Objective: The purpose of this study was to investigate the effects of joint mobilization on foot pressure, ankle moment, and vertical ground reaction force in subjects with ankle instability. Method: Twenty male subjects (age, $25.38{\pm}3.62yr$; height, $170.92{\pm}5.41cm$; w...
Objective: The purpose of this study was to investigate the effects of joint mobilization on foot pressure, ankle moment, and vertical ground reaction force in subjects with ankle instability. Method: Twenty male subjects (age, $25.38{\pm}3.62yr$; height, $170.92{\pm}5.41cm$; weight, $60.74{\pm}9.63kg$; body mass index (BMI), $19.20{\pm}1.67kg/m^2$) participated and underwent ankle joint mobilization. Weight-bearing distribution, ankle dorsi/plantar flexion moment, and vertical ground reaction force were measured using a GPS 400 and a VICON Motion System (Oxford, UK), and subsequently analyzed. SPSS 20.0 for Windows was used for data processing and paired t-tests were used to compare pre- and post-mobilization measurements. The significance level was set at ${\alpha}$ = .05. Results: The results indicated changes in weight-bearing, ankle dorsi/plantar flexion moment, and vertical ground reaction force. The findings showed changes in weight-bearing distribution on the left (pre $29.51{\pm}6.31kg$, post $29.57{\pm}5.02kg$) and right foot (pre $32.40{\pm}6.30kg$, post $31.18{\pm}5.47kg$). There were significant differences in dorsi/plantar flexion moment (p < .01), and there were significant increases in vertical ground reaction forces at initial stance (Fz1) and terminal stance (Fz2, p < .05). Additionally, there was a significant reduction in vertical ground reaction force at midstance (Fz2, p < .001). Conclusion: Joint mobilization appears to alter weight-bearing distribution in subjects with ankle instability, with resultant improvements in stability.
Objective: The purpose of this study was to investigate the effects of joint mobilization on foot pressure, ankle moment, and vertical ground reaction force in subjects with ankle instability. Method: Twenty male subjects (age, $25.38{\pm}3.62yr$; height, $170.92{\pm}5.41cm$; weight, $60.74{\pm}9.63kg$; body mass index (BMI), $19.20{\pm}1.67kg/m^2$) participated and underwent ankle joint mobilization. Weight-bearing distribution, ankle dorsi/plantar flexion moment, and vertical ground reaction force were measured using a GPS 400 and a VICON Motion System (Oxford, UK), and subsequently analyzed. SPSS 20.0 for Windows was used for data processing and paired t-tests were used to compare pre- and post-mobilization measurements. The significance level was set at ${\alpha}$ = .05. Results: The results indicated changes in weight-bearing, ankle dorsi/plantar flexion moment, and vertical ground reaction force. The findings showed changes in weight-bearing distribution on the left (pre $29.51{\pm}6.31kg$, post $29.57{\pm}5.02kg$) and right foot (pre $32.40{\pm}6.30kg$, post $31.18{\pm}5.47kg$). There were significant differences in dorsi/plantar flexion moment (p < .01), and there were significant increases in vertical ground reaction forces at initial stance (Fz1) and terminal stance (Fz2, p < .05). Additionally, there was a significant reduction in vertical ground reaction force at midstance (Fz2, p < .001). Conclusion: Joint mobilization appears to alter weight-bearing distribution in subjects with ankle instability, with resultant improvements in stability.
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제안 방법
, Oxford, UK) on a PC in which VICON workstation software (Oxford Metrics, Oxford, UK) had been installed. After adjusting for the potential errors of the cameras prior to the test, markers were attached to the main joints and muscles of the hip and lower limbs while the participant stood still on the force platforms in order to measure the position of each joint on the computer monitor connected to the VICON optical motion capture system. The markers were round with a diameter of 1.
Ankle moment was measured 3 times as the participant walked 10 m, and vertical GRF was measured via an inverse dynamic method using two force platforms installed on the floor. All data were statistically processed and averaged to compare pre-intervention and post-intervention measurements. For static and dynamic tests, 3- dimensional kinematic gait changes were measured using a 6-camera motion analysis system (120 Hz, VICON Motion Systems Ltd.
First, we performed the body measurements required for data analysis during static examinations, including height, weight, BMI, and length of both lower limbs. Ankle moment was measured 3 times as the participant walked 10 m, and vertical GRF was measured via an inverse dynamic method using two force platforms installed on the floor.
The GPS 400 (Global Postural System) was used to comprehensively analyze foot shape, and the PODATA device was used to analyze weight-bearing distribution, the proportion of foot pressure on the fifth metatarsal, and the proportion of foot pressure on the calcaneus. Foot pressure distribution was analyzed by installing the PODATA device and Philips cameras on the GPS, which automatically calculated the ratio of the maximum length of the forefoot to the minimum length of the midfoot. Recently, foot pressure tests have been used to diagnose foot deformities using quantitative data.
