• 한국전문물리치료학회지
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• 제23권1호
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• pp.20-30
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• 2016

Background: Total knee arthroplasty (TKA) recovers the alignment of the knee joint, but fails to automatically restore the alignment and function of the hip and ankle joints. It may affect the alignment and stability of the knee joint, therefore therapeutic intervention in hip and ankle joint is necessary for the rehabilitation process after TKA. Objects: The aim of this study was to comparison of the effects of the two exercise methods on the coronal plane alignment after TKA. This study conducted an experiment by dividing subjects into a lower extremity isometric co-contraction group (LEIC) and a quadriceps isolated isometric contraction (QIIC) group. Methods: A total of 37 subjects were randomly assigned to the LEIC ($n_1$=19) or the QIIC ($n_2$=18). Exercise was applied to five times per week for three weeks, starting on the eighth day after surgery. Range of motion exercises were performed as a common intervention and then each group performed quadriceps isometric contraction exercises with 10 sets of 5 repetitions. Radiological imaging was performed prior to surgery, one month and six months after surgery. In addition, the hip-knee-ankle angle (HKA) and tibiotalar angle (TTA) were measured. Results: The HKA was close to neutral in the LEIC rather than the QIIC (p<.05). The LEIC showed varus and the QIIC exhibited valgus TTA (p<.05). In a comparison of HKA and TTA over time, there was no significant change in either group (p>.05). According to the comparison of the TTA before surgery, the LEIC showed significant changes in the varus direction (p<.05), while there was no significant change in the QIIC (p>.05). Conclusion: The LEIC method triggered changes in the TTA and brought the HKA close to the neutral. Thus, LEIC is more effective than QIIC in creating stability in the coronal plane alignment of the knee and ankle joints after TKA.

• 근관절건강학회지
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• 제6권2호
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• pp.278-294
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• 1999

The PACE (People nth Arthritis Can Exercise) is an exercise program developed by the Arthritis Foundation to improve muscle strength and joint flexibility for patients with arthritis. The purpose of this study was to explore the effects of PACE program on self-efficacy, pain, and joint function in the Korean immigrant elderly. The PACE program was held twice a week for 6 weeks for Korean immigrant elderly who had osteoarthritis. Twenty four subjects completed the program, who were recruited in two places : 10 elderly in a senior residential apartment, and 14 elderly in a senior center supported by Congregated Meal Program for Korean Elderly. Self-efficacy(Sherer et al., 1982), pain severity(by using Visual Analogue Scale), and number of painful joints were measured before and after the PACE program. To examine the joint flexibility and strengthening, the followings were measured : the extent of the upward arm reach in both sides(flexibility of shoulder), the ability to touch fingertips of the both hands in back pat and rub(flexibility of arm), the degree of range of motion(ROM) of both ankles in their dorsiflexion(flexibility of ankle) and plantarflexion with standing with toe(strengthening of ankle), and the degree of knee extension. Wilcoxon signed rank test was used for data analysis and the significance of the differences in the variables was examined to compare the data obtained before and after the PACE program. After the PACE, followings were found : 1. Self-efficacy was significantly increased. 2. Pain severity and number of painful Joints was significantly decreased. 3. The flexibility of both shoulders and arms were significantly improved, but the flexibility of knee was not changed. 4. The flexibility and strengthening of both ankle was significantly improved. In conclusion, PACE was clearly proved to be an effective exercise program to promote self-efficacy, to reduce pain, and to enhance joint function in the elderly with osteoarthritis. It is suggested that the PACE program should be recommended as one of the useful and appropriate nursing interventions for elderly with osteoarthritis.

• 대한족부족관절학회지
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• 제18권2호
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• pp.56-61
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• 2014

Purpose: This study was conducted among patients with moderate to severe hallux valgus who underwent distal chevron osteotomy and groups of patients with or without Akin osteotomy were compared for evaluation of the relationship between their radiological and clinical outcomes. Materials and Methods: From January 2009 to January 2012, among patients with moderate to severe hallux valgus who underwent distal chevron osteotomy at our institution, 28 cases with additional Akin osteotomy and 35 cases without Akin osteotomy available to follow up of more than one year were included in this study. For radiologic evaluation, hallux valgus angle, 1, 2 intermetatarsal angle, and hallux interphalangeal angle were measured before and after surgery. For clinical assessment, visual analogue scale score, American Orthopaedic Foot and Ankle Society score, subjective satisfaction of the patients, and passive range of motion of the first metatarsophalangeal joints were evaluated. Results: At the final follow up, correction of valgus hallux angle and 1, 2 intermetatarsal angle was obtained from radiation results of both groups and it was found that patients who underwent Akin osteotomy showed radiographically larger angle correction but less subjective satisfaction. Conclusion: Patients with moderate to severe hallux valgus who underwent distal chevron osteotomy showed not only functional but also radiographically satisfactory results, and patients who underwent additional Akin osteotomy showed decreased subjective satisfaction. Therefore, if an incongruent first metatarsophalangeal joint is not observed, distal chevron osteotomy without Akin osteotomy seems preferable.

