• Title/Summary/Keyword: Lateral instability

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Effects of Dual Task Training on Balance and Functional Performance in High School Soccer Players with Functional Ankle Instability

  • Kwak, Kwang-Il;Choi, Bum-Jin
    • The Journal of Korean Physical Therapy
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    • v.28 no.4
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    • pp.254-258
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    • 2016
  • Purpose: This study was conducted to identify the effects of dual task training on balance and functional performance in high school soccer players with functional ankle instability. Methods: Twenty high school soccer players with functional ankle instability were randomly assigned to a single task training group and a dual task training group. One participant who did not participate regularly in the training was excluded. The single task training group (n=9) received balance training on an unstable surface. The dual task training group (n=10) received balance training on an unstable surface and had to catch thrown balls during the balance training. Both groups were trained for 4 weeks, 3 days a week. The balance and functional performance of both groups was measured before and after training. Balance was measured using an anterior-posterior and medio-lateral balance. Functional performance was measured based on a figure-of-8 hop test, up-down hop test, and a single hop test. All data were analyzed by repeated two-way ANOVA tests. Results: A time by group interaction effect was not observed in the medio-lateral balance test, figure-of-8 hop test, or single hop test (p>0.05). A time by group interaction effect was observed in the anterior-posterior balance and up-down hop test (p<0.05). Conclusion: These results suggest that dual task training improved balance and functional performance better than single task training for some items.

Lying Down Instability Undetected on Standing Dynamic Radiographs

  • Kim, Hyeun Sung;Ju, Chang Il;Kim, Seok Won;Kang, Jung Hoon
    • Journal of Korean Neurosurgical Society
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    • v.58 no.6
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    • pp.560-562
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    • 2015
  • It is well known that spinal instability should be evaluated in the standing lateral position. Standing dynamic flexion and extension radiographs are usually used to assess spinal instability. Here, we report a patient who experienced distraction instability while in the supine position rather than the standard standing position. To our knowledge, this is the first report of lying-down instability undetected on standing dynamic flexion and extension radiographs. We discuss the pathophysiological mechanism of this uncommon but possible entity and provide a review of the literature.

Chronic Lateral Ankle Instability: Efficacy of Combination of Ankle Arthroscopic Exploration and Modified Brostrom Operation (족관절 외측 불안정성 재건 시 시행하는 탐험적 관절경의 유용성)

  • Lee, Kyung-Tai;Kim, Jin-Su;Young, Ki-Won;Park, Young-Uk;Kim, Jun-Beom;Kim, Tae-Won;Jo, Jae-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.2
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    • pp.123-129
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    • 2010
  • Purpose: To evaluate the efficacy of the arthroscopic exploration combined with modified Brostrom operation (MBO) for the treatment of chronic lateral ankle instability (CAI). Materials and Methods: Sixty patients who diagnosed a CAI were performed MBO. We divided to 2 groups, whether simultaneously inspected by arthroscopy (group B) or not (group A). The both group's results were compared according to American Orthopedic Foot and Ankle Society Ankle-hindfoot score (AOFAS), functional ankle score and visual analog scale (VAS) at preoperative and final follow-up period. Results: There were no significant differences of AOFAS, functional ankle score and VAS between both groups at final follow-up. However, in group A, 2 cases associated with medial ankle instability and syndesmotic injuries were did not diagnosed preoperatively, showed poor prognosis. In group B, one case had a permanent peroneal nerve symptom. The match rate of intra-articular lesions between preoperative diagnosis and postoperative arthroscopic diagnosis was 30% in group B. Conclusion: Combination of arthroscopic exploration and MBO is effective strategy for intra-operatively discrimination of intra-articular associated lesions for CAI.

Anatomical Reconstruction of the Lateral Ankle Ligaments using Semitendinosus (반건양근 건을 이용한 족관절 외측 인대의 해부학적 재건)

  • Lee, Woo-Chun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.1
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    • pp.19-23
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    • 2008
  • Purpose: Several methods of anatomical reconstruction for chronic lateral ankle instability has been reported to avoid the problems of nonanatomical reconstruction. Precise reconstruction of the normal anatomy is essential to the restoration of normal joint mechanics and stability. The problem with anatomical reconstruction is that it is very difficult to reconstruct the normal anatomic course of the ligaments. We thought making one tunnel at the fibular attachment of anterior talofibular ligament and calcaneofibular ligament was more anatomical than making separate tunnels for each ligaments because the two ligaments are contiguous. In this article, the basis of anatomical reconstruction of the lateral ankle ligaments was reviewed and a technique of reconstruction using semitendinosus was introduced.

