후방 경골 건 기능부전 환자의 임상 증상에 운동 치료가 미치는 영향
The Effect of the Combined Stretching and Strengthening Exercise on the Clinical Symptoms in Posterior Tibial Tendon Dysfunction Patient
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Purpose: The isolated exercise therapy and its effect for the treatment of posterior tibial tendon dysfunction (PTTD) is not well known. The purpose of this study was to identify the clinical effect of stretching and strengthening exercise program on the patients’ muscle function and range of motion, pain and gait in the management of the early stage PTTD. Materials and Methods: From October 2006 to March 2007, 14 patients with early stage PTTD (stage I or IIa) without surgical intervention were randomly assigned into two groups and we analyzed their clinical results. All patients were female and one who have sprained the same ankle during the program and one who withdrew from the program due to her private reason were excluded. At the last, the exercise group (EG) was seven and the control group (CG) was five. Mann-Whitney U test was used for the comparison of pain, ROM, muscle power, AOFAS score and 5 minute walking test of both groups. Wilcoxon-signed rank test was used for the comparison between the pre and post exercise program in EG. Results: The pain was significantly reduced in EG compare to CG and only the dorsiflexion was significantly increased in EG in the analysis of ROM. The dorsi flexion and plantar flexion power were significantly increased in EG. Conclusion: Our 6 weeks stretching and strengthening exercise program showed noticeably improved clinical result, and therefore it is recommended as one of the useful treatment option in the management of early stage PTTD.
Abstract
Purpose: The isolated exercise therapy and its effect for the treatment of posterior tibial tendon dysfunction (PTTD) is not well known. The purpose of this study was to identify the clinical effect of stretching and strengthening exercise program on the patients’ muscle function and range of motion, pain and gait in the management of the early stage PTTD. Materials and Methods: From October 2006 to March 2007, 14 patients with early stage PTTD (stage I or IIa) without surgical intervention were randomly assigned into two groups and we analyzed their clinical results. All patients were female and one who have sprained the same ankle during the program and one who withdrew from the program due to her private reason were excluded. At the last, the exercise group (EG) was seven and the control group (CG) was five. Mann-Whitney U test was used for the comparison of pain, ROM, muscle power, AOFAS score and 5 minute walking test of both groups. Wilcoxon-signed rank test was used for the comparison between the pre and post exercise program in EG. Results: The pain was significantly reduced in EG compare to CG and only the dorsiflexion was significantly increased in EG in the analysis of ROM. The dorsi flexion and plantar flexion power were significantly increased in EG. Conclusion: Our 6 weeks stretching and strengthening exercise program showed noticeably improved clinical result, and therefore it is recommended as one of the useful treatment option in the management of early stage PTTD.
참고문헌 (28)
- Alfredson H., "Chronic Achilles tendinosis: recommendations for treatment and prevention", Sports Med, 29, pp.135~146 (2000)
- Alvarez RG., "Stage I and II posterior tibial tendon dysfunction treated by a structured nonoperative management protocol: an orthosis and exercise program", Foot Ankle Int, 27, pp.2~8 (2006)
- Augustin JF., "Nonoperative treatment of adult acquired flat foot with the Arizona brace", Foot Ankle Clin, 8, pp.491~502 (2003)
- Basmajian JV., "The role of muscles in arch support of the foot", J Bone Joint Surg, 45(A), pp.1184~1190 (1963)
- Chandler TJ., "Physiology of aerobic fitness", endurance, 1994, pp.43, 11~15
- Chao W., "Nonoperative management of posterior tibial tendon dysfunction", Foot Ankle Int, 17, pp.736~741 (1996)
- Crates JM., "Treatement of stage I posterior tibial tendon dysfunction with medial soft tissue procedures", Clin Orthop, 365, pp.46~49 (1999)
- Deland JT., "Posterior tibial tendon insufficiency: which ligaments are involved?", Foot Ankle Int, 26, pp.427~435 (2005)
- Hartsell HD., "Eccentric", concentric ratios at selected velocities for the invertor and evertor muscles of the chronically unstable ankle, 1999, pp.33, 255~259
- Imhauser CW., "Biomechanical evaluation of the efficacy of external stabilizers in the conservative treatment of acquired flatfoot deformity", Foot Ankle Int, 23, pp.727~737 (2002)
- Johnson KA., "Tibialis posterior tendon dysfunction", Clin Orthop Relat Res, 239, pp.196~206 (1989)
- Kanehisa H., "Force-velocity relationships and fatiguability of strength and endurancetrained subjects", Int J Sports Med, 18, pp.106~11 (1997)
- Kim TU., "Acquied flat foot due to rupture of posterior tibial tendon", J Korean Acad Rehab Med, 21, pp.1024~1029 (1997)
- 김원준, "아킬레스건 수술 후 12주간의 재활운동이 발목 안정성에 미치는 영향", 한국체육학회지, 44(6), pp.407~416 (2005), 한국체육학회
- Kohls-Gatzoulis J., "Tibialis posterior dysfunction: a common and treatable cause of adult acquired flatfoot", BMJ, 329, pp.1328~1333 (2004)
- Kulig K., "Non-operative management of posterior tibialis tendon dysfunction design of a randomized clinical trial", BMC Musculoskelet Disord, 7, pp.49~ (2006)
- Lee MS., "Diagnosis and treatment of adult flatfoot", J Foot Ankle Surg, 44, pp.78~113 (2005)
- Leppilahti J., "Isokinetic evaluation of calf muscle performance after Achilles rupture repair", Int J Sports Med, 17, pp.619~623 (1996)
- Mafi N., "Superior short-term results with eccentric calf muscle training compared to concentric training in a randomized prospective multicenter study on patients with chronic Achilles tendinosis", Knee Surg Sports Traumatol Arthrosc, 9, pp.42~47 (2001)
- Mosier SM., "Pathoanatomy and etiology of posterior tibial tendon dysfunction", Clin Orthop, 365, pp.12~22 (1999)
- Muir IW., "Effect of a static calf-stretching exercise on the resistive torque during passive ankle dorsiflexion in healthy subjects", J Orthop Sport Phys Ther, 29, pp.421~424 (1999)
- Pinney SJ., "Current concept review: acquired adult flatfoot deformity", Foot Ankle Int, 27, pp.66~75 (2006)
- Pomeroy GC., "Acquired flatfoot in adults due to dysfunction of the posterior tibial tendon", J Bone Joint Surg, 81(A), pp.1173~1182 (1999)
- Ringleb SI., "Changes in gait associated with acute stage Ⅱ posterior tibial tendon dysfunction", Gait Posture, 25, pp.555~564 (2007)
- Uchiyama E., "Gliding resistance of the posterior tibial tendon", Foot Ankle Int, 27, pp.723~727 (2006)
- Viladot R., "Subtalar arthroereisis for posterior tibial tendon dysfunction: a preliminary report", Foot Ankle Int, 24, pp.600~606 (2003)
- Wapner KL., "Nonoperative treatment of posterior tibial tendon dysfunction", Clin Orthop, 365, pp.39~45 (1999)
- Weinraub GM., "Adult flatfoot", posterior tibial tendon dysfunction: classification and treatment, 2002, pp.19, 345~370