• 대한족부족관절학회지
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• 제12권1호
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• pp.47-54
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• 2008

Purpose: The isolated exercise therapy and its effect for the treatment of posterior tibial tendon dysfunction (PTTD) is not well known. The purpose of this study was to identify the clinical effect of stretching and strengthening exercise program on the patients' muscle function and range of motion, pain and gait in the management of the early stage PTTD. Materials and Methods: From October 2006 to March 2007, 14 patients with early stage PTTD (stage I or IIa) without surgical intervention were randomly assigned into two groups and we analyzed their clinical results. All patients were female and one who have sprained the same ankle during the program and one who withdrew from the program due to her private reason were excluded. At the last, the exercise group (EG) was seven and the control group (CG) was five. Mann-Whitney U test was used for the comparison of pain, ROM, muscle power, AOFAS score and 5 minute walking test of both groups. Wilcoxon-signed rank test was used for the comparison between the pre and post exercise program in EG. Results: The pain was significantly reduced in EG compare to CG and only the dorsiflexion was significantly increased in EG in the analysis of ROM. The dorsi flexion and plantar flexion power were significantly increased in EG. Conclusion: Our 6 weeks stretching and strengthening exercise program showed noticeably improved clinical result, and therefore it is recommended as one of the useful treatment option in the management of early stage PTTD.

• 대한물리치료과학회지
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• 제29권1호
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• pp.47-54
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• 2022

Background: Plyometric exercise is an exercise exerting forceful power in a brief period using isotonic activation. It is effective to improve reaction of muscle, agility, endurance and athletics performance. Weight training is an exericse improving muscular strength, endurance and respirating ability applying diversely in frequency and load of exercise Plyometric exercise and Weight training is to facilitate the athletics performance though improving the function of lower limb muscle, there is a difference that Plyometic jump squats is the way to improve agility and Weight training is the way to improve muscular strength. Therefore, it is necessary to know how this difference effects on athletics performance as measuring ankle, ROM, and jumping ability. Design: Randomized controlled trial. Method: This study was conducted with the voluntary participation of 40 university students, who were randomly assigned to jump squat and calf raise groups (n=20 per group). For each subject, we measured the range of motion of the ankle joint before and after exercise, as well as a standing broad jump and vertical jump test performance. We compared the performance indices before and after exercises using paired t-tests, and between groups using independent-samples t-tests. Conclusions: Both jump squat and calf raise exercises improved ankle joint dorsiflexion and plantar flexion, as well as standing broad jump and vertical jump height performance. However, there were no significant differences before versus after exercise, or between exercise types. Although jump squats and calf raises have different purposes, it is thought that, in combination, these exercises improve performance more effectively than either alone, and that such a combined exercise program improves the quality of training in both the general public and athletes in various sports.

• Journal of Acupuncture Research
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• 제22권4호
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• pp.1-12
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• 2005

Objectives : The Purpose of this study is to report in patient with common peroneal nerve palsy, who improved by oriental medical treatament. Methods : We Checked the temperature of a leg by Digital Infrared Thermal Imaging(DITI) at intervals of 10 days, angle of active dorsiflexion and range of active motion for estimating the improvement of symptoms. We used the Visual Analogue Scale(VAS) for estimating the degree of pain, too. Results : After 4 weeks treatment, the movement and power of ankle joint improved to nearly normal range. The degree of active dorsiflexion of the ankle increased from $-40^{\circ}\;to\;15^{\circ}$ and range of active motion increased from Gr III to Gr I. The difference of temperature between the both legs decreased remarkably. Conclusion : In this case we experienced improvement of symptoms by conservative oriental medical therapy, e.g acupuncture stimulation, herbal medication, physical therapy. It should be needed further investigation on common peroneal nerve palsy and its symptoms in order to set up a reasonable standard about a surgical operation.

