• Title/Summary/Keyword: Foot and ankle

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Effect of Tiger Step on Lower Extremities during Uphill Walking (오르막보행 시 타이거스텝 하지 움직임에 미치는 영향)

  • Kang, Jihyuk;Yoon, Sukhoon
    • Korean Journal of Applied Biomechanics
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    • v.32 no.1
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    • pp.17-23
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    • 2022
  • Objective: The aim of this study was to investigate the effect Tiger-step walking on the movement of the lower extremities during walking. Method: Twenty healthy male adults who had no experience of musculoskeletal injuries on lower extremities in the last six months (age: 26.85 ± 3.28 yrs, height: 174.6 ± 3.72 cm, weight: 73.65 ± 7.48 kg) participated in this study. In this study, 7-segments whole-body model (pelvis, both side of thigh, shank and foot) was used and 29 reflective markers and cluster were attached to the body to identify the segments during the gait. A 3-dimensional motion analysis with 8 infrared cameras and 7 channeled EMG was performed to find the effect of tigerstep on uphill walking. To verify the tigerstep effect, a one-way ANOVA with a repeated measure was used and the statistical significance level was set at α=.05. Results: Firstly, Both Tiger-steps showed a significant increase in stance time and stride length compared with normal walking (p<.05), while both Tiger-steps shown significantly reduced cadence compared to normal walking (p<.05). Secondly, both Tiger-steps revealed significantly increased in hip and ankle joint range of motion compared with normal walking at all planes (p<.05). On the other hand, both Tiger-steps showed significantly increased knee joint range of motion compared with normal walking at the frontal and transverse planes (p<.05). Lastly, Gluteus maximus, biceps femoris, medial gastrocnemius, tibialis anterior of both tiger-step revealed significantly increased muscle activation compared with normal walking in gait cycle and stance phase (p<.05). On the other hand, in swing phase, the muscle activity of the vastus medialis, biceps femoris, tibialis anterior of both tiger-step significantly increased compared with those of normal walking (p <.05). Conclusion: As a result of this study, Tiger step revealed increased in 3d range of motion of lower extremity joints as well as the muscle activities associated with range of motion. These findings were evaluated as an increase in stride length, which is essential for efficient walking. Therefore, the finding of this study prove the effectiveness of the tiger step when walking uphill, and it is thought that it will help develop a more efficient tiger step in the future, which has not been scientifically proven.

Factors Affecting Musculoskeletal Symptoms among Korean Farmers: Focusing on the Sociodemographic Characteristics (농업인의 근골격계 자각증상에 영향을 미치는 요인: 인구사회학적 요인 중심으로)

  • Minji, Lee;Kyungsu, Kim;Dongphil, Choi
    • Journal of agricultural medicine and community health
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    • v.47 no.4
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    • pp.255-267
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    • 2022
  • Objectives: The purpose of this study was to analyze the factors affecting work-related musculoskeletal symptoms in farmers. Methods: In order to examine the factors affecting the musculoskeletal symptoms among farmers, data of 'Occupational Disease Survey for Farmers' was performed by the RDA(Rural Development Administration). Results: The odds ratio of work-related musculoskeletal symptoms among female farmers were 1.42(1.30-1.56) times higher than male farmers. The older aging and longer the agricultural work period, the higher odds ratio of musculoskeletal symptoms was shown. By major crops, all crop farmers showed higher odds ratio of musculoskeletal symptoms compared to rice crop farmers. As a result of examining the effective factors on the odds ratio of musculoskeletal symptoms by body parts, female farmers had higher odds ratio of musculoskeletal symptoms than male farmers by 1.38(1.26-1.51) times in waist, 1.58(1.44-1.74) times in knee, 1.32(1.05-0.67) times in hand/wrist, and 1.30(1.06-1.59) times in foot/ankle. By crops, animal husbandry farmers had higher odds ratio of musculoskeletal symptoms than rice crop farmers by 1.44(0.89-2.35) times in waist, and field crop farmers were 1.37(1.07-1.77) times higher in knee. Compared with rice crop farmers, odds ratio of the shoulder part the shoulder parts were 1.19(0.81-1.76) times higher in greenhouse crop farmers and 1.16(0.97-1.38) times higher in dry field crop farmers. Odds ratio of the hands/wrist parts were higher odds ratio of musculoskeletal symptoms than rice crop farmers by 1.69(1.00-2.87) times in greenhouse crop farmers. Conclusions: The results of this study would help to select the group that needs to be managed first, and could be used as basic data for the development of customized musculoskeletal disorders prevention programs.

