• 대한물리의학회지
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• 제14권2호
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• pp.41-51
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• 2019

PURPOSE: This study was conducted to investigate the effects of combined Joint Mobilization and Functional Electrical Stimulation on Muscle Activation and Mobility of ankle joints in stroke patients and their Modified Functional Reach Test (MFRT) results. METHODS: A total of 26 patients with stroke were randomly selected for enrollment in this study. (1) Functional Electrical Stimulation (FES) (2) combined Joint Mobilization and FES. An EMG system was used to measure tibialis anterior and gastrocnemius activities. Range Of Motion (ROM) of Ankle Joint and MFRT for Dynamic Balance. Pre and post intervention results were compared by paired-t-tests and differences in changes after intervention between groups were identified by the independent t-test. RESULTS: The muscle activation, ROM, and MFRT differed significantly in the experimental group (p<.05). The ROM was significantly different for the active dorsiflexion pre and post intervention in the group that received FES alone (p<.05). CONCLUSION: The results of this study suggest use of a systematic program of proactive posture control to prevent dysfunction when planning interventions for ankle joints can help stroke patients walk efficiently.

• 전기학회논문지
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• 제58권1호
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• pp.203-209
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• 2009

The purpose of this study is to develop a minimally constraint joint angle measurement system for the feedback control of FES (functional electrical stimulation) locomotion. Feedback control is desirable for the efficient FES locomotion, however, the simple on-off control schemes are mainly used in clinic because the currently available angle measurement systems are heavily constraint or cosmetically poor. We designed a new angle measurement system consisting of a magnet and magnetic sensors located below and above the ankle joint, respectively, in the rear side of ipsilateral leg. Two magnetic sensors are arranged so that the sensing axes are perpendicular each other. Multiple positions of sensors attachment on the shank part of the ankle joint model and also human ankle joint were selected and the accuracy of the measured angle at each position was investigated. The reference ankle joint angle was measured by potentiometer and motion capture system. The ankle joint angle was determined from the fitting curve of the reference angle and magnetic flux density relationship. The errors of the measured angle were calculated at each sensor position for the ankle range of motion (ROM) $-20{\sim}15$ degrees (dorsiflexion as positive) which covers the ankle ROM of both stroke patients and normal subjects during locomotion. The error was the smallest with the sensor at the position 1 which was the nearest position to the ankle joint. In case of human experiment, the RMS (root mean square) errors were $0.51{\pm}1.78(0.31{\sim}0.64)$ degrees and the maximum errors were $1.19{\pm}0.46(0.68{\sim}1.58)$ degrees. The proposed system is less constraint and cosmetically better than the existing angle measurement system because the wires are not needed.

• 한국운동역학회지
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• 제32권2호
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• pp.37-42
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• 2022

Objective: The aim of this study is to analyze the effect of the strength of the ankle support on the walking characteristics and ankle joints when men with flexible flat feet walk. Method: 13 adult male subjects (age: 23.9 ± 2.4 yrs, height: 173.0 ± 5.0 cm, weight: 76.9 ± 13.2 kg, Navicular Drop Test (NDT): 10.2 ± 0.8 mm) participated in this study. Each participant had to walk with the 3 conditions, barefoot, soft arch support and hard arch support, along a walkway while their kinematics was recorded at 100 Hz. Results: Based on the results of this study, it is considered that men with flexible flat feet should use hard arch support rather than bare feet to induce normal arch shape, relieve foot damage caused by excessive ankle joint abnormalities and improve stability. Conclusion: Our results for men with flat flexibility, there was a significant difference in the value of step length when walking was performed using two arch supports with different strengths. The angle of ankle dorsiflexion was significantly increased, and the ankle eversion angle was significantly decreased.

