Effects of Nintendo Wii Fit Plus training on ankle strength with functional ankle instability

[Purpose] The objective of this study was to examine the effects of a training program using the Nintendo Wii Fit Plus on the ankle muscle strengths of subjects with functional ankle instability. [Subjects and Methods] This study was conducted using subjects in their 20s who had functional ankle instability. They were randomized to a strengthening training group and a balance training group with 10 subjects in each, and they performed an exercise using Nintendo Wii Fit Plus for 20 minutes. In addition, every participant completed preparation and finishing exercises for 5 minutes, respectively. [Results] The muscle strengths after conducting plantar flexion and dorsiflexion significantly increased at the angular velocities of 60° and 120° in the strengthening training group. Furthermore, the muscle strengths after conducting plantar flexion, dorsiflexion, eversion, and inversion significantly increased at the angular velocities of 60° and 120° in the balance training group. [Conclusion] The balance training group using Nintendo Wii Fit Plus showed better results than the strengthening training group. Consequently, it is recommended to add the balance training program of the Nintendo Wii Fit Plus to conventional exercise programs to improve ankle muscle strength in functional ankle instability at a low cost.Key words: Nintendo Wii Fit Plus, Functional ankle instability, Strength     

Impact of a rehabilitation program on muscular strength and endurance in peripheral arterial occlusive disease patients

Rehabilitation care and physical exercise are known to constitute an effective treatment for chronic peripheral arterial occlusive disease (PAOD) at the intermittent claudication (IC) stage. Improvements in functional capacities and quality of life have been reported in the literature. We decided to assess the effects of hospital-based exercise training on muscle strength and endurance for the ankle plantar and dorsal flexors in this pathology.Patients and methodsThis prospective study included 31 subjects with chronic peripheral arterial occlusive disease (PAOD) and IC who followed a 4-week rehabilitation program featuring walking sessions, selective muscle strengthening, general physical exercise and therapeutic patient education. An isokinetic assessment of ankle plantar and dorsal flexors strength was conducted on the first and last days of the program. We also studied the concentric contractions at the angular velocity of 30°/s and 120°/s for muscle strength and at 180°/s for muscle fatigue. We also measured the walking distance for each patient.ResultsWalking distance improved by 246%. At baseline, the isokinetic assessment revealed severe muscle weakness (mainly of the plantar flexors). The only isokinetic parameter that improved during the rehabilitation program was the peak torque for plantar flexors at 120°/s.ConclusionAll patients presented with severe weakness and fatigability of the ankle plantar and dorsal flexors. Our program dramatically improved walking distance but not muscle strength and endurance.     

The Activities of the Muscles around the Ankle Joint during Foot-gripping are Affected by the Angle of the Ankle

[Purpose] The purpose of this study was to determine the activities of the muscles around the ankle joint during foot gripping. [Subjects] The subjects of this study were 17 healthy females. [Methods] We measured the maximum voluntary contraction (MVC) activities of the soleus muscle, the medial head of the gastrocnemius muscle, and the tibialis anterior muscle, and calculated %IEMG during foot gripping in 3 different ankle joint positions: 10° of plantar flexion, 0°, and 10° of dorsiflexion. [Results] The maximal force of foot gripping achived by the crural muscles in any ankle position was 30–50% IMEG of the MVC. Repeated analysis of variance showed that the %IEMG was significantly lower in 10°of dorsiflexion than in the other 2 positions for all muscles. [Conclusion] These results suggested that the crural muscles help the ankle joint by co-contracting during foot gripping.Key words: Foot-gripping strength, Angle of the ankle joint, Muscle activity     

Which Treatment is More Effective for Functional Ankle Instability: Strengthening or Combined Muscle Strengthening and Proprioceptive Exercises?

