• Journal of the Korean Society of Physical Medicine
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• v.14 no.2
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• pp.9-19
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• 2019

PURPOSE: This study compared the effects of three different clamshell exercises (CLAM) on the gluteus medius (GMED), quadratus lumborum (QL), anterior hip flexor (AHF), gluteus medius/quadratus lumborum ratio, and gluteus medius/anterior hip flexor ratio by studying the activities of participants with GMED weakness. METHODS: Eleven subjects with weak GMED participated in this study. Subjects performed CLAM under three different conditions (standard, and modified 1 and 2). Surface electromyography was then used to measure the muscle activity and one-way repeated-measures analysis of variance was used to assess the statistical significance of the measured variables. RESULTS: GMED and the QL muscle activities did not differ significantly between the standard CLAM and the modified CLAM with the 2 different foot positions (F=4.74, P=.02; F=4.57, P=.02, respectively). AHF activity was significantly different in the two different foot positions when compared to the standard CLAM (F=11.17, P=.00). However, there was no significant difference between the AHF activities for the two different foot positions (P=.09). Finally, GMED/QL and GMED/AHF ratios were not significantly different between the three different CLAM exercises (F=.63, P=.55; F=.82, P=.45, respectively). CONCLUSION: Modified CLAM can be recommended as a good method to minimize AHF activity while maintaining GMED activity in subjects with weak GMED.

• Physical Therapy Rehabilitation Science
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• v.7 no.4
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• pp.164-171
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• 2018

Objective: The purpose of this research was to determine the immediate effects of wearing a foot-pressure-based insole (FPBI) on ankle dorsiflexion range of motion (DFROM), postural sway, and muscle activation in healthy individuals with genu varum. Design: Cross-sectional study. Methods: This study was conducted on thirteen adults, with six male and seven females subjects. The mean age was 24.08 years. Foot pressure was measured to apply the FPBI and the weight bearing lunge test was performed with the application of a flat insole (FI) and FPBI. Examination was randomly performed in four conditions to measure both postural sway and muscle activation. All participants applied both the FI and FPBI with four conditions. The four conditions were as follows: 1) Romberg test posture with eyes closed, 2) Romberg test posture with eyes opened, 3) dominant single leg standing with eyes opened, and 4) non-dominant single leg standing with eyes opened. Results: For ankle DFROM between the FI and FPBI, a significant increase was observed in both the dominant and non-dominant leg (p<0.05). For postural sway between the FI and FPBI in the Romberg test posture with eyes closed and dominant single leg standing with eyes opened conditions, a significant decrease was observed (p<0.05). However, the postural sway between FI and FPBI in the Romberg test posture with eyes opened and non-dominant single leg standing with eyes opened, no significant decrease was observed. Also, there were no significant effects on muscle activation between the application of the FI and FPBI. Conclusions: The result showed that FPBI immediately improved ankle DFROM and postural sway. It seems that FPBI may improve genu varum in healthy individuals with genu varum.

• Physical Therapy Korea
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• v.29 no.3
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• pp.208-214
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• 2022

Background: Pronated foot posture (PFP) contributes to excessive dynamic knee valgus (DKV). Although foot orthoses such as medial arch support (MAS) are widely and easily used in clinical practice and sports, few studies have investigated the effect of MAS on the improvement of DKV during stair descent in individuals with a PFP. Moreover, no studies reported the degree of improvement in DKV according to the severity of PFP when MAS was applied. Objects: This study aimed to examine the immediate effect of MAS on DKV during stair descent and determine the correlation between navicular drop distance and changes in DKV when MAS is applied. Methods: Twenty individuals with a PFP (15 males and five females) participated in this study. The navicular drop test was used to measure PFP severity. The frontal plane projection angle (FPPA) was calculated under two conditions, with and without MAS application, using 2-dimensional video analysis. Results: During stair descent, the FPPA with MAS (173.1° ± 4.7°) was significantly greater than that without MAS (164.8° ± 5.8°) (p < 0.05). There was also a significant correlation between the navicular drop distance and improvement in the FPPA when MAS was applied (r = 0.453, p = 0.045). Conclusion: MAS application can affect the decrease in DKV during stair descent. In addition, MAS application should be considered to improve the knee alignment for individuals with greater navicular drop distance.

