• The Journal of Korean Physical Therapy
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• 제19권5호
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• pp.51-63
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• 2007

Diabetic foot ulcers result from abnormal mechanical loading of the foot, such as repetitive pressure applied to the plantar aspect of the foot while walking. Diabetic peripheral neuropathy causes changes in foot structure, affecting foot function and subsequently leading to increased plantar foot pressure, which is a predictive risk factor for the development of diabetic foot ulceration. To early identify the insensitive foot makes it possible to prevent diabetic foot ulceration and to protect the foot at risk from abnormal biomechanical loading. Abnormal foot pressures can be reduced using several different approaches, including callus debridement, prescription of special footwear, foot orthosis. injection of liquid silicone, Achilles tendon lengthening, and so forth. Off-loading of the diabetic wound is a key factor to successful wound healing as it is associated with reduced inflammatory and accelerated repair processes. Pressure relief can be achieved using various off-loading modalities including accommodative dressing, walking splints, ankle-foot orthosis, total contact cast, and removable and irremovable cast walkers.

• 대한족부족관절학회지
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• 제22권3호
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• pp.100-104
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• 2018

Purpose: An axillary crutch is the most commonly used assistive device in foot and ankle patients who require nonweightbearing. On the other hand, its use frequently induces axillary or wrist pain and critical neurovascular injuries have been reported in several studies. This study compared the clinical outcomes of patients using the knee walker and axillary crutch. Materials and Methods: A retrospective analysis was performed comparing the utility of a knee walker and axillary crutch as a nonweightbearing ambulatory aid for 62 foot and ankle patients treated between November 2016 and March 2018. A comparative study of the two orthosis could be performed because all the patients temporarily used an axillary crutch before or after the use of a knee walker. A demographic study and comparative analysis based on the visual analogue scale (VAS) satisfaction score (0~100), complications, and fall down history were evaluated. Furthermore, under the assumption of having retreatment, their preference of orthosis between the knee walker and axillary crutch was investigated. Results: The mean age of the patients was 36.5 and the mean duration of ambulation with a knee walker and axillary crutch were 5.2 and 2.4 weeks. The VAS satisfaction score of the knee walker and crutch was 88.8 and 27.5, respectively (p<0.05). The most frequent complications of the knee walker and crutch were ipsilateral knee pain (6 cases) and axillary or wrist pain (56 cases), respectively. No case of falling down occurred during knee walker ambulation, but there were two cases of crutch ambulation. Fifty-eight patients (93.5%) preferred the knee walker and four patients (6.5%) preferred a crutch. Conclusion: Compared to the axillary crutch, the knee walker afforded lower complication and higher satisfaction. Most patients preferred the knee walker to a crutch. Therefore, the knee walker is an efficient and safe orthosis for foot and ankle patients who require nonweightbearing.

• 대한물리의학회지
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• 제15권1호
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• pp.1-9
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• 2020

PURPOSE: Many patients with stroke have difficulties in walking with foot-drop. Various types of ankle-foot orthoses (AFOs) have been developed, but their weight needs to be reduced with the assistance of the ankle dorsiflexor. Therefore, an elastic AFO (E-AFO) was devised that not only improves the stability and flexibility of the ankle but also assists with ankle dorsiflexion while walking. This study examined the effects of an E-AFO, on the walking patterns of foot-drop patients with stroke. METHODS: Fourteen patients walked with and without an E-AFO, and the gait parameters were assessed using the GAITRite system. The spatiotemporal data on the gait patterns of stroke patients with foot-drop were compared using paired t-tests; the level of statistical significance was set to α<.05. RESULTS: No significant differences were observed in the velocity (p=.066) and affecte+d step length (p=.980), but the affected and less-affected stance (p=.022, p=.002) and swing time (p=.012, p=.005) were significantly different. The E-AFO produced a significant difference in the less-affected step length (p=.032). CONCLUSION: The E-AFO has a significant effect on the walking patterns of individuals with foot-drop and stroke. The E-AFO could be a useful assistive device for gait training in stroke patients.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2004년도 춘계학술대회 논문요약집
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• pp.116-116
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• 2004

