• Physical Therapy Korea
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• v.30 no.4
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• pp.281-287
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• 2023

Background: The flexible flatfoot is characterized by a flattening of the foot arch due to excessive bodyweight. The use of shoe insoles or taping methods has been identified as effective in realigning the navicular or calcaneus bones and addressing supination in pronated feet. Objects: This study aimed to analyze the difference between the arch taping attachment method, introduced in a previous study, and a novel taping method designed to provide support to the inner aspect of the heel bone in cases of flexible flatfoot. Methods: A navicular drop test was performed to discriminate flexible flatfoot. To analyze the differences in pressure distribution during walking for each taping method, the subjects underwent testing in the barefoot state with no attachments. The procedure included a sequence of arch taping and heel taping. Subsequent analysis of pressure distribution during walking utilized the GaitRite^® system (GAITRite Gold, CIR Systems Inc.). Results: Arch taping and calcaneus taping significantly reduced the integrated pressure over time and peak pressure on the medial side of the midfoot for both feet compared to the barefoot state. Conclusion: The findings of this study suggest that supporting the inside of the heel through calcaneus taping, without direct stimulation to the longitudinal arch and navicular bone, is an effective intervention for flexible flatfoot.

• Korean Journal of Adult Nursing
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• v.16 no.2
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• pp.276-287
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• 2004

Purpose: This study was undertaken to investigate the effects of foot reflexo-massage on physical, psychological, and physiological parameters in patients with osteoarthritis of the knee. Method: This study was employed non-equivalent control group pretest-posttest time series experimental design. The subjects of this study were 47 elderly patients with osteoarthritis of the knee from two different nursing homes in Deajeon. The patients were divided into two groups; 26 patients in experimental group, the rest in control group. Each patient in experimental group received the 30-minute foot reflexo-massage, 3 times per week for 4 weeks. The dependent variables of each patient were measured before treatment, after 2 weeks and after 4 weeks during the treatment session. The collected data was analyzed using the Social Package Social Science(version 10.0) software program. Result: There were significant differences in the flexion angle of both knees; the flexion and extension muscle strength of both knees; systolic blood pressure; POMS; plantaris skin temperature and blood velocity of dorsalis pedis artery between the two groups over different the three measurement times. Conclusion: The results suggest that foot reflexo-massage could be an effective intervention to improve physical, psychological and physiological parameters for patients with knee osteoarthritis.

• Journal of Korean Foot and Ankle Society
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• v.20 no.3
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• pp.121-125
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• 2016

Purpose: This study investigates the amputation rate within 1 year after the diagnosis of diabetic foot ulcer and its associated risk factors. Materials and Methods: This study enrolled 60 patients with diabetic foot ulcer. The mean and standard deviation age was $64.4{\pm}12.8years$ (range, 32~89 years); the mean and standard deviation prevalence period for diabetes mellitus was $21.0{\pm}7.5years$ (range, 0.5~36 years). The amputation rate was evaluated by dividing the subjects into two groups - the major and minor amputation groups - within 1 year following the initial diagnosis of diabetic foot ulcer. Multivariate Cox proportional hazards regression analysis was used to identify the risk factors for amputation. Results: The total amputation rate of 38.3% (n=23) was comprised of the amputation rate for the major amputation group (10.0%) and rate for the minor amputation group (23.8%). There was a high correlation between peripheral artery disease (toe brachial pressure index <0.7) and amputation (hazard ratio [HR] 5.81, confidence interval [CI] 2.09~16.1, p<0.01). Nephropathy was significantly correlated with the amputation rate (HR 3.53, CI 1.29~9.64, p=0.01). Conclusion: Clinicians who treat patients with diabetic foot complications must understand the fact that the amputation rate within 1 year is significant, and that the amputation rate of patients with peripheral artery disease or nephropathy is especially high.

• Physical Therapy Korea
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• v.8 no.3
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• pp.1-10
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• 2001

The purpose of this study was to compare the static pressure, dynamic pressure, dynamic pressure-time integral, relative impulse, and contact time between the sound lower limb and amputated lower limb in trans-tibial amputee subjects using Parotec system. Seventeen trans-tibial amputee subjects wearing endoskeletal trans-tibial prosthesis voluntarily participated in this study. The results were as follows: 1) In static standing condition, there were significantly higher static pressure in sound lower limb insole sensor of 10, 14, 15, 18, 19, 23, and 24 and in amputated lower limb insole sensor of 9, 12, and 16 (p<.05). 2) In dynamic gait condition, there were significantly higher dynamic pressure in sound lower limb insole sensor of 2, 18, 22, 23, and 24 and in amputated lower limb insole sensor of 5, 9, 10, 11, 12, 14, 15, and 16 (p<.05). 3) In dynamic gait condition, there were significantly higher pressure-time integral in sound lower limb insole sensor of 2, 4, 18, 19, 20, 21, 23, and 24 and in amputated lower limb insole sensor of 5, 11, 12, and 15 (p<.05). 4) In dynamic gait condition, there were significantly higher relative impulse in sound lower limb insole sensor of 18, 19, 20, 22, 23, and 24 and in amputated lower limb insole sensor of 5, 9, 10, 11, 12, and 15 (p<.05). 5) In dynamic gait condition, there was significantly higher percentage of contact time in push off phase of sound lower limb and in support phase of amputated lower limb (p<.05). These results suggest that trans-tibial amputee subjects had characteristics of shortened push off phase due to unutilized forefoot and of lengthened support phase with higher pressure in the midfoot.