[Purpose] The purpose of this study was to implement combined muscle strengthening and proprioceptive exercises to examine the effects of combined exercises on functional ankle instability. [Subjects and Methods] Experiments were conducted with 30 adult males and females. The study subjects were randomly assigned to either a control group (Group A), a muscle strengthening exercise group (Group B), or a combined muscle strengthening and proprioceptive exercise group (Group C) consisting of 10 subjects each. In Group A, measurements were only conducted before and after the experiment without any intervention, whereas the exercise programs for Group B and Group C were implemented three days per week for four weeks. [Results] Muscle strength showed significant increases in Groups B and C compared with the control group during plantar flexion, dorsiflexion, inversion, and eversion. The Cumberland ankle instability tool showed significant increases in Group B and Group C compared with Group A and significant increases in Group C compared with Group B. [Conclusion] Applying combined muscle strengthening and proprioceptive exercises to those who have functional ankle instability is more effective than applying only muscle strengthening exercises.Key words: Functional ankle instability, Strength, Cumberland ankle instability tool     

Effects of posture and lower limb muscle strength on the results of the Star Excursion Balance Test

[Purpose] This study aimed to clarify the relationship between the distance measurements in the Star Excursion Balance Test and participants’ posture and lower limb muscle strength. [Participants and Methods] Nine healthy male college students participated in this study. Star Excursion Balance Test distance was measured in both lower limbs by performing anterior, posterolateral, and posteromedial trials; measuring the maximum reach; and performing three-dimensional motion analysis to determine the posture at maximum reach. Isokinetic muscle strength for knee flexion/extension, hip flexion/extension, and hip adduction/abduction were measured using an isokinetic machine. [Results] The hip extension strength, reach side ankle dorsiflexion angles, stance side knee flexion, reach side knee flexion, and knee flexion strength were selected as significant explanatory variables in the anterior direction. For the posteromedial direction, hip adduction and hip extension strength, reach side hip flexion angle, and stance side hip flexion angle were selected. For the posterolateral direction, reach side knee flexion angle and stance side ankle dorsiflexion, knee flexion strength and reach side hip flexion angle were selected. [Conclusion] The related factors differed between the dominant and non-dominant legs even in the same reach direction.     

Assessment of Effective Ankle Joint Positioning in Strength Training for Intrinsic Foot Flexor Muscles: A Comparison of Intrinsic Foot Flexor Muscle Activity in a Position Intermediate to Plantar and Dorsiflexion with that in Maximum Plantar Flexion Using Needle Electromyography

[Purpose] The effectiveness of intrinsic foot flexor strength training performed in the plantar flexion position was examined using needle electromyography. [Subjects] The subjects of this study were 18 healthy men. [Methods] We used needle electromyography to measure the muscle activities of the flexor hallucis brevis (FHB), and the flexor digitorum brevis (FDB) in maximum plantar and an intermediate position. [Results] Significant increases in muscle activities were observed for both FHB and FDB, and the rates of increase from the intermediate position to the plantar flexion position were 43% for FHB and 46% for FDB. [Conclusion] This study demonstrated that it is possible to evaluate intrinsic foot flexors, in addition to the numerous reports on treatment methods focusing on extrinsic foot flexors. Furthermore, the results suggest that toe flexion exercises performed during plantar flexion of the ankle joint are an effective method for intrinsic foot flexor strength training.Key words: Intrinsic foot flexor muscles, Needle electromyography, Muscle activity     

肌内效贴对离心收缩诱发的踝关节肌肉疲劳后的肌力和平衡能力的影响

目的:探讨肌内效贴贴扎对离心运动诱发的踝关节周围肌群疲劳后肌肉力量以及静态平衡能力的即刻影响。方法:受试对象为45名健康男性大学生,将受试者随机分成3组各15例进行不同测试(正常组、肌肉疲劳组以及肌内效贴组)。其中,正常组直接进行肌力与平衡测试;肌肉疲劳组在BIODEX等速训练仪的离心/离心的训练方式下进行连续的踝背伸及跖屈进而诱导肌肉疲劳,当疲劳出现时立即进行肌力与平衡测试;肌内效贴组采用与肌肉疲劳组相同的训练方法,在疲劳后即刻接受肌内效贴贴扎随后进行肌力与平衡测试,包括：向心模式60°/s和180°/s速度下的等速肌力和睁眼/闭眼状态下的静态平衡测试。结果:在等速肌力方面,肌肉疲劳组60°/s与180°/s跖屈、背伸各项肌力指标均较正常组降低(均P<0.05);肌内效贴组60°/s跖屈峰力矩与平均功率、60°/s背伸峰力矩、平均峰力矩、平均功率均较肌肉疲劳组增加(均P<0.05)。180°/s跖屈平均峰力矩、背伸平均峰力矩、平均功率均较肌肉疲劳组增加(均P<0.05),肌内效贴组背伸峰力矩较正常组降低(P<0.05)。在静态平衡方面,在睁眼状态下肌肉疲劳组Y...     

