• Physical Therapy Korea
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• v.31 no.2
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• pp.151-158
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• 2024

Background: In Taekwondo athletes, ankle sprain is the most common risk factor for injury. Repeated ankle injuries lead to weakness and imbalance of the ankle muscles, resulting in chronic ankle instability (CAI). Both the ankle and toe muscles contribute to the inversion and eversion of the foot at the subtalar joint. Therefore, it is necessary to consider the ankle and toe joint positions when measuring ankle invertor and evertor strength. Objects: This study aimed to compare the muscle strength and ratio differences of the ankle invertor and evertor muscles in both the toe and ankle positions between the CAI and uninjured sides in Taekwondo athletes. Methods: Fifteen Taekwondo athletes participated in this study. The isometric strengths of both the ankle invertor and evertor were determined in different ankle and toe positions (dorsiflexion with toe extension, dorsiflexion with toe flexion, plantarflexion with toe extension, and plantarflexion with toe flexion). Paired t-tests were used to determine the differences between the ankle invertor and evertor in strength and ratio according to toe and ankle positions between the ankle CAI side and the uninjured side. Results: The results demonstrated that ankle evertor strength significantly decreased in all ankle and toe positions on the CAI side (p < 0.05). In addition, significant differences were observed in the ratios of the ankle invertor and evertor strengths in the dorsiflexion with toe flexion, plantarflexion with toe extension, and plantarflexion with toe flexion positions (p < 0.05). Conclusion: The findings of this study suggest that athletes, trainers, and clinicians should consider ankle and toe positions when measuring invertor and evertor strength and develop ankle rehabilitation protocols for Taekwondo athletes with CAI.

• Physical Therapy Korea
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• v.25 no.2
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• pp.22-29
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• 2018

Background: Deficits of both ankle dorsiflexion range of motion (DFROM) and dynamic balance are shown in persons with chronic ankle instability and the elderly, with the risk of falls. Objects: This study aims to investigate the relationship between DFROM and dynamic balance in elderly subjects and young adults. Methods: Fifty-nine subjects were divided into three groups: ankle stability young group (SY), ankle instability young group (IY) and ankle stability older group (SO). We recruited three old subjects with ankle instability, but excluded them during a pilot testing due to the safety issue. DFROM was measured by weight bearing lunge test (WBLT) and dynamic balance was measured via star excursion balance test (SEBT) in anteromedial, medial, and posteromedial directions. The group differences in WBLT and SEBT and each group's correlation between WBLT and SEBT were detected using the R statistical software package. Results: The dorsiflexion range of motion was significantly different between the SY, IY, and SO groups. The SO group showed the highest DFROM and IY group showed the lowest DFROM (SY: $45.88{\pm}.66^{\circ}$, IY: $39.53{\pm}1.63^{\circ}$, SO: $47.94{\pm}.50^{\circ}$; p<.001). However, the SO group showed the lowest dynamic balance score for all SEBT directions (SY: $87.24{\pm}2.05cm$, IY: $83.20{\pm}1.30cm$, SO: $77.23{\pm}2.07cm$; p<.05) and there was no relationship between the dorsiflexion range of motion and dynamic balance in any group. Conclusion: Our findings suggest that ankle DFROM is not a crucial factor for dynamic stability regardless of aging and ankle instability. Other factors such as muscle strength or movement coordination should be considered for training dynamic balance. Therefore, we need to establish the rehabilitation process by measuring and treating ROM, balance, and muscle strength when treating young adults with and without ankle instability as well as elderly people.

• Journal of Korean Foot and Ankle Society
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• v.6 no.1
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• pp.124-128
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• 2002

After a severe ankle sprain, the incidence of residual complaints, particularly on the medial side of the joint, is high. We experienced a case of medial impingement between medial malleolus and anteromedial osteophyte of talus, specially in the dorsiflexion of the right ankle. Twenty five-year-old male was complained tenderness and chronic pain over the medial side of the right anklel for 3 years after an inversion sprain of the ankle. The plain radiography revealed a bony osteophyte on the anteromedial side of talus. The patient was treated by the open arthrotomy of the ankle. At surgery, impingement between articular surface of medial malleolus and osteophyte of the talus was observed when ankle dorsiflexion was done. Chondral lesion of medial malleolus and chondromalacic degeneration on anteromedial talus was viewed. Surgical removal of osteophyte on talus and debridement and multiple drilling of chondral lesion on medial malleolus was done. The symptom was improved. After postoperative 1 year, recurrence was not.

