• 대한정형도수물리치료학회지
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• 제26권1호
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• pp.55-63
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• 2020

Background: This study was conducted to compare the effects of an incline board, proprioceptive neuromuscular facilitation (PNF) stretching, and joint mobilization on the dorsiflexion of the ankle joint and muscle tone of the plantar flexor and ankle in stroke patients. Methods: Forty-five stroke subjects were randomly divided into three groups: each JMG (Joint Mobilization Group), IBG (Inclined Board Group) and PSG (PNF Stretching Group). The experiment was performed for eight weeks between August 1 and October 31, 2018. Results: The dorsiflexion of the ankle joint was significant between the groups and by period (p<.05). JMG had a significant change by period (p<.05). Differences between groups by period increased after 8 weeks in the PSG and the JMG (p>.05). The gastrocnemius lateral muscle tone was significant between the groups (p<.05), and medial muscle tone was interacted between groups and time (p<.05). Conclusion: An effective intervention method to increase the dorsiflexion of the ankle joint and decrease the muscle tone when performing PNF stretching, and joint mobilization in stroke patients was confirmed. Future studies are recommended to variety research of PNF stretching and joint mobilization.

• 대한물리의학회지
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• 제16권1호
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• pp.83-92
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• 2021

PURPOSE: This study examined whether ankle joint stabilizing taping and muscle control taping influenced the ankle range of motion (ROM), muscle tone, and balance ability in chronic stroke patients. METHODS: Ten stroke patients were assigned randomly to experimental group 1 (joint stabilization taping n = 5) and experimental group 2 (Muscle control taping n = 5). After general physical therapy in both groups, ankle stabilization taping was applied to experimental group 1, and muscle control taping was applied to experimental group 2 three times a week for a total of six weeks (18 times). RESULTS: The muscle tone and stiffness of the gastrocnemius (GCM) showed significant differences between the experimental 1 and experimental 2 groups (p < .05). The Berg Balance Scale (BBS) and ROM also showed significant differences within the experimental 1 and experimental 2 groups (p < .05). The BBS and ROM also showed no significant differences between the experimental 1 and experimental 2 groups (p > .05). CONCLUSION: This study examined the muscle tone, balance, and ROM on the paraplegic side of stroke patients using kinesio taping, and the effect of the taping application method was confirmed from the preceding study. Therefore, it can decrease the paralysis side muscle tone and improve the ROM and balance ability.

• Physical Therapy Rehabilitation Science
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• 제11권2호
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• pp.127-135
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• 2022

Objective: The purpose of this study was to investigate the effects of combining Mulligan taping and flossing bands on lower limb muscle activity and static and dynamic balance. Design: A randomized controlled trial. Methods: Sixty-eight patients with chronic ankle instability were randomized into three groups that were treated with Mulligan taping (MT, n=22), flossing band (FB, n=23) and Mulligan taping combined with flossing band (MT+FB, n=23), and various parameters were compared before and after the intervention. The muscle activity of the lower extremities, including the tibialis anterior, peroneus longus and medial of gastrocnemius muscles was measured using BTS FREE EMG 1000, while the static and dynamic balance were measured using the Biorscuue balance measuring equipment. Results: There was a significant difference in muscle activity of the tibialis anterior muscle, before and after the intervention, in the MT group (p<0.01), FB (p<0.001) and MT+FB (p<0.001). There was also a significant difference in the muscle activity of the tibialis anterior muscle in the MT+FB group when compared with that in MT and FB groups (p<0.05). We also observed a significant difference in the dynamic balance all the groups (p<0.001). Conclusions: Therefore, combining Mulligan taping and flossing bands for patients with chronic ankle instability may improve dynamic balance and tibialis anterior muscle activity.

• 한국전문물리치료학회지
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• 제20권4호
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• pp.47-54
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• 2013

The purpose of this study was to investigate the effects of active and passive postural perturbation on ankle dorsiflexor responses in stroke patients. The subjects consisted of 13 stroke patients. Using wireless electromyography, the patients' ankle dorsiflexor muscle responses were measured under the following conditions: active dorsiflexion (AD), active perturbation (AP), and passive perturbation (PP). Tibialis anterior muscle activity increased most significantly during PP of the affected side ($118.64{\pm}56.28$). The most significant increase for the non-affected side was in AD ($72.64{\pm}24.56$). Tibialis anterior muscle activity was compared under each condition. The affected side showed significant differences between PP and AD and between PP and AP (p<.05). The non-affected side showed not significant differences between each condition. The ratios of tibialis anterior muscle activity under AP to that under AD were 1.00 on the affected side and .75 on the non-affected side and the difference was not significant (p>.05). The ratios of tibialis anterior muscle activity under PP to that under AD were 3.30 on the affected side and 1.14 on the non-affected side and the difference was significant (p<.05). Passive perturbation improved tibialis anterior muscle activity on the affected side, and training based on this approach may have the potential to improve the ankle dorsiflexion of people with stroke.

• The Journal of Korean Physical Therapy
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• 제35권5호
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• pp.145-150
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• 2023

Purpose: This study examined the effects of ankle control training using neuromuscular electrical stimulation (NMES), leg muscle activation, and balance in stroke patients. Methods: Thirty-one stroke patients diagnosed with cerebral infarction and cerebral hemorrhage were selected for the study. The experimental group underwent ankle control training using NMES, while the control group applied NMES to the paretic tibialis anterior muscle for 30 minutes per session, five times a week for four weeks. The muscle activity changes were measured using surface electromyography, and balance parameters were evaluated using a functional reach test (FRT). Results: The intra-group comparison of the concentric muscle activity revealed improvements in the experimental group, including paretic tibialis anterior (TA) muscle (p<0.05), medial gastrocnemius muscle (MG) (p<0.01), and lateral gastrocnemius muscle (LG) (p<0.05), as well as MG (p<0.05), LG (p<0.05), soleus muscle (p<0.05) of the non-paretic side, and soleus muscle symmetry index (p<0.05). The intra-group comparison of the eccentric muscle activity showed improvements in the experimental group, including MG (p<0.01) and LG (p<0.01) of the paretic side, as well as MG (p<0.01), LG (p<0.01) of the non-paretic side, and LG symmetry index (p<0.01). The intra-group comparison of the functional reach test revealed significant differences in the test results in the experimental and control groups (p<0.05). Conclusion: Ankle control training using NMES had a positive effect on the changes in muscle activation and improved balance in patients with stroke.

