• Journal of the Korean Society of Physical Medicine
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• v.9 no.1
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• pp.75-82
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• 2014

PURPOSE: PURPOSE: The purpose of this study was to analyze the effect and examine the feasibility of an intervention of ankle strategy exercise on balance of patients with hemiplegia. METHODS: The subject were randomly allocated to three groups: ankle strategy exercise (group A), balance exercise (group B) and control (group C). Group A was received the conventional physical therapy plus ankle strategy exercises for 20 minutes in one session. Group B was received the same conventional physical therapy plus balance exercises for 20 minutes in one session. Two active groups were performed in the session 3 times a week, for a total of 6 weeks. and Group C was only received the same conventional physical therapy. Balance test was assessed using center of pressure (COP) in the anteroposterior (A-P), mediolateral (M-L) direction, Berg balance scale (BBS) and Timed Up and Go Test (TUG). RESULTS: All groups showed improvements in balance parameters. In especial, the Group A was statistically significant differences in almost part evaluation items and showed more improvements in BBS and TUG parameters than Group B and Group C. and moving distance of M-L COP was more improvements than Group B. CONCLUSION: Ankle strategy exercises had more influence on balance than balance exercises and neurodevelopmental treatment.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.4
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• pp.2212-2220
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• 2020

Background: Repetitive damage to the ankle joint causes chronic ankle instability, and studies comparing the effects of exercise in open and closed chains as a treatment method are very rare. Objectives: To investigate the effects of open and closed kinetic exercises on muscle activity and dynamic balance of ankle joint in adults with chronic ankle instability. Design: Single-blind randomized controlled trial. Methods: The selected 30 subjects are randomly divided into open kinetic chain exercise experimental group (EGI, n=10), closed kinetic chain exercise experimental group (EGII, n=10), and stretching control group (CG, n=10). Open and closed kinetic exercises lasted 30 minutes three times a week for six weeks and stretching exercises performed four actions for 20 seconds and five sets. The measurement tools using surface electromyography to measure muscle activity in the ankle joint. The dynamic balance of the ankle was evaluated using the Y-Balance test. Results: Following the intervention, closed and open kinetic chain exercise group showed significant difference in tibialis anterior and gastrocnemius muscle activity and dynamic balance (P<.05). However, no significant difference in tibialis anterior and gastrocnemius muscle activity and dynamic balance between closed and open kinetic chain exercise group (P<.05). Conclusion: This study provides evidence that closed and open kinetic chain exercise can be presented as an effective exercise for the muscle activity of ankle muscle and dynamic balance of the subject with chronic ankle instability.

• The Journal of Korean Physical Therapy
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• v.31 no.4
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• pp.176-183
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• 2019

Purpose: The purpose of this study was to investigate the short term effects of ASEJ (ankle strengthening with emphasis on jumping) for 3weeks on strength, mechanical properties, and balance and to compare the balance with and without HH(high-heel) condition. Methods: ASEJ (a combined exercise of squat, heel raise up, and jumping) were performed for the subjects in 11 female ankle instability young females ($21.7{\pm}2.0yrs$ Cumberland ankle instability score $19{\pm}6.5$). To investigate the effect of ASEJ, investigator used dynamometer for measuring strength, MyotonPRO for measuring mechanical properties(tone, stiffness, and elasticity of the muscles), I-Balance test for static balance, and Y-balance test for dynamic balance between the condition with and without HH condition. All data were normally distributed and analyzed using the SPSS 22.0 statistical program. Comparing pre- and post-intervention and the condition with and without HH conditions data were examined using the paired t-test. The level of significance was chosen as 0.05 for all the analyses. Results: 3wks of ASEJ would strengthen leg muscles and increasing muscle tone and stiffness in most muscles however there was decreasing muscle elasticity of gastrocnemious. In addition, the ASEJ improves the static balance for ankle instability young females and increases the dynamic balance when wearing the heels especially. Conclusions: the ASEJ could recommend to improve the strength and balance for ankle instability young females. Also, measuring the balance with HH conditions well represents the risk of ankle damage in female.

• PNF and Movement
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• v.15 no.1
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• pp.85-96
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• 2017

Purpose: Peripheral neuropathy accompanied by sensory disturbance, such as limb paralysis and hemiplegia, is mainly caused by acute disseminated encephalomyelitis (ADEM). This case study aimed to determine the effect of ankle strengthening exercises that use proprioceptive neuromuscular facilitation (PNF) on the gait, balance, ankle-control ability, and sit-to-stand ability on a patient with ADEM. Methods: A 10-year-old male with quadriplegia and ankle-control impairment participated in this 4-week training intervention. The patient, diagnosed with ADEM, was treated with ankle strengthening exercises that used PNF. Results: The patient demonstrated improvements in balance, ankle-control ability, sit-to-stand ability, and gait performance. Outcome measures (manual muscle test, modified Ashworth scale, sensory assessment, coordination assessment, Berg balance scale, 5 time sit-to-stand test, and 10 m walk test) were taken before and after the training program. Conclusion: The results of this case suggest that an ankle strengthening exercise that uses PNF can improve the gait, balance, ankle-control ability, and sit-to-stand ability in patients with ADEM. In ADEM, the initial treatment is important, and the use of ankle strengthening exercises with PNF could lead to meaningful results. However, there is limited research due to an insufficient number of cases. In the future, more patients will need to be studied.

