• 대한족부족관절학회지
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• 제22권4호
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• pp.135-144
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• 2018

Acute lateral ankle sprain, which is the most common musculoskeletal injury, can be treated effectively with appropriate evidence-based initial care using PRICE (protection, rest, ice, compression, and elevation) and functional rehabilitation. Many systemic reviews reporting a high-level of evidence supporting the clinical usefulness and necessity of primary surgical repair for acute lateral ankle sprain have been insufficient. Regardless of the severity of ligament complex injuries, the surgical treatment for acute lateral ankle sprain without concomitant pathologies is not recommended and should be considered only in young professional athletes with complete ligament rupture (grade III) and severe instability.

• Korean Journal of Radiology
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• 제22권3호
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• pp.384-394
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• 2021

Objective: To quantitatively assess biochemical alterations in the cartilage of the subtalar and midtarsal joints in chronic lateral ankle instability (CLAI) patients with isolated anterior talofibular ligament (ATFL) injuries and combined calcaneofibular ligament (CFL) injuries using MRI T2 mapping. Materials and Methods: This study was performed according to regulations of the Committee for Human Research at our institution, and written informed consent was obtained from all participants. Forty CLAI patients (26 with isolated ATFL injuries and 14 with combined ATFL and CFL injuries) and 25 healthy subjects were recruited for this study. All participants underwent MRI scans with T2 mapping. Patients were assessed with the American Orthopedic Foot and Ankle Society (AOFAS) rating system. The subtalar and midtarsal joints were segmented into 14 cartilage subregions. The T2 value of each subregion was measured from T2 mapping images. Data were analyzed with ANOVA, the Student's t test, and Pearson's correlation coefficient. Results: T2 values of most subregions of the subtalar joint and the calcaneal facet of the calcaneocuboid joint in CLAI patients with combined CFL injuries were higher than those in healthy controls (all p < 0.05). However, there were no significant differences in T2 values in subtalar and midtarsal joints between patients with isolated ATFL injuries and healthy controls (all p > 0.05). Moreover, T2 values of the medial talar subregions of the posterior subtalar joint in patients with combined CFL injuries showed negative correlations with the AOFAS scores (r = -0.687, p = 0.007; r = -0.609, p = 0.021, respectively). Conclusion: CLAI with combined CFL injuries can lead to cartilage degeneration in subtalar and calcaneocuboid joints, while an isolated ATFL injury might not have a significant impact on the cartilage in these joints.

• 대한족부족관절학회지
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• 제22권1호
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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.

• 대한통합의학회지
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• 제5권3호
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• pp.63-70
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• 2017

Purpose : The purpose of this study was to investigate the effects of the virtual reality exercise program on ankle balance with ankle taping or microwave. Methods : This study was performed on 18 subjects. Eighteen subjects were divided into two groups; conducted virtual reality exercises with taping (n=9), and performed virtual reality exercises after microwave application (n=9). Both groups performed the exercise three times a week for four weeks. The data was analyzed by the Wilcoxon signed-rank test for comparing before and after changes of factors in each group and performed the Mann-Whitney test for comparing groups. Result : Taping and microwave groups were increased dynamic balance after virtual reality exercises (p<.05). There was no significant difference in balance after applying taping and microwave for virtual reality exercises (p<.05). Conclusion : Reducing the frequency of recurrent ankle sprain in functional ankle subjects, it is recommended to perform virtual reality exercise after applying taping and microwave.

• 디지털융복합연구
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• 제14권11호
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• pp.357-367
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• 2016

본 연구에서는 가상현실 기반 신경근 자세조절 융합 훈련을 이용하여 기능적 발목 불안정성을 가진 축구선수들의 균형 능력과 점프 수행력에 미치는 효과에 대하여 알아보고자 하였다. 축구선수는 가상현실 기반 신경근 자세조절 융합 훈련군 15명과 일반적인 트레드밀 훈련군 15명으로 나누어 8주간 주 3회, 30분간 시행하였고, 균형 능력을 평가하기 위해 Biorescue를 이용하여 신체 중심 이동면적, 총 궤적길이, 안정성 한계를 측정하였다. 점프 수행력을 측정하기 위해 Counter movement jump with arm swing과 제자리 멀리 뛰기를 측정하였다. 균형 능력 비교에서는 신체 중심 이동면적과 총 궤적 길이 및 안정선한계에서 통계적으로 유의한 차이를 보였고, 점프 수행력 비교에서는 Counter movement jump with arm swing과 제자리 멀리 뛰기에서 통계적으로 유의한 차이를 보였다. 이에 따라 가상현실 기반 신경근 자세조절 융합 훈련이 일반적인 트레드밀 훈련 보다 균형 능력과 점프 수행력을 향상시키는데 효과적임을 알 수 있었다.

