Objective: The purpose of this study was to determine the interrelationship between ranges of motion of the knee and ankle joints on the sagittal plane and the attenuation magnitude of impact shock at high frequency (9~20 Hz) in the support phase during downhill running. Method: Fifteen male heel-toe runners with no history of lower extremity injuries were recruited for this study (age, $25.07{\pm}5.35years$; height, $175.4{\pm}4.6cm$; mass, $75.8{\pm}.70kg$). Two uniaxial accelerometers were mounted to the tuberosity of tibia and sacrum, respectively, to measure acceleration signals. The participants were asked to run at their preferred running speed on a treadmill set at $0^{\circ}$, $7^{\circ}$, and $15^{\circ}$ downhill. Six optical cameras were placed around the treadmill to capture the coordinates of the joints of the lower extremities. The power spectrum densities of the two acceleration signals were analyzed and used in the transfer function describing the gain and attenuation of impact shock between the tibia and the sacrum. Angles of the knee and ankle joints on the sagittal plane and their angle ranges were calculated. The Pearson correlation coefficient was used to test the relationship between two variables, the magnitude of impact shock, and the range of joint angle under three downhill conditions. The alpha level was set at .05. Results: Close correlations were observed between the knee joint range of motion and the attenuation magnitude of impact shock regardless of running slopes (p<.05), and positive correlations were found between the ranges of motion of the knee and ankle joints and the attenuation magnitude of impact shock in $15^{\circ}$ downhill running (p<.05). Conclusion: In conclusion, increased knee flexion might be required to attenuate impact shock during downhill and level running through change in stride or cadence while maintaining stability, and strong and flexible ankle joints are also needed in steeper downhill running.
The characteristics of the patients after the calcaneal fracture that were associated with an unsatisfactory outcome were subtalar incongruity, decreased Bohler angle ratio of the fractured to the normal side, an age of more than fifty years, work involving strenuous labor, and increased time missed from work due to the injury. The purpose of this study was to examine the reliability of measurements of the range of motion of the subtalar joint. To determine reliability, evaluates of the correlatioinship between the degree of the displacement of the subtalar joint and Circle draw test after the calcaneal fracture. Fifty patients who had had fifty five calcaneal fractures were managed with open reduction and internal fixation. The results were reviewed retrospectively, between 4months and three years after the operation, with use of an evaluation system for the subtalar joint and with plain radiographs. At follow up evaluation, the result was assessed on the basis of restoration of anatomy and function of the subtalar joint. We evaluated the subtalar joint with plain films that consist of anteroposterior projection, lateral projection, calcaneal axial view, and Broden's view, and the measurements of the displacement of the subtalar joint surface after the calcaneal fracture. And we evaluated the range of motion of the subtalar joint with Circle draw test for physical evaluation. Circle draw test was evaluated and demonstrated the motion of flexion-supination-adduction and extension-pronation-abduction of the subtalar joint. And there are correlationship between the degree of the displacement and range of motion of the subtalar joint after the calcaneal fracture. The report critically reviews methords used to measure Circle draw test for physical examination of the follow up after the calcaneal fracture.
Purpose: Regardless of potential and actual complications, the sesamoidectomy either tibial side or fibular side or both, had been used as a surgical option for various pathologic conditions. The objective of this cadaveric study was to identify the changes of range of motion of great toe after sesamoidectomy. Material and Methods: Eight fresh cadaver legs were used. The angular changes of the hallucal articulations were measured by traction of the flexor hallucis longus tendon at the proximal border of fibro-osseous tarsal tunnel and by traction of the extensor hallucis longus tendon at the superior border of inferior extensor retinaculum. The measurement started at neutral position and proceeded to the maximum for respective tendons. After sesamoidectomy either partial or total, same procedures were repeated and the angular changes were measured. Results: In flexion of great toe, there were significant metatarsophalangeal angular differences at 1 cm traction in total sesamoidectomy and lateral sesamoidectomy. In extension of great toe, there were significant metatarsophalangeal angular differences at more than 2 cm traction in total sesamoidectomy. In other measurements, there were no significant angular changes of the hallucal articulations. Conclusion: The sesamoidectomy resulted in change of motion of great toe. Statistical analysis showed that the significant increases in the initial flexion and maximal extension occurred with total sesamoidectomy and the significant increase in the initial flexion occurred with lateral sesamoidectomy.