• Physical Therapy Korea
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• v.22 no.2
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• pp.41-51
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• 2015

The purposes of this study were 1) to determine the effects of low-dye taping on peak plantar pressure following treadmill walking exercise, 2) to determine whether the biomechanical effectiveness of low-dye taping in peak plantar pressure was still maintained following removal of the tape during treadmill walking, and 3) to determine the trend towards a medial-to-lateral shift in peak plantar pressure in the midfoot region before and after application of low-dye taping. Twenty subjects with flexible flatfoot were recruited using a navicular drop test. The peak plantar pressure data were recorded during five treadmill walking sessions: (1) un-taped, (2) baseline-taped, (3) after a 10-minute treadmill walking exercise, (4) after a 20-minute treadmill walking exercise, and (5) after removal of the taping. The foot was divided into six parts during the data analysis. One-way repeated measures analysis of variance was performed to investigate peak plantar pressure variations in the six foot parts in the five sessions. This study resulted in significantly increased medial forefoot peak plantar pressure compared to the un-taped condition (p=.017, post 10-minute treadmill walking exercise) and (p=.021, post 20-minute treadmill walking exercise). The peak plantar pressure in the lateral forefoot showed that there was a significant decrease after sessions of baseline-taped (p=.006) and 10-minute of treadmill walking exercise (p=.46) compared to the un-taped condition. The tape removal values were similar to the un-taped values in the five sessions. Thus, the findings of the current study may be helpful when researchers and clinicians estimate single taping effects or consider how frequently taping should be replaced for therapeutic purposes. Further studies are required to investigate the evidence in support of biomechanical effectiveness of low-dye taping in the midfoot region.

• Korean Journal of Applied Biomechanics
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• v.28 no.4
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• pp.237-244
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• 2018

Objective: Flat-footed people struggle with excessive ankle joint motion during walking and running. This study aimed to investigate the effects of customized three-dimensional 3D-printed insoles on the kinematics of flat-footed people during daily activities (walking and running). Method: Fifteen subjects (height, $169.20{\pm}2.61cm$; age, $22.87{\pm}8.48years$; navicular bone height, $13.2{\pm}1.00mm$) diagnosed with flat feet in a physical examination participated in this study. Results: The customized 3D-printed insoles did not significantly affect 3D ankle joint angles under walking and running conditions. However, they shifted the trajectory of the center of pressure (COP) laterally during fast walking, which enhanced the load distribution on the foot during the stance phase. Conclusion: The customized 3D-printed insoles somewhat positively affected the pressure distribution of flat-footed people by changing the COP trajectory. Further research including comparisons with customized commercial insoles is needed.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.14 no.1
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• pp.39-47
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• 2008

Purpose : The purpose of this study was to investigate the change of the peak plantar pressure distribution under the foot areas and the range of motion (ROM) of ankle joint according to gradients in treadmill gait. Method : Thirty normal subjects (15 male and 15 female) walked on treadmill at three gradient conditions ($0^{\circ}$, $10^{\circ}$, and $15^{\circ}$) in normal speed. The ankle ROM was measured using the CMS70P that is three dimensional analyzer for excursion of ankle ROM, plantar flexion, and dorsi flexion. The peak plantar pressure distribution under the hallux, 1st metatarsal head (MTH) and heel was measured using the F -Scan system with an in-shoe sensor. Data was collected from 9 steps of left sife foot in at each gradient condition while all subjects walked. Result : As the treadmill gradient increased, the excursion of ankle joint was significantly increased (p<.05). Also, plantar flexion and dorsi flexion was significantly increased according to treadmill gradients (p<.05). The peak plantar pressure under the 1st MTH was significantly increased (p<.05) and the peak plantar pressure under the heel was significantly decreased (p<.05) as the treadmill gradient increased. No significant different in the peak plantar pressure under the hallux was observed. Conclusion : This study suggests that physical therapy for patients who have limited ankle ROM should be considered sufficient range of motion for functional ambulation. And individuals that have painful forefoot syndromes, including metatarsalgia, hallux valgus, and plantar ulceration should be careful in walking to uphill, as there is high plantar pressure under the forefoot.