For our study, foot pressure was first measured while the participant maintained standing balance, facing forward, with the legs spread apart 30°, and the limits of stability were measured while the participant maintained standing balance using an ankle strategy to shift their center of gravity to the maximum range.
Such functional rehabilitation constitutes an important step in preventing damage, and reduces pain and edema more effectively than surgical fixation (Scott, 2007); in particular, functional rehabilitation comprised of proprioceptive exercises has been reported to reduce re-injury of the ankle ligaments (Michael & Thomas, 2003). In this study, we applied ankle mobilization techniques to indi- viduals with AI and established hypotheses pertaining to foot pressure, which represents changes in body pressure, ankle joint moment, which represents intraarticular muscle activation, and vertical ground reaction force (GRF), which represents the reaction force to the moment and the ground. Then, we examined the effects of ankle articular mobilization on foot pressure, ankle joint moment, and vertical GRF in individuals with AI, in an attempt to provide basic data to assess clinical utility.
Furthermore, the fact that there was a significant change during midstance (Fz0) following intervention shows that the blockade of sensory feedback via visual input resulted in greater reliance on proprioceptive sensory input, and improved ankle stability led to more symmetric distribution of body weight on the soles of the feet, distributing the body weight through the hip, knee, and ankle joints, and thereby leading to a marked decrease in vertical GRF. It is difficult to generalize the findings of this study to all individuals with AI, and we are limited in the interpretation of our results because we did not conduct an EEG test on the ankle muscles while measuring foot pressure, ankle joint moment, and vertical GRF. These limitations should be addressed in future studies.
The participants' general characteristics were determined using a body composition analyzer (InBody J05, Bio- space, USA). The inclusion criteria were as follows: normal individuals with no ambulatory problems from orthopedic surgery or dysfunction in the lower extremities, and those who could maintain independent standing for at least one minute. Individuals with a history of hypertension or diabetes, visual or vestibular dysfunction, or orthopedic dis- orders of the upper and lower extremities or the trunk were excluded from the study.
In this study, we applied ankle mobilization techniques to indi- viduals with AI and established hypotheses pertaining to foot pressure, which represents changes in body pressure, ankle joint moment, which represents intraarticular muscle activation, and vertical ground reaction force (GRF), which represents the reaction force to the moment and the ground. Then, we examined the effects of ankle articular mobilization on foot pressure, ankle joint moment, and vertical GRF in individuals with AI, in an attempt to provide basic data to assess clinical utility.
This study quantitatively assessed the effects of ankle articular mobili- zation on foot pressure, ankle moment, and vertical GRF, and compared the pre-intervention and post-intervention effects after treatment for 30 min/day for 3 days per week for 6 weeks (Figure 1).
대상 데이터
After adjusting for the potential errors of the cameras prior to the test, markers were attached to the main joints and muscles of the hip and lower limbs while the participant stood still on the force platforms in order to measure the position of each joint on the computer monitor connected to the VICON optical motion capture system. The markers were round with a diameter of 1.4 cm. The measurement values were computed using the VICON PlugIn-Gait model (Figure 4).
이론/모형
4 cm. The measurement values were computed using the VICON PlugIn-Gait model (Figure 4).
성능/효과
According to the results of the present study, at initial stance (Fz1), during which the body's center of gravity rapidly drops and weight accelerates, the pre- and post-intervention vertical GRFs were 105.57 ± 5.72% BW and 111.50 ± 8.91% BW, respectively, and those at midstance (Fz0), during which the body advances over the stationary foot and the center of gravity rises upward, were 83.33 ± 3.68% BW and 69.69 ± 6.18% BW, respectively.
After the intervention, the weight on the left and right foot were found to be 29.57 ± 5.02 kg and 31.18 ± 5.47 kg, respectively.
In terms of medial and lateral GRF, the peak medial GRFs before and after the intervention were 3.65 ± 1.66% BW and 4.16 ±.16% BW, respectively, while the peak lateral GRFs before and after the intervention were 14.66 ± 3.32% BW and 19.95 ± 3.81% BW, respectively, showing a significant increase in peak lateral GRF after the intervention (p < .01).
Prior to the intervention, the pressure on the fifth metatarsal of the left and right foot were 42.85 ± 9.60% kg and 35.37 ± 13.34% kg, respectively, while those after the intervention were 41.58 ± 9.97% kg and 36.29 ± 13.38% kg, respectively.
In order to reduce AI, the functional motions of the ankle joints should be emphasized with particular attention to the dynamics of neuromuscular control that stabilize the ankles. The hypothesis of this study was accepted since the reinforcement of ankle proprioception via the MWM technique increased ankle stability by increasing plantar flexion moment, ankle ROM, and lateral GRF during weight-bearing. Hence, we expect that increased ankle stability will result in the effective delivery of accurate proprioceptive information, preventing ankle injury during unpredictable situations or due to changes in the environment.
참고문헌 (27)
Akbari, M., Mohammadi, M. & Saeedi, H. (2007). Effects of rigid and soft foot orthoses on dynamic balance in females with flat foot. Medical Journal of the Islamic Republic of Iran, 21, 91-97.
