치료적 운동을 병행한 발목 관절가동술이 만성 발목 불안정성을 가진 노인의 발목 관절가동범위와 균형에 미치는 영향 = The effect of ankle mobilization combined with therapeutic exercise on ankle joint range of motion and balance in the elderly with chronic ankle instability

다국어 초록 (Multilingual Abstract)

Background: This study analyzed the effects of balance and ankle joint range of motion in elderly people suffering from chronic ankle instability; when therapeutic exercise was applied alongside ankle joint mobilization, as a method to reduce the risk of falls and improve the ability to balance.
Design: A Single Subject experience design.
Method: This study was conducted on 10 elderly people aged 65 years or older with chronic ankle instability. Therapeutic exercise and four types of ankle joint mobilization were used during the study. The therapeutic exercise was applied for 10 minutes, and after a 5-minute rest period, four joint mobilization techniques were applied for 5 minutes each time, for a total of 20 minutes. The procedures were performed by a skilled person with more than 10 years of physical therapy clinical experience and conducted three days a week for a four-week period. An evaluation was conducted before and after the experiment, for four weeks. The evaluation items were the joint range of motion and static and dynamic balance.
Result:: The study results show that, as a result of applying therapeutic exercise and ankle joint mobilization for four weeks, static and dynamic balance improved significantly after the intervention compared to before the intervention (p<.05), and instep and plantar flexion joint angles in the range of motion of the ankle joint were also significantly improved (p<.05).
Conclusions: Ankle joint mobilization combined with therapeutic exercise for the elderly with chronic ankle instability can be proposed as an effective treatment intervention method to improve joint range of motion and balance, and the study suggests that it can be more actively used in clinical practice.

참고문헌 (Reference)

1 정경만 ; 정유진, "휠체어 몸통 훈련이 급성기 뇌졸중 환자의 낙상 효능감, 낙상 위험도, 일상생활활동에 미치는 영향: 무작위 대조군 예비 연구" 대한물리치료과학회 29 (29): 1-11, 2022

2 정경만, "후방 보행훈련이 급성기 뇌졸중 환자의 균형, 균형 자신감, 낙상 효능에 미치는 영향: 무작위 대조군 예비연구" 대한물리치료과학회 28 (28): 1-9, 2021

3 박재용 ; 안윤정 ; 송영주, "핀 수영선수의 만성적 발목 불안정성에 따른 등속성 하지 근력 및 관절가동범위에 관한 연구" 한국사회체육학회 (50) : 835-844, 2012

4 박재명, "발에 대한 관절가동술을 병행한 체성감각자극이 일부 노인 여성의 균형과 보행속도에 미치는 영향-사례조사" 19 (19): 67-71, 2013

5 조경미 ; 김민영, "노인 낙상 후 중등도 이상 손상에 영향을 미치는 요인" 한국노인간호학회 21 (21): 33-40, 2019

6 주성범 ; 공원태 ; 박기덕 ; 이한용, "고령남성에게 발목 관절가동술 적용이 발목 관절가동범위와 균형제어능력에 미치는 영향" 한국체육과학회 20 (20): 1037-1045, 2011

7 Werner BC, "Validation of an innovative method of shoulder range of motion measurement using a smartphone clinometer application" 23 (23): 275-282, 2014

8 Salom-Moreno J, "Trigger Point Dry Needling and Proprioceptive Exercises for the Management of Chronic Ankle Instability : A Randomized Clinical Trial" 2015 : 790209-, 2015

9 Williams CM, "The tiltmeter app is a novel and accurate measurement tool for the weight bearing lunge test" 16 (16): 392-395, 2013

10 Whipple RH, "The relationship of knee and ankle weakness to falls in nursing home residents : an isokinetic study" 35 (35): 13-20, 1987

11 Abe Y, "The postural control characteristics of individuals with and without a history of ankle sprain during single-leg standing : relationship between center of pressure and acceleration of the head and foot parameters" 26 (26): 885-888, 2014

12 Sawkins K, "The placebo effect of ankle taping in ankle instability" 39 (39): 781-787, 2007

13 Gilbreath JP, "The effects of mobilization with movement on dorsiflexion range of motion, dynamic balance, and self-reported function in individuals with chronic ankle instability" 19 (19): 152-157, 2014

14 Uh BS, "The benefit of a single-leg strength training program for the muscles around the untrained ankle" 28 (28): 568-573, 2000

15 박주완 ; 김원복, "The Effect of Functional Training Using a Sliding Rehabilitation Machine on the Mobility of the Ankle Joint and Balance in Children with CP" 대한물리의학회 9 (9): 293-299, 2014

16 "Prevention Agency"

17 Ferrer A, "Multifactorial assessment and targeted intervention to reduce falls among the oldest-old : a randomized controlled trial" 9 : 383-393, 2014

18 Abate M, "Limited joint mobility(LJM)in elderly subjects with type II diabetes mellitus" 53 (53): 135-140, 2011

19 Chevutschi A, "Immediate effects of talocrural and subtalar joint mobilization on balance in the elderly" 20 (20): 1-8, 2015

20 Paris SV, "Foundations of clinical orthopaedics" University of St Augustine for Health Sciences 1999

21 Holland GJ, "Flexibility and physical functions of older adults : A review" 10 (10): 169-206, 2002

22 World health organization, "Falls Geneva" World Health Organization

23 Korea disease control and prevention agency, "Epidemiologic characteristics of injured elderly inpatients in Korea: the results of the Korea national hospital discharge survey" 2004

24 Borg FG, "Entropy of balance-some recent results" 7 : 38-, 2010

25 Olmsted LC, "Efficacy of the star excursion balance tests in detecting reach deficits in subjects with chronic ankle instability" 37 (37): 501-506, 2002

26 Kaminski TW, "Effect of strength and proprioception training on eversionto inversion strength ratios in subjects with unilateral functional ankle instability" 37 (37): 410-415, 2003

27 Hoch MC, "Dorsiflexion range of motion significantly influences dynamꠓic balance" 14 (14): 90-92, 2011

28 Nagai K, "Differences in muscle coactivation during postural control between healthy older and young adults" 53 (53): 338-343, 2011

29 Kim K, "Development of an efficient rehabilitation exercise program for functional recovery in chronic ankle instability" 28 (28): 1443-1447, 2016

30 Mecagni C, "Balance and ankle range of motion in community-dwelling women aged 64 to 87 years : A correlational study" 80 (80): 1004-1011, 2000

31 Smith BI, "Ankle strength and force sense after a progressive, 6-week strength training program in people with functional ankle instability" 47 (47): 282-288, 2012

32 Arnold BL, "Ankle instability is associated with balance impairments : a meta-analysis" 41 (41): 1048-1062, 2009

33 Basnett CR, "Ankle dorsiflexion range of motion influences dynamic balance in individuals with chronic ankle instability" 8 (8): 121-128, 2013

34 Takao M, "Anatomical reconstruction of the lateral ligaments of the ankle with a gracilis autograft : a new technique using an interference fit anchoring system" 33 (33): 814-823, 2005

35 Lord SR, "Age-associated differences in sensori-motor function and balance in community dwelling women" 23 (23): 452-460, 1994

36 Slayer MA, "A randomized conꠓtrolled trial of piroxicam in the management of ankle sprain in Australian Regular Army recruits. the Kapooka Ankle Sprain Study" 25 : 544-553, 2001

37 Eils, E, "A multi-station proprioceptive exercise program in patients with ankle instability" 33 (33): 1991-1998, 2001

38 Statistics Korea, "2018 Survey on Aged" Statistics Korea