National Survey of Injury and Poisoning on a Representative Sample Population of Koreans (우리나라 대표적(代表的) 표본인구(標本人口)의 연간(年間) 손상(損傷) 및 중독발생율(中毒發生率)과 역학적(疫學的) 특성(特性))

  • Kim, Joung-Soon;Kim, Sung-Soo;Chang, Sung-Chill
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.3 s.47
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    • pp.447-463
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    • 1994
  • Despite the public health importance of injury and poisoning in terms of its high mortality and incidence, epidemiologic information to be utilized are scarce in Korea. This study was carried out in 1990 on a representative sample population (about 55,000 persons) along with the 6th National Tuberculosis Prevalence Survey in order to estimate the magnitude of injury and poisoning occurrence and to identify its epidemiologic characteristics which can be aided for establishing preventive strategy. Pre-tested and structured Questionnaire was used by trained interviewer to collect data including general information of the person, various information on the injury and poisoning during the past one year such as time and place of its occurrence, its nature and external causes, type of medical institute attended, duration of treatment and outcome of the accident occured. In analysis of the data collected incidence rates per 1000 persons by sex, age group and its nature as well as external causes, and relative frequencies were calculated. The result obtained are as followings; 1. The incidence rate per 1000 was 30 for both sexes, 39 for male and 22 for female, male being 1.8 times more frequent than female. Age adjusted incidences were not much different from the crude rates. Age group specific rate curve showed bimodal shape in both sexes, small peaks in preschool children and higher peaks in older ages. The incidence rate per 1000 people by area was highest in Jeon-bug province (57/1000) and the lowest in Daegu city(11/1000). 2. The place where the injuries occured were road in 46%, within the boundary of house in 25%, and working place in 12% The injuries and poisoning had occured more frequently during the months from March to August of the year than other months. 3. The relatively frequent injuries by its nature were contusion with intact skin surface (19%), fracture of upper limb (13%), open wound of head, neck and trunk (12%) and fracture of lower limb (11%) among males; contusion with intact skin surface (28%), sprains and strains of joints and adjacent muscle (14%), fracture of upper limb (10%) and fracture of lower limb (9%) among females. Higher incidence rate among males than females were fracture of skull (4.5 times), open wound and fractures of limbs ($2{\sim}3$ times). Age specific rate of injuries and poisoning by its nature showed increasing pattern by age in fractures of upper and lower limbs and sprains & strains of joints whereas the age group of 30's showed highest incidence in open wounds of upper limb. Fractures of radius and ulna in upper limb, fractures of tibia & fibula and ankle in lower limb were most frequent among fractures of upper and lower limbs. The frequent injuries among sprains and strains of joints and adjacent muscles were that of ankle, foot and back, and among open wound were that of head and fingers. 4. Relative frequency of injuries and poisoning by external causes showed following order : other accidents (25%), accidental falls (23%), motor vehicle accident (22%) and other road vehicle accident (14%) among males and accidental falls (37%), motor vehicle accident (24%) and other accident (18%) among females. The external causes revealing higher incidences among males than females, were other road vehicle accident (4.8 times), vehicle accident not elsewhere classifiable (4.4 times), accidental poisoning (4.4 times), accidents due to natural and environmental factors (2.8 times), and sucide & self-inflicted injuries (2.8 times). Age specific incidence by external causes for frequent injuries showed that incidence of other accident steadily increased from 10's till age 50's; motor vehicle traffic accident increased from age 20's and dropped after age 60's; on the other hand accidental fall increased strikingly by age. The most frequent external causes among motor vehicle traffic accidents was motor vehicle traffic accident involving collision with pedstrain (69%), pedal cycle accident (30%) and other road vehicle accident (71%) among other road vehicle accidents; falls on same level from slipping, tripping or standing (44%) and other falls from one level to another among accidental falls; accidents caused by machinary (32%) for male and striking against or struck accidentally by objects or person for female among other accidents. 5. Seventy nine percent of the injuries and poisonings were treated in general hospital or hospital/clinic. The duration of treatment ranged from a few days to 123 weeks; the majority(52%) took under 2 weeks, 36% for $3{\sim}8$ weeks and 4% over 21 weeks. 6. The accident resulted in full recovery of normal healthy state in 62%, residual functional defects in 21% and on process of treatment in 16%.

