• 대한족부족관절학회지
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• 제14권1호
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• pp.53-57
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• 2010

Purpose: This study was designed to evaluate the clinical and radiographical results of anatomical reconstruction by Chen method for chronic lateral ankle instability. Materials and Methods: Fifteen patients with chronic lateral ankle instability who had undergone anatomical reconstruction of anterior talofibular and calcaneofibular ligaments by Chen method were evaluated retrospectively. Average age of the patients was 31.3 years, and average follow-up period was 15.5 months. Preoperative and postoperative radiographs including varus stress view and magnetic resonance imaging (MRI) were analyzed. The clinical evaluation was performed according to the American Orthopaedic Foot and Ankle Society (AOFAS) scale. Results: Radiographically average talar tilt angle was $15.3^{\circ}$ preoperatively, and the difference with contralateral normal side was $10.1^{\circ}$. At last follow up, talar tile angle and the difference with contralateral side improved to $5.9^{\circ}$ and $1.3^{\circ}$ respectively. AOFAS scale was 66.6 preoperatively and 87.3 postoperatively. In MRI findings, four patients had associated intra-articular lesion such as articular cartilage defect, synovitis and osteoarthritis. The talar tilt angle improvement and AOFAS scale of patients without intra-articular lesion was better than those of four patients with intra-articular lesions. Surgical wound pain occurred in six patients and sural neuropathy in three patients. Conclusion: The anatomical reconstruction by Chen method was an easy and effective procedure for symptomatic chronic lateral ankle instability. Careful operative technique may prevent the surgical wound pain and sural neuropathy.

• 대한정형도수물리치료학회지
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• 제27권3호
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• pp.17-24
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• 2021

Background: The study aimed to examine changes in muscle activity by measuring the Q-angle and lower extremity activity when going down the stairs, after the application of either Mulligan taping or flossing bands to patients with chronic ankle instability. Methods: A total of 19 men with chronic ankle instability in their 20s and 30s participated in the study. Participants were randomly divided into two groups: the Mulligan taping group (n = 9) and the flossing band group (n=10). The Mulligan taping group had three sets of Mulligan joint operations repeated 10 times, after which the Mulligan tape was applied. The flossing band group either performed functional activities or exercised for 2 minutes after flossing band application. After the application of either Mulligan taping or flossing bands, changes in the Q-angle and lower limb muscular activity while going down the stairs were measured and compared. Results: In the Mulligan taping group, the Q-angle significantly decreased from 13.63° to 12.7° during the step down. Similarly, the Q-angle of the flossing band group significantly decreased from 15.95° to 15.48° (p<.05). There was no difference in lower limb muscle activity between the two groups when going down the stairs. The muscle activity of the tibialis anterior significantly increased from 34.12% to 40.2%, and the difference between the two groups were statistically significant (p<.05). Conclusions: The study found that the application of Mulligan taping and flossing bands to patients with chronic ankle instability decreased the Q-angle and lower limb muscle activity when going down the stairs.

• 대한물리의학회지
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• 제18권1호
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• pp.9-14
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• 2023

PURPOSE: This study examined the effect of vibration stimulation of a vibration foam roller on the change in the range of motion of the ankle joint and proprioception in patients with chronic ankle instability. An additional aim was to provide basic data for rehabilitation programs for chronic ankle instability patients. METHODS: This study was a randomized crossover design of 22 patients with chronic ankle instability. All subjects were divided into a vibrating group, a non-vibrating group, and a control group. The vibration and non-vibration groups performed the interventions, but the control group did not. For the measurement, the range of motion and proprioception of the ankle joint was measured using an electronic protractor (Electrogoniometer, BPM Pathway, UK). RESULTS: The vibration group showed significant differences in the dorsiflexion angle, dorsiflexion proprioception, and plantar flexion proprioception (p < .05). The non- vibration group showed significant differences in the dorsiflexion angle and dorsiflexion proprioceptive sensation (p < .05). The vibration group and the control group showed significant differences in dorsiflexion proprioception and plantar flexion proprioception (p < .05). CONCLUSION: The range of motion and proprioception of the ankle joint were improved in the group that received vibration stimulation after the intervention than before the intervention. Future research will be needed on patients with various diseases.

