• Korean Journal of Applied Biomechanics
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• v.15 no.1
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• pp.177-195
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• 2005

The purpose of this study was to analyze the kinematic variables of ankle joints and EMG signal of the lower limbs muscle activity for the different walking speed. The subjects were 6 males of twenties. It was classified into three different walking speed-0.75m/s, 1.25m/s, 1.75m/s. The walking performances were filmed by high speed video camera and EMG signal was gained by ME3000P8 Measurement Unit. Tibialis anterior(TA), Gastrocnemius medial head(GM), Gastrocnemius lateral head(GL), Ssoleus(SO) were selected for the dorsiflexion and plantarflexion of the ankle joint. The result of this study were as follows: 1. In the gait cycle, The time parameters for the phases were showed significant difference without the terminal stance phase and terminal swing phase for the different walking speed. 2. The angle of ankle joint was no significant difference for each time point and MDF, MPF but increasing walking speed the angle had the increasing pattern slightly. 3. The angular velocity of ankle joint was showed the significant difference for LHC, RTO, RKC, LHU, MPF and MDF point along the walking speed. 4. TA was showed about 2-3 times muscle activity at the 1.75m/s than 1.25m/s in some phases. And it was showed the similar muscle activity between the 0.75m/s and 1.25m/s but, showed a little much muscle activity in the 0.75m/s. GM was showed about 2-3 times muscle activity in the 1.75m/s than 1.25m/s, and even much muscle activity at the 0.75m/s than 1.25m/s in some phases. GL was showed increasing pattern of muscle activity specially in the initial swing phase as the walking speed increased. SO was showed about 3 times muscle activity in the 1.75m/s than 1.25m/s during the plantarflexion of ankle joint. It was showed the similar muscle activity between the 0.75m/s and 1.25m/s but, showed a little much muscle activity in the 1.25m/s.

• Korean Journal of Applied Biomechanics
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• v.15 no.2
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• pp.93-102
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• 2005

The purpose of this study was to examine the effect of step length on the joint moment. The subjects were 4 undergraduate and graduate students in their 20s with normal legs. The subjects were individually tested by the running timer at the walking speed of 0.67m/s, 134m/s, and 2.46m/s. The step length was regulated to -10% of normal, normal and +10% of normal step length using foot print. The walking performances of each subjects were filmed using a high speed video camera. The raw data were analyzed by LabVIEW Graphical Program and these data were analyzed by ANOVAs and Scheffe. The results of this study were as follows: The maximum dorsiflexion moment of the ankle joint increased as the step length increased only at the fast walking speed. Although there wasn't significant difference shown in the plantar flexion moment, regular pattern in the plantar flexion moment which increased as the step length increased was found. The first maximum extension moment of the knee joint increased only at the normal walking speed, but there appeared no significant difference in the maximum flexion and second extension moment. The maximum extension moment of the hip joint increased at the normal and fast walking speed. Although there wasn't significant difference, regular pattern in flexion moment which increased as the step length increased was found.

• The Korean Journal of Rehabilitation Nursing
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• v.7 no.2
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• pp.159-168
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• 2004

Purpose: The purpose of this study was to examine effect of Tai-Chi exercise program on joint flexibility for osteoarthritis patients. To evaluate the effects, quasi-experimental study was used for pre and post test with a nonequivalent control group. Method: Fifty-tow subjects participated in the experiment(twenty-seven for experimental group and twenty-five for control group) and they were from two different senior citizen centers in J city. The experiment period was from April 2002 through August 2002. The experiment group took part in Tai-Chi exercise program for eighteen weeks(three times a week for four weeks and five times a week for fourteen week). The exercise was performed for 50 minutes at every time (15 minutes for warm-up, 30 minutes for Tai-Chi exercise, and 5 minutes for ending). In order to pursue study purpose, the SPSS/WIN 8.0 program was chosen for the statistical analysis; ANCOVA was employed in examining test hypothesis; t-test and $x^2$-test were used to examine homogeneity between experimental and control group. Result: The study results were as follows :Score of vertebral joint flexibility increased significantly after of Tai-Chi exercise program. Score of wrist joint extension increased significantly after of Tai-Chi exercise program. Score of wrist joint flexion increased significantly after of Tai-Chi exercise program. Score of elbow joint extension increased significantly after of Tai-Chi exercise program. Score of elbow joint flexion increased significantly after of Tai-Chi exercise program. There was a slight increase of knee joint extension in the Tai-Chi exercise group compared to control group, but without statistical significance. Score of knee joint flexion increased significantly after of Tai-Chi exercise program. Score of ankle plantar flexion increased significantly after of Tai-Chi exercise program. Score of ankle dorsiflexion increased significantly after of Tai-Chi exercise program. Conclusion: As shown in the results, Tai-Chi exercise program can be effective nursing intervention for osteoarthritis patient to improve joint flexibility.

