• The Journal of Korean Physical Therapy
• /
• v.27 no.5
• /
• pp.345-350
• /
• 2015

Purpose: This study was conducted to determine the effects of ankle joint position during closed kinetic chain (CKC) exercise on knee extensor strength and balance in patients with chronic stroke. Methods: Sixteen patients with chronic stroke participated in the study. Participants were randomly assigned to two groups: $15^{\circ}$ ankle joint plantar flexion group (n=8) and ankle joint neutral group (n=8) during CKC exercise. All participants underwent conventional physical therapy for 30 minutes. In addition, the experimental group ($15^{\circ}$ ankle joint plantar flexion group) and control group (ankle joint neutral group) participated in a 20-minute CKC exercise program. In both groups exercise was performed three times a week for four weeks. Outcomes including knee extensor strength and balance ability (Five times sit-to-stand test, Timed up and go test, and Balancia) were measured before and after exercise. Results: Significant differences in knee extensor strength and balance ability were observed between pre- and post-exercise in all groups (p<0.05). The improvement of knee extensor strength and dynamic balance was significantly higher in the experimental group than in the control group (p<0.05). Conclusion: These findings demonstrated that $15^{\circ}$ ankle joint plantar flexion during closed kinetic chain exercise is effective in improvement of knee extensor strength and dynamic balance in patients with chronic stroke.

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

• Journal of the Korean Society of Physical Medicine
• /
• v.14 no.4
• /
• pp.153-162
• /
• 2019

PURPOSE: This study compared ankle joint exercise and thigh exercise on the isometric strength of the lower limb and balance ability. METHODS: Twenty-seven subjects were divided into ankle joint exercise (AEG, n=9), tight exercise (TEG, n=9), and control group (CON, n=9). AEG and TEG performed ankle joint and tight exercises three times a week for four weeks. The following were measured before and four weeks after each exercise: isometric strength at knee flexion and extension of the lower limb; isometric strength at ankle plantar flexion and dorsiflexion of the lower limb; static balance of trace length and C90 area; and the dynamic forward, backward, leftward, and rightward balance for each region. RESULTS: The results showed that the isometric strength of plantar flexion (p<.05) was increased significantly in AEG compared to those in TEG and CON. The dynamic leftward (p<.05) and rightward balance (p<.05) were increased significantly in both AEG and TEG compared to that in CON. On the other hand, the static balance of the trace length and C90 area, isometric strength of ankle dorsiflexion, knee flexion and extension of the lower limb, and dynamic forward and backward balance did not show significant differences between the groups. CONCLUSION: Ankle joint exercise improves the isometric strength of plantar flexion compared to tight exercise.

• Journal of International Academy of Physical Therapy Research
• /
• v.10 no.2
• /
• pp.1791-1796
• /
• 2019

Background: Vibration exercise after ankle surgery improves proprioception and ankle muscle strength through vibration stimulation. Objective: To examine the effects of vibration exercise on the ankle stability. Design: Randomized controlled clinical trial (single blind) Methods: Twenty soccer players were randomly divided into experimental group and control group. The Vibration exercise program was conducted 12 weeks and 3 times a week. Ankle joint proprioceptive sensory test and Isokinetic muscle strength test were performed using Biodex system pro III to measure plantar flexion / dorsiflexion and eversion / inversion motion. Results: The result of isokinetic test of ankle joint is showed significant improvement in all measurement items, such as leg flexion, lateral flexion, external and internal muscle forces, compared to previous ones by performing vibration movements for 12 weeks. However, in the comparison group, plantar flexor ($30^{\circ}$), eversion muscle ($120^{\circ}$), inversion ($30^{\circ}$) of limb muscle strength were significantly improved compared with the previous phase; was no significant difference in dorsi-flexion. There was no significant difference between groups in all the items. Conclusions: In this study, we analyzed the effects of rehabilitation exercise on soccer players who had reconstructed with an ankle joint ligament injury through vibration exercise device. As a result, we could propose an effective exercise method to improve the ability, and confirmed the applicability as an appropriate exercise program to prevent ankle injuries and help quick return.