• 한국운동역학회지
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• 제28권1호
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• pp.37-43
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• 2018

Objective: The aim of this study was to analyze muscle activation of the lower extremities as a function of changes of the center of pressure (CoP) of the foot during squats in order to provide quantitative information to trainers who would like to teach correct movements for developing muscles. Method: Ten men with over three years of weight training experience participated in this study (age: $26.1{\pm}0.8yrs$, height: $171.2{\pm}3.9cm$, body mass: $71.1{\pm}5.7kg$, 60%RM: $84{\pm}9kg$, career: $4.0{\pm}0.7yrs$). The participants were instructed to perform a squat in each of 3 conditions, with different CoP's (the front, middle, and rear of the foot). Results: The position of the CoP showed significant differences according to instructions in both the eccentric and concentric contraction phases (p < .05). The range of movement of the hip and ankle joints showed significant differences corresponding to changes of the CoP position (p < .05). The rectus femoris and gluteus maximus muscle showed significant differences for different CoP positions only in the concentric contraction phase, while the gastrocnemius and anterior tibialis were significantly different in both the concentric and eccentric contraction phase (p < .05). Conclusion: When the target muscle of squat training is the gastrocnemius, the CoP should be located in the front of the foot for effective muscle training. When the target muscles of squat training are the gluteus maximus and quadriceps femoris, the CoP should be located on the rear of the foot.

• PNF and Movement
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• 제20권1호
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• pp.19-29
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• 2022

Purpose: The purpose of this study was to analyze the gait patterns of adults with intellectual disability and healthy adults based on collected kinematic data on the lower extremities and to investigate the gait patterns of intellectually disabled people by comparing the differences between the two groups. Methods: The participants were divided into in one group of healthy adults (n = 9) and one group with mild intellectual disabilities (n = 9). 3D motion analysis (Myomotion) was used to collect kinematic data from each group while the participants walked 3 times over 10 m. As a statistical method, each group's kinematic data during walking was analyzed and compared using an independent sample t-test. Results: Comparing the kinematic data of the lower extremities during walking between the group with mild intellectual disability and the healthy group, there were significant differences between the two groups in the hip and ankle joints in the stance and swing phases. Conclusion: The analysis suggests that people with intellectual disabilities have kinematic differences compared with healthy people. Based on the results of this study, it is necessary to conduct further research on rehabilitation programs for joint stabilization, exercise for increasing joint range of motion, muscle strengthening exercise, and proprioception training for people with intellectual disabilities with insufficient physical function.

• 대한물리치료과학회지
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• 제22권2호
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• pp.43-47
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• 2015

Background : Many factors affect foot and ankle biomechanics during walking, including gait speed and anthropometric characteristics. This study examined the effect of walking speed on peak plantar pressure during the walking. Method : Thirty two normal healthy subjects (16 men, 16 women) were recruited. Peak plantar pressure was investigated using pressure distribution platforms (Pedoscan system) under the hallux heads of the first, second, and third metatarsal bones, and heel. Result : The results also suggest that slow walking speeds may decrease forefoot peak plantar pressure in patients with peripheral neuropathy who have a high risk of skin breakdown under the forefoot(p<0.05). Conclusion : The results also suggest that slow walking speeds may decrease forefoot peak plantar pressure in patients with restricted low extremity range of motion who have a high risk of skin breakdown under the forefoot.

• 대한족부족관절학회지
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• 제20권2호
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• pp.67-72
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• 2016

Purpose: The purpose of this study was to assess the 2-year follow-up results of patients with a trimalleolar fracture, who had undergone an anterior incision cannulated screw fixation of the posterior malleolar fragment, which had more than 25% of articular involvement or had no cortical continuity with the distal tibia. Materials and Methods: Among 28 patients with a trimalleolar fracture who had undergone fixation of the posterior malleolar fragment between February 2005 and February 2010, 14 patients, who underwent an anterior incision cannulated screw fixation of posterior malleolar fragment and were followed-up for more than 2 years, were selected. The postoperative clinical and radiological findings immediately and at the 1- and 2-year follow-up were compared. The clinical findings were evaluated as American Orthopaedic Foot and Ankle Society (AOFAS) score. The radiological assessment was evaluated as the maintenance of reduction, period to bone union, and the presence of nonunion, malunion, and complications. Results: The clinical outcome by mean AOFAS score revealed 83.0 points in the group with preoperative displacement below 2 mm and 80.7 points in the group with preoperative displacement above 2 mm postoperatively. The mean AOFAS score was 91.7 and 93.1 points in the group with preoperative displacement below 2 mm on 1- and 2-year follow-up, respectively, and 89.8 and 91.7 points in group with the preoperative displacement above 2 mm on 1- and 2-year follow-up, respectively. After a 2-year follow-up among 14 cases selected for this study, 13 cases showed an excellent reduction state and only 1 case (7.1%) showed a displacement of more than 2 mm. No complication were encountered in the group with preoperative displacement below 2 mm. On the other hand, among 8 patients in the group with preoperative displacement above 2 mm, there were 3 with limitations of the range of motion of the ankle joint (37.5%) and 1 post-traumatic arthritis (12.5%) at the 2-year follow-up. Conclusion: Anterior incision cannulated screw fixation of the posterior malleolar fragment could be a valuable method for the treatment of trimalleolar fractures that provides satisfactory results.