Journal of the Korean Society of Physical Medicine (대한물리의학회지)

The Korean Society of Physical Medicine (대한물리의학회)
권호 표지
DOI QR코드

DOI QR Code

Effects of Therapeutic Exercise on Pain, Range of Motion, Strength and Balance Ability in a Patient with Anterior Ankle Impingement: A Case Study

치료적 운동이 앞 발목 충돌 증후군 환자의 통증, 관절가동범위, 근력 및 균형능력에 미치는 영향: 증례보고

  • Park, Sang-Ho (Department of Kinesiologic Medical Science, Graduate, Dankook University) ;
  • Kim, Ah-Ram (Department of Kinesiologic Medical Science, Graduate, Dankook University) ;
  • Yoo, Kyung-Tae (Department of Physical Therapy, Namseoul University) ;
  • Lee, Ho-Seong (Department of Kinesiologic Medical Science, Graduate, Dankook University)
  • 박상호 (단국대학교 대학원 운동의과학과) ;
  • 김아람 (단국대학교 대학원 운동의과학과) ;
  • 유경태 (남서울대학교 물리치료학과) ;
  • 이호성 (단국대학교 대학원 운동의과학과)
  • Received : 2016.09.09
  • Accepted : 2016.10.28
  • Published : 2016.11.30
Download PDF
⟨ Previous Next ⟩

Abstract

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.

