• Title/Summary/Keyword: Dorsiflexion of the ankle joint

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The Effectiveness of Backward Gait Training on the Treadmill in Children With Spastic Diplegic Cerebral Palsy: A Pilot Study (트레드밀에서 뒤로걷기 훈련이 경직성 양하지 뇌성마비 아동의 보행에 미치는 영향: 사전 연구)

  • Kim, Sung-Gyung;Ryu, Young-Uk;Kim, Won-Ho
    • Physical Therapy Korea
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    • v.19 no.3
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    • pp.81-90
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    • 2012
  • The aim of the current study was to assess the effectiveness of backward gait training on the treadmill in patients with spastic diplegic cerebral palsy (CP). Twelve patients with spastic diplegic CP participated in the study. An 8-week course of backward gait training was administered to the subjects for 3 days per week. Pre-intervention and post-intervention assessments of temporal-spatial gait parameters, the symmetry of the bilateral lower extremity weight bearing, and gross motor function were analyzed using motion analysis system, force plate, and Gross Motor Function Measurement (GMFM). There were significant improvements (p<.05) in the measures of both step length and right stance phase time. Joint kinematics showed increase in right hip abduction in initial contact and terminal swing, right hip external rotation and knee flexion in mid-swing, left ankle dorsiflexion in initial contact and terminal swing (p<.05). The symmetry of the bilateral lower extremity weight bearing and GMFM also significantly increased (p<.05). These findings indicate that backward gait training using a treadmill is beneficial for patients with spastic diplegic CP.

The Effects of the Band Type Foot Drop Device (밴드형 첨족예방기구의 효과와 유용성)

  • Kang Hyun-Sook;Kim Won-Ock;Lee Hya-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.3
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    • pp.391-400
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    • 2000
  • A long-term bed rest results in an inevitable foot drop. Yet preventive device such as a foot board and high-neck tennis shoes, are not widely used. This study was conducted to compare the effects of a pillow-type foot board with that of the band-type device. The band-type device of a resonable price is designed for an effective prevention of foot drop, and the convenience for it use. Among the non-equivalent control group design, foot drop preventive effects, usefulness of the device, as well as its cost effectiveness were examined. The study was carried out for four months from December 1999, and its subject had been patients and nurses of two intensive care units at K medical center in Seoul. According to the study purpose, the data collected were analyzed by $x^2-test$ and t-test. The results are as follow : 1. The ROM of ankle joint is promoted in the experimental group with a band-type device comparing the control group with a pillow type one. Dorsiflexion is particularly increased in the experimental group as compared with the control group, while planterflexion hardly shows any change. 2. The usefulness score of the experimental group nurses using the band-type device (23.97) is higher than that of the control group nurses (18.88). 3. In an aspect of the unit production cost, band-type devices are low-priced compare with pillow-type or other foot board (wooden) or high-neck tennis shoes. In summary, the newly developed band-type device is both useful and preventive for a foot drop. It is also desirable regarding to the production cost and the cost effectiveness. This fact proves that the new anti-foot drop device could be practical both for clinical care and home care. Yet the results were obtained by some subjects, it should be used after a further examination. More effective nursing intervention could be observed throughout general studies, including proper positioning and foot and ankle exercises which are the important variables of the foot drop prevention.

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The Comparison of the Gluteus Maximus Activity during Various Prone Hip Extension in Subject with Chronic Low Back Pain

  • Kwon, Yoo-Hun;Cynn, Heon-Seock;Park, Dong-Hwan;Shin, A-Reum;Baik, Seung-Min;Lee, Ji-Hyun
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.3
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    • pp.29-37
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    • 2019
  • PURPOSE: Prone hip extension (PHE) has been used for assessment of lumbo-pelvic movement and strengthening exercise for weakness of the hip joint muscles in patients with chronic low back pain (CLBP). On the other hand, few studies have examined which are the best PHE exercises to activate the gluteus maximus (GM) selectively in physical therapy practice. To aim of this study compared the muscle activity of the GM, rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA) during these four different prone hip extensions, PHE, PHE with quadriceps activation (PHEQA), PHE with ankle dorsiflexion (PHEAD), and PHE with ankle plantarflexion (PHEAP), in subjects with CLBP. METHODS: Nineteen subjects with low back pain participated in this study. Subject performed four PHE exercises and surface electromyography (EMG) was used to evaluate the muscle activity. Data were analyzed by one-way repeated-measures analysis of variance (${\alpha}=.05/3=.017$) and a Bonferroni adjustment was performed if a significant difference was found. RESULTS: The muscle activities recorded by EMG showed significant among the four exercises. The muscle activity of the GM increased significantly during PHEQA than during PHEAP (P=.012). CONCLUSION: PHEQA is the most effective exercise for eliciting greater GM muscle activation among the four PHE exercises in subjects with CLBP.

