• 한국전문물리치료학회지
• /
• 제20권1호
• /
• pp.64-73
• /
• 2013

The purposes of this study were to develop a new orthosis controlling ankle and knee joint motion during the gait cycle and to identify the effects of the newly designed orthosis on gait kinematics and tempospatial parameters, including coordination of the extremities in stroke patients. Fifteen individuals who had sustained a stroke, onset was 16 months, participated in this study. Before application of the measurement equipment the subjects were accustomed to walking on the ankle-foot orthosis (AFO) or stance control knee with knee flexion assisted-oil damper ankle-foot orthosis (SCKAFO) for 5 minutes. Fifteen patients were investigated for 45 days with a 3-day interval between sessions. Measurements were walking in fifteen stroke with hemiparesis on the 3D motion analysis system. Comparison of AFO and SCKAFO are gait pattern. The difference between the AFO and SCKAFO conditions was significant in the gait velocity, step length of the right affected side, stance time of both legs, step-length asymmetry ratio, single-support-time asymmetry ratio, ${\phi}$-thigh angle and ${\phi}$-shank angle in the mid swing (p<.001). Using a SCKAFO in stroke patients has shown similar to normal walking speeds can be attained for walking efficiency and is therefore desirable. In this study, the support time of the affected leg with the SCKAFO was longer than with the AFO and the asymmetry ratio of single support time decreased by more than with the AFO. This indicates that the SCKAFO was effective for improving gait symmetry, single-support-time symmetry. This may be due to the decrease of gait asymmetry. Thus, the newly designed SCKAFO may be useful for promoting gait performance by improving the coordination of the extremity and decreasing gait asymmetry in chronic stroke patients.

• 한국응용과학기술학회지
• /
• 제37권2호
• /
• pp.224-231
• /
• 2020

본 연구의 목적은 유도 허벅다리걸기 기술 발휘 시 발목 관절의 테이핑 처치가 하지 관절과 압력중심(COP, center of pressure)에 미치는 영향을 분석하는데 있었다. 대학 유도 선수 20명(연령, 20.9±0.8세; 신장, 168.6±7.4cm; 체중, 73.5±11.6kg; 신체질량지수, 25.7±2.6kg/㎡)이 참여하였으며, 발목 관절 테이핑 처치 전과 후의 2가지 조건에서 허벅다리걸기 기술 발휘 시 지지다리 관절의 각도와 압력중심 요인을 분석하여 다음의 결과를 도출하였다. E2(t=2.411, p=.027) E4(t=2.388, p=.029)시점에서 발목 관절의 각도는 테이핑 처지 전에 비해 처치 후 발목의 각도가 통계적으로 적은 수치를 나타내었고, E2(t=-2.343, p=.032) E3(t=-4.531, p=.000)시점에서 힙 관절의 각도는 통계적으로 크게 나타났다. 그리고 발목 관절 테이핑 처치 후 좌·우의 COP 이동은 상대를 메치는 P3 국면에서 통계적으로 크게 나타났으며(t=2.670, p=.016), 전·후의 COP 이동은 상대의 무게 중심을 기울이는 P1 국면에서 통계적으로 적은 수치를 나타내었다(t=2.846, p=.011). 그러므로 허벅다리걸기를 특기로 사용하는 유도 선수들은 발목 관절 테이핑으로 인해 발생하는 지지관절의 운동 기능과 COP의 이동범위를 고려하여 사용하는 것에 대하여 제안하고자 한다.

• 대한족부족관절학회지
• /
• 제17권1호
• /
• pp.11-16
• /
• 2013

Freiberg's disease is a osteochondrosis of a metatarsal head that is recognized as primarily a disorder of the second metatarsal. It is seen more often in girls. Pain and limitation of motion of the affected joint is the predominant clincal feature. The radiographic appearance demonstrates from osteosclerosis in the early stage to osteolysis with collapse in the later stage. Conservative therapy may take the form of rest, a stiff shoe, and even a cast support to decrease the stress across the joint. Surgical intervention may also be of benefit. Surgery have been attempted either to modify the diseae process or to salvage the situation once the metatarsophalangeal joint develops degenerative changes. Metatarsophalangeal joint instability is common cause of forefoot pain that can develop in association with a traumatic episode and inflamatory tissue disorders as well as neighboring toe deformities. The second ray is by far the most frequently involved. The diagnosis can be made by clinical observation and physical examination including drawer test. Many surgical procedures have beem recommended when conservative treatment has failed. Procedures described range from soft tissue releases and tendon trasfer to the direct plantar plate repair combined with a Weil osteotomy.