• Archives of Plastic Surgery
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• v.36 no.6
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• pp.799-802
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• 2009

Purpose: Schwannoma is one of common neoplasm in the central and peripheral nervous systems. However, schwannoma of sciatic nerve is rare, especially large schwannoma arising in sciatic nerve is extremely rare. This is a report of our experience with large schwannoma arising in sciatic nerve with minimal neurologic symptoms. Methods: A 65 - year - old man presented with palpable mass in middle portion of posterior thigh. No definitive neurologic deficits were detected on physical examinations. CT and sonography showed well - defined mass with large dimension. The mass was excised and confirmed histologically as a schwannoma. In postoperative period, NCS and EMG were followed. Results: The patient complained of difficulty in dorsiflexion of ipsilateral ankle joint postoperatively. NCS and EMG obtained immediately and showed sciatic neuropathy. After 2 months postoperatively, NCS and EMG were followed and abnormal findings of previous NCS and EMG were not found. Dorsiflexion of ankle joint was improved to normal range of motion. Conclusion: We report a rare case of large schwannoma arising in sciatic nerve with no definitive neurologic symptoms.

• The Journal of Korean Physical Therapy
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• v.32 no.4
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• pp.245-249
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• 2020

Purpose: This study examined the effects of local vibration using a massage gun on the triceps surae flexibility by measuring the ankle dorsiflexion range of motion (ROM) compared to static stretching in healthy adults. Methods: Twenty healthy subjects were instructed in this study. They were allocated randomly to two groups: local vibration (LV) and static stretching (SS). The ankle dorsiflexion ROM was measured before and after the intervention in supine (open kinetic chain, OKC) and standing (closed kinetic chain, CKC). The LV group received local vibration using a massage gun for five minutes on their triceps surae, and the SS group stood on the Q board with a dorsiflexed ankle for five minutes. The ROM between pre- and post-intervention and the change in ROM between two groups were analyzed. A paired t-test was used to compare the ROM between pre- and post-intervention, while an independent t-test was used to compare the change in ROM between the two groups. Results: Both groups showed a significant difference between pre- and post-intervention in the position of both the OKC and CKC. The change in ROM, however, was not significantly different between the two groups. Conclusion: The application of local vibration using a massage gun for five minutes on the triceps surae could improve its flexibility as much as the application of static stretching. A massage gun for the application of a local vibration stimulus may be effective, simple, portable, and comfortable.

• Journal of Biomedical Engineering Research
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• v.24 no.5
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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.

• Journal of Biomedical Engineering Research
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• v.18 no.1
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• pp.71-78
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• 1997

Kinematic and kinetic studies were performed to investigate the walking characteristics on a treadmill with various slopes at the same speed of 1.25m/sec. Six different slopes of the treadmill were selected . -4%(-$2.3^{\circ}$), 0%($0^{\circ}$), 5%($2.9^{\circ}$), 10%($5.7^{\circ}$), 15%($8.6^{\circ}$), and 20%($11.3^{\circ}$). With increased slopes of the treadmill, both hip and knee flexion angles significantly increased at initial contact, and the maximum hip flexion during swing phase and the maximum knee flexion during stance phase also significantly increased Ankle dorsiflexion angle at initial contact and the maximum dorsiflexion increased with increased slopes. However, the maximum plantarflexion in early swing was slightly reduced with increased slopes. Hip extension in late stance and the maximum knee flexion in early swing was not changed sigilificantly with increased slopes. As for the vertical ground reaction force, compared to the yond level walking, both the first and the second peak forces increased, but the mid-support force decreased.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.2
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• pp.63-70
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• 2021