• Journal of Korean Foot and Ankle Society
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• v.26 no.3
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• pp.130-135
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• 2022

Purpose: Smart insoles are wearable devices that are inserted into shoes. Smart insoles with built-in pressure and acceleration sensors can measure the plantar pressure, stride length, and walking speed. This study evaluated the validity and reliability of the plantar pressure measurements of smart insoles during walking on flat ground. Materials and Methods: Twenty one subjects were included in this study. After wearing smart insoles, I-SOL^® (Gilon, Seongnam, Korea), the subjects walked a 10 m corridor six times at a rate of 100 steps/min, and the middle three steps, free from direction changes, were chosen for data analysis. The same protocol was repeated after wearing Pedar-X (Novel Corporation, Munich, Germany), an insoletype plantar pressure measurement equipment with proven validity. The average maximum pressure (P_peak, kPa) and the time at which P_peak appeared (P_time, %stride) were calculated for each device. The validity of smart insoles was evaluated by using the interclass correlation coefficient (ICC) of P_peak and P_time between the two instruments, and Cronbach's alpha was obtained from the P_peak values to evaluate the reliability. Results: The ICC of P_peak was 0.651 (good) in the hallux, 0.744 (good) in the medial forefoot, 0.839 (excellent) in the lateral forefoot, and 0.854 (excellent) in the hindfoot. The ICC of P_time showed 0.868 (excellent) in the hallux, 0.892 (excellent) in the medial forefoot, 0.721 (good) in the lateral forefoot, and 0.832 (excellent) in the hindfoot. All ICC values showed good or excellent results. The Cronbach's alpha of P_peak measured in the smart insoles was 0.990 in the hallux, 0.961 in the medial forefoot, 0.973 in the lateral forefoot, and 0.995 in the hindfoot; all indicated excellent reliability in all areas. Conclusion: The plantar pressure measurements of smart insoles during walking on a flat ground showed validity compared to Pedar-X, and high reliability after repeated measurements.

• Korean Journal of Applied Biomechanics
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• v.26 no.4
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• pp.343-351
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• 2016

Objective: The purpose of this study was to help improve game performance and provide preliminary data to enhance the efficiency of the kick and stability of the support foot by comparing the kinematic characteristics of the repeated side kick (geodeupyeopchagi) in poomsaeKoryo between expert and non-expert groups. Method: The subjects were divided into 2 groups according to proficiency in Taekwondo, an expert group and a non-expert group (n = 7 in each group), to observe the repeated side-kick technique. Four video cameras were set at a speed of 60 frames/sec and exposure time of 1/500 sec to measure the kinematic factors of the 2 groups. The Kwon3D XPprogramas used to collect and analyze three-dimensional spatial coordinates. Ground reaction force data were obtained through a force plate with a 1.200-Hz frequency. An independent samplesttest was performed, and statistical significance was defined as .05. The SPSS 18.0 software was used to calculate the mean and standard deviation of the kinematic factors and to identify the difference between the experts and non-experts. Results: The angular displacement of the hip joint in both the expert and non-expert groups showed statistical significance on E1 and E4 of the left support foot and E5 of the right foot (p<.05). The angle displacement of the knee joint in both groups showed statistical significance on E4 of the left support foot, and E1 and E2 of the right foot (p<.05). The angular velocity of the lower leg in both groups showed no statistical significance on the left support foot but showed statistical significance on E2 and E6 of the right foot (p<.05). The angular velocity of the foot in both groups showed no statistical significance on the left support foot but showed statistical significance on E2 of the right foot (p<.05). The vertical ground reaction force in both groups showed statistical significance on E2 (p<.05). The center of pressure in all directions in both groups showed statistical significance (p<.5). Conclusion: While performing the repeated side kick (geodeupyeopchagi), the experts maintainedconsistency and stability of the angle of the support leg while the kick foot moved high and fast. On the other hand, the angle of the support foot of non-experts appeared inconsistent, and the kick foot was raised, relying on the support leg, resulting in unstable and inaccurate movement.

• Journal of the Korean Society of Clothing and Textiles
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• v.10 no.2
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• pp.21-28
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• 1986

This paper is concerned with the mutual relationship among interpressure, last. foot within a new shoe and foot within a fifty-hour-used shoe at the standing posture at three different heel-heights 1. The interrelationship between the heel-heights and interpressure is very significant at the level of $0.1\%$. The heel-heights cause high interpressure at different parts of foot; heel point and big toe point in a 3 cm-heel shoe, big toe point and heel outside joint point in a 5 cm-heel shoe, and little toe point, heel-outside joint point, and arch point in a 7 cm-heel shoe. 2. Foot girth and foot width measurements either within a new shoe or within a fifty-hour-used shoe significant at the level of $5\%,\;1\%,\;0.1\%$ and show discrepancies at three different heel heights; the part between instep and ball joint in a 3 cm-heel shoe, toe part in a 5 cm-heel shoe, heel-inside joint. heel-outside joint and toe part in a 7 cm-heel shoe are highly influenced by heel heights. The higher the shoe-hee15 are, the more heavily the fore part of foot is pressured in lateral direction because shoe is made to have high instep from a fashion viewpoint. Higher shoe heels prevent weight pressure from being concentrated on heel. If shoe heels are toe high, people in such shoes feel easily tired. It is very worthy of note in selecting shoes to consider not only the shoe fashion but also fore shoe type, heel height, and shoe material with proper elasticity.