Objective: The purpose of this study was to understand the injury mechanism and to provide quantitative data to use in prevention or posture correction training by conducting kinematic and kinetic analyses of risk factors of lower extremity joint injury depending on the change of direction at different angles after a landing motion. Method: This study included 11 men in their twenties (age: $24.6{\pm}1.7years$, height: $176.6{\pm}4.4cm$, weight: $71.3{\pm}8.0kg$) who were right-leg dominant. By using seven infrared cameras (Oqus 300, Qualisys, Sweden), one force platform (AMTI, USA), and an accelerometer (Noraxon, USA), single-leg drop landing was performed at a height of 30 cm. The joint range of motion (ROM) of the lower extremity, peak joint moment, peak joint power, peak vertical ground reaction force (GRF), and peak vertical acceleration were measured. For statistical analysis, one-way repeated-measures analysis of variance was conducted at a significance level of ${\alpha}$ <.05. Results: Ankle and knee joint ROM in the sagittal plane significantly differed, respectively (F = 3.145, p = .024; F = 14.183, p = .000), depending on the change of direction. However, no significant differences were observed in the ROM of ankle and knee joint in the transverse plane. Significant differences in peak joint moment were also observed but no statistically significant differences were found in negative joint power between the conditions. Peak vertical GRF was high in landing (LAD) and after landing, left $45^{\circ}$ cutting (LLC), with a significant difference (F = 9.363, p = .000). The peak vertical acceleration was relatively high in LAD and LLC compared with other conditions, but the difference was not significant. Conclusion: We conclude that moving in the left direction may expose athletes to greater injury risk in terms of joint kinetics than moving in the right direction. However, further investigation of joint injury mechanisms in sports would be required to confirm these findings.
Physiotherapyists frequently use manipulative therapy technique to treat dysfunctionand pain resulting from ankle sprain. Despite the high prevalence of lateral ankle ligament injuries, few studies are available indicating any physical associations with the development of lateral ankle ligament injuries, or information of treatment for lateral ankle ligament injuries. To investigate the effect of passive joint mobilization, the anteroposterior glide on the talus, on increasing weight-bearing dorsiflexion, single support time and VAS. Sixty lateral ankle ligament injuries (grade I and grade II) aged between 17 and 27 years (mean age 21) were recruited. Subjects were randomly assigned to 1 of 2 treatment groups. The control group received a protocol of rest, ice, compression, and elevation (RICE) and massage. The experimental group received the anteroposterior mobilization, using a force that avoided incurring any increase in pain, in addition to the RICE protocol. Subjects in both groups were treated every second day for a maximum of 2 weeks or until the discharge criteria were met, and all subjects were given a home program of continued RICE application. Outcomes were measured after each treatment. The results showed that the experimental group than the control group. Weight-bearing dorsiflexion (F=7.640, P<0.05), single support time (F=85.532, P<0.05) and VAS (F=10.610, P<0.050). Between-groups differences were observed as; experimental group is increased weight-bearing dorsiflexion, single support time and reduced VAS.
Kim, Ji-hyun;Park, Joo-hee;Yoon, Hyeo-bin;Lee, Jun-hyeok;Jeon, Hye-seon
한국전문물리치료학회지
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제27권2호
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pp.133-139
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2020
Background: The gastrocnemius (GCM) is one of the lower extremity muscles that tend to tighten easily. GCM tightness results in limited ankle dorsi-flexion (DF), especially when the knee joint is fully extended. Joint flexibility is determined by the morphological and physiological characteristics of joints, muscles, tendons, and ligaments. Impaired joint flexibility can be attributed to increased susceptibility to muscle injury. High-frequency diathermy is clinically used to reduce pain and muscle tightness and to improve limited range of motion. Objects: This study aimed to investigate the immediate effects of high-frequency therapy in subjects with GCM tightness. Methods: The study was designed as a one-group before-after trial. The subjects included 28 volunteers with GCM tightness (an active ankle DF angle of less than 12°) without any known neurological and musculoskeletal pathologies in the ankle and calf areas. WINBACK Transfer Electrode Capacitive and Resistive Therapy equipment was used to apply high-frequency therapy to the subjects' GCMs for 10-15 minutes. The pennation angle and the fascicle length of the GCM were measured using ultrasonography. The flexibility of the ankle joint, peak torque to the passive ankle DF (Biodex), and soft tissue stiffness (MyotonPRO) were also measured. Results: The pennation angle was significantly decreased following the treatment; however, no significant difference in the fascicle length was found (p < 0.05). The flexibility was significantly increased and both the passive peak torque to passive ankle DF and the soft tissue stiffness significantly decreased (p < 0.05). Conclusion: High-frequency therapy is immediately effective for improving the muscle's architectural properties and functional factors in subjects with GCM tightness. Further longitudinal clinical studies are required to investigate the long-term effects of high-frequency therapy on subjects with GCM tightness from various causes.
The purpose of this study is to investigate the effect of using socks combined with EMS on ankle pain reduction and ankle function improvement in home training participants. In this study, the conductive fabric was combined using socks that can properly compress the ankle. First, VAS was measured during EMS training after fatigue was induced and compared with fatigue during rest. It was confirmed that the level of VAS after EMS training was lower than after rest and fatigue. It was also confirmed that EMS training, which combines EMS with socks, was effective in reducing pain. The experimental action is a measurement action of WBLT and lying posture, and the situation before and after EMS training was compared by performing 30 minutes on the treadmill to cause delayed muscle pain during exercise. As a result of this study, it was found that pain reduction and ROM function were improved when electrical stimulation was performed using EMS socks. It was also confirmed that the application of electrical stimulation to EMS socks effected on ankle fatigue and function improvement. From the study results, it is expected that wearing socks equipped with EMS significantly reduces ankle injuries and improves functional recovery for home training participants.
