• 한국전문물리치료학회지
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• 제4권1호
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• pp.30-38
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• 1997

The patients with hemiplegia show different body weight distribution as compared to normal subjects. These patients load their body weight more on sound leg than affected leg. The purpose of this study was to examine the effect of foot placement under three conditions: forward, intermediate, and backward placement, on body weight distribution and time needed to rise while assuming sit-to-stand. Fourteen patients with hemiplegia participated in the study. Their body weight distributions during sit-to-stand under the three different conditions were measured by a limb loader and time needed to rise was measured by a stopwatch. The data were analysed by the repeated measure of one-way ANOVA. Statistical Analysis demonstrated that body weight distribution was less asymmetric in backward foot placement. The difference of body weight bearing rate between sound leg and affected leg was significantly decreased as foot placement moved from forward to backward. These results show that backward foot placement during sit-to-stand make patient with henuplegia distribute their body weight more evenly on the lower extremity.

• Physical Therapy Rehabilitation Science
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• 제12권2호
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• pp.161-166
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• 2023

Objective: The purpose of the study was to investigate the effect of shoe sole deformation on the muscle activity and balance of the lower extremities when standing on one foot. Design: Crossed-control group study Methods: A total of 18 healthy adults participated in this study. 9 participants with normal shoe and 9 participants with deformed in shoe out-soles (wear shoes) were included. Muscle activity of the tibialis anterior, fibularis longus and gluteus medius during one leg standing was measured using a electromyography. A balance board was used to evaluate balance ability when standing on one leg. The balance ability when standing on one leg was measured by the sway speed and distance of the center of gravity. Results: Muscle activity of the tibialis anterior, fibularis longus and gluteus medius was no significant difference between groups (P > 0.05). Balance ability when standing on one leg was significantly different from the group wearing normal shoes in all variables related to the sway distance and sway speed of the center of gravity. Conclusions: Through this study, the wear of the outer sole of the shoe indirectly confirmed the effect on the wearer's lower extremity muscle activity and balance ability when standing on one foot. These results of this study are expected to be used as basic data for future studies on shoe wear, lower extremity muscle activity and balance ability.

• The Journal of Korean Physical Therapy
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• 제13권2호
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• pp.381-397
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• 2001

In the patients with hemiplegia caused by stroke and TBI. postural sway is increased and open displaced laterally over the non-affected leg, reflecting asymmetry in weight bearing on lower extremities during standing balance. Recovery of symmetric weight bearing and postural stability is an important aim in physical therapy. Plastic AFO has been used for hemiplegic patients in order to help their abnormal walking patterns. Past studies have mainly focused on the AFO influences on hemiplegic walking patterns without balance function approaches. The purpose of this study was to identify the immediate effects of plastic AFO and shoes on the static balance in hemiplegic patients. The scale for static balance were weight bearing on affected leg(%), sway area(mm2), sway path(mm), maximal sway velocity(mm/s), anteroposterior sway angle($^{\circ}$ ), and lateral angle($^{\circ}$ ). Seventeen hemiplegic patients participated in this study: 13 men and 4 women, with an average age of 50.18 years. Static balance was measured using BPM(balance performance monitor; dataprint software version 5.3) under four standing condition namely bare-foot standing. standing in shoes, standing with AFO, and standing in shoes with AFO. In order to assure the statistical significance of the results, an one-way ANOVA, the independent t-test. and a pearson's correlation were applied at the .05 level of significant. The results of this study were as follows: 1) There were statistically significant differences in weight bearing(%) on the static balance between affected leg and non-affected leg(p<.01). 2) There were statistically significant differences in sway reverse frequence(Hz) in standing with AFO between affected leg and non-affected leg(p<.05). 3) Sway area(mm2) on standing in shoes with AFO was lower than bare-foot standing(p<.05), Lateral sway angle($^{\circ}$ ) on standing in shoes with AFO was lower than bare-foot standing and standing in shoes(p<.05). 4) Weight bearing in affected leg was not significantly correlated with postural sway.

• 대한물리의학회지
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• 제13권4호
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• pp.131-138
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• 2018

PURPOSE: This study was conducted to compare the muscle activity of the proximal muscles of the lower limb according to the distance between the front and rear foot during lunge and to determine the most effective foot position for activation of the proximal muscle in the limb. METHODS: A total of 49 young adults were enrolled in this study. All subjects performed lunge by positioning the big toe of the back foot and the heel of the front foot at intervals of 40%, 60%, and 80% of the subject's own leg length. Muscle activity of the vastus medialis oblique, rectus femoris (RF), vastus lateralis oblique (VLO), gluteus medius, biceps femoris, and semitendinosus (ST) was then measured during three intervals of lunge operation. Each operation was measured three times for 10 seconds each, after which the average value was calculated and analyzed. RESULTS: There were significant differences in muscle activities of RF, VLO, and ST among the three intervals of the foot (p<.05). Post hoc, comparisons revealed lunge at 40% intervals resulted in higher RF and VLO activity than at 60% and 80% intervals (p<.05). In the semitendinosus muscle, 80% leg length intervals showed higher muscle activity than 40% (p<.05). CONCLUSION: Strengthening of the proximal muscles of the lower extremities during lunge exercise is considered to be most effective when placing the fore- and rear foot at intervals corresponding to 40% of the leg length.