• Korean Journal of Applied Biomechanics
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• v.21 no.2
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• pp.207-213
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• 2011

The purpose of this study was to investigate changes in elastic properties of tendon structure of human ankle dorsiflexor following eccentric exercise. Six male subjects(age: $27.3{\pm}2.0$ years, height: $180.3{\pm}1.4$ cm, weight: $82.6{\pm}5.3$ kg) and three female subjects(age: $26.7{\pm}2.9$ years, height: $170.0{\pm}4.2$ cm, weight: $66.6{\pm}1.4$ kg) performed a single bout eccentric exercise consisting of 120 repetitions of maximum eccentric contractions. Prior to and following the eccentric exercise, isometric ankle dorsiflexion strength along with longitudinal ultrasound image of the tibialis anterior(TA) were collected. Muscle strength decreased about 30% after eccentric exercise. From the muscle strength vs. aponeurosis elongation curve, we obtained an index of stiffness. Stiffness of deep aponeurosis of the TA was assessed and found to be decreased from $87.4{\pm}33.56$ N/mm to $73.1{\pm}23.52$ N/mm. The results of this study suggest that decrease in stiffness of the TA aponeurosis following eccentric exercise might have significant implications to functions of the muscle-tendon complex and the involved joint motion and provide better understanding of eccentric exercise in the fields of training and rehabilitation.

• The Journal of the Korean bone and joint tumor society
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• v.10 no.1
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• pp.22-28
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• 2004

We retrospectively reviewed the cases of peroneal nerve palsy in seven patients after musculoskeletal tumor resection. Their mean age was 38 years. Three had osteosarcoma in proximal fibula, 2 had chondrosarcoma in proximal fibula and calf and 2 had malignant fibrous histio cytoma in calf. Four of 7 patients had been managed using active dorsiflexion brace. Three patients who underwent tibialis posterior transfer and could walk without brace were able to discontinue the use of the orthosis. Peroneal nerve palsy after wide excision of tumor including peroneal nerve can not resolve spontaneously and results in severe functional disability. To improve the gait function, active surgical treatment should be considered.

• Journal of Korean Foot and Ankle Society
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• v.8 no.2
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• pp.149-152
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• 2004

Purpose: We assessed the clinical results of modified Brostrom procedure as a revision method after failure of a primary reconstruction. Materials and Methods: This is a retrospective study of seven patients treated with Modified Brostrom procedure after failed lateral ankle ligament reconstruction between 1996 and 2002. Instability symptom developed average 4.7 month after the initial reconstruction surgery at other clinics. All patients had significant functional impairment before surgery and not responded to conservative protocols. Modified Brostrom procedure was applied to all patients. Results: The average follow up was 51 months (18 to 84). Seven of eight patients had clinical stability following revision reconstruction, six patients (75%) returned to their previous functional level. American Orthopaedic Foot and Ankle Society ankle-hindfoot scores averaged 87.5. There is no difference in active or passive range of motion of plantar flexion or dorsiflexion when compared to the contralateral ankle. However, three patients were noted to have lost some degree of inversion when compated to contralateral ankle. Two patients had osteochondral lesion and multiple spurs and had pain around the ankle that prevented their full recovery. One patient complained of persistent pain which was considered complex regional pain syndrome. Conclusion: Though the outcome of the Modified Brostrom procedure as a method of revision surgery was less satisfactory compared to the results of primary ankle reconstruction, it would be an appropriate option when concomitant abnormalities were not accompanying.

• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.142-145
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• 2009

Purpose: The aim of this study was to retrospectively evaluate the clinical and radiological results of the first metatarsophalangeal joint arthrodesis with two crossed screws fixation. Materials and Methods: We treated 23 patients (24 cases) with arthrodesis of the first metatarsophalangeal joint using two crossed screws fixation between December 2000 and May 2005. There were 3 male patients and 20 female patients. Ages ranged from 28 to 74 years (mean, 50 years). Follow-up ranged from 4.1 to 8.2 years (mean, 6.5 years). The American Orthopaedic Foot and Ankle Society (AOFAS) score and their satisfaction was evaluated clinically, foot anteroposterior and lateral radiograph, radiologically. Results: Of the 24 cases, 6 had surgery for dorsal plate and screws fixation because of failure to acquire firm fixation with two crossed screws fixation. All 6 cases acquired bony union. Fusion of the hallux first metatarsophalangeal joint occurred in 16/18 cases (89%). Nonunion occurred in 2 cases (11%) and was asymptomatic. At last follow-up, hallux valgus angle ranged from 11 to 25 degrees(mean, 17.7 degrees), dorsiflexion ranged from 15 to 25 degrees (mean, 22 degrees).The mean preoperative AOFAS score of 37 points(range, 28 to 45 points) improved to a mean of 77 points (range, 65~90 points) postoperatively. The result of the procedure as rated subjectively by the patient was excellent for 5 cases, good for 11 cases and fair for 2. Conclusion: Comparatively, the arthrodesis of the first metatarsophalangeal joint with crossed screws fixation showed a satisfactory clinical results, we thought that require technical attention for firm fixation in operation.

• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.169-174
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• 2009

Purpose: To evaluate the clinical results between interlocking intramedullary nail with fibular fixation and nail only for treating distal tibiofibular diaphyseal fractures. Materials and Methods: From March 2003 to September 2006, 19 distal tibiofibular fractures were antegrade nailed after anatomical reduction and fixation of fibular fractures, and another 37 fractures fixed with nails only. Average age of patients was 48.6 years. These two groups were compared by VAS (visual analogue scale) & ankle ROM according to degree of comminution and fracture configuration. The statistical analysis was evaluated by t-test. Results: There was no statistical difference between fibular fixation group and non-fixation group in VAS score according to fracture comminution and configuration (p>0.05). However, compared according to fracture configuration, mean ankle eversion of fibular fixation group in oblique fractures was 18.3 degrees, and that of non-fixation group was 12.5 degrees (p<0.05). In addition, mean ankle plantar flexion, dorsiflexion, inversion and total ankle ROM of fibular fixation group in spiral fractures was 40.0, 20.0, 30.0 and 108.3 degrees of each and that of non-fixation group was 38.3, 18.5, 27.0 and 101.7 degrees (p<0.05). Conclusions: In oblique and spiral fractures of distal tibiofibular diaphysis, interlocking intramedullary nail with fibular fixation had the advantage in postoperative ankle ROM. So, it can be a worthy method for the treatment of distal tibiofibular diaphyseal fractures.

• Journal of Korean Foot and Ankle Society
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• v.12 no.1
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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.

• The Journal of Korean Physical Therapy
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• v.25 no.5
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• pp.239-245
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• 2013

Purpose: Osteoarthritis occurs in many different joints of the body, causing pain, stiffness, and decreased function. The knee is the most frequently affected joint of the lower limb. The aim of this study was to investigate the differences of biomechanics between independent gait and anterior walker dependent gait of patients with osteoarthritis of the knee. Methods: Lower limb joint kinematics and kinetics were evaluated in 15 patients with knee osteoarthritis when walking independently and when walking with an anterior walker. Participants were evaluated in a gait laboratory, with self-selected gait speed and natural arm swing. Results: When walking with a dependent anterior walker, participants walked significantly faster (p<0.01), using a longer stride length (p<0.01), compared to independent gait. When walking with a dependent anterior walker, participants exhibited significantly greater knee flexion/extension motion (p<0.01) and lower knee flexion moment (p<0.05) compared to independent gait. When walking with a dependent anterior walker, participants showed significantly greater peak ankle motion (p<0.01), ankle dorsiflexion/plantarflexion moments (p<0.01), and ankle power generation (p<0.05) compared to independent gait. Conclusion: These biomechanical properties of gait, observed when participants walked with a dependent anterior walker, may be a compensatory response to impaired knee function to allow sufficient power generation for propulsion. Therefore, rehabilitative strategies for patients with osteoarthritis of the knee are needed in order to improve not only knee function but also hip and ankle function.