The Effect of Ground Tilt on the Lower Extremity Muscle Activity of Stroke Patients Performing Squat Exercises

[Purpose] The purpose of this study was to determine the effect of ground tilt on the lower extremity muscle activity of stroke patients performing squat exercises. [Subjects] Fifteen hemiparetic patients volunteered to participate in this study. [Methods] The subjects performed squat exercises at three different ground tilt angles: 15° plantar flexion, a neutral position, and 15° dorsiflexion. A surface electromyogram (sEMG) was used to record the electromyographic activities of the leg extensor muscle in the vastus lateralis (VL), vastus medialis (VM), gastrocnemius lateralis (GL), and gastrocnemius medialis (GM). The sEMG activity was analyzed using a one-way repeated measures ANOVA and a post hoc Bonferroni correction. [Results] The results of this study are summarized as follows. Significant differences were noted for the VL and the GL when the angle of the ankle joint was between the 15° plantar flexion and neutral positions during squat exercises involving the VL and when the angle of the ankle joint was between the neutral position and 15° dorsiflexion during squat exercises involving the VM. [Conclusion] In this study, sEMG showed that the VL and GL changed significantly during squat exercises according to the ground tilt angle of hemiparetic patients. Therefore, squat exercises with different ground tilt angles can be used to improve VL and GL strength.Key words: Electromyogram, Hemiplegic patient, Squat exercises     

Relationship between navicular drop and measuring position of maximal plantar flexion torque of the first and second-fifth metatarsophalangeal joints

[Purpose] The purpose of this study was to determine the relationship between navicular drop and plantar flexion torque of the first and second-fifth metatarsophalangeal joints. [Subjects] Ten healthy young men participated in this study. [Methods] The Pearson product-moment correlation coefficient was calculated to determine the relationship between navicular drop and plantar flexion torque of the first and second-fifth metatarsophalangeal joints. [Results] Significant negative correlations were observed between navicular drop and plantar flexion torques in the lengthened position of the intrinsic toe plantar flexion muscles, but no correlations were found between navicular drop and plantar flexion torques in the neutral position of the ankle and metatarsophalangeal joints. Moreover, the intrinsic toe plantar flexion muscles were found to contribute to the formation of the medial longitudinal arch. [Conclusion] Navicular drop correlates with metatarsophalangeal joint muscle strength in plantar flexion where the intrinsic toe muscles are capable of exerting force.Key words: Toe flexor strength, Intrinsic foot muscle, Medial longitudinal arch     

Musculoskeletal profile of male collegiate soccer players

Twenty-five collegiate soccer players were evaluated for lower extremity flexibility and muscle strength at the end of preseason training and before the onset of the collegiate soccer season on two successive seasons. The purpose of the evaluation was to determine whether symmetry was present in their legs and whether deficits in flexibility or strength would affect the susceptibility to hamstring or groin muscle strain injuries. The mean (+/- SE) flexibility of the dominant leg for hip abduction was 41 degrees +/- 1.2 degree; for hip flexion, 76 degrees +/- 1.9 degree; for hip extension, 174 degrees +/- 0.7 degree; and for ankle dorsiflexion, 33 degrees +/- 1.3 degree. The mean (+/- SE) isokinetic torque of the dominant leg (tested at 30 degrees per second) for knee extension was 214 +/- 8 newton meters and for flexion was 128 +/- 4 newton meters, while isometric strength for hip flexion was 315 +/- 8 newtons and for ankle plantar flexion was 1721 +/- 58 newtons. No significant differences were found between the dominant and nondominant legs in flexibility or strength. During this study no hamstring or groin strain injuries occurred. The lack of leg muscle strain injuries appeared to be directly related to the initiation of a controlled warmup and stretching program and underlines the importance of this in injury prevention. Interestingly, more than 50% (13 of 25) of the players were found to have significant deficits in one or more specific muscle groups. Two athletes sustained low back strain injuries and one athlete had a knee sprain injury.(ABSTRACT TRUNCATED AT 250 WORDS)     

