• 대한족부족관절학회지
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• 제8권2호
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• pp.131-137
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• 2004

Purpose: We evaluated the results of various surgical treatments for hallux valgus with and without attempting to correct sesamoid subluxation. Materials and Methods: Thirty-one cases in 26 patients were involved in this study: Group I (15 cases) - surgery performed only to correct the hallux valgus angle (HVA) and the first-second intermetatarsal angle (IMA) in AP view; Group II (16 cases) - surgery performed to correct HVA and IMA and also to reduce the subluxation of sesamoid. The degree of sesamoid subluxation was measured from a pre- and intraoperative sesamoid tangential views. For both groups, we analysed the status of the sesamoid in pre- and postoperative radiographs and performed clinical evaluation using the Mayo clinic forefoot scoring system. Results: The average amount of correction during postoperative period and loss of correction at last follow-up in the sesamoid tangential view were as follows: soft tissue procedures (5 cases) - group I: grade $1.0{\pm}0.4/1.5{\pm}0.3$ and group II: grade $2.0{\pm}0.9/0.5{\pm}0.08$; chevron osteotomy (12 cases) - group I: grade $1.0{\pm}0.5/1.2{\pm}0.3$ and group II: grade $2.2{\pm}0.7/0.9{\pm}0.2$; proximal metatarsal osteotomy (14 cases) - group I: grade $4.0{\pm}0.4/1{\pm}0.2$ and group II: grade $4.7{\pm}1.1/0.8{\pm}0.1$. In clinical evaluation, more than 93% of the feet had a good result in both groups. The analysis of these data for each treatment type did not show any statistically significant differences between groups I and II. Conclusion: The radiologic and clinical results did not validate our attempts to reduce the sesamoid during surgery.

• 대한족부족관절학회지
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• 제13권2호
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• pp.124-128
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• 2009

Purpose: The authors intended to analyze the operative results of mild to moderate hallux valgus treated with distal chevron metatarsal osteotomy. Materials and Methods: Twenty six feet of twenty three patients were followed for more than 1 year after the distal chevron metatarsal osteotomy. Biplanar osteotomy with wedge resection was done when the distal metatarsal articular angle (DMAA) was increased. The mean age was 39 years, and the mean follow up period was 27 months. Clinically preoperative and postoperative AOFAS hallux MP-IP scale and satisfaction after the surgery were analyzed. Radiologically hallux valgus angle, the 1st intermetatarsal angle, DMAA and sesamoid position before and after the operation were analyzed. Results: Distal chevron osteotomy was done in 15 cases and biplanar osteotomy was done in 11 cases. Clinically AOFAS scale was increased from 65.3 points preoperatively to 92.2 points postoperatively. Two patients were not satisfied with the results. Radiologically hallux valgus angle was decreased from $21.9^{\circ}$ preoperatively to $8.5^{\circ}$ postoperatively. The first intermetatarsal angle was decreased from $11.8^{\circ}$ preoperatively to $6.7^{\circ}$ postoperatively. DMAA was decreased from $11.8^{\circ}$ preoperatively to $5.5^{\circ}$ postoperatively. There was one case of minor wound infection. Conclusion: Distal chevron metatarsal osteotomy appears to be safe and satisfactory procedure for mild to moderate hallux valgus.

• 대한족부족관절학회지
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• 제12권1호
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• pp.1-8
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• 2008

Purpose: To evaluate the value and limitation of modified Mau osteotomy through the review of 30 feet treated by this procedure. Materials and Methods: We retrospectively analyzed 30 cases treated with modified Mau osteotomy since 2002. The mean duration of follow-up was 10 months. We reviewed medical records to describe each case and select several clinical factors which related with surgical procedure and could influence on final results. We measured radiographic parameters such as hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), sesamoid position and also assessed clinical outcomes by AOFAS score and satisfaction degrees. Results: The mean preoperative HVA and IMA were $40.4^{\circ}$, $17.4^{\circ}$ and the mean amounts of correction were $31.2^{\circ}$ and $11.5^{\circ}$. Amounts of delayed loss of correction were 16.8% in HVA and 19.2% in IMA. Initial HVA, rotational angle and translation distance of the distal fragment, stability of fixation, first ray instability were revealed as significant factors for the final result from this procedure. DMAA was increased by rotation of the distal fragment and decreased by adding translation on the rotation. Conclusion: Modified Mau osteotomy is an effective procedure to get enough correction. But, it is important to try to avoid excessive rotation of the distal fragment because it may worse joint congruity. It may be worthwhile to pay close attention to the direction of saw and stability of fixation.