Keywords

References

  1. Arnold BL, Linens SW, de la Motte SJ, et al. Concentric evertor strength differences and functional ankle instability: a meta-analysis. J Athl Train. 2009;44(6):653-62. https://doi.org/10.4085/1062-6050-44.6.653
  2. Battaglia PJ, Craig K, Kettner NW. Ultrasonography in the Assessment of Lateral Ankle Ligament Injury, Instability, and Anterior Ankle Impingement: A Diagnostic Case Report. J Chiropr Med. 2015;14(4):265-9. https://doi.org/10.1016/j.jcm.2015.05.004
  3. Bok SK, Lee TH, Lee SS. The effects of changes of ankle strength and range of motion according to aging on balance. Ann Rehabil Med. 2013;37(1):10-6. https://doi.org/10.5535/arm.2013.37.1.10
  4. Bonnel F, Toullec E, Mabit C, et al. Chronic ankle instability: biomechanics and pathomechanics of ligaments injury and associated lesions. Orthop Traumatol Surg Res. 2010;96(4):424-32. https://doi.org/10.1016/j.otsr.2010.04.003
  5. Buda R, Baldassarri M, Parma A. Arthroscopic Treatment and Prognostic Classification of Anterior Soft Tissue Impingement of the Ankle. Foot Ankle Int. 2016;37(1):33-9. https://doi.org/10.1177/1071100715603190
  6. Collins N, Teys P, Vicenzino B. The initial effects of a Mulligan's mobilization with movement technique on dorsiflexion and pain in subacute ankle sprains. Man Ther. 2004;9(2):77-82. https://doi.org/10.1016/S1356-689X(03)00101-2
  7. Croy T, Cosby NL, Hertel J. Active ankle motion may result in changes to the talofibular interval in individuals with chronic ankle instability and ankle sprain copers: a preliminary study. J Man Manip Ther. 2013;21(3):127-33. https://doi.org/10.1179/2042618612Y.0000000022
  8. Cruz-Diaz D, Lomas-Vega R, Osuna-Perez MC, et al. Effects of 6 Weeks of Balance Training on Chronic Ankle Instability in Athletes: A Randomized Controlled Trial. Int J Sports Med. 2015;36(9):754-60. https://doi.org/10.1055/s-0034-1398645
  9. Denegar CR, Hertel J, Fonseca J. The effect of lateral ankle sprain on dorsiflexion range of motion, posterior talar glide, and joint laxity. J Orthop Sports Phys Ther. 2002;32(4):166-73. https://doi.org/10.2519/jospt.2002.32.4.166
  10. Devgan A, Rohilla R, Tanwar M, et al. Comparative analysis of arthroscopic debridement in osseous versus soft tissue anterior ankle impingement. J Clin Orthop Trauma. 2016;7(3):200-6. https://doi.org/10.1016/j.jcot.2016.02.014
  11. Docherty CL, Moore JH, Arnold BL. Effects of strength training on strength development and joint position sense in functionally unstable ankles. J Athl Train. 1998;33(4):310-4.
  12. Drewes LK, McKeon PO, Paolini G, et al. Altered ankle kinematics and shank-rear-foot coupling in those with chronic ankle instability. J Sport Rehabil. 2009;18(3):375-88. https://doi.org/10.1123/jsr.18.3.375
  13. Elveru RA, Rothstein JM, Lamb RL. Goniometric reliability in a clinical setting. Subtalar and ankle joint measurements. Phys Ther. 1988;68(5):672-7. https://doi.org/10.1093/ptj/68.5.672
  14. Ferkel RD, Heath DD, Guhl JF. Neurological complications of ankle arthroscopy. Arthroscopy. 1996;12(2):200-8. https://doi.org/10.1016/S0749-8063(96)90011-0
  15. Fong DT, Chan YY, Mok KM, et al. Understanding acute ankle ligamentous sprain injury in sports. Sports Med Arthrosc Rehabil Ther Technol. 2009;1:14.
  16. Golditz T, Steib S, Pfeifer K, et al. Functional ankle instability as a risk factor for osteoarthritis: using T2-mapping to analyze early cartilage degeneration in the ankle joint of young athletes. Osteoarthritis Cartilage. 2014;22(10):1377-85. https://doi.org/10.1016/j.joca.2014.04.029
  17. Hale SA, Hertel J, Olmsted-Kramer LC. The effect of a 4-week comprehensive rehabilitation program on postural control and lower extremity function in individuals with chronic ankle instability. J Orthop Sports Phys Ther. 2007;37(6):303-11. https://doi.org/10.2519/jospt.2007.2322
  18. Horak FB, Shupert CL, Mirka A. Components of postural dyscontrol in the elderly: a review. Neurobiol Aging. 1989;10(6):727-38. https://doi.org/10.1016/0197-4580(89)90010-9
  19. Iizuka Y, Iizuka H, Mieda T. Association between neck and shoulder pain, back pain, low back pain and body composition parameters among the Japanese general population. BMC Musculoskelet Disord. 2015;16(1):333. https://doi.org/10.1186/s12891-015-0759-z
  20. Isakov E, Mizrahi J. Is balance impaired by recurrent sprained ankle? Br J Sports Med. 1997;31(1):65-7. https://doi.org/10.1136/bjsm.31.1.65
  21. Jacobs E, Groot D, Das M, et al. Pseudoaneurysm of the anterior tibial artery after ankle arthroscopy. J Foot Ankle Surg. 2011;50(3):361-3. https://doi.org/10.1053/j.jfas.2011.01.004
  22. Jonsson E, Seiger A, Hirschfeld H. One-leg stance in healthy young and elderly adults: ameasure of postural steadiness? Clin Biomech (Bristol, Avon). 2004;19(7):688-94. https://doi.org/10.1016/j.clinbiomech.2004.04.002
  23. Kaminski TW, Buckley BD, Powers ME, et al. Effect of strength and proprioception training on eversion to inversion strength ratios in subjects with unilateral functional ankle instability. Br J Sports Med. 2003;37(5):410-5. https://doi.org/10.1136/bjsm.37.5.410
  24. Kang DY, Kim YM, Lee KS. Comparisons of lower extremity strength, cognition, and ankle mobility according to the 8.5seconds cut-off point for the 8-foot up-and-go test in elderly women. J Korean Soc Phys Med. 2015;10(3):305-11.
  25. Kim K, Jeon K. Development of an efficient rehabilitation exercise program for functional recovery in chronic ankle instability. J Phys Ther Sci. 2016;28(5):1443-7. https://doi.org/10.1589/jpts.28.1443
  26. Kim KJ, Jegal H, Jun HJ, et al. The Comparison of Balance using Cumberland Ankle Instability Tool to Stable and Instability Ankle. J Korean Soc Phys Med. 2013;8(3):361-8. https://doi.org/10.13066/kspm.2013.8.3.361