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Analysis Characteristic the Using Surface Electromyography of Head Neck and Around of Shoulder Muscles Express Scaling Working of the Dental Hygienist (치과위생사의 스켈링 작업 시 발현되는 두경부 및 견부 주위 근육들의 표면 근전도를 이용한 특성 분석)

  • Jeon, Eun-Suk;Nam, Kun-Woo;Ha, Mi-Sook
    • Journal of dental hygiene science
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    • v.12 no.4
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    • pp.437-442
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    • 2012
  • The current research examines the aching part and the muscle activity that happens during scaling practice subject to 20 dental hygienic students and therefore propose a basic data according to the working attitude of the Dental Hygienist. During the scaling we used the free EMG (BTS Inc., Milan, Italy) to measure the muscle activity, and in order to check the musculoskeletal pain area we used the Nordic-style questionnaire, and the measured research results are as following: At the moment of scaling according to posture the occurrence of the pain showed no difference among the groups elbow, back, leg, knee, ankle/foot but in the neck, shoulder, wrist/hand, waist showed a high difference in the degree of pain according to posture. Results from measuring the muscular activity according to posture, in the group that had a good posture, the trapezius and brachial muscles showed a change according to time, and in the group that had a bad posture a high muscle activity was shown in larynx, trapezius and brachial muscles. In the muscle activity, the changing aspect between the two parts, the group that fulfilled a scaling in a good posture showed a low muscle activity, but in the group that fulfilled the scaling in a bad posture the muscle activity increased excessively. Therefore we examined that when fulfilling a scaling maintaining a bad posture can help in using more effectively the activity of the muscle, in the future I think there is a need to raise the office efficiency by subjecting to dental hyginiest that are in the clinics and performing experiments.

Kinematic analysis of skill between flexed and extended type of knee during Jigeo-Cha-Gi in Taekwon-Do (태권도 찍어차기의 무릎편 유형과 구부린 유형의 운동학적 비교분석)

  • Kim, Dong-Kyu;Ryew, Che-Cheong
    • Korean Journal of Applied Biomechanics
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    • v.15 no.4
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    • pp.25-42
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    • 2005
  • The study was to investigate kinematic difference between flexed and extended type of knee during Jigeo-Cha-Gi in Taekwon-Do. For this subjects participated were consisted of weights of fin (1), bantam (1) and welter class(1) of male 3 national representative level skilled in two type(flexed and extended type) of Jigeo-Cha-Gi. 3D cinematography analysis was performed for motion analysis and Kwon 3D ver. 3.1) was used for 3D coordinates & analysis variables calculation. In Temporal variable there was no significant difference statistically in all phases & total elapsed time between flexed and extended type, but flexed type was delayed more 0.016 sec than extended type. In displacement of COG there was significant difference in level of p<.05 showing longer mean 6.13 cm in case of flexed type than extended type in displacement of COG during all phase and too significant difference in level of p<.01 showing longer mean 4.4 cm in case of flexed type than extended type in displacement of COG in follow through phase. In velocity of COG there was significant difference in level of p<.001 showing higher mean 15.53cm/s in case of flexed type than extended type in velocity of COG(Y direction) during targeting phase and peak velocity(Y) was more fast 8.74 cm/s in extended type than flexed type. In velocity of leading leg in forward direction(Y) there was significant difference in level of p<.05 showing higher thigh mean value in case of flexed type than extended type but showing higher foot mean value in extended type at level of p<.001 than flexed type in velocity of COG(Y direction). In velocity of leading leg in vertical direction(Z) there was no significant difference in the second & third phase in case of vertical velocity level, but momentum transferred efficiently form proximal to distal endpoint. In front-back & right-left orientation angle of trunk there was possibility of more stable Jigeo-Cha-Gi in extended than flexed type by decreasing in right-left orientation angle of trunk. In relative angle of lower leg(hip, knee, ankle) there was significant difference in level of p<.001 showing longer mean 32.74 deg. in case of flexed type than extended type in hip joint during the second phase but maintained insufficient extended knee of mean 168 deg. in targeting phase.

