• 대한정형외과학회지
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• 제56권2호
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• pp.157-163
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• 2021

목적: 아킬레스건의 황색종은 드물게 발생하며 증상이 심할 경우 수술적 치료가 필요한 경우가 있다. 전 절제술 후 재건술은 높은 수술의 숙련도를 요하며 다양한 합병증에 대한 우려가 있다. 본 연구에서는 양측 아킬레스건에 발생한 거대 황색종에 대해 자가 아킬레스건을 보존하는 쐐기형 절제술 후 추시 결과를 분석하고자 하였다. 대상 및 방법: 2010년 7월부터 2018년 5월까지 양측 아킬레스건에 발생한 황색종 환자 5명에 대해 자가 아킬레스건을 보존하는 쐐기형 절제술을 시행하였다. 평균 나이는 49세(범위, 40-55세)였고 추시 기간은 평균 21.4개월(범위, 12-31개월), 남자는 3명, 여자는 2명이었다. 수술 후 발생한 합병증을 기록하였으며 족관절 운동 범위, American Orthopaedic Foot & Ankle Society(AOFAS) ankle/hindfoot score, 치료 만족도 시각적 척도(visual analogue scale for overall satisfaction), single-limb heel raise 가능 여부, 그리고 직장으로의 복귀 시간을 측정하여 수술 후 임상적인 평가를 시행하였다. 결과: 1명에서 열개창(wound dehiscence)이 발생하였으며 추가적인 수술적 치료 없이 호전되었다. 마지막 추시에서 모든 환자들의 족관절의 운동 범위는 정상이었으며 AOFAS ankle/hindfoot score는 평균 91점(범위, 85-96점)이었고 치료 만족도 시각적 척도는 8-10점의 분포를 보였다. 직장으로의 복귀는 평균 27.6일(범위, 17-58일)이었으며 모든 환자는 single-limb heel raise가 가능하였다. 결론: 아킬레스건에 황색종이 발생하였을 경우 자가 아킬레스건을 보존하며 시행하는 쐐기형 절제술은 좋은 수술적 치료가 될 수 있을 것으로 판단된다.

• 대한족부족관절학회지
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• 제7권2호
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• pp.194-200
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• 2003

Purpose: To evaluate the effectiveness of ankle arthrography in diagnosis and treatment of the ankle sprain. Materials and Methods: Arthrography was performed to eighteen patients who were diagnosed as ankle sprain clinically from September, 1990 to April, 2003. Splint immobilization for three days and return to daily life were for the eleven patients who showed normal limits of extension of joint and no dye leakage on arthrography, cast for 3 weeks and compression brace wearing were for 4 patients who showed anterior talofibular ligament tear on arthrography. 3 patients diagnosed as anterior talofibular and calcaneofibular ligament tears were treated with cast for 6 weeks and then brace for 3 weeks. Results: The range of motion of the injured joint was recovered normally at the time of 3 month of postoperative follow up examination. But two patients complained a mild pain after exercise but it did not affect ordinary activities. Eleven patients who were normal on arthrography returned to daily activities in a week. Conclusion: It is reasonable to determine the extent of ankle sprain and treatment method for it using arthrography.

• 한국전문물리치료학회지
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• 제22권1호
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• pp.30-36
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• 2015

The purpose of this study was to examine the relationships between the ankle dorsiflexion passive range of motion (DF PROM) under a non-weight bearing condition and the normalized reach distance in three directions of the Y-Balance Test (YBT). Sixty-one healthy adults (32 males and 29 females, age: $23.0{\pm}3.0$ years, height: $169.3{\pm}8.9cm$, weight: $61.9{\pm}5.4kg$) participated in this study. The ankle DF PROM was measured using a goniometer. To assess dynamic balance, all subjects performed three trials to determine the maximum lower extremity reach in the anterior, posteromedial, and posterolateral directions of the YBT. The relationship between the ankle DF PROM and both the normalized reach distance in each direction and the composite score of the YBT were analyzed using the Pearson correlation. Only the normalized reach distance in the anterior direction of the YBT was significantly related to the ankle DF PROM measured under a non-weight bearing condition (r=.50, p<.001). Neither the normalized reach distances in the posterior directions nor the composite score of the YBT were significantly correlated with the ankle DF PROM measured under a non-weight bearing condition. These findings suggest that ankle DF PROM does not affect the overall dynamic balance of the lower extremity, with only the anterior dynamic balance affected among the three directions.