• 대한족부족관절학회지
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• 제21권1호
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• pp.12-16
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• 2017

Purpose: Anterior drawer and varus stress radiographs are commonly to diagnose chronic lateral ankle instability. We compared the preoperative stress radiographs with the intraoperative radiographs under anesthesia to determine the accuracy and efficacy of stress radiographs in an outpatient clinical environment. Materials and Methods: Data was collected from patients who underwent a modified $Brostr{\ddot{o}}m$ operation for painful chronic unilateral lateral ankle instability between January 2014 and June 2016. Subjects were divided into three groups-complete tear, partial tear, and instability without rupture-according to the status of preoperative MRI findings of the anterior talofibular ligament. The anterior drawer and varus stress radiographs were taken preoperatively and intraoperatively under anesthesia. Results: Ninety-six patients, with a mean age of 29.63 years, were enrolled. There were 39, 46, and 11 patients in the complete tear, partial tear, and instability without rupture groups, respectively. On the anterior drawer and varus stress radiographs of the affected limb, talar anterior translation and varus tilting were significantly increased by 2.56 mm and $2.0^{\circ}$. The gaps between the unaffected limbs were also increased by 2.47 mm and $1.32^{\circ}$ after anesthesia. Although the stress radiographs were taken under anesthesia, the results were often smaller than the diagnostic value. Conclusion: Stress radiographs for painful chronic lateral ankle instability taken at the outpatient clinic might be inaccurate for diagnosis.

• 대한정형도수물리치료학회지
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• 제28권3호
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• pp.69-77
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• 2022

Background: Ankle sprains, and the resulting ankle instability worsen to chronic due to recurrent ankle injuries or sprains, 78% of which are accompanied by posture instability and damage due to changes in the position of the talus of the ankle. The purpose of this study is to investigate the immediate effect of applying MWM taping on the patient's muscle strength and balance ability in patients with chronic ankle instability. Methods: 15 people with MWM taping and 15 people with Kinesio taping were applied, and after applying the taping of the ankle, 10 minutes of walking treadmill and 10 times of forward lunge operation, the change in ankle muscle strength and balance ability was confirmed. The strength test of the ankle was performed using a test device called Biodex system 4 (USA) for the movement of the dorsi-flexion and plantar flexion of the foot, and the balance of the two groups was measured using Biodex balance system (USA) to test balance ability. Results: The comparison of muscle strength changes in the ankle does not show a significant increase in the group applying MWM compared to the group applying kinesio taping (p<.05). In the comparison of equilibrium capabilities, the MWM taping group also showed a significant increase in the MWM taping group compared to the kinesio taping group (p<.05). Conclusion: When applying MWM taping and kinesio taping to patients with chronic ankle instability, there was no significant difference in comparison of muscle strength changes, but there was a significant difference in comparison of balance ability.

• The Journal of Korean Physical Therapy
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• 제23권4호
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• pp.15-22
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• 2011

Purpose: The purpose of this study was to investigate the relationship between hip abductor muscle strength and lumbar instability in patients with chronic low back pain. Methods: Fifty-two female patients were recruited for this study. The patients' history was recorded and was used to determine the general characteristics of the female complaints. The women were additionally examined to determine whether the level of pain was characteristic of patients with chronic lumbar instability. The following tests were also carried out in the subjects during the examination: 1) the prone instability test. 2) the test for aberrant movement patterns during lumbar flexion test. 3) the straight leg raising test. 4) posterior-to-anterior mobility test, and 5) the test for age and strength of the hip abductor muscle following assessment of the dominant side. In particular, hip abductor muscle strength was evaluated using a dynamometer. Results: The test results showed that the number of positive responses for the five types of lumbar instability tests performed, was significantly related to the strength of the hip abductor muscle. The average hip abductor muscle strength in total subjects was $72.89{\pm}7.66N$, whereas the average hip abductor muscle strength in subjects who showed positive responses to more than four out of the five tests, was $44.70{\pm}5.79N$. Conclusion: The results demonstrated that the hip abductor muscle strength and lumbar instability were negatively correlated. The lower was the strength of the hip abductor muscle, the higher was the possibility of lumbar instability.

• The Journal of Korean Physical Therapy
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• 제34권3호
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• pp.91-97
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• 2022

Purpose: This study investigated the short-term effectiveness of extracorporeal shock wave therapy (ESWT) on pain, the ankle instability, the ankle function, dorsiflexion range of motion (ROM), and dynamic balance in patients with chronic ankle instability (CAI). Methods: Eighteen participants were divided into an experimental (n=9) and control group (n=9). The ESWT in the experimental group was applied to the lateral collateral ligament in combination with the tibialis anterior whereas the ESWT was applied to the lateral collateral ligament of the ankle alone in the control group. Pain, the ankle instability, the ankle function, dorsiflexion ROM, and dynamic balance were measured using the Visual analog scale, Cumberland ankle instability tool, American Orthopedic Foot and Ankle Society ankle-hindfoot score, weight-bearing lunge, and Y-balance test, before and after ESWT intervention. Results: Significant interactions (group × time) and time effects were observed in the dorsiflexion ROM and dynamic balance. Bonferroni's post-hoc analysis showed that the experimental group revealed a more significant change in dorsiflexion ROM and dynamic balance than the control group. There was a significant time effect in the pain, the ankle instability, and the ankle function, but no significant interaction (group × time) was observed. Conclusion: The ESWT could improve the pain, ankle instability, ankle function, dorsiflexion ROM, and dynamic balance in patients with CAI. Furthermore, the ESWT combined with lateral ankle ligaments and tibialis anterior more improves the dorsiflexion ROM and dynamic balance.