• 한국전문물리치료학회지
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• 제12권3호
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• pp.46-55
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• 2005

The purpose of this study was to evaluate the effect of concurrent and reciprocal isometric contraction and angle of ankle joint on fatigue of concentrically contracting contralateral dorsiflexor and plantar flexor. Seventeen able-bodied subjects participated in the study. Concurrent and reciprocal isometric contraction were performed under three different ankle joint angles (dorsiflexion, neutral position, plantar flexion). During concurrent or reciprocal isometric contraction. fatigue of concentrically contracting contralateral tibialis anterior, gastrocnemius, and soleus was investigated and compared. There was no interaction between different ankle joint angles and direction of isometric contraction (p<.05). No significant differences were found among three different ankle joint angles (p<.05). Contralateral muscle fatigability was lower in reciprocal isometric contraction than that in concurrent isometric contraction (p<.05). Therefore, the findings of this study suggest that reciprocal isometric contraction is more beneficial than concurrent isometric contraction inducing less fatigability during contralateral concentric contraction.

• 대한족부족관절학회지
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• 제6권1호
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• pp.86-91
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• 2002

Purpose: This study was designed to evaluate whether the method "Distal pulling with wire" after primary repair of Achilles tendon, can result in early restoration of ankle motion. Materials and Methods: In 14 cases of tendocalcaneus repair, the proximal stump was pulled down distally by wire and fixed the ends of wire to the transcalcaneal K - wire. We evaluated the range of motion of ankle joint at 4th, 6th, 12th week in 10 patients whom we followed up for more than 1 year. We evaluated the results of Achilles tendon repair by Hooker's criteria. Results: Range of motion of ankle joint revealed as follows. Degree of mean dorsiflexion improved - $5.1^{\circ},\;15.0^{\circ},\;22.4^{\circ}$ at 4th, 6th and 12th week respectively, while plantarflexion improved $21.5^{\circ},\;32.7^{\circ}$ and $42.3^{\circ}$ respectively. At one year follow up, seven of them had no problems in active daily life and sports activities. According to Hooker's criteria, the result rated excellent in nine, satisfactory in one. Conclusion: Early gain of ankle joint motion was possible by "Distal pulling with wire" after primary repair of Achilles tendon.

• The Journal of Korean Physical Therapy
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• 제23권4호
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• pp.45-51
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• 2011

Purpose: To determine the correct measurement methods of the ankle joint complex range of motion for measuring the neutral position and evaluate the rater reliability. In addition, the impact of training on the rater reliability was also assessed. Methods: The subjects were eleven healthy women, who were evaluated by two physical therapists and one physical therapist recorded the results of the study. Standard goniometer was used as the measurement tool. The ankle and subtalar joint neutral position and the active range of motion of the ankle and subtalar joint were measured. Intra-rater reliability and inter-rater reliability measures were analyzed with intraclass correlation coefficients. Results: Intra-rater reliability and inter-rater reliability ranged from high to medium for the neutral position of the ankle joint complex. Intra-rater reliability for dorsiflexion and plantarflexion measurements was medium, while the inter-rater reliability was high. The range of motion of the subtalar joint was measured, and the intra-rater reliability and inter-rater reliability were low and medium, respectively Also, the intra-rater reliability was increased with formal training of the measurement techniques. Intra-rater reliability was reduced in case the raters had not undertaken the training. Conclusion: In summary, the results obtained with the measurement tools and joint measurement of position, indicate the consistency of repeated measurements made by the same observers. Under the same circumstances along with repetition of the same measurement technique during training caused an increase in the rater reliability of formally trained raters.

• 대한임상전기생리학회지
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• 제11권1호
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• pp.39-44
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• 2013

Purpose : The purpose of present study is to evaluate the joint angles of legs in the standing posture for six patients with unilateral knee osteoarthritis. Methods : The participants underwent unilateral total knee replacement. A motion analysis was used to measure the joint angles of the hip, knee, and ankle. The measurements were taken before the surgery, one week and two weeks after the surgery. Both sides of the legs were evaluated. Results : This result showed that after a certain healing period, both hip joint angles showed a significant difference while there was no significant difference in the knee and ankle joint angles. After surgery, the angle of ankle dorsiflexion was smaller on the operated side than the opposite side compared to the pre-surgery measurements. Conclusion : After surgery, the asymmetry in a standing position left unchanged due to contracture of the knee joint and tightness in the hamstring muscle. Therefore, when physiotherapists plan an initial exercise programs for TKR patients, it is essential to apply adequate exercises which consider the contracture of the leg joints.