• Korean Journal of Applied Biomechanics
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• v.24 no.1
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• pp.19-26
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• 2014

This study investigated foot pressure patterns between experienced skiers and intermediate skiers during alpine skiing. Five experienced skiers and five intermediate skiers participated in this study. Foot pressure measurement system was used to measure vertical ground reaction force (vGRF) and contact area under the six plantar regions. Each participant was asked to perform basic parallel turns and carved turns on a $18^{\circ}$ groomed slope. Each right turn was divided into the initiation phase, the steering phase 1 and 2. For the initiation phase of the basic parallel turns, significantly greater contact area was found on the LRF and RRF of the intermediate skiers (p<.05) and significantly greater vGRF was found on the LRF of the intermediate skiers (p<.05). Also significantly greater vGRF and contact area were found on the LRF and RRF of the intermediate skiers at the steering phase 1 (p<.05) and on the LRF of the intermediate skiers at the steering phase 2 (p<.05). For the carved turns, significantly greater vGRF and contact area were found on the LRF and RRF of the intermediate skiers at all three phase (p<.05). On the other hand, significantly greater vGRF was found on the RFF of the experienced skiers at the steering phase 1 (p<.05). Also significantly greater vGRF and contact area were found on the RMF of the experienced skiers at the steering phase 2 (p<.05). In order to increase performance, we suggest that the intermediate skiers should be unweighted at the initiation phase and shift the body weight to the forefoot of the outer foot at the steering phase 1. Also, the outer ski should be loaded more than the both skis at the steering phase 1 and 2.

• Journal of Korean Foot and Ankle Society
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• v.26 no.1
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• pp.40-47
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• 2022

Purpose: The modified Broström repair (BR) technique has yielded good outcomes in patients with chronic ankle instability. This study compared clinical and radiological outcomes between two groups of patients who underwent modified BR or lateral ligament augmentation using suture tapes (ST). Materials and Methods: Seventy-seven patients (ST group [n=47], BR group [n=30]; body mass index <26.61 kg/m²; mean age, 30.7±11.0 years [range, 17~39 years]; mean follow-up, 34.0±12.0 months [range, 24~59 months]) were retrospectively reviewed between January 2014 and July 2017. The Foot and Ankle Outcome Score (FAOS), American Orthopedic Foot and Ankle Score (AOFAS), Foot and Ankle Ability Measure (FAAM), visual analogue scale (VAS) score, and Sefton grading system were used for clinical assessment. The talar tilt angle and anterior talar translation were measured using the Telos stress device (Telos GmbH, Marburg, Germany) at 150 N for radiological evaluation. Results: FAOS, AOFAS, FAAM, and VAS scores improved in both groups at final follow-up (ST, 91.1±5.2, 93±2, 88.1±4.5, 1.5±0.7 vs. BR, 91.3±5.4, 93±3, 83.3±4.8, 1.2±0.7, respectively; p=0.854, 0.971, <0.001, 0.04, respectively). According to the FAOS, mean sports activity scores for the ST and BR groups at the final follow-up were 90.3±3.2 and 76.6±4.2, respectively, reflecting superior outcomes in the ST group (p<0.001). Sefton grading revealed satisfactory functional outcomes (ST, 91.5% vs. BR, 90.0%). There was significant improvement in the talar tilt angle and anterior talar translation in both the ST and BR groups (7.6°±1.2°, 10.5±1.8 mm vs. 4.9°±1.1°, 7.9±1.5 mm, respectively; p<0.001). Conclusion: The ST group demonstrated comparable clinical but better improvement in mechanical stability and FAOS sports scores than the BR group.

• Journal of Biomedical Engineering Research
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• v.34 no.4
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• pp.197-203
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• 2013

The purpose of this study was to analyze the asymmetry of the reaction forces on lower limbs between dominant and nondominant sides during sit-to-stand movement in normal subjects. Fourteen normal subjects ($22.6{\pm}2.3yrs$, all men) participated in this study. To measure the reaction forces during sit-to-stand movement, two force plates were mounted on the ground and one dual top force plate was mounted on a chair. Five events(movement onset, max thigh reaction force, transition, max hip angle, seat off) were determined from the reaction force and joint angle trajectories. For each of thigh, foot, and total reaction forces, two-way ANOVA was performed with the events and sides as factors. Also investigated was the leg asymmetry expressed as the ratio of the reaction forces of dominant and nondominant sides. The significance of asymmetry was investigated and two-way ANOVA was performed with the events and body parts(foot, thigh and total) as factors. Thigh reaction force and total reaction force showed interaction of events and leg sides(p < 0.01). Post-hoc comparisons showed they were different between sides at the latter stage(transition, max hip angle, and seat off events) (p < 0.01). Asymmetry was also significant at the latter stage(transition, max hip angle, and seat off events) (p < 0.01). Interaction of events and body parts on asymmetry was significant(p < 0.01) and asymmetry was greater in thigh reaction forces than total and foot reaction forces at the events of the latter stage(p < 0.01). The results suggest that asymmetry exist in normal subject and should be fully considered when investigating sit-to-stand strategy of patients.