• 대한물리의학회지
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• 제19권2호
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• pp.29-45
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• 2024

PURPOSE: This study aimed to compare the effects of pain level, lower back pain dysfunction level, psychosocial level, hip abductor strength (HAS), number of positive lumbar instability tests, and dynamic balance (DB) by applying lumbar stabilization exercises according to the presence or absence of gluteus medius muscle weakness in chronic lower back pain (CLBP) patients with lumbar instability. METHODS: Thirty-five CLBP patients with lumbar instability were divided into the gluteus medius weakness (n = 18) and gluteus medius non-weakened (n = 17) groups using the gluteus medius manual muscle test. Intervention applied conservative physical therapy and lumbar stabilization exercises to both groups that lasted three times a week for four weeks. To compare the intervention effects, the quadruple visual analog scale (QVAS), the Korean version of the Oswestry disability index (K-ODI), fear-avoidance beliefs questionnaire (FABQ), HAS, lumbar instability tests positive response counter (LIC), and DB were measured. RESULTS: Significant differences were shown for QVAS, K-ODI, FABQ, HAS, LIC, and DB for both groups pre- and post-intervention (p < .05). Compared to the gluteus medius weakness group, the gluteus medius non-weakened group showed a significant difference (p < .05) in the changes in QVAS, K-ODI, FABQ-W, FABQ-total, and HAS. CONCLUSION: In CLBP patients with lumbar instability, having gluteus medius weakness was less effective in improving lumbar stabilization exercise than gluteus medius non-weakness regarding pain level, lower back pain dysfunction level, psychosocial level excluding physical activity, and hip abductor strength. Therefore, additional gluteus medius strengthening exercises are necessary for patients with lumbar instability and gluteus medius muscle weakness.

• 대한정형외과스포츠의학회지
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• 제12권1호
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• pp.37-41
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• 2013

목적: 만성 내측 족관절 불안전성을 진단하고, 내측 삼각인대 봉합술로 치료한 단기 결과를 보고하고자 한다. 대상 및 방법: 2007. 5부터 2009. 11까지 만성 족관절 불안정성을 호소하였던 262명의 남자 군인 중 만성 내측 족관절 불안정성으로 진단한 29명을 대상으로 하였다. 진단은 진찰소견과 방사선 소견 및 관절경적 소견에서 족관절 내측 이완 소견이 관찰된 경우로 하였으며, 수술은 손상된 삼각인대의 거골-주상골 인대를 봉합 나사를 이용하여 단축, 봉합하는 방법으로 시행하였다. 수술 전후의 미국 족부 족관절 학회 족관절-후족부 점수(AOFAS), 시각 동통 점수(VAS) 및 수술후 족관절 기능 만족도를 측정하여 임상적인 평가를 시행하였다. 결과: 족관절 불안정성을 가진 환자 중 11.1%에서 만성 내측 족관절 불안정성을 가지고 있었으며, 내측 거골-주상골 인대 봉합술을 시행한 후 AOFAS는 수술전 평균 64.5점(범위: 43~83점)에서 수술후 평균 82.0(범위: 60~100)점으로 증가하였으며, VAS는 수술전 평균 6.0점(범위: 4~10점)에서 수술후 평균 3.2점(범위: 1~7점)으로 감소하였다. 만족도는 우수가 13명 (44.8%), 만족이 11명(37.9%), 불만족이 5명(17.2%)이었다. 재발한 경우가 2례 있었으며, 타가인대(allo-tendinous graft)를 이용한 재수술을 시행하였다. 결론: 만성 내측 족관절 불안정성에 대하여 거골-주상골 인대를 봉합하는 수술을 시행한 후 약 83%에서 만족한 성적을 얻었다.

• 대한통합의학회지
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• 제2권1호
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• pp.101-108
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• 2014

Purpose : The purpose of this study was to investigate the effect of horse riding exercise for chronic low back pain patients. Method : 30 subjects in H-equestrian and N-equestrian, K & B hospital were randomly divided two group, instability support surface exercise group and horse-riding exercise group. Each group carried out 40 minutes exercise three times a week for 8 weeks. VAS were measured for sway path of COP movement during standing were measured for evaluation of static balance ability in balance performance monitor(BPM). Result : The results were as follows, scales of VAS between instability support surface exercise and horse-riding exercise groups in post-test, were significantly different in measures(p<.05). And there were significant in two group after exercise(p<.05). The static balance scales of sway path between instability support surface exercise and horse-riding exercise groups in post-test, were significantly different in measures(p<.05). And there were significant in two group after exercise(p<.05). Conclusion : These finding revealed that horse-riding exercise was effective on VAS and static balance abiility of chronic low back pain patient so that these exercise can be new altematives for increase of stability ability in chronic low back pain patients.