Influence of Isokinetic Strength Training of Unilateral Ankle on Ipsilateral One-legged Standing Balance of Adults

[Purpose] The purpose of the current study was to investigate the changes in one-legged standing balance of the ipsilateral lower limb following unilateral isokinetic strength training. [Subjects and Methods] Thirty healthy adult volunteers were randomly assigned to either a training group or a control group, so that each group included 15 subjects. Subjects in the training group performed unilateral ankle isokinetic exercises of the dominant leg using the Biodex 3 PRO System for a period of four weeks. Ipsilateral one-legged standing balance was evaluated before and after the intervention with three stability indexes of balance using the Biodex System: Anterior-Posterior Stability Index (APSI), Medial-Lateral Stability Index (MLSI), and Overall Stability Index (OSI). [Results] Comparison of pre- and post-test data revealed significant improvements in strength values (dorsiflexion, plantarflexion, eversion, and inversion) and stability indexes (APSI, MLSI, OSI). [Conclusion] These results suggest that ankle strengthening exercise can be considered as a form of exercise that may assist individuals with improvement of balance.Key words: Postural balance, Isokinetic exercise, Strength training     

Isokinetic Training Effect of Ankle Positions on Knee Extensor Strength

[Purpose] The purpose of this study was to determine which ankle position most influences knee extensor strength in training programs for strengthening the knee extensors using three different active ankle positions. [Subjects] Twenty-one healthy adults (6 males and 15 females) participated in this study. [Methods] Subjects were trained isokinetically in knee extension and flexion at 70 or 80% of 1RM under three actively and naturally fixed, contracted ankle conditions: dorsiflexion, plantarflexion, and resting position. After each group successfully executed the training four times a week for three weeks, mean peak torque (PT) and total work (TW) variables were measured and compared at 60°/sec and 180°/sec among the three groups. [Results] Significant differences were revealed in knee extensor TW at 60°/sec, PT and TW at 180°/sec, with the greatest PT and TW observed with the ankle in active dorsiflexion position. [Conclusion] These results suggest that active ankle dorsiflexion in a knee strength training program may be more effective at increasing knee extensor strength than a resting or plantarflexion position.Key words: Ankle position, Knee extensor strength, Isokinetic training     

The Effect of Ankle Joint Muscle Strengthening Training and Static Muscle Stretching Training on Stroke Patients’ C.O.P Sway Amplitude

[Purpose] This study implement ankle joint dorsiflexion training for ankle muscle the weakness that impairs stroke patients’ gait performance, to examine the effect of the training on stroke patients’ plantar pressure and gait ability. [Subjects and Methods] In this study, 36 stroke patients diagnosed with stroke due to cerebral infarction or cerebral hemorrhage performed the training. Static muscle stretching was performed four times a week for 20 minutes at a time for 6 weeks by the training group. Ankle dorsiflexor training was performed four times a week, two sets per time in the case of females and three sets per time in the case of males for 6 weeks, by another group. Center of pressure sway amplitude was measured using the F-scan system during gait. All subjects were assessed with the same measurements at a pre-study examination and reassessed at eight weeks. Data were analyzed statistically using the paired t-test and one-way ANOVA. [Results] Among the between ankle dorsiflexor training group, static muscle stretching group, and control group, the difference before and after the training were proven to be statistically significant. [Conclusion] Compared to other training groups, the ankle muscle strength training group showed statistically significant increases of forward thrust at stroke patients’ toe-off which positively affected stroke patients’ ability to perform gait.Key words: Plantar pressure, Stroke, Muscle stretching     

Effect of Togu-exercise on Lumbar Back Strength of Women with Chronic Low Back Pain

