Effect of Muscle Taping and Joint Taping on Static and Dynamic Balance in Normal Adults with Chronic Ankle Instability

( Hyun-Sung Kim ),( Jae-young Park ) 대한통합의학회 2022 대한통합의학회지 Vol.10 No.1

Purpose : This study was conducted to investigate the effect of muscle taping and joint taping on static and dynamic balance in normal adults with chronic ankle instability. Methods : The subjects of this study were 32 people who met the inclusion criteria. This cross-sectional study was conducted using the Kinesio tape, an elastic tape, was used. Subjects were randomized to exclude the effect of sequence, and no taping, joint taping, and muscle taping were applied as taping interventions. One-leg standing test and a Functional reach test were conducted to measure static balance, and Y-balance test was conducted to measure dynamic balance. One way repeated ANOVA was performed to investigate the difference in balance ability according to the taping intervention. If there was a significant difference, a post-hoc was performed using the Bonferroni method. Results : In the case of static balance, joint taping showed more significant results than did no taping and muscle taping (p<.05), and muscle taping showed more significant results than did no taping (p<.05). In the case of dynamic balance, muscle taping showed significantly larger results than did no taping and joint taping (p<.05) and joint taping showed significantly larger results than did no taping (p<.05). Conclusion : This study found that mechanical stimulation of muscles and joint compression by elastic taping increased ankle stability and improved static and dynamic balance. In particular, for static balance, joint taping was more effective than muscle taping, and for dynamic balance, muscle taping was more effective than joint taping. Applying the appropriate taping method to individual subjects has the advantage of maximizing the therapeutic effect for the recovery of balance ability. Similarly, the application of various tapings to subjects with ankle instability will have a positive effect on functional improvement.

봉합 나사를 이용한 변형 Br$\ddot{o}$strom 술식 및 관절경 검사를 이용한 족관절 외측 불안정성의 치료

이진영,김갑래,이은수,박현진,Lee, Jin-Young,Kim, Gab-Lae,Lee, Eun-Soo,Park, Hyun-Jin 대한족부족관절학회 2009 대한족부족관절학회지 Vol.13 No.2

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.

봉합 나사를 이용한 변형 Bröstrom 술식 및 관절경 검사를 이용한 족관절 외측 불안정성의 치료

이진영,김갑래,이은수,박현진 대한족부족관절학회 2009 대한족부족관절학회지 Vol.13 No.2

Purpose: To evaluate the result of modified Bröstrom 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 Bröstrom 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 Bröstrom procedure with anchor suture and arthroscopic procedure are reliable treatment method for chronic ankle lateral instability which has intraarticular pathology.

외측 발목 불안정성을 치료하지 않으면 어떻게 되는가

우승훈,정형진,Woo, Seung Hun,Chung, Hyung-Jin 대한족부족관절학회 2021 대한족부족관절학회지 Vol.25 No.1

The term chronic lateral ankle instability (CLAI) embraces a spectrum of conditions that involve functional and mechanical instability, both in athletes and lower-demand patients. The hallmarks of CLAI are recurrent sprains, persistent pain, and repeated episodes of the ankle giving way. CLAI is the main complication of acute ankle sprains, which can cause discomfort in daily and sports activity. Approximately 10% to 30% of patients with acute ligament ruptures will develop chronic instability over the course of a year from the index injury. An accurate diagnostic approach and successful treatment plan should be established based on a comprehensive understanding of the concept of functional and mechanical instability. Unfortunately, the optimal modality for the management of CLAI is unclear. Even after conservative treatment or surgical intervention, it could result in degenerative changes to the ankle joint in the long term. Thus far, the incidence of ligamentous posttraumatic ankle osteoarthritis was reported to be 13% to 78%. The mean latency time between injury and osteoarthritis was at least 10 to 34.3 years. CLAI is an important pathological condition that can cause discomfort or dysfunction in daily activity in the short term, resulting in joint destruction in the long term. Therefore, it is important to understand the various complications that can occur when CLAI is not treated properly.

