The purposes of this study were to describe and compare pint moments according to 6 types of gait methods during free speed. 15 volunteers(7 male, 8 female: mean age = 23.33 yrs.) participated and performed 6 types of gait methods. From the 3 types of pint moments of lower extremities(hip, knee, ankle and foot), the following results were made: 1. In left hip pint, the flexion-extension moment was not significantly different, but the adduction-abduction moment and rotation moment were showed different curves during stance phase. 2. In left knee pint, the flexion-extension moment was not significantly different, but the varus-valgus moment and rotation moment were showed different curves during stance phase. 3. In left ankle and foot the dorsiflexion-plantarflexion moment was not significantly different but the varus-valgus moment and rotation moment were showed different curves during stance phase. In conclusion, because weight loading gait with 10-20% of body weight were normal gait patterns, It was inferred that all weight loading gaits did not indicate noxious reactions of human body.
PURPOSE: The purpose of this study was to investigate the effect of the elastic band and stretching exercise program on ankle joint maximal voluntary isometric contraction (MVIC) and plantar pressure in high-heel wearing women in their 20s. METHODS: Twenty women in their twenties were randomly assigned to the experimental group (n=10) and the control group (n=10). The experimental group (n=10) performed the elastic band exercise program, while the control group (n=10) performed the stretching exercise program. Both exercise programs were performed three times a week for a total of four weeks. The BTE Primus RS was used in order to measure the ankle joint MVIC during dorsiflexion, plantar flexion, inversion, and eversion. Maximum pressure ($N/cm^2$), average pressure ($N/cm^2$) were measured using the Pedoscan. SPSS v. 21.0 software was used for all statistical analyses in this study. RESULTS: The measurement of the ankle joint's MVIC revealed that in inversion, a significant change in both feet was seen in both the experimental and control groups. In eversion, there was a significant change in both feet only in the experimental group. In terms of the rest of the results, no significant changes were visible. With regard to the plantar pressure, no significant results were seen for either foot in the comparison between or within the groups. CONCLUSION: Exercise program using elastic band and exercise program using stretching were effective on MVIC of ankle joint muscles, although it had no effect on changes of plantar pressure.
For professional drivers, there is a possibility to have musculoskeletal disorders on ankle joint due to repetitive pedaling operation. Therefore, this study have focused to examine ankle active range of motion (AROM), dorsiflexor strength, and pressure pain threshold (PPT) of tibialis anterior muscle (TA) in taxi drivers compared to a age-matched control group. Thirty male taxi drivers with at least 10 years of driving experience and thirty male sedentary workers were evaluated for ankle AROM, dorsiflexor strength, and PPT of TA. Multiple independent t-tests were used to identify significant differences between two groups. For the results, taxi drivers had significantly less AROM in dorsiflexion and greater AROM in external tibial rotation compared to the control group. Also, dorsiflexor strength and PPT of TA in taxi drivers was significantly lower than in the control group. This study indicates that the repetitive ankle movements associated with driving have an effect on ankle AROM, dorsiflexor strength, and PPT of TA and may lead to work-related musculoskeletal disorders on ankle. Professional drivers may need to be educated to prevent a potential musculoskeletal disorders associated with repetitive movement.
PURPOSE: This study was conducted to assess the effects of local vibration on ankle plantarflexion spasticity and clonus in patients with spinal cord injury. METHODS: The subjects were 14 inpatients with complete or incomplete spinal cord injury (SCI) whose scores were higher than 1 on the Modified Ashworth Scale (MAS) and Spinal Cord Assessment Tool for Spastic Reflexes (SCATS) scale of paraplegia. A randomized single-blind cross-over design was used. Vibration treatment involved a single application of vibration for 10 min in the sitting position, and placebo treatment involved the patient remaining in the sitting position for 10 min. One day after treatment, vibration and placebo treatments were crossed over. Spasticity was measured by using the MAS, and resistance force, by using a hand-held dynamometer; clonus was gauged by using the SCATS scale and clonus burst duration. Additionally, the burst maximal frequency and voluntary ankle dorsiflexion angle of the triceps surae were measured. RESULTS: The application of vibration treatment in the sitting position significantly reduced the MAS scores and resistance force, but significantly increased the dorsiflexion angle of the ankle joint (p<0.05). Furthermore, the vibration treatment diminished the clonus burst duration and SCATS score significantly (p<0.05). Although it reduced the burst maximal frequency of the lateral gastrocnemius and medial soleus, this was significant only for the lateral gastrocnemius. The placebo treatment did not significantly affect any of the test parameters. CONCLUSION: Vibration treatment in the sitting position was effective in cases of spasticity and clonus caused by SCI.
