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Purpose: This study investigated the short-term effectiveness of extracorporeal shock wave therapy (ESWT) on pain, the ankle instability, the ankle function, dorsiflexion range of motion (ROM), and dynamic balance in patients with chronic ankle instability (CAI). Methods: Eighteen participants were divided into an experimental (n= 9) and control group (n= 9). The ESWT in the experimental group was applied to the lateral collateral ligament in combination with the tibialis anterior whereas the ESWT was applied to the lateral collateral ligament of the ankle alone in the control group. Pain, the ankle instability, the ankle function, dorsiflexion ROM, and dynamic balance were measured using the Visual analog scale, Cumberland ankle instability tool, American Orthopedic Foot and Ankle Society ankle-hindfoot score, weight-bearing lunge, and Y-balance test, before and after ESWT intervention. Results: Significant interactions (group × time) and time effects were observed in the dorsiflexion ROM and dynamic balance. Bonferroni's post-hoc analysis showed that the experimental group revealed a more significant change in dorsiflexion ROM and dynamic balance than the control group. There was a significant time effect in the pain, the ankle instability, and the ankle function, but no significant interaction (group × time) was observed. Conclusion:The ESWT could improve the pain, ankle instability, ankle function, dorsiflexion ROM, and dynamic balance in patients with CAI. Furthermore, the ESWT combined with lateral ankle ligaments and tibialis anterior more improves the dorsiflexion ROM and dynamic balance.

Purpose:The purpose of this study was to compare the spatiotemporal and kinematic gait parameters and muscle activity of the lower extremities between forward walking on sand (FWS) and backward walking on sand (BWS) in normal adults. Methods: This study was conducted on 13 healthy adults. Subjects performed FWS and BWS and the spatiotemporal and kinematic gait parameters of stride time, stride length, velocity, cadence, step length, stance, swing, double support, and hip range of motion (ROM), knee ROM were measured by a wearable inertial measurement unit system. In addition, the muscle activity of the rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA), and gastrocnemius (GA) was measured. Results: The stride length, stride velocity, cadence, and step length in the BWS were significantly lower than FWS (p< 0.05), and stride time was significantly greater (p< 0.05). However, there was no significant difference in the ratio of stance, swing, and double support between the two (p> 0.05). The kinematic gait parameters, including hip and knee joint range of motion in BWS, were significantly lower than FWS (p< 0.05). The muscle activity of the RF in BWS was significantly higher than FWS (p< 0.05), but the muscle activity of the BF, TA, GA did not show any significant differences between the two movements (p> 0.05). Conclusion:A strategy to increase stability by changing the gait parameters is used in BWS, and this study confirmed that BWS was a safe and effective movement to increase RF muscle activity without straining the joints. Therefore, BWS can be recommended for effective activation of the RF.

In sensorimotor conflicts, the brain forms and updates a new sensorimotor relationship through a trial-error process. As humans adapt to new sensorimotor mapping, goal-directed movements become increasingly precise. Using functional near-infrared spectroscopy, we investigated the cortical activity of sensorimotor adaptation in a spatial orientation task with sensorimotor conflict. Participants formed a new sensorimotor relationship by adapting to a reversed spatial orientation task in which the visual feedback guiding hand movements was reversed. We measured cortical activity and behavior data, including response time and accuracy. In the initial sensorimotor adaptation phase, we observed activation in the somatosensory association cortex, supramarginal gyrus (SMG), angular gyrus, and the third visual cortex. Among these brain regions, the left SMG was consistently activated during all the phases of sensorimotor adaptation. These findings suggest dynamic aspects of cortical activity patterns associated with sensorimotor adaptation in spatial orientation tasks, including sensorimotor conflict.