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

• Journal of the Korean Society of Physical Medicine
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• v.13 no.2
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• pp.129-135
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• 2018

PURPOSE: The imbalance of pretibial muscles can be a factor contributing to the development of pes planus. However, no study has yet compared the muscle activity of the tibials anterior (TA) to that of the extensor digitorum longus (EDL). The purpose of this study was to determine whether there are differences in the electromyographic (EMG) TA and EDL amplitude indexes (AIs) between normal and pes planus feet. METHODS: A total of 14 subjects with normal feet and 15 subjects with bilateral pes planus participated in this study. TA and EDL muscle activities were measured using a wireless EMG system and the angles of ankle dorsiflexion and eversion of the subtalar joint were measured using a universal goniometer during active ankle dorsiflexion in the prone position. AI was calculated as follows: $\text{amplitude_{TA}-amplitude_{EDL}/(amplitude_{TA}+amplitude_{EDL})}/2{\times}100$. RESULTS: The AIs of the TA and EDL were significantly lower in pes planus feet than in normal feet (p<.05). The angle of subtalar eversion was significantly greater in pes planus feet than in normal feet during active ankle dorsiflexon (p<.05). However, there was no significant difference in the angle of ankle dorsiflexion between normal feet and pes planus feet (p>.05). CONCLUSION: This study showed that TA muscle activation was lower in pes planus feet than in normal feet, resulting from greater eversion range of motion during active ankle dorsiflexion. We suggest that the imbalance of ankle dorsiflexors must be considered in pes planus management.

• Physical Therapy Korea
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• v.26 no.3
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• pp.84-90
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• 2019

Background: Ankle evertor muscles are important for preventing lateral ankle sprain. Since, the evertor muscles cross the ankle and toe joints, the position at which the ankle evertor muscle strength is measured is important. However, no studies have previously investigated the effect of ankle and toe positions on the strength of the ankle evertor muscle. Objects: This study is aimed to determine the effect of various ankle and toe joint positions on the strength of the ankle evertor muscles in healthy subjects. Methods: Eighteen healthy subjects participated in this study. Isometric ankle evertor strength of the dominant leg was determined in each subject in different ankle and toe positions (dorsiflexion (DF) with toe extension (TE), DF with toe flexion (TF), plantar flexion (PF) with TE, and PF with TF). A 2 by 2 repeated analysis of variance (ANOVA) was used to determine the difference in the evertor strength between the ankle positions (PF and DF) and toe positions (TE and TF). Results: The results indicate that there was no significant ankle position by toe position interaction effect (p=.83). However, the ankle evertor strength was significantly increased in the ankle DF position than in the PF position (p<.01), and the ankle evertor strength during eversion with TE was significantly higher than eversion with TF (p<.01). Conclusion: The findings of this study suggest that clinicians should consider the ankle and toe positions when measuring the muscle strength and during performance of selective muscle strengthening exercises of the ankle evertor muscles.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.1
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• pp.121-130
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• 2023

Purpose : This study aimed to investigate the effect of blood flow restriction exercise on ankle muscle strength and balance ability to achieve maximum efficiency with the same exercise intensity and time. Methods : Twenty-six adults are randomly assigned to experimental group (n=13) and comparison group (n=13). The experimental group performed ankle joint strength exercises with blood flow restriction applied while the comparison group performed ankle joint strength exercises without blood flow restriction applied three times a week for four weeks. The digital muscle measurement, Y-balance test, and Cumberland ankle instability tool were used to evaluate the subject's muscle strength, dynamic balance, and ankle instability index before and after the intervention. Results : In within-group comparison muscle strength, all the two groups showed significant improvements post intervention (p<.05). In between-group comparison, there was significant difference in the change of dorsiflexion, eversion strength pre and post intervention (p<.05). but plantarflexion was no significant difference between pre and post intervention in the group comparison (p>.05). In within-group comparison dynamic balance, all the two groups showed significant improvements post intervention (p<.05). In between-group comparison, there was no significant difference in the change of Y-balance score pre and post intervention (p>.05). In within-group comparison ankle instability index, all the two groups showed significant improvements post intervention (p<.05). In between-group comparison, there was no significant difference in the change of CAIT score pre and post intervention (p>.05). Conclusion : The results of this study show that ankle joint strength exercise improved the strength and balance ability of those complaining of chronic ankle instability, and ankle joint strength exercise applied with blood flow restriction was more effective in dorsiflexion and eversion strength exercise than ankle joint strength exercise without blood flow restriction.