• 국제물리치료학회지
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• 제12권1호
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• pp.2272-2278
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• 2021

Background: Vibration stimulation has emerged as a treatment tool to help reduce spasticity during physical therapy. Spasticity includes problems of reduced range of motion (ROM) and stiffness. However, the benefits of vibration rolling (VR) on interventions for stroke patients are unclear. Objectives: This study aimed to investigate the effect of VR intervention on the ankle ROM and ankle stiffness in stroke patients. Design: A randomized crossover study. Methods: Seven stroke patients completed two test sessions (one VR and one non-VR [NVR]) in a randomized order, with 48 hours of rest between each session. Participants completed intervention and its measurements on the same day. The measurements included ankle dorsiflexion and plantarflexion ROM and stiffness of ankle muscles, including the tibialis anterior, medial, and lateral gastrocnemius muscle. Results: After VR, ankle dorsiflexion ROM, lateral gastrocnemius stiffness, and medial gastrocnemius stiffness improved significantly (all P<.05). After NVR, only the lateral gastrocnemius stiffness improved significantly (P<.05). Furthermore, in the cases of changed values for ankle dorsiflexion ROM and lateral gastrocnemius stiffness were compared within groups, VR showed a more significant difference than NVR (P<.05) Conclusion: VR improved ankle ROM and muscle stiffness. Therefore, we suggest that practitioners need to consider VR as an intervention to improve dorsiflexion ROM and gastrocnemius stiffness in stroke patients.

• Physical Therapy Rehabilitation Science
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• 제6권1호
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• pp.39-44
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• 2017

Objective: The purpose of this study is to show the effectiveness of performing squat exercises at various angles to show the maximum muscle activity of the Vastus Medialis Oblique (VMO) and Biceps femoris (BF). Design: Cross-sectional study. Methods: A total of seventeen healthy young adults (8 males and 9 females) voluntarily participated in the study. All subjects randomly performed three different squat variations as follows: A squat performed with the ankle joint at $0^{\circ}$ of incline, a squat performed with the ankle joint at $5^{\circ}$ of incline, and a squat performed with the ankle joint at $10^{\circ}$ incline. Muscle activity was measured using surface electromyography. Electrodes were placed on the VMO and BF to measure the muscle activity on the various ankle angles for comparison analysis. Results: There was a significant increase in bilateral VMO muscle activation at $10^{\circ}$ of incline compared to $0^{\circ}$ and $5^{\circ}$ (p<0.05). Greater increases in muscle activation and exercise effect was observed with increasing incline angles of the board. Changes in bilateral BF muscle activity were found; however, none were found to be significant. Conclusions: Bilateral VMO activity was found to be significant when the squats were performed at an ankle angle of $10^{\circ}$ of incline when compared to at an ankle angle of $0^{\circ}$ and $5^{\circ}$ of incline. Squats performed on an incline can be recommended as an effective method to facilitate lower extremity muscle activities.

• 대한물리의학회지
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• 제18권2호
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• pp.83-92
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• 2023

PURPOSE: This study examined the effect of using a smartphone according to the direction of wearing a bag on muscle characteristics and balance ability in adults in their 20s with chronic ankle instability. METHODS: Twelve people with chronic ankle instability were examined for three weeks. The types of carrying a bag were classified into three conditions: to the right, to the left, and on both sides. The muscle characteristics and balance ability were measured and analyzed. The one-way ANOVA was used to obtain a difference between conditions. RESULTS: A significant difference in the muscle tone of medial gastrocnemius was observed between the dominant group and the non-dominant group. The muscle tone and stiffness of the peroneus longus decreased significantly after walking with a smartphone and carrying a bag. The maximum slope of the forward and reverse directions increased and decreased significantly, respectively, after walking with a smartphone and carrying a bag on both sides. CONCLUSION: In this study, muscle fatigue causes a decrease in muscle tone and stiffness with chronic ankle instability when carrying a heavy back while walking, and there were asymmetric changes in the balance ability. Therefore, adults with chronic ankle instability should carefully avoid carrying a heavy bag for extended times, irrespective of the style or type of the bag.

• 국제물리치료학회지
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• 제8권2호
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• pp.1190-1194
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• 2017

The purpose of this study was to investigate the complex ankle exercises on balance. 22 participants (male: 14, female: 8) with functional ankle instability were participated. Functional ankle instability was selected to be less than 24 points using the Cumberland ankle instability tool (CAIT) with people who had severe ankle sprain and then experiencing ankle giving way. A total of 20 minutes performed three times a week for four weeks with muscle strength and balance exercises. Muscle strengthening exercise was performed with Theraband, and balance exercise was performed with unstable support plates. Biodex balance system(R) was used to measure static and dynamic balance. The dynamic balance was selected in grade 2, 4, and 8. The static and dynamic balance (grade: 2, 4,and 8) balance was significantly decreased in anterior-posterior, and medial-lateral directions (p<.05). The instability was significantly increased after exercise (p<.05). These results suggest that complex exercises are beneficial to decreasing the functional ankle instability.

• 대한족부족관절학회지
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• 제19권4호
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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.