[Purpose] The present study analyzed the effect of the Togu exercise program on the lumbar back strength of middle-aged women who did not perform regular exercise, and presents an effective exercise method for middle-aged women with chronic low back pain symptom. [Subjects] The subjects were 16 women with chronic low back pain attending N University, Chungcheong-do, Korea. [Methods] Height, weight, body fat, and body mass index (BMI) were measured using a body composition analyzer (Inbody 720, Biospace, Korea), which utilizes bioelectrical impedance analysis. Using isokinetic lumbar muscle strength measurement equipment [Isomed 2000, Back system, (Germany)], peak torque/body weight, total work and average power of flexion and extension of the lumbar region were measured. For lumbar stabilization exercises, an air cushion (Germany), jumper (Germany), and aero step (Germany) were employed. First, warm-up exercise was conducted for 10 minutes, followed by 10 sets of the 3 main exercises using the above tools with 10-second rest intervals. The main exercise was done for 40 minutes in total. [Results] The paired sample t-test showed significant in the Togu exercise group peak torque of flexion, peak torque of extension, total work of flexion, total work of extension, average power of flexion, average power of extension, after the exercise showed a significant difference in the Togu exercise group. [Conclusion] The trunk muscle actiation program for middle-aged women had a significant effect on muscle strength and low back pain. Therefore the trunk muscle activation program is effective at increasing muscular strength of middle-aged women, and the results suggest improve muscle strength is effectively stabilizaties the lumbar region.Key words: Isokinetic, Lumbar stabilization, Togu     

基于功能性近红外光谱技术探索脑卒中后偏瘫患者不同踝关节牵伸训练任务与皮层活动的相关性

目的：通过功能性近红外光谱技术(fNIRS)初步探讨脑卒中后偏瘫患者在执行不同踝关节牵伸训练任务过程中大脑皮层感兴趣区域（ROIs）的激活差异及其相关性。方法：将26例脑卒中偏瘫患者分为2组：非优势半球组患者14例,优势半球组患者12例。病例入组时,首先对受试者进行临床功能评估,再运用fNIRS监测受试者在执行患侧踝关节牵伸训练任务过程中ROIs氧合血红蛋白(oxy-Hb)的浓度变化。结果：主动踝关节背屈与跖屈训练任务的脑区激活程度高于被动踝关节背屈与跖屈训练及静息状态（P<0.05）,而踝关节被动牵伸训练任务的脑区激活程度高于静息状态（P<0.05）。另外,优势半球组患者受累侧ROIs激活整体上高于非受累侧,且大脑半球偏侧化指数（LI）数值大于0的可能性大。非优势半球组患者在执行患侧踝关节牵伸训练任务时,感觉运动皮层（SMC）的激活程度与6min步行试验（6MWT）的步行距离成正相关（r=0.5531~0.6165,P<0.05）。结论：脑卒中后偏瘫患者踝关节不同牵伸训练任务与皮层活动存在一定的差异及相关性。     

Correlation between ankle plantar flexion strength and degree of body sway

[Purpose] The purpose of this study is to consider the correlation between ankle plantar flexion strength and degree of body sway. [Participants and Methods] Twenty-one healthy adult males were targeted. A handheld dynamometer was used to measure ankle plantar flexion strength. The Body Pressure Measurement System was used to measure the degree of body sway. Lastly, correlation between ankle plantar flexion strength and degree of body sway was considered. [Results] A negative correlation was observed between ankle plantar flexion strength and degree of body sway. [Conclusion] Regarding ankle plantar flexion strength and degree of body sway, results of a consideration using a handheld dynamometer and Body Pressure Measurement System were the same as that of previous studies using large equipment.     

The effects of calf muscle self-massage on ankle joint range of motion and tendon-muscle morphology

IntroductionSelf-massage using a foam roller (foam rolling) has been used to improve joint range of motion (ROM). However, the effect of foam rolling on the morphology of a targeted muscle, tendon, and muscle-tendon unit (MTU) has not been fully clarified. This study aimed to investigate extensibility changes in the gastrocnemius muscle (GM), MTU, and the Achilles tendon (AT) in terms of maximum ankle dorsiflexion (max-DF) following a foam rolling intervention. This was an interventional study with no controls.MethodsStudy participants comprised 10 male and female students (mean [standard deviation]: 22.7 [2.5] years; height, 164.2 [6.7] cm; weight, 57.9 [7.9] kg). The foam rolling intervention was performed on the right leg plantar flexor muscles for 3 min. The outcomes were max-DF with specified resistance values (ROM-SR) and non-specified resistance values (ROM-NSR) and GM, MTU, and AT extensibility. An ultrasound device was used to determine the rate of change by subtracting the value in a neutral ankle joint position (0°) from the ankle max-DF to identify GM, MTU, and AT extensibility. All outcomes were measured pre- and post-intervention.ResultsThe range of ankle joint dorsiflexion increased significantly following the foam rolling intervention (Δ: ROM-SR, +4.35 [5.79]; ROM-NSR, +4.18 [4.43]), whereas GM extensibility increased 4.0 mm, although no significant difference was observed pre- and post-intervention.ConclusionFoam rolling was effective in increasing ankle joint dorsiflexion ROM. Moreover, it was suggested that the GM morphology might be affected by the intervention.     