Kinetic analysis of the lower limb in visual handicap children (시각장애 아동의 보행 시 하지의 운동역학적 분석)

  • Yi, Jae-Hoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.9
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    • pp.3952-3958
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    • 2011
  • This study was to investigate the difference in gait pattern between the visual handicap children and non handicap children in by analyze the biomechanical variation and pattern of lower limb. Therefore, we have made a choice of four visually handicapped children and two subjects, who had no medical disorder for the last six months. In order to collect the gait pattern data of each group, we have used six infrared cameras and one forceplate Also, we have used QTM program to collect the raw data and Visual3D program to calculate kinetic variable. The results were as follows, An/Posterior GRF of breaking phase and propulsion phase in stance phase was lower in visual handicapped children than that of non handicapped children and breaking phase was longer than propulsion phase. extension moment at the ankle was quite lower than general gait pattern and there was little variation at the knee joint which makes the results differ from the general gait pattern. However, hip joint moment was relatively higher than that of other joints. Mechanical variation of lower limb, in case of foot and shank, showed similar results. but generated very low mechanical energy. In thigh, the form of mechanical energy generation was slightly different in each group but generated more mechanical energy than other segments.

Effect of Golf Shoe Design on Kinematic Variables During Driver Swing (골프화의 구조적 특성 및 내부형태에 따른 스윙의 운동학적 변인에 미치는 영향)

  • Park, Jong-Jin
    • Korean Journal of Applied Biomechanics
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    • v.19 no.1
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    • pp.167-177
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    • 2009
  • The purpose of this study was to investigate effect of golf shoe design on kinematic variables during golf swing. Five professional male golfers with shoe size 270mm were recruited for the study. Swing motion was collected using 8 high speed camera motion analysis at a sampling of 180Hz. Kinematic variables were calculated by EVaRT 4.2 software. Driver swing was divided into four events; El(adress), E2(top), E3(impact) and E4(finish). Time, peak velocity, velocity of center of mass, velocity of the foot and ankle angle during Phase 1(El-E2), Phase 2(E2-E3), and Phase 3(E3-E4) were analyzed in order to investigate the relationship between golf shoe design and swing performance. The findings indicated that type C golf shoes would be beneficial for stability and control of movement during address and swing performance. Furthermore, faster speed of golf shoes, center of mass, and both feet were observed with Type C golf shoes. It is expected that golfers with Type C golf Shoes provide greater force as they control the center of mass faster and increase rotational force during impact compared to other golf shoes.

Clinical and Radiological Outcomes of 'Blocking Kirschner Wire Technique' in Displaced Intra-Articular Calcaneal Fractures via the Extended Sinus Tarsi Approach (전위된 관절 내 종골 골절에서 확장된 족근동 접근법을 통한 Kirschner Wire 강선 지지대 고정술의 임상 및 영상학적 결과)

  • Lee, Jeong-Kil;Kang, Chan;Kim, Sang-Bum;Lee, Gi-Soo;Hwang, Jung-Mo;An, Byung-Kuk
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.3
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    • pp.224-233
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    • 2021
  • Purpose: The purpose of this study was to retrospectively evaluate the effect of 'Blocking Kirschner Wire (K-Wire) Technique', which has been developed to reduce protrusion of the lateral wall, in maintaining the level of reduction through clinical and radiological outcomes. Materials and Methods: Twenty-two patients with displaced intra-articular calcaneal fractures who used the blocking K-wire to maintain reduction (group A) and 44 patients that did not use blocking K-wire and were paired in 1:2 ratio with those Group A patients (group B), between January 2015 and December 2017 were enrolled in the study. All surgical procedures were performed via the extended sinus tarsi approach, and internal fixation using cannulated screws, Steinmann pins and K-wires was performed. American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale and postoperative recovery of exercise ability were compared for postoperative clinical outcomes. The radiological results were compared the Böhler angle, Gissane angle, calcaneal height and width, step off of posterior calcaneal joint, and the degree of protrusion of the lateral wall. Moreover, postoperative complications in both groups were compared. Results: There were no significant differences in the clinical outcomes of the two groups (p=0.924, p=0.961). The amount of Böhler angle, Gissane angle, calcaneal height and width, and step off of posterior calcaneal joint from the radiological results was not significantly different between the two groups (p=0.170, p=0.441, p=0.230, p=0.266, and p=0.400). However, the degree of protrusion of the lateral wall was 1.78 mm and 4.95 mm in group A and group B, respectively, and the difference between the two groups was significant (p=0.017). Although sural nerve entrapment and painful exostosis were more frequent in group B, they were occurred in a non-significant manner (p=0.293, p=0.655). Conclusion: Most of the clinical and radiological results as well as the complications were not significantly different between the two groups. However, the degree of protrusion of the calcaneus lateral wall in group A was promising. The 'Blocking K-Wires Technique' established by the authors may be an effective surgical option for maintaining the reduction of the lateral wall protrusion in displaced intraarticular calcaneal fractures.