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Edge Flame Instability of CH4-Air Diffusion Flame Diluted with CO2 (이산화탄소로 희석된 메탄-공기 확산화염의 에지화염 불안정성)

  • Hwang, Dong-Jin;Kim, Jeong-Soo;Keel, Sang-In;Kim, Tae-Kwon;Park, Jeong
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.30 no.9 s.252
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    • pp.905-912
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    • 2006
  • Experiments in low strain rate methane-air counterflow diffusion flames diluted with $CO_2$ have been conducted to investigate the flame extinction behavior and edge flame oscillation in which flame length is less than the burner diameter and thus lateral conductive heat loss in addition to radiative loss could be remarkable at low global strain rates. The critical mole fraction at flame extinction is examined in terms of velocity ratio and global strain rate. It is seen that flame length is closely relevant to lateral heat loss, and this sheets flame extinction and edge flame oscillation considerably. Lateral heat loss causes flame oscillation even at fuel Lewis number less than unity. Edge flame oscillations are categorized into three: a growing-, a harmonic- and a decaying-oscillation mode. Onset conditions of the edge flame oscillation and the relevant modes are examined with global strain rate and $CO_2$ mole fraction in fuel stream. A flame stability map based on the flame oscillation modes is also provided at low strain rate flames.

Intermediate-Term Clinical Outcomes after Autologous Osteochondral Transplantation for Lateral Osteochondral Lesions of the Talus (외측 거골 골연골 병변에 대한 자가 골연골 이식술 후의 중기 추시 임상결과)

  • Sung-Hoo Kim;Byung-Ki Cho
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.4
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    • pp.137-143
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    • 2023
  • Purpose: Autologous osteochondral transplantation (AOT) is indicated for patients with a large osteochondral lesion of the talus (OLT), accompanying subchondral cyst, and the failure of bone marrow stimulation (BMS) procedures. Despite the many reports on the clinical results of surgical treatment for medial osteochondral lesions, those of lateral lesions are rare. This paper reports the intermediate-term clinical outcomes after AOT for lateral OLTs. Materials and Methods: Twenty-one patients with lateral OLTs were followed up for at least three years after AOT. The clinical evaluations comprised the Foot and Ankle Outcome Score (FAOS) and Foot and Ankle Ability Measure (FAAM). The radiographic assessment included the irregularity of the articular surface (subchondral plate), the progression of degenerative arthritis, and the changes in talar tilt angle and anterior talar translation. Results: The mean FAOS and FAAM scores improved significantly from 42.1 to 89.5 and 39.5 to 90.6 points, respectively, at the final follow-up (p<0.001). The radiological evaluation revealed two cases (9.5%) of articular step-off ≥2 mm and 1 case (4.8%) of progressive arthritis. The mean talar tilt angle and anterior talar translation improved significantly. As postoperative complications, there was one case of a local wound problem, one case of superficial peroneal nerve injury, and one case of donor site morbidity. At a mean follow-up of 62.3 months, no patient showed a recurrence of instability or required reoperation for OLT. Conclusion: AOT for the lateral OLTs demonstrated satisfactory intermediate-term clinical outcomes, including daily and sports activity abilities. Most OLT could be accessed through lateral ligament division and capsulotomy, and the incidence of iatrogenic complications, such as recurrent sprains or chronic instability, was minimal. AOT appears to be an effective and relatively safe treatment for patients with large lateral osteochondral lesions unresponsive to conservative therapy, with subchondral cysts, or with failed primary BMS.

The Indication of Ankle Lateral Ligament Reconstruction Using Tendon Graft in Chronic Ankle Instability (만성 족관절 불안정증에서 건이식을 이용한 외측 인대 재건술의 적응증)

  • Park, Jae Yong;Choi, Gi-Won;Cho, Jae-ho;Kang, Chan;Choi, Kyungjin;Chung, Jin-Wha;Kim, Hak Jun;Bae, Su-Young;Cha, Seung-Do;Kim, Ki Chun;Han, Seung Hwan;The Insurance Committee of Korean Foot and Ankle Society
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.1
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    • pp.12-18
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    • 2016
  • Purpose: The purpose of this study is to review the indications of ankle lateral complex reconstruction using tendon graft. Materials and Methods: We searched PubMed using the index, "ankle, instability, lateral ligament, reconstruction" from 1990 to present (September 30, 2015). We excluded 1) modified Brőstrom operation (MBO), 2) conventional tenodesis surgery, 3) review article, 4) technical note, and 5) articles written in another foreign language. We reviewed 24 papers through the publication events, operational method, the indications of surgery, and the specific features of the patient group. Results: There were the indications of 1) previous ligament surgery failure, 2) situation when ligament repair is impossible due to the ligament defect, 3) severe instability (preoperative talar tilt >$15^{\circ}$, anterior draw >10 mm or the difference of contralateral side talar tilt >$5^{\circ}$, anterior draw >3 mm), and 4) overweight (body mass index >$30kg/m^2$). Other considerations included 1) generalized joint laxity and 2) workers, highly-demanded or athlete highly-affected by instability. Conclusion: The ankle lateral complex reconstruction using tendon graft could be indicated in patients with the possibility of MBO failure with several considerations.