Impact of Chronic Lateral Ankle Instability with Lateral Collateral Ligament Injuries on Biochemical Alterations in the Cartilage of the Subtalar and Midtarsal Joints Based on MRI T2 Mapping

Tao Hongyue,Hu Yiwen,Lu Rong,Zhang Yuyang,Xie Yuxue,Chen Tianwu,Chen Shuang 대한영상의학회 2021 Korean Journal of Radiology Vol.22 No.3

Objective: To quantitatively assess biochemical alterations in the cartilage of the subtalar and midtarsal joints in chronic lateral ankle instability (CLAI) patients with isolated anterior talofibular ligament (ATFL) injuries and combined calcaneofibular ligament (CFL) injuries using MRI T2 mapping. Materials and Methods: This study was performed according to regulations of the Committee for Human Research at our institution, and written informed consent was obtained from all participants. Forty CLAI patients (26 with isolated ATFL injuries and 14 with combined ATFL and CFL injuries) and 25 healthy subjects were recruited for this study. All participants underwent MRI scans with T2 mapping. Patients were assessed with the American Orthopedic Foot and Ankle Society (AOFAS) rating system. The subtalar and midtarsal joints were segmented into 14 cartilage subregions. The T2 value of each subregion was measured from T2 mapping images. Data were analyzed with ANOVA, the Student’s t test, and Pearson’s correlation coefficient. Results: T2 values of most subregions of the subtalar joint and the calcaneal facet of the calcaneocuboid joint in CLAI patients with combined CFL injuries were higher than those in healthy controls (all p < 0.05). However, there were no significant differences in T2 values in subtalar and midtarsal joints between patients with isolated ATFL injuries and healthy controls (all p > 0.05). Moreover, T2 values of the medial talar subregions of the posterior subtalar joint in patients with combined CFL injuries showed negative correlations with the AOFAS scores (r = -0.687, p = 0.007; r = -0.609, p = 0.021, respectively). Conclusion: CLAI with combined CFL injuries can lead to cartilage degeneration in subtalar and calcaneocuboid joints, while an isolated ATFL injury might not have a significant impact on the cartilage in these joints.

족관절 외측 불안정성 재건 시 시행하는 탐험적 관절경의 유용성

이경태,김진수,양기원,박영욱,김준범,김태원,조재호,Lee, Kyung-Tai,Kim, Jin-Su,Young, Ki-Won,Park, Young-Uk,Kim, Jun-Beom,Kim, Tae-Won,Jo, Jae-Ho 대한족부족관절학회 2010 대한족부족관절학회지 Vol.14 No.2

Purpose: To evaluate the efficacy of the arthroscopic exploration combined with modified Brostrom operation (MBO) for the treatment of chronic lateral ankle instability (CAI). Materials and Methods: Sixty patients who diagnosed a CAI were performed MBO. We divided to 2 groups, whether simultaneously inspected by arthroscopy (group B) or not (group A). The both group's results were compared according to American Orthopedic Foot and Ankle Society Ankle-hindfoot score (AOFAS), functional ankle score and visual analog scale (VAS) at preoperative and final follow-up period. Results: There were no significant differences of AOFAS, functional ankle score and VAS between both groups at final follow-up. However, in group A, 2 cases associated with medial ankle instability and syndesmotic injuries were did not diagnosed preoperatively, showed poor prognosis. In group B, one case had a permanent peroneal nerve symptom. The match rate of intra-articular lesions between preoperative diagnosis and postoperative arthroscopic diagnosis was 30% in group B. Conclusion: Combination of arthroscopic exploration and MBO is effective strategy for intra-operatively discrimination of intra-articular associated lesions for CAI.

만성 족관절 불안정증에서 건이식을 이용한 외측 인대 재건술의 적응증

박재용,최기원,조재호,강찬,최경진,정진화,김학준,배서영,차승도,김기천,한승환,2015 대한족부족관절학회 보험장애판정위원회,Park, Jae Yong,Choi, Gi-Won,Cho, Jae-ho,Kang, Chan,Choi, Kyungjin,Chung, Jin-Wha,Kim, Hak Jun,Bae, Su-Young,Cha, Seung-Do,Kim, Ki Ch 대한족부족관절학회 2016 대한족부족관절학회지 Vol.20 No.1