• Physical Therapy Rehabilitation Science
• /
• 제9권4호
• /
• pp.222-229
• /
• 2020

Objective: The purpose of this study was to investigate the effect of treadmill exercise on the posture and walking speed of chronic stroke survivors with an ankle-foot orthosis. Design: Randomized controlled trial. Methods: Twenty-four chronic persons with chronic stroke admitted to Bobath Memorial Hospital in Seongnam city were divided into two groups by random blind method. Treadmill exercise with an elastic ankle-foot orthosis was performed in the experimental group and treadmill exercise was performed in the control group. The experiment was carried out for 6 weeks, and the experiment was carried out three times a week for 20 minutes per session. To measure the effect, static balance was measured using the MTD system before and after training, and the Berg Balance Scale (BBS) was used to measure functional balance. Results: There was a statistically significant difference between the 2 groups in the BBS measurement results for confirming the functional balance (p<0.05). Also, there was a significant difference between the 2 groups in single limb support time, step time and step length (p<0.05). Conclusions: In this study, it was found that treadmill exercise with an elastic ankle-foot orthosis in persons with chronic stroke was effective in maintaining functional balance, walking ability, step length, and step time. Therefore, it is necessary to use a flexible ankle-foot orthosis with proper treadmill exercise as a method of improving balance and walking speed of chronic stroke survivors.

• 한국운동역학회지
• /
• 제20권1호
• /
• pp.91-99
• /
• 2010

The purpose of this study was to the kinetic variables effects from the use of arch support inserts on low-arched people. We selected 10 people for the research and separated them into 2 groups, 5 people for the normal arched group and 5 people for the low arched group. Each group wear shoes which have a 3 step convertible arch support (level 0, level 2, level 5) and we measured their foot pressure and 3D motion analysis data. As a result, we found that the mean pressure at the heel of the low arched group was decreased when using the arch supports. The arch support induced the correct grounding area for the foot and dispersion of foot pressure. 3D motion analysis found that as the height of the arch support was increased, the movement of the Y-axis(inversion-eversion) was increased to relieve the shock to the heel. The arch support insert limited the range of motion(ROM) of the Z-axis(abduction-adduction) of the low arched person's ankle joint and prevented ankle injury caused by the excessive eversion when walking. Low arched people are seen to be easily tired due to the ineffective shock absorption of the knees and abnormal walking motion. In order to improve the problems, a 3 step convertible arch support(level 5) insert would improve the low-arched people's walking ability. In other words, the low arched people should be expected to walk as well as normal arched people when they wear shoes with the arch support insert.

• 대한족부족관절학회지
• /
• 제16권2호
• /
• pp.108-115
• /
• 2012

Purpose: To evaluate several risk factors related to re-ulceration of diabetic foot including psychosocial aspects such as familial support and degree of independence of patients' activity. Materials and Methods: We reviewed medical records and performed telephone interview with eighty-five patients who had a history of hospitalization in our hospital due to diabetic foot ulceration from year 2002 to 2010. Based on the collected data, we analyzed several factors such as age, gender, prevalence duration, accompanying diseases, HbA1c level, degree of independence and familial support. Results: The mean age was 61.4 years and most common in the 4th decade. There were 57 cases (67%) of recurrence, predominance of male. Eleven patients with recurrent diabetic foot ulceration had undergone major amputations. Psychosocial problems such as depression, insufficient familial support and mortality were more frequently observed in recurrent group. Conclusion: This study shows that psychosocial factor such as familial support for patient with diabetic foot could be important to reduce the recurrence rate of diabetic foot ulceration. Therefore, we should pay attention to strategic plans for prevention, screening, treatment, and aftercare through the prospective studies including psychosocial risk factor in diabetic foot ulceration.

• The Journal of Korean Physical Therapy
• /
• 제13권2호
• /
• pp.453-458
• /
• 2001

The aim of this study is to present the basic reference data of age and specific gait parameters for Parkinson's Disease Patients. The basic gait parameters were extracted from 5 patients, 5 men and 65 years of age using VICON 512 Motion Analyzer. The temporal gait parameters and kinematic parameters is data of Parkinson's Disease Patients. The results were as follows; 1. The cadence, velocity, stride length decreased and single limb support period, double limb support period increased than normal adult in the temporal parameters. 2. The mean angles of joint pelvic tilt and hip, knee, ankle joint decreased than normal adult at kinematic characteristics on sagittal plane. 3. The mean angles of joint pelvic tilt and hip, knee joint has no difference than normal adult at kinematic characteristics on coronal plane. 4. The mean angles of joint pelvic tilt, hip joint no difference and internal, external rotation in ankle joint significantly decreased than normal adult at kinematic characteristics on transverse plane.