Changes of Elastic Properties in In Vivo Human Tibialis Anterior Aponeurosis Following Maximum Eccentric Exercise (최대 신장성 수축 운동 후 인체 족배굴곡근 건막의 탄성 변화)

  • Jeong, Jin-Young;Lee, Sung-Cheol;Lee, Hae-Dong
    • 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.

Immediate effects of a neurodynamic sciatic nerve sliding technique on hamstring flexibility and postural balance in healthy adults

  • Park, Jaemyoung;Cha, Jaeyun;Kim, Hyunjin;Asakawa, Yasuyoshi
    • Physical Therapy Rehabilitation Science
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    • v.3 no.1
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    • pp.38-42
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    • 2014
  • Objective: In this study, we applied a neurodynamic sciatic nerve sliding technique to healthy adults to elucidate its effects on hamstring flexibility and postural balance. Design: Cross-sectional study. Methods: This study targeted twenty four healthy adults (16 men, 8 women). A neurodynamic sciatic nerve sliding technique was applied 5 times to all subjects' dominant leg. The subjects were asked to sit on the bed while performing cervical and thoracic flexion, as well as knee flexion with ankle plantar flexion. Then, they were asked to perform cervical and thoracic extension and knee extension with their ankle in dorsiflexion and maintain the position for 60 s. For postural balance, we measured postural sway while the subjects maintained a one-legged standing posture using the Good Balance System and measured the hip joint flexion range of motion using a standardized passive straight leg raise (SLR) test. Results: SLR test increased significantly from $79^{\circ}$ before the intervention to $91.67^{\circ}$ after the intervention (p<0.05). Regarding the participants' balance evaluated using the one-legged standing test, the X-speed decreased significantly from 18.61 mm/s to 17.17 mm/s (p<0.05), the Y-speed decreased from 22.28 mm/s to 20.52 mm/s (p<0.05), and the velocity moment was significantly decreased from $89.33mm^2/s$ to $74.99mm^2/s$ after the intervention (p<0.05). Conclusions: Application of the neurodynamic sciatic nerve sliding technique exhibited improved hamstring flexibility and postural balance of healthy adults.

A Clinical Case Study of Common Peroneal Nerve Palsy(Foot Drop) Following Entrapment Neuropathy (압박성 신경병증에 의한 족하수(足下垂) 환자(患者) 1례(例)에 대한 임상적(臨床的) 고찰(考察))

  • Shin, Jeong-Cheol;Lee, Dong-Hyun;Wei, Tung-Shuen;Kim, Seon-Jong;Choe, Won-Hwak;Ryu, Chung-Ryul;Yun, Yeo-Choong;Cho, Myung-Rae;Che, Wu-Suk;Na, Gun-Ho
    • Journal of Acupuncture Research
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    • v.22 no.4
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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.

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Effect of uneffected side insole on Gait Pattern in Hemiplegia Patients (편마비 환자의 비손상측 안창 착용이 보행에 미치는 영향)