• Anxiety and mood
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• v.3 no.2
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• pp.104-109
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• 2007

Objective : In the present study, we evaluated the differences between the skin electric conductance of patients with posttraumatic stress disorder (PTSD) and normal controls in order to determine the possibility of using skin electric conductance as a diagnostic measure. Method : The PTSD group included 14 subjects who were diagnosed with PTSD in St. Mary's Hospital after a motor vehicle accident, and the normal control group included 12 healthy subjects. The conductivity and capacitance of both groups were measured twice, and the data from each group was compared. Results : There was no significant difference in gender, but the patients in the PTSD group were significantly older than those in normal control group. The activity (conductivity) between the left head-left hand, right hand-right head, and right head-left head was significantly elevated in the PTSD group as compared with the normal control group. In addition, the reactivity (capacitance) between the right head-left head, left head-left hand, right hand-left hand, right hand-right foot, right foot-left foot, and left foot-left hand was significantly elevated in the PTSD group. Conclusion : In this study, the skin electric conductance of the patients with PTSD was significantly elevated in comparison with that of the healthy subjects. Although there were some limitations of this study, the results of this study suggested that skin electric conductance can be used to evaluate elevated psychophysiological responses in patients with PTSD. Future studies with more subjects and more structure are needed in order to confirm our results.

• Journal of Korean Foot and Ankle Society
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• v.18 no.3
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• pp.108-114
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• 2014

Purpose: Ligament reattachment technique using a suture anchor appears to show satisfactory functional outcomes and mechanical stability compared with conventional bone tunnel technique. This study was prospectively conducted in order to evaluate functional outcomes of modified Brostrom procedures using the suture bridge technique for chronic ankle instability in athletes. Materials and Methods: Twenty eight athletes under 30 years of age were followed for more than two years after undergoing the modified Brostrom procedure using the suture bridge technique. Functional evaluation consisted of the foot and ankle outcome score (FAOS), foot and ankle ability measure (FAAM) score. Range of motion and time to return to exercise were evaluated using a periodic questionnaire. Talar tilt angle and anterior talar translation were measured through stress radiographs for evaluation of mechanical stability. Results: FAOS improved significantly from preoperative mean 59.4 points to 91.4 points (p<0.001). Daily living and sport activity scores of FAAM improved significantly from preoperative mean 50.5, 32.5 points to 94.8, 87.3 points, respectively (p<0.001). Talar tilt angle and anterior talar translation improved significantly from preoperative mean $16.8^{\circ}$, 13.5 mm to $4.2^{\circ}$, 4.1 mm at final follow-up (p<0.001). Times to return to exercise were as follows: mean 10.2 weeks in jogging, 15.4 weeks in spurt running, 13.1 weeks in jumping, 11.5 weeks in walking on uneven ground, 9.1 weeks in standing on one leg, 7.2 weeks in tip-toeing gait, 8.4 weeks in squatting, and 10.6 weeks in descending stairs. Conclusion: Modified Brostrom procedure using the suture bridge technique showed satisfactory functional outcomes for chronic ankle instability in athletes. Optimal indication and cost-effectiveness of the suture bridge technique will be studied in the future.

• Journal of the Korea Convergence Society
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• v.10 no.11
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• pp.199-207
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• 2019

This study was a convergence study of pre- and post-treatment clinical outcomes and radiologic results of school aged flexible flat foot using insole inserted indoor sandal. Thirty five subjects were asked to wear insole inserted indoor sandals at least five times a week and at least four hours a day. Before and after the $4^{th}$ and $8^{th}$ week of the treatment, foot radiography and FAOS questionnaire were performed. Statistical analysis was performed using repeated measure ANOVA. The clinical results showed statistically significant improvement in FAOS symptom and pain category. Radiological results showed a tendency of improvement in the Anterioposterior Talo-$1^{st}$ Metatarsal angle, the Lateral Talo-$1^{st}$ Metatarsal angle, and the Talo-Horizontal angle, but no statistical significance was found. In this study, the use of insole inserted indoor sandal during the majority of the indoor life in school aged flexible flat foot patients is effective in alleviating symptoms and pain relief in the short term.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.9
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• pp.20-28
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• 2019

This study comparatively analyzes general walking shoes on the conical top foundation of the ground condition and the pressure distribution during walking with shoes that are currently under development. Two categories of footwear were used: general footwear and a footwear conical top foundation that is currently under development. Experiments were carried out on hard ground and sandy soil in 15 male twenties that satisfy the conditions of normal foot wearing 260 mm. The pressure during walking was measured using Techstorm's Wireless Insole System, and foot pressure was measured in 7 zones of the foot. Studies have shown different maximum forces, average pressures, and pressure distributions depending on the shoe and ground conditions. This study shows that shoes with general low pressure dispersion effects depending on the feet in hard ground and sand ground are different from shoes with the conical top foundation that is currently under development. It is expected that it will be useful for the development of shoes that can be worn in all hard ground and sandy ground by selecting various rubber materials through further research.