• 한국정밀공학회지
• /
• 제25권3호
• /
• pp.165-175
• /
• 2008

An ankle-foot orthosis(AFO) is a brace for persons with gait disabilities to support or replace the function of ankle joint. Ankle-foot orthoses(AFO's) are usually prescribed to alleviate the drop-foot by constraining the excessive plantar flexion. The shape and the strength of the AFO are often based on 'trial and error' due to a lack of knowledge of the stress distribution in the AFO. In this study, an improved stress-freezing method was proposed to measure the stress distribution characteristics in the AFO. As a result, a photoelastic material with low freezing temperature was developed to measure the stresses under a person's direct contact loading condition. The three-dimensional stress-1rozen photoelastic models of AFO's for five stages of stance phase such as heel contact, foot flat, mid stance, heel off, and toe off were produced. The results of photoelastic analysis revealed that the stresses developed in the AFO were varied considerably from tensile to compressive or vice versa, during walking. At the posterior part of ankle joint in the AFO, the maximum compressive stress of 1.81MPa was observed in the mid stance, and the maximum tensile stress of 0.74MPa was observed during heel contact. The overall stress levels in the AFO's were low in the toe off phase. The results suggested that the posterior part of ankle joint might be the most fragile part in the AFO.

• 한국운동역학회지
• /
• 제29권2호
• /
• pp.105-112
• /
• 2019

Objective: The main purpose of this study was to investigate the effects of wearing an ankle weight belt while performing gait in water by focusing on the effect of using ankle weights have on the gait kinematics and the muscle activities for developing optimum training strategies. Method: A total of 10 healthy male university students were recruited for the study. Each participant was instructed to perform 3 gait conditions; normal walking over ground, walking in water chest height, and walking in water chest height while using ankle weights. All walking conditions were set at control speed of $4km/h{\pm}0.05km/h$. The depth of the swimming pool was at 1.3 m, approximately chest height. The motion capture data was recorded using 6 digital cameras and the EMG was recorded using waterproof Mini Wave. From the motion capture data, the following variables were calculated for analysis; double and single support phase (s), swing phase (s), step length (%height), step rate (m/s), ankle, knee, and hip joint angles ($^{\circ}$). From the electromyography the %RVC of the lower limb muscles medial gastrocnemius, rectus femoris, erector spinae, semitendinosus, tibialis anterior, vastus lateralis oblique was calculated. Results: The results show significant differences between the gait time, and step length between the right and left leg. Additionally, the joint angular velocities and gait velocity were significantly affected by the water resistance. As expected, the use of the ankle weights increased all of the lower leg maximum muscle activities except for the lower back muscle. Conclusion: In conclusion, the ankle weights can be shown to stimulate more muscle activity during walking in chest height water and therefore, may be useful for rehabilitation purposes.

• Physical Therapy Rehabilitation Science
• /
• 제12권2호
• /
• pp.123-129
• /
• 2023

Objective: Kinesio tape has been applied to the ankle to improve balance and gait. Stroke patients show abnormal gait patterns due to foot drop. This study aimed to determine the effects of ankle balance taping which to support the ankle joint on balance and gait in patients with chronic stroke. Design: A randomized controlled trial. Methods: Twenty-four chronic stroke patients were selected and randomized into experimental group (n=12) and control group (n=12). The experimental group applied kinesio taping three times a week for three weeks, and the control group applied placebo taping for the same amount of time. To evaluate the effectiveness of the treatment, the subjects' walking ability, static balance, and dynamic balance were assessed before and after the experiment. Gait speed and spatiotemporal gait ability were measured to examine walking ability, postural sway velocity and velocity moment for static balance, and Timed-Up and Go test and Berg Balance Scale were conducted to check dynamic balance. Results: The experimental group showed a significant increase in walking ability, static balance, and dynamic balance in the within-group pre-post difference (p<0.05). In the between-group comparison, the experimental group had a significant difference in walking ability than the control group (p<0.05). Conclusions: Ankle balance taping can help improve gait, and this study can be used as a basis for future studies of ankle balance taping.