편마비 환자의 보행운동 개선을 위한 보조기구로 족부보장구(Ankle Foot Orthosis, A.F.O.)가 활용되고 있다 족부보장구는 Fig. 1에 제시한 바와 같이 보행특성상 무수히 반복되는 충격과 굽힘하중을 받는다. 따라서 족부보장구용 재료는 피로특성이 우수한 탄소섬유 강화재(Carbon Fiber Reinforced Plastic, 이하 CFRP)를 주로 사용한다. 그러나 CFRP의 상용재인 프리프레그(prepreg)는 강한 이방성의 단방향 섬유이므로 섬유방향과 하중작용방향의 관계에 매우 민감하다.(중략)

• 제어로봇시스템학회:학술대회논문집
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• 제어로봇시스템학회 2005년도 ICCAS
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• pp.2444-2447
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• 2005

The purpose of this study was to analyze the gait motion of the aged with a lower limbs orthosis. The gait motion was analyzed with and without lower limbs orthosis using APAS 3D Motion Analysis System. The pattern of lower limbs motion was tracked based on four targets attached to the body of the subject. The targets were positioned at hip, knee, ankle, and foot. The parameters measured were the displacement, the velocity, and the acceleration of the four targets. The improvement in the measured values on the displacement and the velocity of the four targets were small with the orthosis due to inconvenience of wearing it, but the increase in the acceleration was large due to the elastic force of the rubber actuator. Especially, the increase of the acceleration of foot with lower limbs orthosis seems to help the gait motion of the elderly.

• 대한족부족관절학회지
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• 제7권1호
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• pp.78-82
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• 2003

Purpose: The purpose of the study is to evaluate the clinical outcomes of acute achilles tendon rupture patients treated by early mobilization after operative repair. Materials and Methods: In this retrospective study, 12 patients of acute Achilles tendon rupture were surgically treated from May 2001 to November 2002, with follow-up period of at least 6 months. There were 10 men and 2 women, and mean age was 35.9 year. The repair method was single Krackow suture technique. Two to three weeks after the operation, early ROM with removable ankle-foot orthosis(AFO) was started. We used Amer-Lindholm scale for the clinical evaluation and analyzed patient's satisfaction and subjective strength deficit. Results: We had 11 excellent results(92%), and 1 good results(8%). One-leg heel raising was possible in all patients. All the patients returned to the preinjury occupations and 7 patients(58%) reached the preoperative level of sports activities. There was no significant difference in ankle ROM and ankle plantar flexion isokinetic strength compared to contralateral side. There was, no reruptures. Conclusion: Early mobilization proved to be a well tolerated, safe, and effective means for the compliant patient.

• 한국소음진동공학회:학술대회논문집
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• 한국소음진동공학회 2003년도 춘계학술대회논문집
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• pp.888-892
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• 2003

This study was tested for the bending stress analysis of Experimental stress analysis on various ankle foot orthoses(AFOs) was fulfilled. Stress was measured by Strain gages which were attached on 8 region in AFOs Results revealed that the peak compressive/tensile stress in the orthoses occured in the lateral region of neck. The Stress Analysis system was made by the electronic oscilloscope, strain gage sensors, amplifier, A/D converter, PC with C program It will be able to using the important data in splint design. Selected AFOs were some different materials but all have same shape except one type(orthosis with joint). C program Is used for managing data. Thus lateral side of the neck region is failed easily.

• 대한족부족관절학회지
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• 제17권1호
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• pp.1-10
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• 2013

The bunionette, or a 'tailor's bunion', is a lateral bony prominence of the fifth metatarsal head. A bony deformity itself rarely causes symptom but if a painful inflammation of the overlying soft tissue is accompanied, it needs treatment. Conservative care using a shoe modification, padding, or orthosis is effective in most cases. Surgical management is indicated when the conservative methods have failed to improve symptoms, and the techniques include exostectomy, metatarsal osteotomies (distal, diaphyseal, or proximal), metatarsal head resection or fifth ray resection. We reviewed the etiology, clinical features, radiographic classification, nonoperative and operative treatments of the bunionette.

