Analysis of medical services provided to patients with ankle sprains in Korea between 2015 and 2017: a cross-sectional study of the health insurance review and assessment service national patient sample database

Quantification of gait characteristics and muscle activation in patients with chronic ankle instability during walking on sand: A randomized crossover trial

BACKGROUND

Limited evidence exists regarding the movement control patterns of individuals with chronic ankle instability (CAI) during sand walking. This study aimed to analyze gait characteristics and muscle activation in patients with CAI while walking on sand.

METHODS

This study recruited 30 participants, including 15 patients with CAI and 15 healthy controls. Patients with CAI were selected based on having experienced at least a lateral ankle sprain within 12 months before recruitment. They also had to scoring ≤ 27 on the Cumberland ankle instability tool. This study was conducted using a randomized crossover trial. All participants were asked to walk three times each at their natural speed on both sand and paving blocks for a distance of 50m. There was at least a week between each trial.

RESULTS

The lower limb gait kinematics, spatiotemporal, and muscle activity parameters while walking on sand and paving blocks were compared between both groups. Significant differences in knee angle were observed between 60.83% and 75.34% of the gait cycle during walking on sand in the patients with CAI. Regarding spatiotemporal parameters, cadence (P = .001) and stride length (P = .049) showed significant differences as the main effect. In the CAI group, the recruitment threshold for the peroneus longus muscle was significantly lower during walking on sand than on paving blocks (P < .001). In contrast, the motor unit action potential (MUAP) was significantly higher (P < .001). For the tibialis anterior muscle, the recruitment threshold and number of motor units were significantly lower during walking on sand than on paving blocks (P = .006 and P = .003, respectively), and the MUAP was significantly higher (P < .001). During walking on sand, patients with CAI exhibited increased knee flexion angle, stride length, and MUAP, along with decreased cadence and recruitment thresholds.

CONCLUSION

These results suggest that sand can influence gait characteristics and muscle activation in patients with CAI. Our findings indicate that gait characteristics and muscle activation changes in patients with CAI could potentially benefit CAI rehabilitation.

Analysis of medical service utilization for post-stroke sequelae in Korea between 2016 and 2018: a cross-sectional study

In this retrospective cross-sectional observational study, the medical service utilization of post-stroke sequelae patients was examined using a national patient sample. The Korean Health Insurance Review and Assessment Service-National Patients Sample database was used to investigate the medical service utilization of 19,562 patients, diagnosed with post-stroke sequelae of cerebrovascular disease (I69) in Korea between January 2016 and December 2018. We compared the demographic characteristics, diagnosis code subtypes, frequency of healthcare utilization, medical costs, and comorbidities of standard care (SC) and Korean medicine (KM) users. Overall, patients aged ≥ 65 years accounted for the highest percentage, and utilization of medical services increased among patients aged ≥ 45 years. Outpatient care was higher among SC (79.23%) and KM (99.38%) users. Sequelae of cerebral infarction accounted for the highest percentage of diagnosis subtypes. Physical therapy and rehabilitation therapy were most frequent in SC, whereas injection/procedure and acupuncture were most frequent in KM. Cerebrovascular circulation/dementia drugs were prescribed most frequently in SC. Circulatory, digestive, endocrine, and metabolic disorders were the most common comorbidities in SC, whereas musculoskeletal and connective tissue disorders were most common in KM. Overall, SC and KM users showed differences in the number of medical service claims, cost of care, and comorbidities. Our findings provide basic research data for clinicians, researchers, and policy makers.

Decreased patient visits for ankle sprain during the COVID-19 pandemic in South Korea: A nationwide retrospective study

Social distancing measures including school closure and the cancelation of sports activity were enforced during the early phase of the coronavirus disease 2019 (COVID-19) pandemic to reduce the spread of severe acute respiratory syndrome coronavirus 2 in South Korea. To assess the impact of the COVID-19 pandemic on the nationwide burden of musculoskeletal injury in 2020, we analyzed data on the number of patient visits for ankle sprain in South Korea. We collected national reimbursement data on the number of patient visits for ankle sprain between August 2010 and July 2020. To quantify the impact of the COVID-19 pandemic on the number of reductions in patient visits for ankle sprain, we developed a regression model adjusting for the annual cycle of the patient visit during 2016/17-2018/19. During the COVID-19 pandemic in South Korea, the overall number of patient visits for ankle sprain dropped by 7.9%. The number of patient visits for ankle sprain substantially reduced by 23.4% among school-aged children (6-19 years) during the COVID-19 pandemic in South Korea. Our findings suggest that the social distancing measure has had a positive impact on reducing the burden of medical usages for ankle sprain.