Kim, Yong-Wook;Jo, Seung-Yeon;Byeon, Yeoung-In;Kwon, Ji-Ho;Im, Seok-Hee;Cheon, Su-Hyeon;Kim, Eun-Joo
대한물리의학회지
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제14권1호
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pp.53-61
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2019
PURPOSE: This study examined the dynamic range of motion (ROM) of the hip, knee, and ankle joint when wearing different shoe sole lifts, as well as the limb asymmetry of the range according to the leg length discrepancy (LLD) during normal speed walking. METHODS: The participants were 40 healthy adults. A motion analysis system was used to collect kinematic ROM data. The participants had 40 markers attached to their lower extremities and were asked to walk on a 6 m walkway, under three different shoe lift conditions (without an insole, 1 cm insole, and 2 cm insole). Visual3D professional software was used to coordinate kinematic ROM data. RESULTS: Most of the ROM variables of the short limbs were similar under each insole lift condition (p>.05). In contrast, when wearing a shoe with a 2 cm insole lift, the long limbs showed significant increases in flexion and extension of the knee joint as well as; plantarflexion, dorsiflexion, pronation, eversion, and inversion of the ankle joint (p<.05). Of the shoes with the insole lifts, significant differences in all ROM variables were observed between the left and right knees, except for the knee internal rotation (p<.05). CONCLUSION: As the insole lift was increased, more ROM differences were observed between the left and right limbs, and the asymmetry of the bilateral lower limbs increased. Therefore, appropriate interventions for LLD are needed because an artificial mild LLD of less than 2.0 cm could lead to a range of musculoskeletal problems of the lower extremities, such as knee and ankle osteoarthritis.
The purpose of this study was to explore the effects of GEAP on pain, joint function, activities of daily living(ADL) and fatigue in chronic arthritis patients. The GEAP was held twice a week for 6 weeks for chronic arthritis patients at one university hospital in Seoul, Korea. Thirty four subjects completed the program, who were recruited at four times from September, 1999 to September, 2000. The effect of GEAP were evaluated as follows: Pain severity and number of painful joints ADL, fatigue were measured before and after the GEAP. In order to examine the joint flexibility and strengthening, the followings were measured: the extent of the upward arm reach in both sides(flexibility of shoulder), the ability to touch fingertips of the both hands in back pat and rub(flexibility of arm), the degree of range of motion (ROM) of both ankles in their dorsiflexion(flexibility of ankle) and plantarflexion with standing with toe(strengthening of ankle), and the degree of knee extension, and the grip strength. Paired t-test and Wilcoxon signed rank test were used for data analysis and the significance of the differences in the variables was examined to compare the data obtained before and after the GEAP. After the GEAP, followings were found: 1. Pain severity and number of painful joints was significantly decreased. 2. The flexibility of both shoulders and arms, knee, both ankle were significantly improved. 3. The strengthening of both arms was significantly improved, but the strengthening of ankle was not changed. 4. ADL was significantly increased. 5. Fatigue was significantly decreased. In conclusion, GEAP used in this study was clearly proved to be an effective exercise program to reduce pain and fatigue, to enhance joint function and ADL in people with chronic arthritis. It is suggested that the GEAP should be recommended as one of the useful and appropriate nursing interventions for chronic arthritis patients.
The PACE (People nth Arthritis Can Exercise) is an exercise program developed by the Arthritis Foundation to improve muscle strength and joint flexibility for patients with arthritis. The purpose of this study was to explore the effects of PACE program on self-efficacy, pain, and joint function in the Korean immigrant elderly. The PACE program was held twice a week for 6 weeks for Korean immigrant elderly who had osteoarthritis. Twenty four subjects completed the program, who were recruited in two places : 10 elderly in a senior residential apartment, and 14 elderly in a senior center supported by Congregated Meal Program for Korean Elderly. Self-efficacy(Sherer et al., 1982), pain severity(by using Visual Analogue Scale), and number of painful joints were measured before and after the PACE program. To examine the joint flexibility and strengthening, the followings were measured : the extent of the upward arm reach in both sides(flexibility of shoulder), the ability to touch fingertips of the both hands in back pat and rub(flexibility of arm), the degree of range of motion(ROM) of both ankles in their dorsiflexion(flexibility of ankle) and plantarflexion with standing with toe(strengthening of ankle), and the degree of knee extension. Wilcoxon signed rank test was used for data analysis and the significance of the differences in the variables was examined to compare the data obtained before and after the PACE program. After the PACE, followings were found : 1. Self-efficacy was significantly increased. 2. Pain severity and number of painful Joints was significantly decreased. 3. The flexibility of both shoulders and arms were significantly improved, but the flexibility of knee was not changed. 4. The flexibility and strengthening of both ankle was significantly improved. In conclusion, PACE was clearly proved to be an effective exercise program to promote self-efficacy, to reduce pain, and to enhance joint function in the elderly with osteoarthritis. It is suggested that the PACE program should be recommended as one of the useful and appropriate nursing interventions for elderly with osteoarthritis.