• 대한족부족관절학회지
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• 제26권2호
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• pp.88-94
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• 2022

Purpose: This study was based on the Korean Foot and Ankle Society (KFAS) member survey and aimed to report the current trends in the epidemiology, diagnosis, and management of acute Achilles tendon rupture (AATR) over the past few decades. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in October 2021. The questions were mainly related to the clinical experience and preferred management of patients with AATR. Answers with a prevalence ≥50% of the respondents were considered a tendency. Results: Seventy-one (12.9%) of the 550 members responded to the survey. The male sex ratio in AATR was answered mean 78%, and the most common age groups were 30~40 years (n=49; 69.0%), and 40~50 years (n=37; 52.1%), in that order. The most common seasons for the occurrence of AATR were spring (37 cases; 52.1%) and autumn (27 cases; 38.0%). Also, sports-related rupture had an average occurrence of 76.2%. The most important clinical factor to determine the type of treatment was the history of previous injuries, and 75.9% of respondents started conservative treatment in the 2010s. The most preferred protocol of conservative treatment was an orthosis capable of ankle range of motion after casting (68.5%), and 53.7% 'satisfied' and 1.9% 'very satisfied' with conservative treatment. The most preferred surgical method was open repair (80.3%), and the Krackow method (60.6%), and 49.3% of treated patients responded 'satisfied' and 45.1% 'very satisfied' with this treatment. Conclusion: This study gives updated information concerning the current trend of epidemiology, diagnosis, and treatment of AATR in Korea. Both consensus and variation in the approach to AATR were identified using this survey study. This study may raise the awareness of various possible approaches toward AATR and should be used to further establish a standard protocol for the management of this injury.

• 한국전문물리치료학회지
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• 제7권4호
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• pp.39-46
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• 2000

본 연구는 강직성 편측 뇌성마비 환자의 보행 기시(gait initiation)의 특성을 파악하고, 동적 단하지 보조기(dynamic ankle foot orthosis : DAFO)가 이런 환자들의 보행 기시에 미치는 영향을 알아보기 위하여 실시하였다. 연구대상자는 19세 선천성 강직성 우측 뇌성마비를 가진 여자 대학생이었다. 연구대상자는 4개의 다른 보행 기시 조건에서 각 조건당 7회의 보행 기시를 하였는데, 각각의 보행 기시 조건은: 1) 보조기 없이 좌측 하지로 보행 기시; 2) 우측 하지 보조기 착용 상태에서 좌측하지로 보행 기시; 3) 보조기 없이 우측 하지로 보행 기시; 4) 우측 하지 보조기 착용 상태에서 우측 하지로 보행 기시였다. 두개의 힘 판(force plate) 위에서 본인이 선택한 가장 편안한 방법과 속도로 2 m를 걷도록 하였다. 연구대상자가 보행 기시를 하는 동안 양쪽 가자미근과 앞정강근에 부착된 4개의 표면 전극으로부터 근 전도 신호와 보행 기시를 하는 연구 대상의 양 발 아래 놓인 두개의 힘 판의 자료를 분석하여 체중(body weight : BW)으로 정량화 하였다. 실험결과는 각 조건마다 7회 실시된 측정값들의 평균을 이용하였다. 본 사전연구의 결과는 다음과 같다. 1. 보행 기시 전 양다리로 선 상태에서 환측보다 건측으로 많은 체중지지를 하였으나(환측 42.57%BW, 건측 58.03%BW) 보조기의 착용이 환측으로의 체중지지를 향상시켰다(환측 44.46%BW, 건측 55.54%BW). 2. 보행 기시 중 가자미근과 앞정강근의 동시수축(coactivation)이 계속되었는데 이러한 양상은 보조기의 착용 유무에 따라 크게 달라지지 않았다. 3. 힘 판에서 들어온 지면 반발력(ground reaction force)의 수직 분력(vertical element, Fz)과 전후 분력(anterior-posterior element, Fx)을 분석한 결과, 건측 다리로 보행 기시를 할 때 보조기 착용은 가속을 촉진시켜 역학적으로 유리하였다. 이상의 연구 결과는 보조기의 착용이 건측 다리로 보행 기시를 할 때 미치는 신경학적, 역학적 장점들에 대한 구체적 연구의 필요성 및 근거를 제시하고, 환자들의 보행훈련 접근에 보다 효율적인 보행방법을 소개하는데 이용될 수 있다.