Pilot study to test the safety of an exercise machine on healthy adult females

Aim:  To assess the safety and effectiveness of a chair-type training machine developed for the elderly and to conduct a training program in healthy women using this machine.
Methods:  Twenty-four healthy women (mean age: 27.0 ± 5.4 years; range: 21–38 years) were randomly assigned to the exercise program (intervention) group ( n  = 12) or the control group ( n  = 12). Intervention: Training program using the chair-type training machine for the elderly in 60-min sessions twice a week for 12 weeks. Measurements: Safety standards for machinery (ISO 12100) and physiological phenomena (blood pressure, heart rate, and subjective symptoms and objective symptoms) were assessed. The primary endpoints were isometric muscle strength (knee joint extension strength (KJES)), ankle dorsal flexion strength (ADFS), and ankle plantar flexion strength (APFS); these were assessed using standardized protocols at the beginning and the end of intervention.
Results:  There were two dropouts in the intervention group. The safety of the machine was judged as acceptable based on the standard. No training-related medical problems occurred. It was observed that 12 weeks after the end of the training program, the isometric muscle strengths of all the left muscles and the right APFS were reinforced in the intervention group ( P  < 0.05). The right KJES and right ADFS of the intervention group did not show significant change when compared to the control.
Conclusion:  The chair-type training machine and the training program with this machine are safe and effective for increasing muscle strength.     

Effects of a Fall Prevention Exercise Program on Muscle Strength and Balance of the Old-old Elderly

[Purpose] The purpose of this study was to investigate the effects of an 8-week balance exercise and elastic-resistance exercise program on muscle strength and balance of the old-old elderly (over the age of 75). [Subjects and Methods] Fifty-five elderly persons were recruited from the community and assigned to three groups for convenience: balance exercise (intervention group 1; INT 1), resistance exercise (intervention group 2; INT 2), and control (CON) groups. The intervention was performed twice a week at a senior center and three times a week at home for 8 weeks. Muscle strength and balance were evaluated before and at the end of the trial, using a PowertrackIIand Tetrax. [Results] There were significant improvements in the strength of all seven muscle groups and balance in the INT 2 group. In the INT 1 group, there were significant improvements in the strength of all muscle groups except for the knee flexor and ankle plantar flexor muscle groups. [Conclusion] This study demonstrated that an intervention using balance exercises or elastic-resistance exercises is effective at improving the muscle strength and balance of the old-old elderly. These type of exercises should be appropriate for the physical characteristics of the subjects.Key words: Falls, Muscle strength, Postural balance     

Physique,range of motion,and gross muscle strength in hemiplegic para swimmers: a cross-sectional case series

[Purpose] The physical functions related to swimming should be evaluated to enhance competitive performance and prevent sports injuries. This study aimed to determine the physique, range of motion, and gross muscle strength of the limbs among hemiplegic para swimmers. [Participants and Methods] Three male para swimmers with hemiplegia and five male para swimmers with impaired vision were included in the study. The limb circumference, range of motion, quadriceps flexibility, and gross muscle strength were evaluated. The hemiplegic swimmers and swimmers with impaired vision were compared using an unpaired t-test. [Results] The maximum values of the upper and forearm circumferences; the range of motion for shoulder flexion, external rotation, ankle dorsiflexion on the paretic side; and the single-leg sit-to-stand test of the dominant limb were significantly lower in hemiplegic swimmers than in swimmers with impaired vision. [Conclusion] Hemiplegic swimmers had decreased upper limb circumferences on the paretic limb; the range of motion for shoulder flexion, external rotation, and ankle dorsiflexion on the paretic limb; and muscle strength on the dominant lower limb.