• Title/Summary/Keyword: Joint Instability

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The study of stabilizing structure of the glenohumeral joints (상완견관절의 안정적 구조에 관한 연구)

  • Lee Jin-Hee;Kim Jin-Sang
    • The Journal of Korean Physical Therapy
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    • v.12 no.3
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    • pp.433-444
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    • 2000
  • The purpose is paper was to discuss current concepts related to anatomic stabilizing structures of the shoulder joint complex and their clinical relevance to shoulder instability. The clinical syndrome of shoulder instability represents a wide spectrum of symtoms and signs which may produce various levels of dysfunctions, from subtle subluxations to gross joint instability. The glenohumeral joint attains functional stability through a delicate and intricate interaction between the passive and active stabilizing structures. The passive constraints include the bony geometry, glenoid labrum, and the glenohumeral joint capsuloligaments structure. Conversely, the active constraints, also referred to as active mechanism, include the shoulder complex musculature, the projprioceptive system, and the musculoligamentous relationship. The interaction of the active and passive mechanism which provide passive and active glenohumeral joint stability will be throughtly discussed in this paper

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Effect of Taping Technique Applied to Adults with Knee Instability on Landing Error Scoring System, Lower Extremity Joint Angle

  • Son, Jin-Kyu;Park, Sam-Ho;Lee, Myung-Mo
    • Physical Therapy Rehabilitation Science
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    • v.10 no.4
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    • pp.406-413
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    • 2021
  • Objective: The purpose of this study was to investigate effects of taping technique applied to knee instability. Design: Cross sectional study. Methods: Twenty-six participants with knee instabilityparticipated in this study. They were randomly assigned to the Kinesio taping (KT) group (n=13) and the dynamic taping (DT) group (n=13). Both groups applied knee stabilization taping techniques. In order to compare the effects of each taping technique, the change in the landing error scoring system (LESS) and lower extremity joint angle wasrecorded before and after the intervention. Results: Both groups significantly decreased in the change before and after the LESS (p<0.05). At the joint angle of the lower extremities, KT group significantly reduced the valgus angle at the max knee flexion (p<0.05). In DT group knee joint flexion and hip joint flexion angles were significantly increased at foot contact (p<0.05). In max knee flexion, the knee joint flexion angle was significantly increased (p<0.05). In foot contact, max knee flexion, the knee joint valgus angle was significantly increased (p<0.05). DT group showed more significant changes in knee joint flexion angle at foot contact and hip joint flexion angle at max knee flexion. Conclusions: Dynamic taping is a clinically applicable intervention method for lowering the risk of non-contact injury in participants with knee instability and for knee stability during rehabilitation exercises.

Effect of Muscle Taping and Joint Taping on Static and Dynamic Balance in Normal Adults with Chronic Ankle Instability

  • Kim, Hyun-Sung;Park, Jae-Young
    • Journal of The Korean Society of Integrative Medicine
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    • v.10 no.1
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    • pp.101-108
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    • 2022
  • Purpose : This study was conducted to investigate the effect of muscle taping and joint taping on static and dynamic balance in normal adults with chronic ankle instability. Methods : The subjects of this study were 32 people who met the inclusion criteria. This cross-sectional study was conducted using the Kinesio tape, an elastic tape, was used. Subjects were randomized to exclude the effect of sequence, and no taping, joint taping, and muscle taping were applied as taping interventions. One-leg standing test and a Functional reach test were conducted to measure static balance, and Y-balance test was conducted to measure dynamic balance. One way repeated ANOVA was performed to investigate the difference in balance ability according to the taping intervention. If there was a significant difference, a post-hoc was performed using the Bonferroni method. Results : In the case of static balance, joint taping showed more significant results than did no taping and muscle taping (p<.05), and muscle taping showed more significant results than did no taping (p<.05). In the case of dynamic balance, muscle taping showed significantly larger results than did no taping and joint taping (p<.05) and joint taping showed significantly larger results than did no taping (p<.05). Conclusion : This study found that mechanical stimulation of muscles and joint compression by elastic taping increased ankle stability and improved static and dynamic balance. In particular, for static balance, joint taping was more effective than muscle taping, and for dynamic balance, muscle taping was more effective than joint taping. Applying the appropriate taping method to individual subjects has the advantage of maximizing the therapeutic effect for the recovery of balance ability. Similarly, the application of various tapings to subjects with ankle instability will have a positive effect on functional improvement.