Analysis of Ankle Bony Abnormality in the Patients with Chronic Ankle Sprain and Marked Ankle Instability (저명한 불안정성을 가진 만성 족관절 염좌 환자의 족관절 골성 병변에 대한 분석)

  • Jung, Chul-Yong;Eun, Il-Soo;Kim, Byung-Cheol;Choi, Sung-Jong;Yoo, Chong-Il;Kim, Jong-Kyun;Choi, Hyun-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.7-10
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    • 2006
  • Purpose: We analyzed the ankle bony abnormality of patients with marked ankle instability who had chronic ankle sprain more than 3 years. Materials and Methods: We evaluated the chronic ankle sprain (more than 3 years) patients with marked ankle instability tested by varus stress test and anterior draw test from March 2000 to December 2005. Eighty-nine patients (104 ankle) were evaluated and there were 38 males and 51 females. The mean age of patient at the time of diagnosis was 34.5 (range, 18 to 56 years). The average duration of morbidity was 7 years and 3 months (range, 3 years and 3 months to 21 years). The patients who had history of dislocation, fracture, malalignment, operated patients, and rheumatoid ones were excluded. Plain radiographs of AP, lateral, oblique and mortise view were checked. Results: Radilologic abnormalities were found at 74 ankles (71%) among 104 ankles. Frequent sequences of location were anterior talotibial osteophyte, medial malleolar osteophyte, Os subfibulare, lateral malleolar osteophyte. Posteior osteophyte, ankle arthritis, talar articular defect were rarely found. Conclusion: Seventy-one percent among patients with chronic ankle sprain and marked ankle instability showed more than one radiologic abnormalities. Thus, more exclusive and accurate ankle examination should be performed in these patients.

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Effect of Kinesio Taping on Pain Decrease and Functional Disability Improvement of Subjects with Lumbar Instability (키네시오 테이핑이 허리뼈 불안정성을 가진 대상자의 통증감소 및 기능장애 개선에 미치는 효과)

  • Cho, Hyoshin;Weon, Jonghyuc;Lee, Kwonho;Cha, Hyungyu
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.3
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    • pp.71-81
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    • 2020
  • Purpose : The purpose of this study is to investigate the instant effect of Kinesio taping on pain decrease and improvement of functional disorder of the subjects who have lumbar instability. Methods : A total of 20 patients (13 men and 7 women) who have lumbar instability were chosen as the subjects. The experiment was conducted by assigning the subjects into Kinesio taping group and placebo taping group. A visual analog scale (VAS) was used to measure back pain and Biering-Sorensen test was applied to measure the muscle endurance of back extensor muscles. A digital dynamometer was used to test the isomeric contraction strength of lumbar extensor muscle. The subject performed single-leg stance and double-leg stance task and their static balancing ability was measured by a testing device that captures the static balancing ability. Results : In a within-group comparison, Kinesio taping group showed a significant decrease of VAS (p<.05) and a significant increase of endurance and strength of lumbar extensor muscle (p<.05). In Kinesio taping group, the shift distance in anterior-posterior sway and medial-lateral sway during the double-leg stance significantly decrease (p<.05). The shift distance in anterior-posterior sway and medial-lateral sway also significantly decreased during the single-leg stance (p<.05). Placebo taping group showed a significant decrease of visual analog scale (p<.05). In a between-group comparison, Kinesio taping group showed a significantly larger decrease of VAS (p<.05), significant larger increase of muscle endurance and muscle strength (p<.05), and significant larger decrease of anterior-posterior sway in the double-leg stance (p<.05), compared to placebo taping group. Conclusion : Application of Kinesio taping to the subjects with lumbar instability produced positive effect of reducing pain, increasing muscle strength and endurance, and improving static balancing ability.

Osborne-Cotterill Lesion a Forgotten Injury: Review Article and Case Report

  • Vargas, Daniel Gaitan;Woodcock, Santiago;Porto, Guido Fierro;Gonzalez, Juan Carlos
    • Clinics in Shoulder and Elbow
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    • v.23 no.1
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    • pp.27-30
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    • 2020
  • Osborne-Cotterill lesion is an osteochondral fracture located in the posterolateral margin of the humeral capitellum, which may be associated with a defect of the radial head after an elbow dislocation. This lesion causes instability by affecting the lateral ulnar collateral ligament over its capitellar insertion, which is associated with a residual capsular laxity, thereby leading to poor coverage of the radial head, and hence resulting in frequent dislocations. We present a 54-year-old patient, a physician who underwent trauma of the left elbow after falling from a bike and suffered a posterior dislocation fracture of the elbow. The patient subsequently presented episodes of instability, and additional work-up studies diagnosed the occurrence of Osborne-Cotterill lesion. An open reduction and internal fixation of the bony lesion was performed, with reinsertion of the lateral ligamentous complex. Three months after surgery, the patient was asymptomatic, having a flexion of 130° and extension of 0°, and resumed his daily activities without any limitation. Currently, the patient remains asymptomatic 2 years after the procedure. Elbow instability includes a large spectrum of pathological conditions that affect the biomechanics of the joint. The Osborne-Cotterill lesion is one among these conditions. It is a pathology that is often forgotten and easily overlooked. Undoubtedly, this lesion requires surgical intervention.