Purpose: To investigate the short term result of the first metatarsophalangeal arthrodesis for treating the hallux valgus deformity of rheumatoid arthritis, using a lag screw and dorsal mini-plate. Materials and Methods: From December 1999 to September 2001, The first metatarsophalangeal arthrodesis of 14 cases (9 patients) was underwent, using a lag screw and dorsal mini-plate. The follow-up period was averaged in 14.6 months. The subjective findings with respect to pain, functional aspect of ability to stand and walk, and to shoe-wearing were evaluated. The objective findings, such as the gross alignment and the radiological measurements for the hallux valgus angle, 1,2 intermetatarsal angle, and dorsiflexion angle were also studied. Results: After the arthrodesis of the first metatarsophalangeal joint, the subjective improvement in pain, function and alignment was graded as excellent in seven (50%) feet, good in seven (50%) feet, and fair or poor in none. The hallux valgus angle and 1,2 intermetatarsal angle were reduced from $44.1{\pm}7.1$ and $15.5{\pm}6.2$ degrees to $13.6{\pm}2.6$ and $10.2{\pm}2.2$ degrees respectively. The dorsiflexion angle was measured in $20.3{\pm}3.7$ degrees after the fusion. The radiological fusion was observed at average 8 weeks after the operation in all cases. The overall complication of the procedure was few, except the delayed wound healing in one. Conclusion: The arthrodesis of the first metatarsophalangeal joint using a lag screw and dorsal mini-plate was regarded as an excellent method of various operative modalities to correct the rheumatoid hallux valgus deformity.
The purpose of this study was to investigate the effects of foot type and ankle joint fatigue levels on the trajectories of center of pressure and center of mass during a single-leg stance. The study subjects included 24 healthy women (normal foot group, n=10; pronated foot group, n=14). Ankle joint muscle fatigue was induced by using an isokinetic dynamometer, where the fatigue levels were measured on plantar flexion and dorsiflexion at angular velocities of $30^{\circ}/s$ at 50% and 30% of the peak torque of ankle plantar flexion. Following assessments in the anteroposterior direction according to the level of fatigue, the pronated foot group showed decreased single-leg stance ability at 50% and 30% of the fatigue level. Moreover, the normal foot group showed better single-leg stance ability than the pronated foot group at 30% of the fatigue level. Following assessments in the mediolateral direction, we noted that the single-leg stance ability did not differ significantly according to the levels of fatigue or foot type. In conclusion, ankle plantar flexion at 50% and 30% of the peak torque reduced the ability of the pronated foot group to achieve a single leg stance in the anteroposterior direction. Moreover, the normal foot group showed better single-leg stance ability than the pronated foot group.
Lee, Seong-Joo;Lim, Ji Young;Lee, Chang-Hyung;Park, Dae-Sung
Physical Therapy Rehabilitation Science
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제8권4호
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pp.218-224
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2019
Objective: This reliability study examined the effects of applying varying induced inward pressures using a transducer placed at 0° neutral ankle position (NEU) and 15° ankle dorsiflexion (DF) on tibialis anterior (TA) muscle thickness using a custom-made device with a force indicator during rehabilitative ultrasound imaging. Design: Cross-sectional study. Methods: Twenty-four healthy subjects were recruited in this study. Two examiners measured the muscle thickness of the TA at 0° NEU and 15° DF in 3 conditions of inward pressures (1.0 N, 2.0 N, and 4.0 N) using a custom-made holder. The muscle thickness was measured three times for each of the conditions arranged in random order. For intra- and inter-rater reliability, the intraclass correlation coefficients (ICCs) with 95% confidence intervals, standard error of measurement, minimal detectable change, and coefficient of variation were analyzed. One-way repeated measures analysis of variance was conducted for investigating changes of TA muscle thickness according to the inward pressures of the transducers. Results: The intra-rater reliability of TA muscle thickness measurement was excellent (ICC3,1: 0.92-0.96) for all conditions (at both ankle joint angles per varying inward pressure). Likewise, the inter-rater reliability of TA muscle thickness measurement was excellent (ICC2,1: 0.89-0.97) under same conditions. The mean of TA thickness showed the trend of decreasing significantly with increased inward pressures at all ankle joint angles (p<0.05). Conclusions: Use of this custom-made device with a force indicator is useful to accomplish the high intra- and inter-rater reliability of TA muscle thickness measurement at both ankle joint angles in reducing the measurement error.
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