What Happens without Treating Chronic Lateral Ankle Instability (외측 발목 불안정성을 치료하지 않으면 어떻게 되는가)

  • Woo, Seung Hun;Chung, Hyung-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.1
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    • pp.6-9
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    • 2021
  • The term chronic lateral ankle instability (CLAI) embraces a spectrum of conditions that involve functional and mechanical instability, both in athletes and lower-demand patients. The hallmarks of CLAI are recurrent sprains, persistent pain, and repeated episodes of the ankle giving way. CLAI is the main complication of acute ankle sprains, which can cause discomfort in daily and sports activity. Approximately 10% to 30% of patients with acute ligament ruptures will develop chronic instability over the course of a year from the index injury. An accurate diagnostic approach and successful treatment plan should be established based on a comprehensive understanding of the concept of functional and mechanical instability. Unfortunately, the optimal modality for the management of CLAI is unclear. Even after conservative treatment or surgical intervention, it could result in degenerative changes to the ankle joint in the long term. Thus far, the incidence of ligamentous posttraumatic ankle osteoarthritis was reported to be 13% to 78%. The mean latency time between injury and osteoarthritis was at least 10 to 34.3 years. CLAI is an important pathological condition that can cause discomfort or dysfunction in daily activity in the short term, resulting in joint destruction in the long term. Therefore, it is important to understand the various complications that can occur when CLAI is not treated properly.

Freer Test for an Intraoperative Evaluation of a Lisfranc Joint Injury: A Technical Report (리스프랑 관절 손상 수술 중 시행하는 프리어 검사법)

  • Young, Ki Won;Lee, Hong Seop;Park, Seongcheol;Jeong, Gu Min
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.4
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    • pp.165-167
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    • 2020
  • Failure to achieve stable fixation during surgery for a Lisfranc joint injury leads to subtle instability that causes dysfunction and posttraumatic osteoarthritis. Therefore, it is important to check for appropriate fixation during surgery. This paper reports a test that evaluates the joint instability dynamically during the open reduction of the Lisfranc joint and checks the stability after fixation. a Freer elevator was inserted into the interosseous area between the medial cuneiform and second metatarsal base, and a twisting force was applied to evaluate the dynamic instability of the Lisfranc joint. After fixation of the Lisfranc joint, the stability of the fixation could be tested by trying this maneuver with the Freer elevator. Overall, the Freer test can be considered a valuable test in open surgery for a Lisfranc joint injury.

Effects of excessive Pronation of the Foot on Knee joint Strength and Gait (발의 과도한 회내 상태가 슬관절 근력과 보행에 미치는 영향)

  • Jung, Sang-mo
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.27 no.2
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    • pp.77-85
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    • 2021
  • BACKGROUND: This study aimed to determine the changes in muscle strength and walking ability in patients who complained of knee instability due to excessive pronation of the foot. METHODS: Twenty patients (ten men and ten women) who complained of instability of the knee joint due to excessive pronation of the foot participated in the experiment. In the experimental group, the internal rotation of the tibia caused by excessive adduction of the foot was maintained as external rotation, and the joint state was to recognize the movement of the joint position changed through maintenance of the muscle. This exercise was performed five times for each patient, and the muscle strength maintenance was performed for 20 seconds. In the control group, stretching and range of motion (ROM) exercises were performed. For the stretching exercise, one specific motion was performed for 20 second, and the ROM exercise was performed to confirm the change in muscle strength in the knee joint area and walking ability. RESULTS: The knee flexion and extension strength in the patients with excessive pronation of the foot differed significantly from those in the subjects from the control group (p<.05). Further, the before-after comparison of the step time and length in the evaluation of walking ability, which affects overall postural movement due to knee joint instability, revealed a significant difference between the experimental and control groups (p<.05). CONCLUSION: The patients that were subjected to manual therapy and ROM exercise for the knee joint showed improved knee joint muscle strength and walking ability compared to the subjects from the control group.