• PNF and Movement
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• v.22 no.2
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• pp.191-199
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• 2024

Purpose: This study aimed to investigate the effects of ankle stretching with intrinsic muscles on ankle range of motion, static and dynamic balance, and gait speed in chronic stroke patients. Methods: The participants were 20 chronic stroke patients, divided into two groups, 10 in the ankle stretching with intrinsic muscles group and 10 in the slant board exercise group. Both groups performed their respective interventions once daily, with three sets per session, five times a week for four weeks. Ankle range of motion, dynamic and static balance, and gait speed were measured before and after the intervention. An independent t-test was used to compare the results between the two groups before and after the intervention. Results: Both groups showed significant improvements in ankle range of motion, dynamic and static balance, and gait speed after the intervention (p < .05). The ankle stretching with intrinsic muscles group showed more significant improvements in ankle range of motion, dynamic and static balance, and gait speed after the intervention compared to the slant board group (p < .05). These results suggest that ankle stretching with intrinsic muscles may be more effective than the slant board for certain outcomes. Conclusion: Ankle stretching with intrinsic muscles is effective in improving ankle range of motion, dynamic and static balance, and walking speed.

• Journal of the Korea Convergence Society
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• v.10 no.11
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• pp.217-223
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• 2019

The relationship between balance and ankle muscle characteristics (strength and flexibility) may be important to identify those at an increased risk of falling and to develop fall-prevention training programs. The association between ankle muscle characteristics (strength and flexibility) and balance has not previously been studied. The purpose of this study assessed the relationship between ankle muscle characteristics and balance. Sixteen healthy participants volunteered to participate in the study. Dynamic balance measured using Y-balance kit. Ankle muscle characteristics (strength and flexibility) measured using hand-held dynamometer and goniometry. The results indicated a positive correlation between ankle invertor muscle strength and Y-balance test performance. Clinicians should consider ankle muscle strength during therapeutic interventions to improve dynamic balance.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.22 no.2
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• pp.57-63
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• 2016

Background: Instability due to ankle sprains will be accompanied by a problem of balance and pain change. Balance trainer is used to improve the ankle strength and balance ability. The purpose of this study was to evaluate the change of pain and postural balance ability in ankle joint after balance trainer application in patients with ankle sprain and instability. Methods: Twenty patients in K hospital in Incheon were enrolled. Balance trainer was applied to 10 subjects in the experimental group and 10 subjects in the Balance cushion under the same conditions as the experimental group to compare the pain and balance ability. Results: In the experimental group, there was a significant difference in the change of the pain variation. In the postural balance ability comparison, there was a significant difference in total and post - posterior comparison compared to the control, but there was no significant difference in the postural balance ability comparison. Conclusion: Pain and postural balance ability of patients with instability due to ankle sprain improved the pain and balance ability of the Balance trainer group compared to the Balance cushion training group.

• The Journal of Korean Physical Therapy
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• v.27 no.5
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• pp.345-350
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• 2015

Purpose: This study was conducted to determine the effects of ankle joint position during closed kinetic chain (CKC) exercise on knee extensor strength and balance in patients with chronic stroke. Methods: Sixteen patients with chronic stroke participated in the study. Participants were randomly assigned to two groups: $15^{\circ}$ ankle joint plantar flexion group (n=8) and ankle joint neutral group (n=8) during CKC exercise. All participants underwent conventional physical therapy for 30 minutes. In addition, the experimental group ($15^{\circ}$ ankle joint plantar flexion group) and control group (ankle joint neutral group) participated in a 20-minute CKC exercise program. In both groups exercise was performed three times a week for four weeks. Outcomes including knee extensor strength and balance ability (Five times sit-to-stand test, Timed up and go test, and Balancia) were measured before and after exercise. Results: Significant differences in knee extensor strength and balance ability were observed between pre- and post-exercise in all groups (p<0.05). The improvement of knee extensor strength and dynamic balance was significantly higher in the experimental group than in the control group (p<0.05). Conclusion: These findings demonstrated that $15^{\circ}$ ankle joint plantar flexion during closed kinetic chain exercise is effective in improvement of knee extensor strength and dynamic balance in patients with chronic stroke.

• Journal of International Academy of Physical Therapy Research
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• v.9 no.4
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• pp.1651-1656
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• 2018

The purpose of this study was to assess the changes in balance and proprioception of adults with limited ankle joint dorsiflexion, after the application of talocrural joint mobilization. The subjects of this study included 23 college students in their twenties with limited ankle joint dorsiflexion. The students were randomly assigned to the ankle joint mobilization group (AJMG, n=12) and the control group (CG, n=11). After 2 weeks of intervention using grade III talocrural joint mobilization in the anterior-posterior movement, the balance and proprioception of the subjects were assessed. Static/dynamic balance capabilities and ankle proprioception were analyzed using paired t-test and independent t-test. The dynamic balance and proprioception of AJMG were significantly improved after intervention (p<.05), In the comparison between the groups after the intervention, the dynamic balance and proprioceptive sense of AJMG were significantly improved compared to the control group (p<.05). This study suggests that AJMG can help improve the dynamic balance and proprioception.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.3
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• pp.361-368
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• 2013

PURPOSE: The purpose of this study was to investigate the comparison of balance on Stable Ankle(SA), Instability Ankle(IA) using Cumberland Ankle Instability Tool(CAIT). METHODS: Total 54(SA: 27, IA: 27) subjects were volunteered to participate in the study. SA can be defined CAIT score ${\geq}28$, with no history of injury to ankle. IA can be defined persisting symptoms of giving way and ${\leq}24$ on the CAIT after ankle sprain. the balance measured using Biodex Balance System$^{(R)}$(BBS). BBS instability protocols used static, dynamic balance level less stable(2), moderate stable(4) and level more stable(8). RESULTS: There were significant differences at overall, Anterior-Posterior(AP), Medial-Lateral(ML) of static balance, dynamic balance level 2, 4. The dynamic balance level 8 found significant difference at ML, but not found significant differences at overall, AP. CONCLUSION: We suggest that CAIT is acquired more exact information for IA intervention, as balance measured.