• 한국운동역학회지
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• 제16권3호
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• pp.165-172
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• 2006

The purpose of this study was to determine effects of 12-week wearing of unstable shoe on the standing posture and gait mechanics. Nine healthy men were asked to wear the unstable shoes for 12-week and walk for 30 minute everyday. Their standing posture and gait mechanics were measured before and after treatment. Standing posture was measured for each side(anterior, posterior, lateral) for standing position. And gait analysis was measured joint angle of a right lower limb between first right heel contact and second right heel contact. Kinematic data were collected using video camera at 30 frame per seconds. Statistical analysis was paired t-test(p<.05) to compare before training with after that. A head tilt angle was significantly decreased for posterior side(p<.05). The angle of between center of line and surface was significantly decreased at midstance and take off during walking(p<.05). Ankle dorsiflexion significantly increased at heel contact2(p<.05) and ankle plantarflexion significantly increased at midstance and midswing(p<.05). The increase of ankle dorsiflexion showed that our results consisted with previous study. In conclusion, there was not large significant difference in static standing posture but joint angle of lower limb represented many changes with increasing of ankle motion during walking. These were of benefit to body by increasing leg muscle activity but it was necessary for man having a ankle problem to consider. Further studies concerning optimum outsole angle of unstable shoes are necessary.

• 대한물리의학회지
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• 제15권2호
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• pp.121-128
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• 2020

PURPOSE: This study examined the changes in the cross-sectional area (CSA) of the abductor hallucis muscle during various ankle positions while performing toespread-out (TSO) exercise. METHODS: Thirty subjects with an average age of 22.1 years were recruited for this study. All subjects were firstly measured for the angle of their first metatarsophalangeal joint using a goniometer. Those with angles greater than 15° were allocated to the HV group. The remaining subjects were placed in the normal group. The CSA of the abductor hallucis was measured by ultrasound in the resting position with no movement and three ankle positions: neutral (0°), plantarflexion (30°), and dorsiflexion (30°). All data were analyzed using a two-way mixed analysis of variance between the groups (normal and HV group) and within the groups (resting, neutral, plantarflexion, and dorsiflexion) to determine the group x position interaction effects. RESULTS: During TSO exercise in the normal group, the CSA of the abductor hallucis was significantly greater in both the plantarflexion and neutral positions compared to the resting position (p_adj < .01), and plantarflexion was significantly greater than the dorsiflexion position (p_adj < .01). During the TSO exercise in the HV group, the CSA of the abductor hallucis for plantarflexion was significantly greater than it was for the resting, neutral, and dorsiflexion positions (p_adj < .01). CONCLUSION: Based on the above results, the TSO exercise in plantarflexion is an effective rehabilitation exercise for subjects with HV.

• Archives of Plastic Surgery
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• 제36권6호
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• pp.799-802
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• 2009

Purpose: Schwannoma is one of common neoplasm in the central and peripheral nervous systems. However, schwannoma of sciatic nerve is rare, especially large schwannoma arising in sciatic nerve is extremely rare. This is a report of our experience with large schwannoma arising in sciatic nerve with minimal neurologic symptoms. Methods: A 65 - year - old man presented with palpable mass in middle portion of posterior thigh. No definitive neurologic deficits were detected on physical examinations. CT and sonography showed well - defined mass with large dimension. The mass was excised and confirmed histologically as a schwannoma. In postoperative period, NCS and EMG were followed. Results: The patient complained of difficulty in dorsiflexion of ipsilateral ankle joint postoperatively. NCS and EMG obtained immediately and showed sciatic neuropathy. After 2 months postoperatively, NCS and EMG were followed and abnormal findings of previous NCS and EMG were not found. Dorsiflexion of ankle joint was improved to normal range of motion. Conclusion: We report a rare case of large schwannoma arising in sciatic nerve with no definitive neurologic symptoms.