• 대한의용생체공학회:의공학회지
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• 제31권3호
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• pp.210-216
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• 2010

This study is vestibular electric stimulation applied between the mastoids during quiet standing elicits postural sway. The aim of this study was to characterize the postural sway response to continuous sinusoidal vestibular electric stimulation across various stimulus frequencies and amplitudes. Binaural bipolar sinusoidal vestibular electric stimulation was applied to the skin overlying the mastoid processes of 10 subjects while they stood on a force plate. The position of the center of pressure(COP) and signals at the feet are obtained on an force plate, while the head and whole body center of mass(COM) was measured with motion analysis system. The stimulus conditions included eight frequencies (1/64, 1/32, 1/16, 1/8, 1/4, 1/2, 1, and 2Hz) and six peak amplitudes (0.1, 0.25, 0.5, 0.7, 1 and 2mA). Each subject experienced one trial at each amplitude-frequency pair. The stimuli elicited sway in lateral plane in all subjects, as evidenced by changes in the stimulus frequency. Our results demonstrate that the vestibular system is sensitive to vestibular electric stimulation intensity changes and responds by altering the magnitude of the response accordingly.

• 대한한의학원전학회지
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• 제33권1호
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• pp.61-80
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• 2020

Objectives : To clarify the construction, changes, and contents of the diagrams of spleen through comparison of 30 different diagrams originated from Mingtangzangfutu. Methods : The diagrams were analyzed in whole shape, ratio between width and height, shape of the lower part, and concavo-convex of the middle part, then matched to the characteristics of the section diagram. The contents of the diagram of the spleen were newly interpreted with comparison to the classical texts. Results : The whole shape is described to be a long sword, long stick, bottle gourd, western pear, sole of feet. The height to width ratio was mostly above 4.0:1, but those listed in the 『Bianquemaishunaning』 and 『Hehensancaituhui』 were 1.9:1~1.0:1, most similar to the numbers described in the 『Nanjing』. The shape of the lower part was narrow and sharp, narrow and flat or wide and flat. To analyze through affiliation characteristic, properties of other affiliations could be found. In comparison to classical texts, the diagrams could be found to be affected by 『Nanjing』 and Wangbing's annotations. The diagrams of the spleen should be composed of the spleen, the cord of spleen, and Sangao(散膏); but those which distinguish the spleen and the cord of spleen are twelve. The description of its shape as being similar to sword or sickle seems to come from Lichan's misunderstanding of the diagram in 『Zhenjiujuying』. Those that mention Sangao are merely two and their opinion on the position are different from each other; both did not identify it with the pancreas. Conclusions : In the process of the diagrams differentiating into 30 they were affected by the classical texts. The various changes seem to come from difference in understanding of the content composition of the diagram of the spleen.

• 한국전문물리치료학회지
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• 제22권1호
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• pp.93-102
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• 2015

Prolonged sitting can contribute to low back pain. The lumbar taping can be applied to correct the sitting posture. This study aimed to investigate the effect of lumbar taping on lumbar kinematics and the muscle activities of multifidus (MF) and internal oblique in the individuals with nonspecific chronic low back pain (NSCLBP) as they type for 30 minutes. Nineteen subjects with NSCLBP (9 people in non taping group and 10 people in taping group) were recruited. Lumbar taping was applied to the taping group before typing. Both groups started typing in a neutral sitting position with their feet on the floor. The change of posture and S2 posterior tilting (S2P) were measured to investigate kinematic data. Three sensors were attached on T12, L3, and S2 to identify the change of posture. Surface electromyography was used to measure the muscle activities. Palpation meter was used to standardize the angle of pelvic tilt in sagittal plane before typing. All instruments were used to measure each data before and after typing. Independent t-test was used to compare the changing values of lumbar kinematics and muscle activities before and after typing between both groups. The changing values of S2P and change of posture of L3 and S2 were significantly smaller in the taping group compared to the non taping group (p<.05). The changing value of muscle activities of MF between before and after typing was significantly smaller in the taping group compared to the non taping group (p<.05). In conclusion, the lumbar taping during the 30-minute typing task can be applied to maintain correct sitting posture in the lumbar and pelvis and to maintain activation of MF.

• 한국전문물리치료학회지
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• 제21권2호
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• pp.1-7
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• 2014

Lumbopelvic stabilization exercise has become the most popular treatment method in lumbar rehabilitation since its effectiveness was shown in some aspects of pain and disability. The abdominal drawing-in maneuver (ADIM) has been extensively implemented to promote lumbopelvic stability. However, performing ADIM correctly is difficult even for healthy subjects, and it is time consuming to train people in ADIM. Thus, the purpose of this study was to compare abdominal muscle [rectus abdominalis (RA), external oblique (EO), and transverse abdominis/internal oblique (TrA/IO)] activity during lumbopelvic stabilization exercises (ADIM only, ADIM with a ball, maximum exhalation only, and maximum exhalation with a ball) performed in a supine position with feet against a wall. Fifteen healthy subjects were recruited for this study. Surface electromyography was used to measure abdominal muscle activity during lumbopelvic stabilization exercises. A one-way repeated-measures analysis of variance was used to determine the statistical significance of RA, EO, and TrA/IO muscle activity during four lumbopelvic stabilization exercises. Both-side TrA/IO muscle activity was significantly greater with maximum exhalation with a ball than with ADIM only or ADIM with a ball (p<.008). The results of this study suggest that maximum exhalation with a ball can be used as an effective lumbopelvic stabilization exercise to increase TrA/IO muscle activity in healthy subjects.