• Journal of International Academy of Physical Therapy Research
• /
• v.11 no.4
• /
• pp.2212-2220
• /
• 2020

Background: Repetitive damage to the ankle joint causes chronic ankle instability, and studies comparing the effects of exercise in open and closed chains as a treatment method are very rare. Objectives: To investigate the effects of open and closed kinetic exercises on muscle activity and dynamic balance of ankle joint in adults with chronic ankle instability. Design: Single-blind randomized controlled trial. Methods: The selected 30 subjects are randomly divided into open kinetic chain exercise experimental group (EGI, n=10), closed kinetic chain exercise experimental group (EGII, n=10), and stretching control group (CG, n=10). Open and closed kinetic exercises lasted 30 minutes three times a week for six weeks and stretching exercises performed four actions for 20 seconds and five sets. The measurement tools using surface electromyography to measure muscle activity in the ankle joint. The dynamic balance of the ankle was evaluated using the Y-Balance test. Results: Following the intervention, closed and open kinetic chain exercise group showed significant difference in tibialis anterior and gastrocnemius muscle activity and dynamic balance (P<.05). However, no significant difference in tibialis anterior and gastrocnemius muscle activity and dynamic balance between closed and open kinetic chain exercise group (P<.05). Conclusion: This study provides evidence that closed and open kinetic chain exercise can be presented as an effective exercise for the muscle activity of ankle muscle and dynamic balance of the subject with chronic ankle instability.

• Physical Therapy Korea
• /
• v.29 no.4
• /
• pp.274-281
• /
• 2022

Background: The range of motion (ROM) and balance ability of the ankle joint affect the stability of the ankle and prevent injuries or hurts from falling. In the clinical tests conducted recently, the floss band is widely used to enhance the range of joint motion and exercise performance, and there are many studies that have applied it to ankle joint increasing dorsi flexion (DF) angle. Objects: This study compared the effects on the range of ankle motion and static/dynamic balance ability of the ankle through three conditions (before floss band intervention, after floss band intervention, and after active exercise intervention) for adults. Methods: One intervention between floss band and active exercise was applied randomly and another intervention was applied the next day. After each intervention, the ROM of the ankle joints and the static balance was checked by measuring conducting one leg test. And the dynamic balance was checked by conducting a Y-balance test. Results: In the case of DF, the range of joint motion showed a significant increase after floss band intervention compared to before floss band intervention (p < 0.05). Static balance ability showed a significant increase after the intervention of floss band and active exercise compared to before the intervention of floss band (p < 0.05). The dynamic balance ability showed a significant increase after the intervention of the floss band compared to before intervention of the floss band and after active exercise intervention (p < 0.05). Conclusion: Based on these results, it was confirmed that the application of floss band to the ankle joint increases DF and improves the static and dynamic balance ability. Based on this fact, we propose the application of a floss band as an intervention method to improve the ROM of the ankle joint and improve the stability of the ankle in clinical field.

• Physical Therapy Rehabilitation Science
• /
• v.12 no.2
• /
• pp.149-154
• /
• 2023

Objective: This study is designed to investigate the effect of ankle joint position on hip extensor muscle activity when bridging exercise in sagittal plane. Design: Cross-sectional study Methods: The subjects were recruited from 20 healthy adult men. The subjects performed three types of bridging exercises (normal bridging, ankle dorsiflexion bridging, ankle plantar flexion bridging) three times for five seconds with a rest of 15 seconds between measurements and two minutes of rest between each motion. The target muscles were the gluteus maximus, biceps femoris, soleus, and tibialis anterior. A surface electromyography was used to measure the muscle activity of these muscles. Results: The results show there was no statistically significant difference between the three types of exercise in the gluteus maximus muscle activity. However, the biceps femoris showed a significant difference between the three types of exercises (p<0.05). Conclusions: In conclusion, when the three different bridging exercises were performed by adding ankle motion to normal bridging exercise, there was a significant difference in the muscle activity of the gluteus maximus relative to the biceps femoris muscle activity in the order of the ankle dorsiflexion bridging, normal bridging, and ankle plantar flexion bridging exercise. Therefore, this could be an effective option for a bridging exercise if applied to patients with a weak gluteal muscle and shortening of the hamstring muscle in further studies.