Collins, N., Teys, P. & Vicenzino, B. (2004). The initial effects of a Mulligan's mobilization with movement technique on dorsiflexion and pain in subacute ankle sprains. Manual Therapy, 9(2), 77-82.
David, P., Halimi, M., Mora, I., Doutrellot, P. L. & Petitjean, M. (2013). Isokinetic testing of evertor and invertor muscles in patients with chronic ankle instability. Journal of Applied Biomechanics, 29(6), 696-704.
Defrin, R., Benyamin, S. B., Aldubi, R. D. & Pick, C. G. (2005). Conservative correction of leg-length discrepancies of 10 mm or less for the relief of chronic low back pain. Archives of Physical Medicine and Rehabilitation, 86(11), 2075-2080.
Giulio, I. D., Maganaris, C. N., Baltzopoulos, V. & Loram, I. D. (2009). The proprioceptive and agonist roles of gastrocnemius, soleus and tibialis anterior muscles in maintaining human upright posture. The Journal of Physiology, 587(10), 2399-2416.
Hertel, J., Denegar, C. R., Buckley, W. E., Sharkey, N. A. & Stokes, W. L. (2001). Effect of rearfoot orthoses on postural control in healthy participants. Journal of Sports Rehabilitation, 10, 36-47.
Hiller, C. E., Kilbreath, S. L. & Refshauge, K. M. (2011). Chronic ankle instability: evolution of the model. Journal of Athletic Training, 46(2), 133-141.
Hopkins, J. T., Coglianese, M., Glasgow, P., Reese, S. & Seeley, M. K. (2012). Alterations in evertor/invertor muscle activation and center of pressure trajectory in participants with functional ankle instability. Journal of Electromyography and Kinesiology, 22(2), 280-285.
Kaltenborn, F. M., Evjenth, O., Kaltenborn, T. B., Morgan, D. & Vollowitz, E. (2014) Manual Mobilization of the Joints, Vol. 1: The Extremities, 8th Edition, Orthopedic Physical Therapy Products.
Kelaher, D., Mirka, G. A. & Dudziak, K. Q. (2000). Effects of semi-rigid arch-support orthotics: an investigation with potential ergonomic implications. Applied Ergonomics, 31(5), 515-522.
Konradsen, L. (2002). Factors Contributing to Chronic Ankle Instability: Kinesthesia and Joint Position Sense. Journal of Athletic Training, 37(4), 381-385.
Menz, H. B., Morris, M. E. & Lord, S. R. (2005). Foot and ankle characteristics is associated with impaired balance and functional ability in older people. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 60(12),1546-1555.
Mettler, A., Chinn, L., Saliba, S. A., Mckeon, P. O. & Hertel, J. (2015). Balance training and center of pressure location in participants with Chronic ankle instability. Journal of Athletic Training, 50(4), 343-349.
McKeon, P. O. & Hertel, J. (2008). Systematic review of postural control and Lateral ankle instability, part II: is balance training clinically effective. Journal of Athletic Training, 43(3), 305-315.
Mulligan, B. R. (2003) Manual Therapy: NAGS SNAGS MWMS ets, 6th Edition, Orthopedic Physical Therapy Products.
Mulligan, B. R. (1993) Mobilisations with movement (MWM'S). The Journal of Manual and Manipulative Therapy, 1(4), 154-156.
Pitei, D. L., Lord, M., Foster, A., Wilson, S., Watkins, P. J. & Edmonds, M. E. (1999). Plantar pressures are elevated in the neuroischemic and the neuropathic diabetic foot. Diabetes Care, 22, 1966-1970.
Schamberger, W., Fredric, T. S. & Webster, T. (2002). The Malalignment Syndrome. Edinburgh, Churchill Living stone.
Singh, N. B. (2005). Evaluation of circumferential ankle pressure as an ergonomic intervention to maintain balance perturbed by localized muscular fatigue of the ankle joint. Master of Science In Industrial and Systems Engineering.
Scott, G., Menz, H. B. & Newcombe, L. (2007). Age-related in foot structure And function. Gait Posture, 26(1), 68-75.
Yaggie, J. A. & McGregor, S. J. (2002). Effects of isokinetic ankle fatigue on the maintenance of balance and postural limits. Archives of Physical Medicine Rehabilitation, 83, 224-228.
Vicenzino, B., Branjerdporn, M., Teys P. & Jordan, K. (2006). Intial changes in posterior talar glide and dorsiflexion of the ankle after mobilization with movement in individuals with recurrent ankle sprain. Journal of Orthopaedic & Sports Physical Therapy, 36(7), 464-471.
Vicenzino, B., Prangley, I. & Martin, D. (2001). The initial effect of two Mulligan mobilisation with movement treatment techniques on ankle dorsiflexion. In Australian Conference of Science and Medicine in Sport. Sports Medicine Australia.
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