Shin, Jin Hyung;Lee, Joong Sook;Han, Ki Hoon;Bae, Kang Ho
한국운동역학회지
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제28권1호
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pp.45-54
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2018
Objective: The purpose of this study was to investigate the effect of foot strengthening exercise program and functional insoles on joint angle and plantar pressure in elderly women. Thirteen elderly women who were enrolled in a university senior citizens academy of a metropolitan city in 2017 were divided into two groups: exercise group with functional insole (n=7) and exercise group without functional insole (n=6). Method: Three-dimensional motion analysis and Pedar-X were performed to compute the joint angle and the foot plantar pressure, respectively. Two-way repeated measure ANOVA was conducted to compare dependent variables within and between groups. The significance level was set at ${\alpha}=.05$. Results: The range of motion (ROM) of the ankle, knee, and hip joints in the exercise group with functional insole increased significantly more than the exercise group without functional insole. In both the experimental group and the comparison group, the maximum foot plantar pressure and the mean foot plantar pressure were decreased, but the comparison group without functional insole showed more decrease. Since the experimental group demonstrated greater pressure than the comparison group in the contact area (forefoot, midfoot), it was distributed over a greater area. Conclusion: The results of this study suggest that participation in foot strengthening exercises and using a functional insole has more positive effects than foot strengthening exercises alone on the joint angle and plantar pressure in elderly women. Increased foot plantar pressure led to an increased contact area (forefoot, midfoot) for distribution of the foot plantar pressure, but the effect of reducing the maximum and average plantar pressures was incomplete. However, wearing functional insoles along with exercise, could help in improving the stability of the joints, by increasing the range of motion, and could help the elderly in movement of the muscles more effectively, leading to an improvement in gait function.
Purpose: The aim of this study was to evaluate the result of extraarticular dorsal closing wedge osteotomy in Freiberg's disease. Materials and Methods: Between February 2012 and July 2014, total 10 patients who underwent dorsal closing wedge osteotomy and followed up more than 1 year were selected for inclusion. Average age was 16.3 years, and average follow-up period was 15.5 months. The diagnosis was made using magnetic resonance imaging of those with a limitation in walking or usual activity due to pain in the metatarsal head. During operation, we removed loose body, and synovectomy was done. Osteotomy at the metatarsal neck and fixation with Kirschner wire were performed. X-ray was taken to check shortening of 2nd metatarsal and bone union. Moreover, we checked the active range of motion of 2nd metatarsophalangeal joint before and after surgery. At the last follow-up, the shortening of metatarsal, American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS), and patient's subjective satisfaction were evaluated. Results: According to the Smillie's stage, there were 3 cases of stage II, 4 cases of stage III, and 3 cases of stage IV. Average bone union time on the osteotomy site was 8 weeks. Average shortening of metatarsal was 2.53 mm. Average AOFAS score improved significantly from 56.9 to 82.8 points at final follow-up (p<0.05), and average VAS score also improved significantly from 6.4 to 1.4 points at final follow-up (p<0.05). Average active range of motion at metatarsophalangeal joint improved from $28.0^{\circ}$ preoperatively to $46.5^{\circ}$ at the final follow-up. Other complications, such as metatarsalgia and arthritis, were not found; however, there was 1 case of delayed union with no symptom. Conclusion: In Freiberg's disease, dorsal closing wedge osteotomy is recommended for the improvement of clinical symptoms and range of motion.
Purpose: The purpose of this study is to report on the result of repairing Achilles tendon using absorbable suture under nerve block. Materials and Methods: We retrospectively reviewed 20 patients with acute Achilles tendon rupture who were followed up for at least six months after the operation. We repaired Achilles tendon using two absorbable sutures using the Krackow technique for the proximal stump and the Kessler technique for the distal stump. A programmed postoperative management including non-weight bearing with a short leg cast for four weeks after the operation was applied for all patients. We evaluated clinical results using American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) for satisfaction, range of motion of ankle, functional recovery rate, and the starting time of single heel raise. Results: The mean VAS score for satisfaction and AOFAS score was 9.2 and 93.0, respectively. The affected ankle showed a mean dorsiflexion rate of 90% and plantar-flexion rate of 94% compared to the uninjured side. The single heel raise could start at a mean of 3.5 months after the operation. Conclusion: Treatment of Achilles tendon rupture with absorbable suture material using the hybrid suture technique of proximal Krackow and distal Kessler showed sufficient stability and minimal chronic inflammatory reaction.
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