Title Page
Abstract
Contents
1. Introduction 14
1.1. Background and necessity 14
1.2. Purpose 19
1.3. Hypothesis 19
2. Theoretical background 20
2.1. Anatomical structure of ankle joint 20
2.2. Gait cycle 23
2.3. MWM 26
3. Methods 27
3.1. Participants 27
3.2. Study procedures 28
3.3. Study methods(lnterventions) 30
3.3.1. Mulligan technique movement with mobilization(MWM) 31
3.3.2. Joint mobilization following the Kaltenborn-Evjenth concept 32
3.4. Assessment 33
3.4.1. ROM 33
3.4.2. Proprioception 34
3.4.3. Static balance 36
3.4.4. Dynamic balance 38
3.4.5. Balance ability 40
3.4.6. Gait analysis 41
3.5. Statistical analysis 42
4. Results 43
4.1. General characteristics of subjects and homogeneity tests 43
4.2. Comparison of the ROM 44
4.2.1. Comparison of the rt ankle dorsiflexion 44
4.2.2. Comparison of the lt ankle dorsiflexion 46
4.3. Comparison of the proprioception(PPC) 48
4.3.1. Comparison of the rt plantarflexion ankle proprioception 48
4.3.2. Comparison of the rt ankle dorsiflexion proprioception 50
4.3.3. Comparison of the lt ankle plantarflexion proprioception 52
4.3.4. Comparison of the lt ankle dorsiflexion proprioception 54
4.4. Comparison of the static balance 56
4.4.1. Comparison of the nintendo balance board sway velocity(NBBSV) 56
4.4.2. Comparison of the nintendo balance board sway length(NBBSL) 58
4.5. Comparison of the Y-balance test 60
4.5.1. Comparison of the rt ankle Y-balance test 60
4.5.2. Comparison of the lt ankle Y-balance test 63
4.6. Comparison of the BBS 66
4.7. Comparison of the 10meter walking test 68
5. Discussion 70
5.1. Talocrural joint mobilization and ROM 73
5.2. Talocrural joint mobilization and proprioception 74
5.3. Talocrural joint mobilization and static balance 76
5.4. Talocrural joint mobilization and dynamic balance 77
5.5. Talocrural joint mobilization and balance ability 78
5.6. Talocrural joint mobilization and gait analysis 79
5.7. Limitations 80
6. Conclusion 81
List of references 83
List of abbreviations 99
Appendix 102
7.1. Mini-mental state examination(Korean ver.) 102
7.2. BBS 104
7.3. Abstract(Korean) 109
7.4. Agreement to participate in research 111
7.5. Explanation for the subject agreement(explanation for subject consent) 112
Table 1. Intervention 30
Table 2. General characteristics of subjects and homogeneity tests 43
Table 3. Comparison of flexion rt ROM between the experimental and control group 44
Table 4. Comparison of flexion lt ROM between the experimental and control group 46
Table 5. Comparison of RPF PPC between the experimental and control group 48
Table 6. Comparison of RDF PPC between the experimental and control group 50
Table 7. Comparison of LPF PPC between the experimental and control group 52
Table 8. Comparison of LDF PPC between the experimental and control group 54
Table 9. Comparison of NBBSV between the experimental and control group 56
Table 10. Comparison of NBBSL between the experimental and control group 58
Table 11. Comparison of rt Y-balance test between the experimental and control group 60
Table 12. Comparison of lt Y-balance test between the experimental and control group 63
Table 13. Comparison of BBS between the experimental and control group 66
Table 14. Comparison of 10MWT between the experimental and control group 68
Figure 1. Flow chart 29
Figure 2. Mulligan technique movement with mobilization(dorsal) 31
Figure 3. Kaltenborn-Evjenth concept Joint mobilization(dorsal) 32
Figure 4. Goniometer(Goninmeters, Korea) 33
Figure 5. Range of Motion 33
Figure 6. iPhone X (MQAC2KH/A, Apple, USA) 35
Figure 7. Proprioception 35
Figure 8. Nintendo wii balance board (Nintendo, Japan) 37
Figure 9. Static balance 37
Figure 10. Y-balance test 39
Figure 11. Dynamic balance 39
Figure 12. 10 meter walking test 41
Figure 13. Comparison of the rt ankle dorsiflexion ROM between the experimental and control group 45
Figure 14. Comparison of the lt ankle dorsiflexion ROM between the experimental and control group 47
Figure 15. Comparison of the rt plantarflexion ankle PPC between the experimental and control group 49
Figure 16. Comparison of the rt ankle dorsiflexion PPC between the experimental and control group 51
Figure 17. Comparison of the lt ankle plantarflexion PPC comparison ofthe lt ankle plantarflexion proprioception 53
Figure 18. Comparison of the lt ankle dorsiflexion PPC between the experimental and control group 55
Figure 19. Comparison of the NBBSV between the experimental and control group 57
Figure 20. Comparison of the NBBSL between the experimental and control group 59
Figure 21. Comparison of the Rt AT Ankle V-balance test between the experimental and control group 61
Figure 22. Comparison of the rt PM ankle Y-balance test between the experimental and control group 61
Figure 23. Comparison of the Rt PL Ankle Y-balance test between the experimental and control group 62
Figure 24. Comparison of the lt AT Ankle Y-balance test between the experimental and control group 64
Figure 25. Comparison of the lt PM Ankle Y-balance test between the experimental and control group 64
Figure 26. Comparison of the lt PL ankle Y-balance test between the experimental and control group 65
Figure 27. Comparison of the BBS between the experimental and control group 67
Figure 28. Comparison of the 10MWT between the experimental and control group 69