• 한국전문물리치료학회지
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• 제25권4호
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• pp.19-26
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• 2018

Background: Alignment of the lower limb is an important factor, influencing balance and gait in kinematics and kinetics, in patients with and without a flat arched foot. Flat arched foot are associated with the range of motion (ROM) of the hip and alignments of the knee joints, is strongly influenced. Objects: The purpose of this research was to investigate the relationship between hip joint ROM and quadriceps angle (Q-angle), by dividing them into two groups according to the presence or absence of flat feet, using a navicular drop test (NDT) and resting calcaneal stance position (RCSP). Methods: Forty elderly patients were allocated to the experimental group (flat foot group, n1=20) or the control group (non-flat group, n2=20). Universal and digital goniometer, tractograph and tape measure were used to determine the related changes in the hip ROM, Q-angle, NDT and RCSP. Results: Data were analyzed using the Pearson correlation coefficients. Active internal ROM of the hip joint (right, r=.803, p<.001), (left, r=.951, p<.001) were highly correlated with NDT, and also, was moderately correlated with Q-angle (right, r=.562, p=.019), (left, r=.757, p<.001). Passive internal ROM of the hip joint (right, r=.742, p=.001), (left, r=.922, p<.001) were highly correlated with NDT, and also, was moderately correlated with RCSP (right, r=-.530, p=.029) and with Q-angle (right, r=.710, p=.001), (left, r=.698, p=.002) in the flat foot group. However, no strong correlation among the hip ROM, NDT, RCSP and Q-angle were found in the non-flat foot group. Conclusion: This research may provide evidence of the correlations between hip internal ROM and flat foot.

• 대한족부족관절학회지
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• 제14권1호
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• pp.16-20
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• 2010

Purpose: This study analyzed the clinical and radiographic outcome of the severe hallux valgus corrected with proximal reverse chevron metatarsal osteotomy and Akin osteotomy. Materials and Methods: The study was based on 18 feet (15 patients) of severe hallux valgus (hallux valgus angle ${\geq}40^{\circ}$ or intermetatarsal angle ${\geq}18^{\circ}$) treated with proximal reverse chevron metatarsal osteotomy and followed for more than 1 year. Akin osteotmy was added in 72% of the patients. Clinically preoperative and postoperative AOFAS Hallux Metatarsophalangeal-interphalangeal score, VAS pain score and satisfaction after the surgery were analyzed. Radiologically hallux valgus angle, hallux valgus interphalangeal angle, the intermetatarsal angle and sesamoid position before and after the operation were analyzed. Results: AOFAS Hallux Metatarsophalangeal-interphalangeal score improved from 54.5 (25-78) to 87.7 (70-100) and VAS pain score decreased from 6.0 (3-8) to postoperative 1.2 (0-5). Ninety-six percents of the patients were satisfied with results. Radiologically hallux valgus angle was decreased from $43.3^{\circ}(31-58^{\circ})$ preoperatively to $6.8^{\circ}(-8-27^{\circ})$ postoperatively. The intermetatarsal angle was decreased from $18.4^{\circ}(11-24)^{\circ}$ preoperatively to $5.3^{\circ}(1-12^{\circ})$postoperatively. The sesamoid subluxation was improved from $2.8{\pm}0.4$ preoperatively to $0.4{\pm}0.6$ postoperatively. Conclusion: Proximal reverse chevron metatarsal osteotomy and lateral soft tissue release with additional Akin osteotomy is good treatment option for severe hallux valgus.

• 대한통합의학회지
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• 제8권2호
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• pp.97-107
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• 2020

Purpose : The purpose of this study is to investigate the effect of squat exercise using a ball on the gap between knees and Q angle of a subject with a genu-varum, and to prove the effect, to provide a clinical basis for developing into a knee correction exercise program. Methods : As a result of posture measurement through GPS, 26 female with genu-varum with a knee length of 5 cm or more were studied. The group was randomly assigned to 13 squat exercise group using ball (experimental group) and 13 general squat exercise groups (control group). The experimental group placed the ball between both knees in a position where the distance between both feet was slightly wider than the shoulder width on a flat support surface, and fixed the ball, and then squat with the start signal. The control group squats without a ball. Each group performed three sets of exercise three times a week for six weeks. Before their exercise, after three and six weeks, EMG, GPS, digital goniometer measurement, the vastus medialis (VM), the vastus lateralis (VL), and the Q-angle were measured in the squat exercise posture. EMG was measured in squat exercise posture. Results : The distance between the knees was reduced. EMG is activated in group A, the group B experimental results showed the high activity of the VL. Q-angle had increased. But the experimental group increased more than the control group. Conclusion : We have confirmed through our experiments that the distance interval between the knees during squat exercises using a ball can be reduced. Furthermore, it would also be helpful to ensure the treatment of genu-varum.