using STARmat^®. The intra-class correlation coefficient (ICC) was used to determine the inter-rater reliability of the tests. Results: The inter-rater reliability for the cervical proprioception ranged from moderate to good (0.66 to 0.83), particularly for flexion (0.82), extension (0.70), right side bending (0.73), left side bending (0.71), right rotation (0.83), and left rotation (0.66). For the dynamic balance, the inter-rater reliability ranged from good to excellent (0.87 to 0.91), particularly for anterior excursion (0.86), posterior diagonal excursion (0.87 to 0.89), and anterior reaching with a single leg balance (0.90 to 0.91). In addition, for the ankle dorsiflexion range of motion, the ICC for the inter-rater reliability ranged from 0.95 to 0.96. Conclusion: STARmat^® is a reliable tool for measuring cervical proprioception, dynamic balance tests, and ankle dorsiflexion range of motion in healthy young adults.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.1
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• pp.51-62
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• 2021

Background: The purpose of this study was conducted to investigate the effects of the ankle mobilization with movement (MWM) technique on ankle dorsiflexion range of motion (ROM), balance, and gait in patients who underwent total knee replacement (TKR). Methods: Thirty patients with knee osteoarthritis were recruited and randomly divided into two groups: the experimental group (EG; n=15) and the control group (CG; n=15). For five days a week for 3 weeks, participants in the EG were treated with the ankle MWM technique and traditional total knee replacement (TKR) exercise, and those in the CG only performed traditional TKR exercises. The dorsiflexion ROM, balance, and gait of the patients were before and after exercise. Results: Balance system SD was used compare changes in dynamic balance. Patients in the EG group showed statistically significant differences after the intervention (p<.05). In addition, there was a statistically significant difference in dynamic balance between the EG and CG groups after the intervention (p<.05). STT-IBS was used to compare changes in velocity, step length, stride length, and ankle dorsiflexion ROM. Patients in the EG group showed statistically significant differences after the intervention (p<.05). In addition, there was a statistically significant difference in the velocity, step length, stride length, and ankle dorsiflexion ROM between the EC and CG groups after the intervention (p<.05). Conclusion: Our results showed that applying the ankle MWM technique with traditional TKR exercises improved ankle dorsiflexion ROM, dynamic balance, and gait in patients.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.1
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• pp.9-14
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• 2023

PURPOSE: This study examined the effect of vibration stimulation of a vibration foam roller on the change in the range of motion of the ankle joint and proprioception in patients with chronic ankle instability. An additional aim was to provide basic data for rehabilitation programs for chronic ankle instability patients. METHODS: This study was a randomized crossover design of 22 patients with chronic ankle instability. All subjects were divided into a vibrating group, a non-vibrating group, and a control group. The vibration and non-vibration groups performed the interventions, but the control group did not. For the measurement, the range of motion and proprioception of the ankle joint was measured using an electronic protractor (Electrogoniometer, BPM Pathway, UK). RESULTS: The vibration group showed significant differences in the dorsiflexion angle, dorsiflexion proprioception, and plantar flexion proprioception (p < .05). The non- vibration group showed significant differences in the dorsiflexion angle and dorsiflexion proprioceptive sensation (p < .05). The vibration group and the control group showed significant differences in dorsiflexion proprioception and plantar flexion proprioception (p < .05). CONCLUSION: The range of motion and proprioception of the ankle joint were improved in the group that received vibration stimulation after the intervention than before the intervention. Future research will be needed on patients with various diseases.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.2
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• pp.23-29
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• 2023

Background: There is still controversy as to whether hip external rotation and dorsiflexion selectively activate the vastus medialis obliquus (VMO) during straight leg raise exercise. Due to the anatomical characteristics, hip adduction must be preceded to activate the VMO. In this study, the activities of the rectus femoris (RF), vastus lateralis (VL), VMO were measured by adding the hip adduction movement to the straight leg raise exercise with hip 45° external rotation and straight leg raise exercise with hip 45° external rotation and dorsiflexion. Through this, we want to find out whether the VMO is selectively activated. Methods: Thirteen healthy participants performed straight leg raise exercise with hip 45° external rotation, straight leg raise exercise with hip 45° external rotation and dorsiflexion, straight leg raise exercise with hip 45° external rotation and adduction, straight leg raise exercise with hip 45° external rotation and adduction and dorsiflexion was randomly performed. Through this, EMG data of the RF, VL, VMO were collected. Results: During the straight leg raise exercise, hip adduction increased the activity of the VMO and VL, no significant difference was found(p>.05). However, in the VMO/VL ratio, straight leg raise exercise with hip 45° external rotation and adduction and dorsiflexion activated the VMO and the VL at a ratio of about 1:1, It showed a significantly higher rate than straight leg raise exercise with hip 45° external rotation(p<.05). Conclusion: During the straight leg raise exercise, hip adduction is considered to be an important movement that can selectively induce the activity of the VMO. Therefore, follow-up studies on this should be conducted.

• Physical Therapy Rehabilitation Science
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• v.12 no.1
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• pp.26-32
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• 2023

Objective: This study attempted to compare the effects of bridge exercise using a sling according to the angle of the ankle to confirm the effective lower extremity muscle activation posture of patients with patellofemoral pain syndrome(PFPS). Design: Cross-sectional study Methods: Seventeen patients with PFPS were recruited and the muscle activities of the vastus medialis, vastus lateralis, rectus femoris, and gluteus maximus were measured according to the ankle position (dorsiflexion, neutral, plantar flexion). After measuring the maximum number of isometric contractions of vastus medialis, vastus lateralis, rectus femoris, and gluteus maximus, bridging exercise using a sling according to each ankle posture was applied to measure lower extremity muscle activity. The evaluation was performed 3 times for 10 seconds. The three ankle postures were randomly performed and the average values were compared. Results: As a result of this study, the vastus medialis muscle showed high muscle activity in the order of dorsiflexion, plantar flexion, and neutral position bridge exercise (p<0.05). And the vastus lateralis showed high muscle activity in the order of dorsiflexion, neutral, and plantar flexion (p<0.05). However, rectus femoris and gluteus maximus did not show significant muscle activity according to the ankle posture, but muscle activity was highest in the dorsiflexion posture. Conclusions: As a result of this study, muscle activity was high in the order of vastus medialis and vastus lateralis during ankle dorsiflexion. This is thought to be a major factor that can be applied in various ways in clinical practice according to the ankle angle when treating PFPS patients.

• PNF and Movement
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• v.11 no.2
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• pp.111-117
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• 2013

Purpose : The purpose of this study was to examine the activity of the knee flexor and extensor with ankle plantar flexion and dorsiflexion. Methods : A total of 18 subjects(Male 6, female 12) performed 4 lower extremity patterns of PNF and the activities of the vastus medialis oblique, rectus femoris, vastus lateralis, biceps femoris, semitendinosus ipsilateral sides were measured using electromyography. Results : During 4 lower extremity patterns of PNF, knee flexor and extensor muscle activity were significantly difference. Knee extensors were shown to be higher knee extension and ankle dorsiflexion combined pattern. Knee flexors were shown to be higher knee flexion and ankle plantarflexion combined pattern. Conclusion : We suggest that it is efficient to strengthening of knee extensors with ankle dorsiflexion and to strengthening of knee flexors with ankle plantar flexion. Also, for the functioning as toe standing, we have to choice appropriate movement pattern.