  • You, Jae-Eung;Jung, Seok
    • Journal of Korean Physical Therapy Science
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    • v.10 no.2
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    • pp.37-41
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    • 2003
  • The aim of this study is to present the basic reference data Effect of uneffected side insole on Gait Pattern in Hemiplegia Patients. The basic gait parameters were extracted from 10 Adult Hemiplegia Patients, 5 left Hemiplegia Patients and 5 right Hemiplegia Patients, 50 to 60 years of age using VICON 512 Motion Analyzer. The results were as follows; 1) The mean Cadence of the shoes to the 1cm insole in shoes were $70.58{\pm}12.67\;steps/min$, to $77.28{\pm}14.58\;steps/min$.(p>0.05) 2) The mean Walking Speed of the shoes to the 1cm insole in shoes were $0.40{\pm}0.17\;m/s$, to $0.49{\pm}0.18\;m/s$.(p>0.05) 3) The mean Stride Length of the shoes to the 1cm insole in shoes were $0.67{\pm}0.20\;m$, to $0.75{\pm}0.19m$.(p>0.05) 4) The mean anterior angles of pint on the pelvic tilt for different the shoes to the 1cm insole in shoes were $13.22{\pm}7.25^{\circ}$, to $11.68{\pm}4.02^{\circ}$.(p>0.06) 5) The mean maximal angles of pint on the hip flexion motion for different the shoes to the 1cm insole in shoes were $24.62{\pm}8.35^{\circ}$, to $24.74{\pm}9.12^{\circ}$.(p>0.05) 6) The mean maximal angles of joint on the knee flexion motion for different the shoes to the 1cm insole in shoes were $34.27{\pm}16.71^{\circ}$, to $35.93{\pm}18.22^{\circ}$.(p>0.05) insole in shoes were $15.97{\pm}7.72^{\circ}$, to $18.77{\pm}11.03^{\circ}$.(p>0.05) 7) The mean maximal angles of joint on the ankle dorsiflexion motion for different the shoes to the 1cm. 8) The mean maximal angles of joint on the ankle plantarflexion motion for different the shoes to the 1cm insole in shoes were $-4.24{\pm}10.66^{\circ}$, to $-7.04{\pm}11.00^{\circ}$.(p<0.05)

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Biomechanical Analysis of Muscle Fatigue and Ground Reaction Force for the Development of Outdoor Walking Shoes

  • Jang, Young-Min;Lee, Joong-Sook;Yang, Jeong-Ok;Lee, Bom-Jin
    • Korean Journal of Applied Biomechanics
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    • v.26 no.4
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    • pp.413-420
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    • 2016
  • Objective: The purpose of this study was to analyze and compare different kinds of outdoor walking shoes in terms of muscle fatigue and ground reaction force on walking, and to provide foundational data for developing and choosing outdoor walking shoes that fit the users. Method: The study subjects were 30 healthy men. The experiment was conducted by using outdoor walking shoes with different inner and outer harnesses of the midsole, and shapes of the outsole. For data collection, electromyography was used to measure the muscle fatigue of the anterior tibial muscle and gastrocnemii, which contribute to the dorsiflexion and plantarflexion of the ankle joint, and the biceps muscle of the thigh and lateral great muscles, which contribute to the flexion and extension of the knee joint. A GRF measurement device was used to measure the X, Y, and Z axes. Results: In the type A outdoor walking shoes, regarding the hardness of the midsole, the inner part was soft, while the outer part was hard. The vertical ground reaction force was the lowest, which means least impact while walking and light load to the knees and ankles. The type C outdoor walking shoes were intended to provide a good feel in wearing the shoes. The tibialis anterior, biceps femoris, and gastrocnemii indicate low fatigue, which means that during a long-distance walk, it will minimize the fatigue in the muscles of the lower limbs. Conclusion: To sum up the study results, the different types of outdoor walking shoes indicate their unique characteristics in the biomechanical comparison and analysis. However, the difference was not statistically significant. Thus, a systematic and constant follow-up research should be conducted to cope with expanding market for outdoor walking shoes. Lastly, this study is expected to present foundational data and directions for developing outdoor walking shoes.