• 한국운동역학회지
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• 제20권4호
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• pp.395-406
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• 2010

The purpose of this study was to analyze the changes in kinematic and kinetic parameters of lower extremity joint according to rehabilitation period. Fourteen collegiate male athletes(age: $22.1{\pm}1.35$ years, height: $182.46{\pm}9.45cm$, weight: $88.63{\pm}9.25kg$) and fourteen collegiate athletes on functional ankle instability(age: $21.5{\pm}1.35$ years, height: $184.45{\pm}9.42cm$, weight: $92.85{\pm}10.85kg$) with the right leg as dominant were chosen. The subjects performed drop landing. The date were collected by using VICON with 8 camera to analyze kinematic variables and force platform to analyze kinetic variables. There are two approaches of this study, one is to compare between groups, the other is to find changes of lower extremity joint after rehabilitation. In comparison to the control group, FAI group showed more increased PF & Inversion at IC and decreased full ROM when drop landing. Regarding the peak force and loading rate, it resulted in higher PVGRF and loading. FAI group used more increased knee and hip ROM because of decreased ankle ROM to absorb the shock. And it used sagittal movement to stabilize. In terms of rehabilitation period, FAI group showed that landing patterns were changed and it increased total ankle excursion and used all lower extremity joint close to normal ankle. Regarding the peak force and loading rate, FAI group decreased PVGRF and loading rate. and also showed shock absorption using increased ankle movement. And COP variable showed that proprioception training increased stability during 8 weeks. The results of this study suggest that 8 weeks rehabilitation period is worthwhile to be considered as a way to improve neuromuscular control and to prevent sports injuries.

• 대한추나의학회지
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• 제4권1호
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• pp.89-98
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• 2003

The multiple acupuncture techniques have been used to relieve the pain of lateral ankle sprain. Recently, early functional rehabilitation is emphasized in rehabilitative concepts using active ROM, facilitated proprioception, alphabet exercise and so forth. Similarly, in oriental rehabilition medicine, traditional movement technique called "Dong-Ki" has been used to relieve pain of ankle sprain. So we used "Dong-Ki" technique with SSP(silver spike point) electrotherapy transformed from alphabet exercise and evaluated the effects in method of randomized controlled trials. Methods : 27 outpatients with lateral ankle sprains were randomized into two groups : 15 samples and 12 controls. Sample group was treated with "Dong-Ki" technique(writing his name with foot) with SSP electrotherapy to relieve pain during additionally. "Dong-KI". Outcomes were measured by 10cm VAS and ankle circumference(cm). Results : In terms of VAS, Sample group had inclination of pain relieving but not significantly meaningful. In terms of ankle circumference measurement, Sample group showed significantly improved.

• 대한족부족관절학회지
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• 제16권2호
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• pp.128-134
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• 2012