• Journal of International Academy of Physical Therapy Research
• /
• v.9 no.4
• /
• pp.1642-1650
• /
• 2018

The purpose of this study was to identify the effect of proprioceptive neuromuscular facilitation (PNF) stretching exercise and joint mobilization on ankle joint range of motion (ROM), plantar pressure, and balance in subjects with stroke. Thirty patients (n=30) were organized into three groups, each of which received different treatments: PNF stretching (n=10), joint mobilization (n=10), and joint mobilization and PNF stretching combined (n=10). Each group received three exercise sessions per week for four weeks. The ankle ROM was measured using a goniometer, and plantar pressure and balance ability were measured using BioResque static posturography. In comparison within each group, the joint mobilization group and the joint mobilization with PNF stretching group showed significant improvements in ankle ROM, plantar pressure, and balance ability (p<.05). In comparison between the groups, a statistically significant difference was found in SECS change between the PNF stretching group, joint mobilization group and the joint mobilization with PNF stretching group. This study found demonstrates that the joint mobilization and joint mobilization with the PNF stretching methods were effective in improving ankle ROM, plantar pressure, and balance ability in stroke patients.

• Korean Journal of Applied Biomechanics
• /
• v.29 no.2
• /
• pp.61-70
• /
• 2019

Objective: This study aimed to investigate the characteristics of the declination of the subtalar joint rotation axis and the structural features of the ankle joint complex such as rear-foot angle alignment and ligament laxity test between chronic ankle instability (CAI) patients and healthy control. Method: A total of 76 subjects and CAI group (N=38, age: $23.11{\pm}7.63yrs$, height: $165.67{\pm}9.54cm$, weight: $60.13{\pm}11.71kg$) and healthy control (N=38, age: $23.55{\pm}7.03yrs$, height: $167.92{\pm}9.22cm$, weight: $64.58{\pm}13.40kg$) participated in this study. Results: The declination of the subtalar joint rotation axis of the CAI group was statistically different from healthy control in both sagittal slope and transverse slope. The rear-foot angle of CAI group was different from a healthy control. Compared to healthy control, they had the structure of rear-foot varus that could have a high occurrence rate of ankle varus sprain. CAI group had loose ATFL and CFL compared to the healthy control. Conclusion: The results of this study showed that the deviation of the subtalar joint rotation axis and the structural features of the ankle joint complex were different between the CAI group and the healthy control and this difference is a meaningful factor in the occurrence of lateral ankle sprains.

• Journal of The Korean Society of Integrative Medicine
• /
• v.6 no.2
• /
• pp.99-106
• /
• 2018

Purpose : Various studies effects of mental practice. However, there is a lack of research on the effects of practice on postural alignment. Therefore this study to the effect of ankle exercise combined with mental practice on postural alignment of legs. Method : Subjects were randomly assigned to mental practice group (experimental group n=15) and general exercise group (control group n=15). Postural alignment was the hip, knee, and ankle joints. When viewed from the side, an arbitrary point in front of the malleolus makes a straight line with the plumb line. Exercise was performed a week for weeks. Exercise programs included muscle strengthening, relaxation, and proprioception exercise. The experimental group mental practice. Result : Both groups showed significant differences in postural alignment ankle joint, knee joint, and hip joint. In particular, the experimental group showed a larger change than the control group. However, significant difference in postural alignment change only the knee joint (p<0.05), and there was no significant difference the hip joint (experimental group=$0.77{\pm}0.81$, control group=$0.87{\pm}1.13$) and ankle joint (experimental group=$0.52{\pm}0.63$, control group=$0.48{\pm}0.41$). Conclusion : This study suggests that mental practice is effective as an exercise method postural alignment. Mental practice also expected to be musculoskeletal disorders. Therefore, additional studies should be conducted to verify the effect of mental practice on the alignment of various parts.