• Physical Therapy Rehabilitation Science
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• v.11 no.4
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• pp.585-590
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• 2022

Objective: The purpose of this study was to investigate the effects of neuromuscular training of ballet dancers with chronic ankle instability on ankle stability and posture controlability. Design: A randomized controlled trial. Methods: A total of Thirty-twoyoung female ballet dancers with chronic ankle instability have voluntarily participated in the study. The participants were randomized to the neuromuscular training group(n₁=11), elastic resistance squat group(n₂=11), and control group(n₃=10). The intervention was applied to a total of 18 exercises per six weeks and conducted in each group for one hour a day, three times a week. All subjects were evaluated for Cumberland ankle instability tool(CAIT), static balance at before-after intervention. Results: In the comparison of the effects within the groups, the effect of the intervention on CAIT and posture control was significantly increased in the neuromuscular training group and elastic resistance squat group (p <0.05). In the comparison of the effects between the groups, the neuromuscular training group, and elastic resistance squat group were found to significantly increase more than the control group (p <0.05). The effect of ankle stability is similar in neuromuscular training and elastic resistance squat training, neuromuscular training is more effective in improving posture control rather than elastic resistance squat training. Conclusions: When planning a rehabilitation training program for a ballet dancer with chronic ankle instability, neuromuscular training can be applied as an intervention method to improve ankle stability and posture control ability.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.4
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• pp.39-48
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• 2015

PURPOSE: This study aimed to compare the degree of lumbopelvic rotation during the active straight leg raise (ASLR) test in chronic low back pain with and without lumbar segmental instability. METHODS: A total of 71 patients with chronic low back pain were recruited for this study. The subjects who tested positive for more than three of the five lumbar segmental instability tests (prone lumbar instability, lumbar passive extension test, anterior posterior mobility test, passive straight leg raise, age) were categorized into the lumbar segmental instability positive group. Patients who tested positive for less than three of the five tests were categorized into the lumbar segmental instability negative group. The lumbopelvic rotation was measured three times during ASLR and a mean was determined. Subjective heaviness during the ASLR was measured on 6 point scale. RESULTS: There was a statistically significant difference in the lumbopelvic rotation angle between the groups with and without lumbar segmental instability (p<.01). There was no significant difference in the subjective heaviness during ASLR. The mean lumbopelvic rotation angle during ASLR was $13.54{\pm}2.86^{\circ}$, and $8.81{\pm}2.47^{\circ}$ in the positive and negative groups, respectively (p<.01). The cut-off value of the lumbopelvic rotation during was $10.5^{\circ}$, the sensitivity was 82.9%, and the specificity was 80.6%. CONCLUSION: These results suggest that lumbopelvic rotation is more prevalent in patients without lumbar segmental instability. Clinically, this important when diagnosing chronic low back pain with lumbar segmental instability, as the lumbopelvic rotation angle during the ASLR test can be used to aid in diagnosis.

• Journal of Korean Foot and Ankle Society
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• v.16 no.2
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• pp.73-78
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• 2012

Severe ankle sprain secondarily leads to chronic lateral ankle instability in 20-30%. Many surgical procedures have been presented for reconstruction of the lateral ankle instability, but controversy still remains for the ideal surgical option. Br$\ddot{o}$strom procedure or its modifications have been widely used but they have some limitations for the instabilities for the over-weight, physically high demanding patients and especially for significantly deficient or attenuated ligaments. Moreover the tenodesis procedures using peroneus brevis tendon are non-anatomical and sacrifice important lateral stabilizing tendon. Therefore recently, many reconstructive procedures for lateral ankle instability utilizing free allograft or autograft tendon have been introduced to anatomically stabilize the lateral ligaments to various degrees.

• Journal of Korean Foot and Ankle Society
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• v.8 no.1
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• pp.81-85
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• 2004

Purpose: The purpose of this study is to evaluate the surgical results of modified $Brostr{\ddot{o}}m$ procedure for chronic lateral ankle instability and to assess whether or not associated injuries may affect postoperative satisfaction. Materials and Methods: Twenty- four patients with chronic lateral ankle instability were evaluated retrospectively from August 1998 to March 2002. Average age was 29.3 years. All patients were performed pre & postoperative ankle anteroposterior and lateral view, stress anterior drawer and varus test using Telos device, MRI and intraoperative arthroscopic evaluations before ligament reconstruction. Results: Of the 24 cases, 23 cases was improved more than average 12 points on AOFAS scales. On modified scales of Hamilton, 3 excellent, 20 good, 1 fair results. On stress view, average 2.2 mm difference was improved on anterior drawer test and average 1.7 degree on varus test. Associated injuries were 8 osteochondral defects, 4 anterior impingements, 2 loose bodies, 2 os subfibulare, 2 os submalleolare and 2 partial ruptures of peroneus brevis. 8 cases with no associated injuries rated excellent or good. Conclusion: The modified $Brostr{\ddot{o}}m$ procedure is believed to be an effective and successful method for chronic lateral ankle instability that didn't respond to conservative treatment. Because associated injuries in chronic lateral ankle instability may affect postoperative satisfaction, appropriate detection and treatment may need for postoperative satisfaction.

• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.175-178
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• 2009

Purpose: To evaluate the result of modified Br$\ddot{o}$strom procedure with anchor suture and explore associate lesion under arthroscopy for chronic lateral instability. Materials and Methods: From May 2005 to March 2009, Retrospective analysis of 126 patients with chronic lateral instability who underwent modified Br$\ddot{o}$strom procedure with anchor suture and arthroscopic procedure was done. Mean follow-up period was 13 months. Results: Chronic lateral instability of the ankle almost had local synovitis by arthroscopic examination. There were osteochondral lesion of talus on the anteromedial aspect in 63 cases, on the anterolateral aspect in 25 cases, osteochondral lesion of tibia side in 8 cases, fat hypertrophy of tibiofibular space in 120 cases, anterior fat impingement in 26 cases, intra-articular loose body in 13 cases. Mean Karlsson scoring scale was improve from 53 preoperatively to 91 postoperatively, There were 70 cases excellent, 27 cases good, 26 cases fair, 3 cases poor result according to the Sefton procedure. Conclusion: Modified Br$\ddot{o}$strom procedure with anchor suture and arthroscopic procedure are reliable treatment method for chronic ankle lateral instability which has intraarticular pathology.

• Korean Journal of Applied Biomechanics
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• v.32 no.1
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• pp.9-16
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• 2022

Objective: The purpose of this study was to investigate how the chronic ankle instability affects postural control during forward jump landing. Method: 20 women with chronic ankle instability (age: 21.7 ± 1.6 yrs, height: 162.1 ± 3.7 cm, weight: 52.2 ± 5.8 kg) and 20 healthy adult women (age: 21.8 ± 1.6 yrs, height: 161.9 ± 4.4 cm, weight: 52.9 ± 7.2 kg) participated in this study. For the forward jump participants were instructed to stand on two legs at a distance of 40% of their body height from the center of force plate. Participants were jump forward over a 15 cm hurdle to the force plate and land on their non-dominant or affected leg. Kinetic and kinematic data were obtained using 8 motion capture cameras and 1 force plates and joint angle, vertical ground reaction force and center of pressure. All statistical analyses were using SPSS 25.0 program. The differences in variables between the two groups were compared through an independent sample t-test, and the significance level was to p < .05. Results: In the hip and knee joint angle, the CAI group showed a smaller flexion angle than the control group, and the knee joint valgus angle was significantly larger. In the case of ankle joint, the CAI group showed a large inversion angle at all events. In the kinetic variables, the vGRF was significantly greater in the CAI group than control group at IC and mGRF. In COP Y, the CAI group showed a lateral shifted center of pressure. Conclusion: Our results indicated that chronic ankle instability decreases the flexion angle of the hip and knee joint, increases the valgus angle of the knee joint, and increases the inversion angle of the ankle joint during landing. In addition, an increase in the maximum vertical ground reaction force and a lateral shifted center of pressure were observed. This suggests that chronic ankle instability increases the risk of non-contact knee injury as well as the risk of lateral ankle sprain during forward jump landing.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.2
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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.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.1
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• pp.63-72
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• 2018

PURPOSE: The aim of this study was to compare the effect of whole body vibration stimulation on ankle instability, ankle range of motion, and balance ability in adult with chronic ankle instability. METHODS: Forty-five adult with chronic ankle instability were randomly equally allocated the I group (whole body vibration stimulated at 10 Hz), or the II group (20 Hz), or the III group (25 Hz). All the participants (male:13/female: 32, age: $26.64{\pm}3.14$) in this study received whole body vibration therapy for an additional 15 minutes after hot pack and ultrasound three times a week for four weeks. Outcome were measured before and after 4 weeks training. RESULTS: All the three groups showed significant differences in AII and CAIT after intervention (p<.05). I group showed the most significant difference (p<.05). All the three groups also showed significant increase in ankle dorsiflexion and plantar flexion after training (p<.05). I group showed greater increase than the other groups in ankle dorsiflexion (p<.05). The X-axis, Y-axis, and fluctuation speed were significantly decreased in the three groups (p<.05), but there was no significant difference between the three groups after the intervention. CONCLUSION: The findings suggest that the whole body vibration stimulation according to various frequencies is effective for improve ankle instability, ankle range of motion and balance ability in adult with chronic ankle instability. 10 Hz whole body vibration stimulation could help improve ankle instability and ankle range more effectively than other frequencies.

• Journal of Korean Foot and Ankle Society
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• v.24 no.2
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• pp.98-101
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• 2020

We report on the case of a patient with chronic instability of the ball-and-socket ankle joint. The patient, a 21-year-old male, was diagnosed 10 years previously with chronic instability of the ball-and-socket ankle joint. He underwent Broström procedure and augmentation using a periosteal turn down from the fibula for this chronic instability despite having received conservative treatment since the diagnosis. After the procedure, the clinical symptoms of ankle instability were improved and the patient is being periodically followed-up. We report on this case of using a Broström procedure as a treatment option for patients with instability of the ball-and-socket ankle joint with normal range of foot and normal ankle joint alignment without damage in the joint and cartilage.

• Journal of Korean Foot and Ankle Society
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• v.13 no.1
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• pp.19-22
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• 2009

Purpose: This retrospective study was designed to determine the type and frequency of associated lesions in patients with chronic lateral ankle instability who had modified Brostrom lateral ankle ligament reconstruction. Materials and Methods: Between 2004 and 2007, 60 cases of 60 patients were enrolled in this study. A retrospective review of the magnetic resonance images of the affected ankle was conducted by two orthopedic surgeons who did not get any information about intraoperative findings and the lesions were admitted when two doctors were coincident. Results: The overall incidence of associated lesions found in this study was about 83%. Peroneal tenosynovitis was the highest frequency (32%), followed by osteochondral lesion of talus (28%), anterolateral impingement (15%), Os subfibula (13%), Os trigonum (12%), ankle synovitis (12%), anterior tibiofibular ligament tear (15%), anterior bony spur (7%). Another findings were loose bodies (5%), flexor tendon tenosynovitis (5%), medial osteophyte (3%). Conclusion: Identifying these associated lesions will be helpful in treating chronic lateral ankle instability especially when the surgeon have a plan to operate the instability. We suggest that the better results can be obtained when the associated lesions are corrected simultaneously.