• PNF and Movement
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• 제19권1호
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• pp.87-95
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• 2021

Purpose: The purpose of this study was to determine the effects of talus stability taping during gastrocnemius stretching on ankle passive dorsiflexion, talus posterior glide, and balance in subjects with limited ankle dorsiflexion. Methods: Fifteen subjects (eight males and seven females) with limited ankle dorsiflexion participated in this study. Ankle passive dorsiflexion range of motion (ROM), talus posterior glide, and the lower quarter Y-balance test (YBT-LQ) were measured pre-stretching, after applying gastrocnemius stretching (GS), and after applying gastrocnemius stretching with talus stability taping (GSTST). The two types of stretching were performed at random. Results: Ankle passive dorsiflexion ROM was significantly increased by both types of stretching (p < 0.05), and ROM was significantly more increased post-GSTST than post-GS (p < 0.05). In addition, talus posterior glide was significantly increased post-GSTST than pre-stretching and post-GS (p < 0.05). However, there was no significant difference between post-GS and pre-stretching (p > 0.05). YBT-LQ score was significantly increased post-GSTST than pre-stretching (p < 0.05). Conclusion: Gastrocnemius stretching with talus stability taping is an effective method for subjects with limited ankle dorsiflexion to improve ankle passive dorsiflexion, talus posterior gliding, and balance.

• 한국전문물리치료학회지
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• 제11권1호
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• pp.53-67
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• 2004

This simulation study investigated the characteristics of normal gait, $30^{\circ}$ crouch gait, $30^{\circ}$ crouch/equinus gait, $45^{\circ}$ crouch gait, $45^{\circ}$ crouch/equinus gait. The knee flexion angles were restricted using a specially designed orthosis. This study was carried out in a motion analysis laboratory of the National Rehabilitation Center. Fifteen healthy male subjects were recruited for the study. The purposes of this study were (1) to compare spatiotemporal parameters, kinematics, and kinetic variables in the sagittal plane among the different gait, (2) to investigate the secondary compensatory strategy, and (3) to suggest biomechanical physical therapy treatment methods. The pattern and magnitude observed in each condition were similar to those of normal gait, except the peak knee extension moment of the unrestricted ankle motion-crouch gait. However, the speed of the $45^{\circ}$ crouch gait was half that of a normal gait. The ankle joint moment in the crouch/equinus gait showed the double-bump pattern commonly observed in children with spastic cerebral palsy, and there was no significant difference in gait speed as compared with normal gait. The peak ankle plantar-flexor moment and ankle power generated during the terminal stance in the crouch/equinus conditions were reduced as compared with normal and $45^{\circ}$ crouch gaits (p<.05). The crouch/equinus gait at the ankle joint was an effective compensatory mechanism. Since ankle plantarflexion contracture can be exacerbated secondary to the ankle compensatory strategy in the crouch/equinus gait, it is necessary to increase the range of ankle dorsiflexion and the strength of plantarflexion simultaneously to decrease the abnormal biomechanical advantages of the ankle joint.

• 한국운동역학회지
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• 제27권3호
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• pp.219-227
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• 2017

Objective: The aim of this study was to analyze the effects of bobsleigh shoes on the lower extremity range of motion and start speed lap time and to develop bobsleigh shoes suitable for winter environments and Korean players based on sports science and optimized biomechanical performance. Background: The bobsleigh shoes used in the start section of the sport are one of the most important equipment for improving athletes' performances. Despite the importance of the start section, there are no shoes that are specifically designed for Korean bobsleigh athletes. Thus, Korean athletes have to wear sprint spike shoes instead of bobsleigh shoes to practice the start. Method: The subjects included four bobsleigh athletes from the Gangwon Province Bobsleigh Skeleton Federation. The study selected the bobsleigh shoe type A (company A) and type B (company B). We analyzed the lower extremity range of motion and sprint time (start line to 10 m) using a Motion Analysis System (USA). Results: In the measurement of the time required for the bobsleigh start section (10 m), the type A shoes demonstrated the fastest section record by $2.765{\pm}0.086sec$ and yielded more efficient movements, hip and knee flexion, hip extension, ankle dorsiflexion, plantar flexion, and inversion than the type B shoes. Conclusion: Type A shoes can yield a better performance via effective lower extremity movements in the bobsleigh start section. Application: In the future, functional analysis should be conducted by comparing the upper material properties, comfort, and muscle fatigue of bobsleigh shoes based on the Type A shoes to develop such shoes suitable for Koreans.

• 한국운동역학회지
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• 제29권3호
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• pp.145-155
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• 2019

Objective: The purpose of this study was to compare the physical characteristics (bone mineral density, joint muscle strength) and running biomechanics between older adults and young adult runners to understand the changes of running strategy by aging. Method: Bone mineral density (Dual Energy X-ray Absorptiometry, USA) of lower lower extremity and muscle strength (Cybex Humac Norm [DEXA], CSMI, USA) were measured to identify the physical characteristics of 10 elderly (age: $67.70{\pm}3.30yrs$, height: $1.68{\pm}0.04m$, mass: $67.70{\pm}3.80kg$) and 10 young adults (age: $21.20{\pm}0.42yrs$, height: $1.73{\pm}0.06m$, mass: $72.11{\pm}4.15kg$). Running data was collected by using an instrumented treadmill (Bertec, USA) and 7 infrared cameras (Oqus 300, Qualisys, Sweden). Two-way repeated ANOVA analysis was used to analyze results at a significant level of .05 with Bonferroni post hoc analysis. Results: Compared to the young adult group, the elderly group showed statistically significant difference in physical characteristics and in running characteristics. Elderly runners showed lower BMD and muscle strength compared with young runners (p<.05). In the running parameters, elderly runners tend to show shorter contact time and stride length compared with young runners (p<.05). In the joint angles, elderly runners showed smaller range of ankle motion compared with young runners (p<.05). Finally, elderly runners showed lower level of joint moment, joint power, and GRF compared with young runners in each running speed (p<.05). Conclusion: The running behavior of the elderly performed periodic running was similar to many variables of young adults. However, there were noticeable differences found in the ankle joints and most kinetic variables compared with young adult runners. This discrepancy may propose that elderly runners should consider appropriate running distance and intensity in the program.

