경사도 변화에 따른 보행운동이 만성 발목 불안정성이 있는 성인의 균형, 근활성도 및 족저압에 미치는 영향

다국어 초록 (Multilingual Abstract)

This study investigated the effects of 10° uphill and downhill walking exercises on balance, muscle activation, and plantar pressure in adults with chronic ankle instability (CAI). A total of 41 participants were divided into three groups: a normal control group (n=13), a 10° uphill walking exercise group (n=14), and a 10° downhill walking exercise group (n=14). Static balance, dynamic balance (assessed using the Modified Star Excursion Balance Test, MSEBT), muscle activation during MSEBT, and plantar pressure during level walking were measured before and after the intervention in the CAI groups, with the results compared to the pre-intervention values of the control group.
Static balance results indicated no significant differences between the CAI groups and the control group before or after the intervention. In the 10° uphill walking exercise group, dynamic balance significantly improved post-intervention, with increased anterior, posterolateral, and posteromedial reach distances and composite scores, narrowing the gap with the control group. Muscle activation analysis showed a significant increase in peroneus longus activity during the anterior reach in the 10° uphill walking exercise group, approaching the control group’s level. Plantar pressure analysis revealed no significant differences between groups before or after the intervention; however, the 10° uphill walking exercise group showed a significant post-intervention increase in forefoot pressure, aligning more closely with the control group.
These findings suggest that 10° uphill walking is effective in enhancing dynamic balance, stabilizing muscle activation, and improving plantar pressure distribution in individuals with CAI. Conversely, 10° downhill walking showed limited benefits in reducing these disparities. This study highlights the potential of incline-based walking exercises as a targeted rehabilitation strategy for CAI. Further research with larger sample sizes and long-term follow-up is warranted to validate these results

목차 (Table of Contents)

• Ⅰ. 서론 1
• 1. 연구의 배경 1
• 2. 연구의 가설 5
• Ⅱ. 연구 방법 6
• 1. 연구 대상 6
• 2. 연구 설계 9
• 3. 측정 장비 및 방법 11
• 가. 측정 장비 11
• 1) 체성분석기 11
• 2) 근전도 분석기 12
• 3) Treadmill 13
• 4) Zebris FDM-1. 514
• 나. 실험 방법 15
• 1) 오르막 및 내리막 10˚ 보행운동 15
• 2) 정적균형 측정 17
• 3) 동적균형 측정 19
• 4) 근활성도 측정 21
• 5) 족저압 측정 23
• 4. 자료 분석 및 통계 24
• Ⅲ. 연구 결과 25
• 1. 균형 25
• 가. 정적균형 25
• 1) 보행운동 전 그룹 간 정적균형 비교 26
• 2) 보행운동 후 그룹 간 정적균형 비교 28
• 3) 경사도 변화에 따른 정적균형 전-후 비교 31
• 나. 동적균형 34
• 1) 보행운동 전 그룹 간 동적균형 비교 34
• 2) 보행운동 후 그룹 간 동적균형 비교 37
• 3) 경사도 변화에 따른 정적균형 전-후 비교 40
• 2. 근활성도 43
• 가. 보행운동 전 그룹 간 근활성도 비교 43
• 나. 보행운동 후 그룹 간 근활성도 비교 47
• 다. 경사도 변화에 따른 근활성도 전-후 비교 50
• 3. 족저압 54
• 가. 보행운동 전 그룹 간 족저압 비교 54
• 나. 보행운동 후 그룹 간 족저압 비교 57
• 다. 경사도 변화에 따른 족저압 전-후 비교 60
• Ⅳ. 고찰 63
• Ⅴ. 결론 69
• 참고문헌 71
• Abstract 80
• List of Table
• Table 1. General Characteristics according to group 8
• Table 2. The placement of surface EMG electrodes 22
• Table 3. Comparison of Static Balance among Groups before Walking Exercise ·· 26
• Table 4. Comparison of Static Balance among Groups after Walking Exercise ·· 29
• Table 5. Comparison of Pre-Post Static Balance according to Slope Changes 32
• Table 6. Comparison of Dynamic Balance among Groups before Walking Exercise 35
• Table 7. Comparison of Dynamic Balance among Groups after Walking Exercise 38
• Table 8. Comparison of Pre-Post Dynamic Balance according to Slope Changes 41
• Table 9. Comparison of Muscle Activity among Groups before Walking Exercise 45
• Table 10. Comparison of Muscle Activity among Groups after Walking Exercise 48
• Table 11. Comparison of Pre-Post Muscle Activity according to Slope Changes 51
• Table 12. Comparison of Plantar Pressure among Groups before Walking Exercise 55
• Table 13. Comparison of Plantar Pressure among Groups after Walking Exercise 58
• Table 14. Comparison of Pre-Post Plantar Pressure according to Slope Changes 61
• List of Figure
• Fig. 1. Schematic diagram of experimental process 10
• Fig. 2. Inbody 11
• Fig. 3. Electromyography 12
• Fig. 4. Treadmill 13
• Fig. 5. Zebris FDM-1.5 14
• Fig. 6. Walking on uphill treadmills 16
• Fig. 7. Walking on downhill treadmills 16
• Fig. 8 Static balance Test 18
• Fig. 9. Modified Star Excursion Balance Test 20
• Fig. 10. Comparison of Static Balance among Groups before Walking Exercise 27
• Fig. 11. Comparison of Static Balance among Groups after Walking Exercise 30
• Fig. 12. Comparison of Pre-Post Static Balance according to Slope Changes 33
• Fig. 13. Comparison of Dynamic Balance among Groups before Walking Exercise 36
• Fig. 14. Comparison of Dynamic Balance among Groups after Walking Exercise 39
• Fig. 15. Comparison of Pre-Post Dynamic Balance according to Slope Changes 42
• Fig. 16. Comparison of Muscle Activity among Groups before Walking Exercise 46
• Fig. 17. Comparison of Muscle Activity among Groups after Walking Exercise 49
• Fig. 18. Comparison of Pre-Post Muscle Activation in the Uphill Group 52
• Fig. 19. Comparison of Pre-Post Muscle Activation in the Downhill Group 53
• Fig. 20. Comparison of Plantar Pressure among Groups before Walking Exercise 56
• Fig. 21. Comparison of Plantar Pressure among Groups after Walking Exercise 59
• Fig. 22. Comparison of Pre-Post Plantar Pressure according to Slope Changes 62