• The Journal of Korean Physical Therapy
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• v.23 no.2
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• pp.23-29
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• 2011

Purpose: The purpose of this study was to determine whether there is a relationship between strength balance and joint position sense related to the ankle joint in healthy women. Methods: Twenty-six healthy women were recruited. Isokinetic strength and joint position sense (JPS) were measured using a Biodex System 4 pro Dynamometer and a Biodex Advantage Software Package. Prior to measuring the JPS and isokinetic strength, the dominant foot was determined according to the Waterloo Footedness Questionnaire. After the JPS test, isokinetic strength was evaluated in velocity $60^{\circ}s$, including practice trial ($90^{\circ}s$). Using the measured isokinetic strength, a Strength Balance Index (SBI) was calculated. Results: Relative to the SBI, the degree of imbalance was varied; but there were imbalances. For each starting position, JPS error showed no significant differences (p>0.05). The relationship between SBI and JPS was found during the inversion to eversion process, eversion to inversion, and dorsi flexion to plantar flexion. Conclusion: There are moderate to mild relationships between JPS and SBI during ankle movement. It is suggested that to prevent ankle injuries, strength balance should be considered along with the other potential factors including anatomical alignment, proprioception, and soft tissues problems.

• Journal of Korean Physical Therapy Science
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• v.23 no.1
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• pp.18-23
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• 2016

Purpose : The purpose of the present study is to report the effect of proprioception of ankle after kinesiotaping application on ankle. Method : This study has conducted to target 30 average adult subjects with no damage to the ankle joint (16 males and 14 females). The group is divided into experimental group and sham groups in random way. The subjects in the experimental group are applied taping kinesiology on ankle joint. The subjects in the sham group are applied a sham taping on the ankle joint which is not actually affected for real ankle joint problem. Each subjects in both groups has tree trials in plantarflexion, dorsiflexion, inversion, and eversion before and after application of the kinesiotaping or sham taping of the bare footed ankle. The outcome were determined from the difference between the target angle and the trial angle produced by the subject. Results : These results from the experiment shows that the experimental group compared to the difference in kinesiotaping angle values were significantly different from each dorsiflexion (DF), eversion (EV) (p<.05). Otherwise, in the sham group did not produce significant differences in any joint movement. In addition, when we compared between two groups (the experimental and sham groups), it did not show that there was significant differences. Conclusion : First, there is no significant difference between the sham group and kinesiotaping group after proprioceptive tests. Second, even though there is no significant outcome in statistical analysis, there is actual differences in the experiment. This result might be ceiling effect, and if the kinesiotaping were applied to actual ankle injury patients, this taping treatment could be very effective for curing this patient.

• Physical Therapy Korea
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• v.18 no.2
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• pp.1-8
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• 2011

The purpose of this study was to investigate the effect of high heeled shoes with the total contact insert (TCI) on the frontal plane of the joints for the lower extremity during the gait. Ten healthy females voluntarily participated in this study and the height of the high heeled shoes was 7 cm. A three-dimensional motion analysis system (VICON) and force plates were used to analyze the movements of the joints for the lower extremities. The results were as follows: There were no significant differences for the angle value on the event of the gait cycle in the maximum eversion and inversion of the ankle joint, the varus and valgus of the knee joint, and the adduction and abduction of the hip joint (p>.05). But, there was a significant difference or the range of motion in the ankle joint (p<.05). The value of ankle and knee moment with a TCI was less than the value for no TCI. And there were significant differences for the moment value of the maximum inversion and eversion on the ankle joint and for the maximum varus and valgus on the knee joint (p<.05). Therefore, a TCI would be effective in stabilizing the joints of the lower extremities and increasing the balance of a body to reduce the injure from a fall during the gait.

