• Journal of Korean Orthopaedic Sports Medicine
• /
• v.10 no.1
• /
• pp.35-40
• /
• 2011

Purpose: This study was performed to evaluate the diagnostic usefulness of ankle stress radiograph for evaluation of chronic lateral ankle instability. Materials and Methods: Among patients undergoing the modified-Brostrom procedure, 42 cases with complete rupture of the anterior talofibular ligament were enrolled in this study. Sixty Korean adults (120 cases) were recruited as the control group. Radiologic measurement of talar tilt and anterior talar translation was performed through stress radiographs using Telos device. We obtained the normal range of Korean adults, and used as a standard value for judgment of mechanical instability. We analyzed the sensitivity, specificity, positive and negative prediction value of ankle stress radiograph. Results: On ankle stress radiograph, normal range of talar tilt angle and anterior talar translation was below $8.3^{\circ}$, below 7.6mm. Talar tilt angle on varus stress radiograph showed 57% of sensitivity, 97% of specificity, 89% of positive and 86% of negative prediction value. Anterior talar translation on anterior drawer stress radiograph showed 69% of sensitivity, 97% of specificity, 91% of positive and 90% of negative prediction value. Conclusion: Ankle stress radiograph had a good specificity, positive and negative prediction value for the evaluation of mechanical instability. However it underestimated the mechanical instability of ankle joint. It must be remembered that normal stress radiograph does not exclude ankle instability.

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

• The Journal of Korean Physical Therapy
• /
• v.33 no.1
• /
• pp.28-33
• /
• 2021

Purpose: This study examined the effects of heel raise exercises combined with neuromuscular electrical stimulation (NMES) on the muscle strength and postural control ability of subjects with functional ankle instability (FAI). Methods: Twenty-two subjects with FAI participated in this study. They were assigned randomly to two groups: 11 each in the NMES and the sham-NMES groups. Heel raise exercise was applied, and NMES electrodes were attached to the peroneus longus muscles. The NMES group applied NMES during the heel raise exercise. NMES was applied for 20 minutes during the heel raise exercise. The heel raise exercise was performed four times a week for five weeks. The muscle strength and balance error scoring system (BESS) were measured before and after the intervention. Results: A comparison of before and after the intervention within the groups revealed improved muscle strength in the NMES and Sham-NMES groups, but the BESS was improved under all conditions only in the NMES group. The Sham-NMES group showed no improvement in the unstable support surface. Furthermore, when comparing the amount of change before and after the intervention between the groups, there were significant differences in the total score and unstable support in the BESS and muscle strength. Conclusion: NMES had a positive effect on the functional activities of the functional ankle instability subjects, such as balancing on an unstable support surface during postural control and increasing muscle strength.

• Annals of Clinical Neurophysiology
• /
• v.11 no.1
• /
• pp.9-15
• /
• 2009

Background: To investigate the differences of locomotor dynamics between Parkinson's disease (PD) patients with tremor dominant symptom and patients with postural instability dominant symptom. Methods: 66 subjects with PD were classified into two subgroups, tremor-dominant group and postural instability and gait disorder group by Unified Parkinson's disease rating scale (UPDRS). The spatial, temporal and electrodynamic gait parameters were recorded automatically using computerized 3-D motion analysis system with electrogoniometer. Results: There was no significant difference in cadence, pelvic tilt range, hip flexion range, knee flexion range and ankle dorsiflexion range. Postural instability and gait disorder group showed decreased gait velocity, short stride length, decreased range of motion in pelvic obliquity, pelvic rotation and ankle plantar flexion. Conclusions: There was meaningful difference in locomotor dynamics between Parkinson's disease(PD) patients with tremor dominant symptom and patients with postural instability dominant symptom.

• The Journal of Korean Physical Therapy
• /
• v.16 no.2
• /
• pp.33-43
• /
• 2004

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. 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). 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.

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

• 대한족부족관절학회:학술대회논문집
• /
• 2008.11a
• /
• pp.15-15
• /
• 2008

• 대한족부족관절학회:학술대회논문집
• /
• 2008.11a
• /
• pp.16-16
• /
• 2008

• Journal of Korean Foot and Ankle Society
• /
• v.13 no.1
• /
• pp.95-98
• /
• 2009

Charcot arthropathy of the foot and ankle is characterized by a combination of sensory, motor and autonomic peripheral neuropathy leading to gross swelling, bony destruction and finally severe bony deformity with joint instability. We report a case of very unstable Charcot arthropathy in ankle joint managed with ankle arthrodesis using fibular strut bone grafting technique.

• Journal of Korean Foot and Ankle Society
• /
• v.22 no.4
• /
• pp.135-144
• /
• 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.