Purpose: The purpose of this study is to review the indications of ankle lateral complex reconstruction using tendon graft. Materials and Methods: We searched PubMed using the index, "ankle, instability, lateral ligament, reconstruction" from 1990 to present (September 30, 2015). We excluded 1) modified Brőstrom operation (MBO), 2) conventional tenodesis surgery, 3) review article, 4) technical note, and 5) articles written in another foreign language. We reviewed 24 papers through the publication events, operational method, the indications of surgery, and the specific features of the patient group. Results: There were the indications of 1) previous ligament surgery failure, 2) situation when ligament repair is impossible due to the ligament defect, 3) severe instability (preoperative talar tilt >$15^{\circ}$, anterior draw >10 mm or the difference of contralateral side talar tilt >$5^{\circ}$, anterior draw >3 mm), and 4) overweight (body mass index >$30kg/m^2$). Other considerations included 1) generalized joint laxity and 2) workers, highly-demanded or athlete highly-affected by instability. Conclusion: The ankle lateral complex reconstruction using tendon graft could be indicated in patients with the possibility of MBO failure with several considerations.

전방 점프 착지 시 만성 발목 불안정성이 자세 조절에 미치는 영향

김규완,전경규,박석우,안세지 한국운동역학회 2022 한국운동역학회지 Vol.32 No.1

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 noncontact knee injury as well as the risk of lateral ankle sprain during forward jump landing.

낙하 착지 시 FRT가 하지의 관절의 시상각과 강직도에 미치는 효과

( Hyung-pil Jun ) 한국운동역학회 2021 한국운동역학회지 Vol.31 No.4

Objective: To investigate effects of Fibular Repositioning Taping (FRT) on lower extremity joint stiffness and angle during drop-landing. Method: Twenty-eight participants (14 healthy, 14 with chronic ankle instability [CAI]) performed droplandings from a 60 cm box; three were performed prior to tape application and three were performed post-FRT. Three-dimensional kinematic and kinetic data were collected using an infrared optical camera system (Vicon Motion Systems Ltd. Oxford, UK) and force-plate (AMTI, Watertown, MA). Joint stiffness and sagittal angle of the ankle, knee, and hip were analyzed. Results: The hip [Healthy: p<.05; M ± SD: 29.43 ± 11.27 (pre), 33.04 ± 12.03 (post); CAI: p<.05; M ± SD: 31.45 ± 9.70 (pre), 32.29 ± 9.85 (post)] and knee [Healthy: p<.05; M ± SD: 53.44 ± 8.09 (pre), 55.13 ± 8.36 (post); CAI: p<.05; M ± SD: 53.12 ± 8.35 (pre), 55.55 ± 9.81 (post)] joints demonstrated significant increases in sagittal angle after FRT. A significant decrease in joint angle was found at the ankle [Healthy: p<.05; M ± SD: 56.10 ± 3.71 (pre), 54.09 ± 4.31 (post); CAI: p<.05; M ± SD: 52.80 ± 6.04 (pre), 49.86 ± 10.08 (post)]. A significant decrease in hip [Healthy: p<.05; M ± SD: 1549.16 ± 517.53 (pre), 1272.48 ± 646.73 (post); CAI: p<.05; M ± SD: 1300.42 ± 595.55 (pre), 1158.27 ± 550.58 (post)] and knee [Healthy: p<.05; M ± SD: 270.12 ± 54.07 (pre), 239.13 ± 64.70 (post); CAI: p< .05; M ± SD: 241.58 ± 93.48 (pre), 214.63 ± 101.00 (post)] joint stiffness was found post-FRT application, while no difference was found at the ankle [Healthy: p >.05; M ± SD: 57.29 ± 17.04 (pre), 59.37 ± 18.30 (post); CAI: p>.05; M ± SD: 69.15 ± 17.63 (pre), 77.24 ± 35.05 (post)]. Conclusion FRT application decreased joint angle at the ankle without altering ankle joint stiffness. In contrast, decreased joint stiffness and increased joint angle was found at the hip and knee following FRT. Thus, participants utilize an altered shock absorption mechanism during drop-landings following FRT. When compared to previous research, the joint kinematics and stiffness of the lower extremity appear to be different following FRT versus traditional ankle taping.

혈류제한 운동이 만성 발목 불안정성을 가진 성인의 발목 근력 및 균형능력에 미치는 영향

연강미,이효정 대한통합의학회 2023 대한통합의학회지 Vol.11 No.1

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.