  27. Koh EK, Weon JH, Jung DY. Effect of Direction of Gliding in Tibiofibular Joint on Angle of Active Ankle Dorsiflexion. J Korean Soc Phys Med. 2014;9(4):439-45. https://doi.org/10.13066/kspm.2014.9.4.439
  28. Lee SY. The Effect of a Taping on Muscle Strength, and Proprioception in Ankle. J Korean Soc Phys Med. 2008;3(4):225-33.
  29. Lee SY, Kim MJ, An BG, et al. The Effects of Trunk and Lower Extremity Muscle Activation on Straight Leg Rising by Various Ankle Joint Rotation Angle. J Korean Soc Phys Med. 2014;9(3):249-53. https://doi.org/10.13066/kspm.2014.9.3.249
  30. Lee JW, Suh JS, Huh YM, et al. Soft tissue impingement syndrome of the ankle: diagnostic efficacy of MRI and clinical results after arthroscopic treatment. Foot Ankle Int. 2004;25:896-902. https://doi.org/10.1177/107110070402501209
  31. Lord SR, Ward JA. Age-associated differences in sensori-motor function and balance in community dwelling women. Age Ageing. 1994;23(6):452-60. https://doi.org/10.1093/ageing/23.6.452
  32. McMurray TP. Footballer's ankle. J Bone Joint Surg. 1950;32B:68-9.
  33. Mecagni C, Smith JP, Roberts KE, et al. Balance and ankle range of motion in community-dwelling women aged 64 to 87 years: a correlational study. Phys Ther. 2000;80(10):1004-11.
  34. Morris LH. Report of cases of athlete's ankle [New notes]. J Bone Joint Surg. 1943;25:220.
  35. Miller JP, Croce RV. Analyses of isokinetic and closed chain movements for hamstring reciprocal coactivation. J Sport Rehabil. 2007;16(4):319-25. https://doi.org/10.1123/jsr.16.4.319
  36. Murawski CD, Kennedy JG. Anteromedial impingement in the ankle joint: outcomes following arthroscopy. Am J Sports Med. 2010;38(10):2017-24. https://doi.org/10.1177/0363546510369335
  37. Park JW, Kim WB. The Effect of Functional Training Using a Sliding Rehabilitation Machine on the Mobility of the Ankle Joint and Balance in Children with CP. J Korean Soc Phys Med. 2014;9(3):293-9. https://doi.org/10.13066/kspm.2014.9.3.293
  38. Pellow JE, Brantingham JW. The efficacy of adjusting the ankle in the treatment of subacute and chronic grade I and grade II ankle inversion sprains. J Manipulative Physiol Ther. 2001;24(1):17-24. https://doi.org/10.1067/mmt.2001.112015
  39. Powers ME, Buckley BD, Kaminski TW, et al. Six weeks of strength and proprioception training does not affect muscle fatigue and static balance in functional ankle instability. J Sport Rehabil. 2004;13:201-27. https://doi.org/10.1123/jsr.13.3.201
  40. Rasmussen S, Hjorth Jensen C. Arthroscopic treatment of impingement of the ankle reduces pain and enhances function. Scand J Med Sci Sports. 2002;12(2):69-72. https://doi.org/10.1034/j.1600-0838.2002.120202.x
  41. Robinson P, White LM. Soft-tissue and osseous impingement syndromes of the ankle: role of imaging in diagnosis and management. Radiographics. 2002;22(6):1457-69. https://doi.org/10.1148/rg.226025034
  42. Riemann BL. Is There a Link Between Chronic Ankle Instability and Postural Instability? J Athl Train. 2002;37(4):386-93.
  43. Salom-Moreno J, Ayuso-Casado B, Tamaral-Costa B, et al. Trigger Point Dry Needling and Proprioceptive Exercises for the Management of Chronic Ankle Instability: A Randomized Clinical Trial. Evid Based Complement Alternat Med. 2015;2015:790209.
  44. Smith BI, Docherty CL, Simon J, et al. Ankle strength and force sense after a progressive, 6-week strengthtraining program in people with functional ankle instability. J Athl Train. 2012;47(3):282-8. https://doi.org/10.4085/1062-6050-47.3.06
  45. Spink MJ, Fotoohabadi MR, Wee E, et al. Predictors of adherence to a multifaceted podiatry intervention for the prevention of falls in older people. BMC Geriatr. 2011;11:51. https://doi.org/10.1186/1471-2318-11-51
  46. Springer BA, Marin R, Cyhan T, et al. Normative values for the unipedal stance test with eyes open and closed. Journal of geriatric physical therapy. 2007;30(1):8-15. https://doi.org/10.1519/00139143-200704000-00003
  47. Talusan PG, Toy J, Perez JL, et al. Anterior ankle impingement: diagnosis and treatment. J Am Acad Orthop Surg. 2014;22(5):333-9. https://doi.org/10.5435/JAAOS-22-05-333
  48. Uh BS, Beynnon BD, Helie BV, et al. The benefit of a single-leg strength training program for the muscles around the untrained ankle. Am J Sports Med. 2000;28(4):568-73. https://doi.org/10.1177/03635465000280042101
  49. Unger F, Lajtai G, Ramadani F, et al. Arthroscopy of the upper ankle joint. A retrospective analysis of complications. Unfallchirurg. 2000;103(10):858-63. https://doi.org/10.1007/s001130050633
  50. Valderrabano V, Pagenstert G, Horisberger M, et al. Sports and recreation activity of ankle arthritis patients before and after total ankle replacement. Am J Sports Med. 2006;34(6):993-9. https://doi.org/10.1177/0363546505284189
  51. Vaseenon T, Amendola A. Update on anterior ankle impingement. Curr Rev Musculoskelet Med. 2012;5(2):145-50. https://doi.org/10.1007/s12178-012-9117-z
  52. Verbrugghe P, Vandekerkhof J, Baeyens I. Pseudoaneurysm of the anterior tibial artery: a complication of ankle arthroscopy. Acta Chir Belg. 2011;111(6):410-1. https://doi.org/10.1080/00015458.2011.11680785
  53. Wang CY, Olson SL, Protas EJ. Test-retest strength reliability: hand-held dynamometry in community-dwelling elderly fallers. Arch Phys Med Rehabil. 2002;83(6):811-5. https://doi.org/10.1053/apmr.2002.32743
  54. Zengerink M, van Dijk CN. Complications in ankle arthroscopy. Knee Surg Sports Traumatol Arthrosc. 2012;20(8):1420-31. https://doi.org/10.1007/s00167-012-2063-x

Cited by

  1. 슬링을 이용한 열린사슬운동과 닫힌 사슬 운동의 턱당기기 동작 시 목굽힘근 두께 비교 vol.18, pp.3, 2016, https://doi.org/10.21598/jkpnfa.2020.18.3.333
  2. 다양한 자세에 따른 턱 당기기 운동이 목과 어깨의 근활성도에 미치는 영향 vol.18, pp.3, 2016, https://doi.org/10.21598/jkpnfa.2020.18.3.403