Influence on Intra-limb Coordination in Individuals Wearing a Knee Extension Constraint Brace during Walking (무릎 신전 제한형 보조기 착용이 보행 시 하지 내 협응에 미치는 영향)

  • Chang, Yoonhee;Jeong, Bora;Kang, Sungjae;Ryu, Jeicheong;Kim, Gyu Seok;Mun, Museong;Ko, Chang-Yong
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.10 no.3
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    • pp.207-214
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    • 2016
  • The aim of this study was to evaluate Influence on intra-limb coordination in individuals wearing knee brace during walking. Seven healthy male adults ($32.3{\pm}2.7$ years old, $175.2{\pm}3.8cm$, $76.2{\pm}8.7kg$) participated. They wore knee brace or didn't wear any knee brace and were asked to walk along a 10 m long walkway. Spatiotemporal parameters, angles of the lower limbs, and intra-limb continuous relative phase (CRP) were measured and calculated. No differences of spatiotemporal parameters were shown (all p > 0.05). There were no changes in the angle and its range of motion (ROM) in the hip for the subjects as wearing knee brace, while ROM ($65.5{\pm}3.7^{\circ}$ vs. $60.5{\pm}3.5^{\circ}$, p < 0.05) of the angle and maximum flexion angles (stance: $31.9{\pm}4.6$ vs. $25.6{\pm}5.5$, swing: $76.7{\pm}3.1$ vs. $68.9{\pm}3.4$, all p < 0.05) in the knee significantly decreased. No changes in ROM of angle in the ankle were shown, whereas maximum dorsiflexion decreased ($22.4{\pm}2.6$ vs. $19.2{\pm}2.1$, p < 0.05) and maximum plantarflexion increased ($9.5{\pm}3.0$ vs. $15.7{\pm}2.2$, p<0.05). There were no changes in most of CRP between joints. CRP between the hip and knee joints decreased ($93.0{\pm}7.8$ vs, $84.7{\pm}4.9$, p < 0.05). Most of CRP standard deviation increased (between the hip and ankle joint during swing: $25.1{\pm}6.7$ vs. $32.4{\pm}1.9$, between the knee and ankle joint during stance: $46.0{\pm}12.9$ vs. $80.1{\pm}31.1$, between the knee and ankle joint during swing: $34.5{\pm}4.1$ vs. $37.6{\pm}3.1$, all p < 0.05). These results indicated that wearing knee brace affected joint angle and intra-limb coordination, but less affected gait features.

Differences in the Joint Movements and Muscle Activities of Novice according to Cycle Pedal Type

  • Seo, Jeong-Woo;Kim, Dae-Hyeok;Yang, Seung-Tae;Kang, Dong-Won;Choi, Jin-Seung;Kim, Jin-Hyun;Tack, Gye-Rae
    • Korean Journal of Applied Biomechanics
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    • v.26 no.2
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    • pp.237-242
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    • 2016
  • Objective: The purpose of this study was to compare the joint movements and muscle activities of novices according to pedal type (flat, clip, and cleat pedal). Method: Nine novice male subjects (age: $24.4{\pm}1.9years$, height: $1.77{\pm}0.05m$, weight: $72.4{\pm}7.6kg$, shoe size: $267.20{\pm}7.50mm$) participated in 3-minute, 60-rpm cycle pedaling tests with the same load and cadence. Each of the subject's saddle height was determined by the $155^{\circ}$ knee flexion angle when the pedal crank was at the 6 o'clock position ($25^{\circ}$ knee angle method). The muscle activities of the vastus lateralis, tibialis anterior, biceps femoris, and gastrocnemius medialis were compared by using electromyography during 4 pedaling phases (phase 1: $330{\sim}30^{\circ}$, phase 2: $30{\sim}150^{\circ}$, phase 3: $150{\sim}210^{\circ}$, and phase 4: $210{\sim}330^{\circ}$). Results: The knee joint movement (range of motion) and maximum dorsiflexion angle of the ankle joint with the flat pedal were larger than those of the clip and cleat pedals. The maximum plantarflexion timing with the flat and clip pedals was faster than that of the flat pedal. Electromyography revealed that the vastus lateralis muscle activity with the flat pedal was greater than that with the clip and cleat pedals. Conclusion: With the clip and cleat pedals, the joint movements were limited but the muscle activities were more effective than that with the flat pedal. The novice cannot benefit from the clip and cleat pedals regardless of their pull-up pedaling advantage. Therefore, the novice should perform the skilled pulling-up pedaling exercise in order to benefit from the clip and cleat pedals in terms of pedaling performance.