Gait Analysis of a Pediatric-Patient with Femoral Nerve Injury : A Case Study (대퇴신경 손상 환아의 보행분석 : 사례연구)

  • Hwang, S.H.;Park, S.W.;Son, J.S.;Park, J.M.;Kwon, S.J.;Choi, I.S.;Kim, Y.H.
    • Journal of Biomedical Engineering Research
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    • v.32 no.2
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    • pp.165-176
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    • 2011
  • The femoral nerve innervates the quadriceps muscles and its dermatome supplies anteromedial thigh and medial foot. Paralysis of the quadriceps muscles due to the injury of the femoral nerve results in disability of the knee joint extension and loss of sensory of the thigh. A child could walk independently even though he had injured his femoral nerve severely due to the penetrating wound in the medial thigh. We measured and analyzed his gait performance in order to find the mechanisms that enabled him to walk independently. The child was eleven-year-old boy and he could not extend his knee voluntarily at all during a month after the injury. His gait analysis was performed five times (GA1~GA5) for sixteen months. His temporal-spatial parameters were not significantly different after the GA2 or GA3 test, and significant asymmetry was not observed except the single support time in GA1 results. The Lower limb joint angles in affected side had large differences in GA1 compared with the normal normative patterns. There were little knee joint flexion and extension motion during the stance phase in GA1 The maximum ankle plantar/dorsi flexion angles and the maximum knee extension angles were different from the normal values in the sound side. Asymmetries of the joint angles were analyzed by using the peak values. Significant asymmetries were found in GA1with seven parameters (ankle: peak planter flexion angle in stance phase, range of motion; ROM, knee: peak flexion angles during both stance and swing phase, ROM, hip: peak extension angle, ROM) while only two parameters (maximum hip extension angle and ROM of hip joint) had significant differences in GA5. The mid-stance valleys were not observed in both right and left sides of vertical ground reaction force (GRF) in the GA1, GA2. The loading response peak was far larger than the terminal stance peak of vertical ground reaction curve in the affected side of the GA3, GA4, GA5. The measured joint moment curves of the GA1, GA2, GA3 had large deviations and all of kinetic results had differences with the normal patterns. EMG signals described an absence of the rectus femoris muscle activity in the GA1 and GA2 (affected side). The EMG signals were detected in the GA3 and GA4 but their patterns were not normal yet, then their normal patterns were detected in the GA5. Through these following gait analysis of a child who had selective injuries on the knee extensor muscles, we could verify the actual functions of the knee extensor muscles during gait, and we also could observe his recovery and asymmetry with quantitative data during his rehabilitation.

Reverse Superficial Sural Artery Flap for the Reconstruction of Soft Tissue Defect Accompanied by Fracture of the Lower Extremity (하지 골절과 동반된 연부조직 결손 재건을 위한 역행성 비복동맥 피판술)

  • Han, Soo-Hong;Hong, In-Tae;Choi, SeongJu;Kim, Minwook
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.253-260
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    • 2020
  • Purpose: Soft tissue defects of the distal lower extremity are commonly accompanied by a fracture of the lower extremities. Theses defects are caused by the injury itself or by complications associated with surgical treatment of the fracture, which poses challenging problem. The reverse superficial sural artery flap (RSSAF) is a popular option for these difficult wounds. This paper reviews these cases and reports the clinical results. Materials and Methods: Between August 2003 and April 2018, patients who were treated with RSSAF for soft tissue defects of the lower third of the leg and ankle related to a fracture were reviewed. A total of 16 patients were involved and the mean follow-up period was 18 months. Eight cases (50.0%) of the defects were due to an open fracture, whereas the other eight cases (50.0%) were postoperative complication after closed fracture. The largest flap measured 10×15 cm2 and the mean size of the donor sites was 51.9 cm2. The flap survival and postoperative complications were evaluated. Results: All flaps survived without complete necrosis or failure. One case with partial necrosis of the flap was encountered, but the wound healed after debridement and repair. One case had a hematoma with a pseudoaneurysmal rupture of the distal tibial artery. On the other hand, the flap was intact and the wound healed after arterial ligation and flap advancement. A debulking operation was performed on three cases for cosmetic reasons and implant removal through the flap was performed in three cases. No flap necrosis was encountered after these additional operations. Conclusion: RSSAF is a relatively simple and safe procedure for reconstructing soft tissue defects following a fracture of the lower extremity that does not require microsurgical anastomosis. This can be a useful treatment option for soft tissue defects on the distal leg, ankle, and foot.