• The Journal of Korean Physical Therapy
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• v.13 no.3
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• pp.735-749
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• 2001

The purpose of this study was to compare the flexibility and isokinetic differences between normal dancers and dancers with chronically sprained ankle. For the experiment Eversion/Inversion testing was performed by a Cybex 770 isokinetic dynamometer at the a speeds of 30$^{\circ}$ /sec and 120$^{\circ}$ /sec on each 7 subject group. The results were; 1) No differences were found between the two groups in ROM of ankle, but ROM of eversion has 2.8$^{\circ}$ higher in the injury group than the normal group. 2) Differences were found between the two groups in peak torque. average power, total work at the evertor and invertor in injury side.(30$^{\circ}$ /sec) 3) Differences were found between the two groups in peak torque at the evertor and invertor in normal side.(30$^{\circ}$ /sec) 4) Differences were found between the two groups in total work at the evertor in normal side. (30$^{\circ}$ /sec) 5) Differences were found between the two groups in peak torque, total work at the evertor and invertor in injury side. (120$^{\circ}$ /sec)

• Journal of the Korean Society of Physical Medicine
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• v.11 no.4
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• pp.93-103
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• 2016

PURPOSE: The purpose of this study is to determine the effect of therapeutic exercise on pain, range of motion and strength, and balance ability in a patient with an anterior ankle impingement (AAI). METHODS: A-32-year-old male presented limited ankle motion and pain with forced dorsiflexion at both ankle joints. In response, a therapeutic exercise program consisted of ankle joint mobilization, strength exercises using an elastic band, and proprioceptive exercises including semi-squats and a one-legged standing exercise with open and closed eyes. The program was performed for 40 min/day, twice per week, for 8 weeks. Pain, range of motion (ROM), and muscle strength (ankle dorsiflexion, plantarflexion, inversion, and eversion), as well as a one-legged standing test of both ankles, were measured before and after 4 and 8 weeks of therapeutic exercise. RESULTS: VAS decreased in both ankles after 8 weeks of exercise, respectively, compared to baseline levels. Range of motion and strength increased in both ankles for dorsiflexion, plantarflexion, inversion, and eversion after 8 weeks of exercise compared to baseline levels. In addition, the ability to perform a one-legged standing test with eyes opened and closed improved in both legs after 8 week of exercise compared to baseline levels. CONCLUSION: These results suggest that therapeutic exercise improves pain, ROM, muscle strength, and balancing ability in patients with AAI.

• Journal of International Academy of Physical Therapy Research
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• v.9 no.1
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• pp.1426-1434
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• 2018

This study was conducted to observe the isokinetic strength (IS) of the hip, ankle, and knee joints in young age groups. Thirty eight men and thirty one women with mean age of $30.4{\pm}3.5$ and $32.8{\pm}4.4years$, respectively, were enrolled in this study. Measurements of hip flexion, extension, abduction, and adduction at $30^{\circ}/sec$, Knee flexion and extension at $60^{\circ}/sec$, ankle inversion, eversion, plantarflexion, and dorsiflexion $30^{\circ}/sec$ were conducted. Absolute IS (Nm), relative IS (Nm/kg), strength ratios, correlations between movements were observed. Significant differences in absolute and relative strength were observed between groups in all movement except in the relative ankle strength. Relative isokinetic strength ratios of hip flexion/extension were .45 and .55, knee flexion/extension were .84 and .89, ankle dorsi/plantarflexion were .30 and .29, and ankle eversion/inversion were .86 and .84 for men and women, respectively. In the hip extension, men had about three times the body weight, and women had about 2.5 times the strength. The abduction muscle had about 1.5 times the body weight of both men and women. Height and body weight showed the significantly strong correlating relationship with hip (r, .76-.86) and knee (r, .67-.84) strength. However, ankle strength showed the comparatively correlating relationship, especially in women (r, .03 - .36). Similar age and physique characteristics of female and male groups could provide useful isokinetic strength reference values for developing the exercise program for healthy and rehabilitation groups.