Freiberg's Disease and Metatarsophalangeal Joint Instability (프라이버그병과 중족지 관절 불안정)

  • Young, Kiwon;Kim, Jinsu;Joh, Joowon
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.1
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    • pp.11-16
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    • 2013
  • Freiberg's disease is a osteochondrosis of a metatarsal head that is recognized as primarily a disorder of the second metatarsal. It is seen more often in girls. Pain and limitation of motion of the affected joint is the predominant clincal feature. The radiographic appearance demonstrates from osteosclerosis in the early stage to osteolysis with collapse in the later stage. Conservative therapy may take the form of rest, a stiff shoe, and even a cast support to decrease the stress across the joint. Surgical intervention may also be of benefit. Surgery have been attempted either to modify the diseae process or to salvage the situation once the metatarsophalangeal joint develops degenerative changes. Metatarsophalangeal joint instability is common cause of forefoot pain that can develop in association with a traumatic episode and inflamatory tissue disorders as well as neighboring toe deformities. The second ray is by far the most frequently involved. The diagnosis can be made by clinical observation and physical examination including drawer test. Many surgical procedures have beem recommended when conservative treatment has failed. Procedures described range from soft tissue releases and tendon trasfer to the direct plantar plate repair combined with a Weil osteotomy.

The effect of whether the lumbar is instable or not and pressure biofeedback application location during clam exercise on pelvic rotation and hip joint muscle activity (클램운동 시 허리불안정성 유무가 골반 돌림 및 엉덩관절 벌림근 근활성도에 미치는 영향)

  • Choi, Yong-gil;Lee, Sang-yeol
    • Journal of Korean Physical Therapy Science
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    • v.28 no.1
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    • pp.23-32
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    • 2021
  • Background: The purpose of this study was to find out how the lumbar instability during clam exercise causes changes in pelvic rotation and hip joint abductor muscle activity. Design: Case-control study. Methods: Twenty male participated in this study. The amount of pelvic rotation was measured using myomotion during the clam exercise in a normal group and a group of patients with low lumbar instability, and the muscle activity of the muscle gluteus medius and the tensor fasciae latae using an EMG device. Results: The amount of pelvic rotation that occurred during the clam exercise was statistically significantly greater in the lumbar instability group than in the normal group (p<.05), and the ratio of muscle activity of the muscle gluteus medius/the tensor fasciae latae was statistically significantly higher in the normal group than in the lumbar instability group (p<.05). Conclusion: In order to stabilize the lumbo-pelvic and strengthen the strength of the hip joints, it is believed that it is necessary to apply exercise while controlling the lumbo-pelvic movement during clam exercises, and various studies will be needed.

Arthroscopic Treatment in Multidirectional Instability of the Shoulder Joint (다방향성 불안정 견관절의 관절경을 이용한 치료)

  • Rhee Kwang-Jin;Byun Ki-Yong;Kwon Soon-Tae;Kim Sang-Bum
    • Clinics in Shoulder and Elbow
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    • v.1 no.1
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    • pp.40-45
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    • 1998
  • Multidirectional instability of the shoulder joint is an unusual entity which is not yet well understood. Traditionally recommended treatment is non-operative, but recently arthroscopic treatment has been performed. This is a retrospective review of 20 patients who had multidirectional instability, who had been treated with arthroscopic capsular shift(7 cases), and arthroscopic treatment using Ho:YAG laser(l3 cases) at Department of Orthopaedic Surgery, Chungnam National University Hospital from July, 1988to February, 1997. Results of this study were as follows: 1. In five patients who were treated with arthroscopic anterior capsular shift only, all cases had redislocation of the shoulder joint. But there was no redislocation in two patients who were treated with arthroscopic anterior and posterior capsular shift. 2. ln three patients who were treated with laser-assisted capsular shift only, all cases had redislocation of the shoulder joint. But there was only one redislocation in ten patients treated with laser-assisted capsular shrinkage and capsular plication. Ho: Y AG laser has been found to be a safe and efficacious adjunct to many arthroscopic shoulder procedures. We had satisfactory results by combining a transglenoid capsular shift with laser-assisted capsular shrinkage. Arthroscopic laser-assisted capsular shrinkage and capsular plication is a one of recommendable treatment options in multidirectional instability of the shoulder joint.

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Chronic Lateral Ankle Instability (만성 족관절 외측 불안정)

  • Bae, Su-Young
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.1
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    • pp.1-8
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    • 2020
  • Acute ankle sprain is the most common injury in the lower extremities, and approximately 10% to 40% of acute lateral ankle ligament injury causes chronic pain or instability. For chronic symptoms lasting after an acute sprain, the possibility of joint damage, such as bony structures, ligaments, cartilage, and nerves around the ankle joint, should be considered. Patients with chronic lateral ankle instability usually complain of repeated sprains or giving way sensations. There has been steady progress in the treatment options until recently, however new treatments are still being attempted. This paper describes the causes, diagnosis, and recent trends in the conservative and operative treatment of chronic lateral ankle instability.