PURPOSE: This study aimed to analyze the factors influencing the improvement of global synkinesis (GS) and gait in stroke patients by the weight shift exercise. METHODS: Twenty stroke patients were randomly assigned to experimental group I (n = 10) and experimental group II (n = 10). In experimental group I, weight shift with upper extremity exercises in a standing position were mediated and in experimental group II, upper extremity exercises in a standing position were mediated. These interventions were conducted in both groups for three sessions per week, 30 minutes per session over four weeks. Before the interventions, leg GS was measured using surface electromyography and the 10m walk test (10MWT). The same parameters were measured four weeks later. RESULTS: The GS and 10MWT of the experimental group I showed that there was a statistically significant difference between dorsiflexion (p < .05) and plantarflexion (p < .01) and 10MWT (p < .01). In experimental group II, there was a statistically significant difference only in 10MWT (p < .01). The comparison between the changes in both groups showed that in the case of GS, there was a statistically significant difference in the dorsiflexion (p < .01) and plantarflexion (p < .05), and in the 10MWT too (p < .05). CONCLUSION: GS of the lower extremities was decreased by improving posture control and enlarging soft tissues due to the symmetrical weight shift in experimental group I, which turned out to be effective in improving the gait speed.

• Physical Therapy Rehabilitation Science
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• v.12 no.2
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• pp.149-154
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• 2023

Objective: This study is designed to investigate the effect of ankle joint position on hip extensor muscle activity when bridging exercise in sagittal plane. Design: Cross-sectional study Methods: The subjects were recruited from 20 healthy adult men. The subjects performed three types of bridging exercises (normal bridging, ankle dorsiflexion bridging, ankle plantar flexion bridging) three times for five seconds with a rest of 15 seconds between measurements and two minutes of rest between each motion. The target muscles were the gluteus maximus, biceps femoris, soleus, and tibialis anterior. A surface electromyography was used to measure the muscle activity of these muscles. Results: The results show there was no statistically significant difference between the three types of exercise in the gluteus maximus muscle activity. However, the biceps femoris showed a significant difference between the three types of exercises (p<0.05). Conclusions: In conclusion, when the three different bridging exercises were performed by adding ankle motion to normal bridging exercise, there was a significant difference in the muscle activity of the gluteus maximus relative to the biceps femoris muscle activity in the order of the ankle dorsiflexion bridging, normal bridging, and ankle plantar flexion bridging exercise. Therefore, this could be an effective option for a bridging exercise if applied to patients with a weak gluteal muscle and shortening of the hamstring muscle in further studies.

• Journal of Korean Foot and Ankle Society
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• v.19 no.4
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• pp.142-150
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• 2015

Purpose: Restoration of ankle stability through the strengthening exercise of peroneus muscles is considered an important factor for achievement of successful outcomes, in the rehabilitation program following ankle ligament injuries. However, there were few definitive data on normal muscle strength, including eversion power by peroneus muscles. This study was conducted to evaluate the muscle strength of ankle joint measured using an isokinetic dynamometer in normal Koreans. Materials and Methods: Sixty adults (120 ankles) were recruited and divided into three groups (20 in their twenties, 20 in thirties, and 20 in forties). Each group consisted of 10 males and 10 females. The selection criteria were no history of ankle injury and no evidence of instability. The peak torque, total work, and deficit ratio were measured using the Biodex$^{TM}$ (Biodex Medical Systems). Differences in muscle strength by age, gender and dominant versus non-dominant side were analyzed. Results: The peak torque of dorsiflexion was average 31.5 Nm at $30^{\circ}/s$ of angular velocity and 18.8 Nm at $90^{\circ}/s$; average 69.3 Nm ($30^{\circ}/s$) and 42.4 Nm ($90^{\circ}/s$) on plantarflexion; average 19.6 Nm ($30^{\circ}/s$) and 10.8 Nm ($90^{\circ}/s$) on inversion; average 12.9 Nm ($30^{\circ}/s$) and 8.0 Nm ($90^{\circ}/s$) on eversion. The deficit ratio of strength in women was average 61.1% of men on dorsiflexion; average 66.2% on plantarflexion; average 48.5% on inversion; average 55.4% on eversion. The deficit ratio in non-dominant foot was average 88.6% of dominant foot on dorsiflexion; average 90.1% on plantarflexion; average 85.1% on inversion; average 85.6% on eversion. Conclusion: The muscle strength of the ankle joint showed a tendency to weaken with age. There were significant differences in muscle strength by gender and dominancy. Further studies for comparison of patients with ankle instability, a comparison between before and after surgery for instability, the correlation between clinical outcomes and the recovery in muscle strength will be needed.