Purpose: To design novel balance tests to assess FAI and evaluate whether these tests are affected by BMI or gender, with the goal of developing reliable FAI assessment tests that are not influenced by these factors. Materials and Methods: Participants included 20 young, healthy volunteers, 12 males and 8 females, with a mean age of $24{\pm}4$ years and a mean BMI of $23{\pm}2.28$. None of the subjects had known ankle instability. The following tests were assessed in each participant: single leg balance (SLB), percentage of leg press (PLP), single leg cycling (SLC), one leg squat (OLS), multiple direction reach-front/back/side (MDR-F/B/S), single leg hop (SLH), two leg jump (TLJ) and side step (SS). Data were analyzed using the SPSS 12.0 software program with ANOVA and t-test used. Results: When grouped by BMI, we found that despite differences in BMI, the performances of all subjects were equivalent except for the one-leg-squat test, for which the mean ratios for underweight ($1.69{\pm}0$), normal weight ($1.05{\pm}0.19$), and overweight ($0.93{\pm}0.30$) individuals were significantly different (p=0.02); ratios for SLB (p=0.273), SLC (p=0.903), PLP (p=0.664), MDR-F/B/S (p=0.498, 0.908, and 0.503, respectively), SLH (p=0.332) were not significantly different. When calculated according to gender, we found that the OLS (p=0.013) and MDRS (p=0.034) were significantly different, while parameters for all the remaining tests were not affected. Conclusion: We found that the SLB, PLP, SLC, MDR-F/B, and SLH ratios were unaffected by BMI or sex and, therefore, are reliable parameters for assessing ankle instability.

• 대한족부족관절학회지
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• 제26권1호
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• pp.40-47
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• 2022

Purpose: The modified Broström repair (BR) technique has yielded good outcomes in patients with chronic ankle instability. This study compared clinical and radiological outcomes between two groups of patients who underwent modified BR or lateral ligament augmentation using suture tapes (ST). Materials and Methods: Seventy-seven patients (ST group [n=47], BR group [n=30]; body mass index <26.61 kg/m²; mean age, 30.7±11.0 years [range, 17~39 years]; mean follow-up, 34.0±12.0 months [range, 24~59 months]) were retrospectively reviewed between January 2014 and July 2017. The Foot and Ankle Outcome Score (FAOS), American Orthopedic Foot and Ankle Score (AOFAS), Foot and Ankle Ability Measure (FAAM), visual analogue scale (VAS) score, and Sefton grading system were used for clinical assessment. The talar tilt angle and anterior talar translation were measured using the Telos stress device (Telos GmbH, Marburg, Germany) at 150 N for radiological evaluation. Results: FAOS, AOFAS, FAAM, and VAS scores improved in both groups at final follow-up (ST, 91.1±5.2, 93±2, 88.1±4.5, 1.5±0.7 vs. BR, 91.3±5.4, 93±3, 83.3±4.8, 1.2±0.7, respectively; p=0.854, 0.971, <0.001, 0.04, respectively). According to the FAOS, mean sports activity scores for the ST and BR groups at the final follow-up were 90.3±3.2 and 76.6±4.2, respectively, reflecting superior outcomes in the ST group (p<0.001). Sefton grading revealed satisfactory functional outcomes (ST, 91.5% vs. BR, 90.0%). There was significant improvement in the talar tilt angle and anterior talar translation in both the ST and BR groups (7.6°±1.2°, 10.5±1.8 mm vs. 4.9°±1.1°, 7.9±1.5 mm, respectively; p<0.001). Conclusion: The ST group demonstrated comparable clinical but better improvement in mechanical stability and FAOS sports scores than the BR group.

• 대한족부족관절학회지
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• 제26권1호
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• pp.16-21
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• 2022

도수 또는 중력 외회전 부하 방사선 검사는 족관절 양과 유사 골절과 단독 외과 골절을 구별할 수 있는 기준이 된다. 부하 방사선 검사상 내측 관절 간격이 넓어지면 삼각인대 손상을 진단할 수 있고 비골 골절에 대한 수술적 처치가 권장된다. 비골 골절에 대하여 관혈적 정복술 후 Cotton test를 시행하여 경비원위인대가 벌어질 경우 이에 대한 고정을 시행한 후 삼각인대의 봉합술 시행 여부는 술자의 선호도 및 수술장 내 소견에 의하여 결정된다. 삼각인대 봉합술은 내과에 suture anchor를 삽입하고 심부와 천부 삼각인대에 대하여 중첩술 후 내과에 anchor를 통하여 고정함으로써 시행한다. 유일하게 무작위로 시행된 족관절 골절에서의 삼각인대 봉합술의 유용성 평가 연구에서는 삼각인대 봉합술의 유용성에 대하여 긍정적인 결론을 도출하지 못하였으나 연구 자체의 제한점이 많아 해석을 하는 데 있어 한계가 있었다. 추후 이에 대한 심도 있는 연구가 필요하리라 판단된다.