• 대한기계학회논문집A
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• 제21권8호
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• pp.1250-1258
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• 1997

This paper reports on the development of a new foot for a quadrupedal jointed-leg type walking robot. The foot has 2 toes, one at the front and the other at the rear side, for stable landing on uneven ground by point contact. The toes can move up and down independantly, guided by double-wishbone shaped parallel links which enable the lower leg to rotate with respect to a remote center on the ground surface. The motion of each toe is damped by a hydropneumatic shock absorber integrated in the foot in order to absorb the dynamic landing shock. Furthermore, the new foot can reduce the maximum hip joint drive torque by shortening the moment arm length between the hip joint and the landing force vector on the ground. Intensive experiments were carried out in this study by using a one-leg walking model to investigate the soft landing performance of the foot which could be hardly offered by conventional robot feet such as a flat plate with a gimbal type ankle joint. And it was confirmed that the hip joint torque of the leg walking on the flat surface could be reduced remarkably by using the new foot.

• 한국정밀공학회지
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• 제26권10호
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• pp.47-55
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• 2009

In this study, a robot foot having toes for firm stepping on uneven surface is proposed. The toes are connected to the lower leg by parallel links so that the lower leg can rotate in the rolling and pitching directions during stance phase without ankle joint. The landing performance of the foot on uneven surface was evaluated by relative comparison with that of the most common foot making point contact with the walking surface, since the test conditions considering real uneven surface could be hardly defined for its objective evaluation. Anti-slip margin(ASM) was defined in this study to express the slip resistance of a robot foot when it lands on a projection with half circular-, triangular- or rectangular cross section, assuming that uneven surface consists of projections having these kind of cross sections in different sizes. Based on the ASM analysis, the slip conditions for the two feet were experimentally confirmed. The results showed that the slip resistance of the new foot is not only higher than that of the conventional point contact type foot but also less sensitive to the surface friction coefficient.

• 대한족부족관절학회지
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• 제21권3호
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• pp.113-116
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• 2017

Synovial fistula of the ankle joint is an uncommon complication from an ankle sprain. This may likely result in an unhealed wound around the ankle joint due to continuous leakage of joint fluid. However, in the event of an open wound on the lower leg, and not on the joint, it may be difficult to consider synovial fistula as a cause of the open wound. We experienced an interesting case with an unhealed open wound on the lower leg due to a synovial fistula of the ankle joint following an ankle sprain. We obtained good results after a treatment using a self-produced suction drainage device on the unhealed open wound.

• Archives of Plastic Surgery
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• 제39권2호
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• pp.94-105
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• 2012

Simple or complex defects in the lower leg, and especially in its distal third, continue to be a challenging task for reconstructive surgeons. A variety of flaps were used in the attempt to achieve excellence in form and function. After a long evolution of the reconstructive methods, including random pattern flaps, axial pattern flaps, musculocutaneous flaps and fasciocutaneous flaps, the reappraisal of the works of Manchot and Salmon by Taylor and Palmer opened the era of perforator flaps. This era began in 1989, when Koshima and Soeda, and separately Kroll and Rosenfield described the first applications of such flaps. Perforator flaps, whether free or pedicled, gained a high popularity due to their main advantages: decreasing donor-site morbidity and improving aesthetic outcome. The use as local perforator flaps in lower leg was possible due to a better understanding of the cutaneous circulation, leg vascular anatomy, angiosome and perforasome concepts, as well as innovations in flaps design. This review will describe the evolution, anatomy, flap design, and technique of the main distally pedicled propeller perforator flaps used in the reconstruction of defects in the distal third of the lower leg and foot.

• The Journal of Korean Physical Therapy
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• 제16권2호
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• pp.99-107
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• 2004

The purpose of this study was to investigate the effect of foot orthotic on postural sway. Subjects were 15 patients(7 men and 8 women) who prescribed foot orthotic at B hospital and L rehabilitation medicine clinic in Seoul. Postural sway during a single limb stance was measured using the CMS 10 Measuring System when subjects positioned on the balance trainer under two treatment conditions(orthotic and nonorthotic). RCSP(resting calcaneal stance position) while subjects were standing on the glass plate was measured using the angle finder after subjects were positioned in prone to divide equally lower leg and calcaneus using the goniometer. The result was as follows. There were significant difference between postural sway of orthotic and nonorthotic conditions(t=4.888, 4.589, p<0.001), and the leg of the small RCSP within a subject has the small postural sway index($x^2=26.000$, p<0.001). In conclusion, foot orthotics provide structural support for detecting and controlling postural sway in patients prescribed foot orthotics.

• Archives of Reconstructive Microsurgery
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• 제11권1호
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• pp.36-40
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• 2002

Purpose : Our clinical experiences in distally based sural artery island flap is presented to show the usefulness and the reliability as an alternative to flaps currently used for defect in lower extremity. Materials and Methods : From February 1998 to September 2001, nine cases of soft tissue defects in the lower leg, the foot, and around the ankle were treated with distally based sural artery island flap. The cause of the wound was trauma in 6 cases, and osteomyelitis in 3 cases. Defects were located at the lower leg in 2 cases, at the foot in 3 cases and around the ankle in 4 cases. The results were retrospectively analyzed. Results : The defect size ranged from $3{\times}3cm\;to\;20{\times}3cm$. Among 9 cases, 7 cases survived and 2 cases were failed. Flap failure was due to not including the deep fascia in one case and due to extensive soft tissue damage in the other case. Both failed cases were reoperated with the split thickness skin graft. Conclusion : The advantages of distally based sural artery island flap follows (1) reliable blood supply, (2) ease of flap elevation, (3) preservation of the major arteries, (4) less donor site morbidity. Owing to the advantages of this flap, we think it is useful for the soft tissue coverage of the lower leg, the foot and around the ankle. Also we believe it will continue to gain acceptance and use in the majority of lower leg reconstruction.