• 한국전문물리치료학회지
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• 제21권2호
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• pp.57-66
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• 2014

The objective of this study was to determine the duration of maintained calf muscle flexibility gained in young adults with calf muscle tightness, as measured by increases in ankle active and passive dorsiflexion range of motion (DFROM) after three stretching interventions. Twenty subjects (5 men and 15 women) with calf muscle tightness received the following three stretching interventions in one leg (assigned at random): static stretching (SS), eccentric training on stable surface (ETS), and eccentric training on unstable surfaces (ETU). The subjects received all three interventions to the same leg, applied in a random order. Each intervention had a break of at least 24 h in-between, in order to minimize any carryover effect. Each intervention used two types of stretching: with the calf muscle stretched and both knees straight, and with the knee slightly bent in order to maximize the activation of the soleus muscle. All three interventions were performed for 200 seconds. We measured the duration of maintained calf muscle flexibility through active and passive ankle DFROM before intervention, immediately after intervention (time 0), and then 3, 6, 9, 15, and 30 min after intervention. We found a difference in the duration of maintained calf muscle flexibility between the three interventions. In the ETS and ETU interventions, a significant improvement in calf muscle flexibility, both ankle active and passive dorsiflexion ranges of motion (ADFROM and PDFROM), was maintained for 30 min. In the SS intervention, however, ADFROM before 9 min and PDFROM before 6 min were statistically different from the baseline. Our results suggest that ETS and ETU may be more effective than SS for maintaining calf muscle flexibility in young adults.

• 대한족부족관절학회지
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• 제13권1호
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• pp.34-39
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• 2009

Purpose: We try to evaluate the clinical results of the acute Achilles tendon rupture treated with Krackow suture technique. Materials and Methods: We reviewed 27 patients with acute Achilles tendon rupture treated between October 2005 and September 2007. There were 26 complete ruptures and 1 incomplete rupture. All were ruptured at tendinous area. There were 21 men and 6 women, and mean age was 38 years. We repaired ruptured Achilles tendon with Krackow suture technique. The results were evaluated with Arner-Lindholm scale for patients' satisfaction, strength of calf muscle power, calf circumference, and ankle motion. The average follow-up was 29 months. Results: The patients' subjective clinical results was excellent in 25 cases and good in 2 cases. There were 15 cases of less than 1 cm, 6 cases of 1${\sim}$3 cm, and 1 case of more than 3 cm in the calf circumference difference between the normal and affected leg. There were 20 cases of less than 5 degrees, and 2 cases of more 5 degrees in the difference of range of motion between the normal and affected ankle. We had an experience of postoperative deep infection in one diabetic patient. Conclusion: We had a good clinical result for acute Achilles tendon rupture treated with Krackow suture method. So we recommand Krackow suture technique for acute Achilles tendon rupture.

• The Journal of Korean Physical Therapy
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• 제25권4호
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• pp.187-194
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• 2013

Purpose: The aim of this study was to investigate the effects of interferential current therapy (ICT) on spasticity, ROM, and the balance function in patients with stroke. Methods: 30 inpatients with stroke were randomly divided into 2 groups: the ICT group (n=15) and the placebo-ICT group (n=15). Two groups have got the traditional rehabilitation for 30 minutes before applying either ICT or placebo-ICT stimulation. The stimulus of ICT has been applied to gastrocnemius at the level of 100 Hz, two times of sensation threshold, while the placebo-ICT group has put on the electrode without electrical stimulus. To assess spasticity in ankle, the modified Ashworth scale (MAS) was used, and goniometer was applied to measure the passive range of motion (PROM). Also, the Berg Balance Scale (BBS), the Timed-up and go (TUG), and the Functional Reach Test (FRT) were carried out to examine the balance ability. Results: The ICT group showed a significant reduction of spasticity and significantly increased PROM than the placebo-ICT group (p<0.05). The placebo-ICT group did not show significant changes in the BBS, the TUG, and the FRT, while the ICT group significantly improved the BBS, the TUG, and the FRT (p<0.05). Conclusion: Our results demonstrated that ICT applied to gastrocnemius effectively decreased spasticity and improved range of motion and balance function in patients with stroke.