• Transactions of the Korean Society of Mechanical Engineers A
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• v.26 no.1
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• pp.7-14
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• 2002

In this study, a stress analysis is made fur an ankle foot orthosis (AFO) in the view point of structural stability. The investigated AFO is a solid and standard type. To analyze the stress distribution on the neck of AFO, the maximum AFO angular translation data is obtained by gait analysis. The material test of polypropylene is made to obtain the mechanical properties of AFO. The maximum dorsiflexion appears at the midstance in the gait analysis. The experimental angular translation at the top of AFO is about 10.3$^{\circ}$ at mid stance. Three models of AFO with different width of neck are made and analyzed with ABAQUS 6.1. The stress levels and distributions of 3 different width(W$_1$, W$_2$=0.85W$_1$, W$_3$=0.60W$_1$) AFO are investigated. As a result, the standard type(W$_1$) appears to the maximum stresses at the medial edge of cutout area surrounding ankle joint. The maximum stresses of the narrower type(W$_2$) are occured on medial edge and center of ankle. The narrowest type(W$_3$) appears to the maximum stresses at center of ankle. The maximum stresses become smaller as ankle width of AFO is narrower.

• Journal of Korean Foot and Ankle Society
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• v.22 no.3
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• pp.100-104
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• 2018

Purpose: An axillary crutch is the most commonly used assistive device in foot and ankle patients who require nonweightbearing. On the other hand, its use frequently induces axillary or wrist pain and critical neurovascular injuries have been reported in several studies. This study compared the clinical outcomes of patients using the knee walker and axillary crutch. Materials and Methods: A retrospective analysis was performed comparing the utility of a knee walker and axillary crutch as a nonweightbearing ambulatory aid for 62 foot and ankle patients treated between November 2016 and March 2018. A comparative study of the two orthosis could be performed because all the patients temporarily used an axillary crutch before or after the use of a knee walker. A demographic study and comparative analysis based on the visual analogue scale (VAS) satisfaction score (0~100), complications, and fall down history were evaluated. Furthermore, under the assumption of having retreatment, their preference of orthosis between the knee walker and axillary crutch was investigated. Results: The mean age of the patients was 36.5 and the mean duration of ambulation with a knee walker and axillary crutch were 5.2 and 2.4 weeks. The VAS satisfaction score of the knee walker and crutch was 88.8 and 27.5, respectively (p<0.05). The most frequent complications of the knee walker and crutch were ipsilateral knee pain (6 cases) and axillary or wrist pain (56 cases), respectively. No case of falling down occurred during knee walker ambulation, but there were two cases of crutch ambulation. Fifty-eight patients (93.5%) preferred the knee walker and four patients (6.5%) preferred a crutch. Conclusion: Compared to the axillary crutch, the knee walker afforded lower complication and higher satisfaction. Most patients preferred the knee walker to a crutch. Therefore, the knee walker is an efficient and safe orthosis for foot and ankle patients who require nonweightbearing.

• Journal of the Korean Society for Precision Engineering
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• v.25 no.3
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• pp.165-175
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• 2008

An ankle-foot orthosis(AFO) is a brace for persons with gait disabilities to support or replace the function of ankle joint. Ankle-foot orthoses(AFO's) are usually prescribed to alleviate the drop-foot by constraining the excessive plantar flexion. The shape and the strength of the AFO are often based on 'trial and error' due to a lack of knowledge of the stress distribution in the AFO. In this study, an improved stress-freezing method was proposed to measure the stress distribution characteristics in the AFO. As a result, a photoelastic material with low freezing temperature was developed to measure the stresses under a person's direct contact loading condition. The three-dimensional stress-1rozen photoelastic models of AFO's for five stages of stance phase such as heel contact, foot flat, mid stance, heel off, and toe off were produced. The results of photoelastic analysis revealed that the stresses developed in the AFO were varied considerably from tensile to compressive or vice versa, during walking. At the posterior part of ankle joint in the AFO, the maximum compressive stress of 1.81MPa was observed in the mid stance, and the maximum tensile stress of 0.74MPa was observed during heel contact. The overall stress levels in the AFO's were low in the toe off phase. The results suggested that the posterior part of ankle joint might be the most fragile part in the AFO.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.1
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• pp.75-81
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• 2017

PURPOSE: The purpose of this study was to compare the activity of the abductor hallucis (AbdH) muscle during short foot exercise (SFE) using foot orthosis (SFE-FO) and the windlass effect (SFO-WE) while sitting and in a one-leg standing position. METHODS: We recruited fourteen subjects with normal feet for this study. Surface electromyography (EMG) was used to measure the muscle activity of the AbdH muscle during SFE, SFE-FO, and SFE-WE while sitting and in a one-leg standing position. Three trials consisting of a 5 s hold for each of the three exercises were performed to measure the EMG activity of the AbdH muscle. Exercise type and position were randomly assigned. Two-way repeated-measures ANOVA was used to analyze the effects of exercise type (SFE vs. SFE-FO vs. SFE-WE) and position (sitting vs. one-leg standing position) on AbdH muscle activity. A statistical significance was set at ${\alpha}=.05$. RESULTS: The EMG activity of AbdH muscle in the SFE-WE exercise was significantly greater than that during SFE and SFE-FO in both exercise positions (p<.001). In addition, the EMG activity of the AbdH muscle in the one-leg standing position was significantly higher than that while sitting (p<.001) during all three exercises. CONCLUSION: These results suggest that SFE-WE is a more effective strengthening exercise than SFE or SFE-FO for activating the AbdH muscle.

• Physical Therapy Korea
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• v.13 no.4
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• pp.64-70
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• 2006

The purpose of this study was to determine whether a relationship existed between foot type and the location of plantar callus in healthy subjects. Twenty-five healthy subjects with plantar callus were recruited for this study. Foot deformities were classified according to the operational definitions as 1) a compensated forefoot varus, 2) an uncompensated forefoot varus or forefoot valgus, or 3) a compensated rearfoot varus. The location of plantar callus was divided into two regions. Fourteen of the 19 feet with compensated forefoot varus and six of the 9 feet showed plantar callus at the second, third or fourth metatarsal head. Five of the 6 feet with uncompensated forefoot varus and twenty of the 16 feet with forefoot valgus showed plantar callus at the first or fifth metatarsal head. A significant relationship was found between foot type and location of callus (p<.01). The results support the hypothesis that certain foot types are associated with characteristic patterns of pressure distribution and callus formation. We believe diabetic patients with insensitive feet and with the types of foot deformity should be fit with foot orthoses and footwears that accommodate their respective deformity in a position as near to the subtalar joint as possible with the goal of preventing plantar ulceration.

• Journal of Acupuncture Research
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• v.36 no.4
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• pp.282-285
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• 2019

Scoliosis is a 3-dimensional spinal deformity defined as lateral curvature of the spine in the coronal plane of more than $10^{\circ}$. This study describes a case of functional scoliosis after hip injury. In this case, the patient fell whilst inline skating (June 2015) causing severe tilting of her spine, and left hip pain. She received outpatient treatment from July 14, 2015 to December 28, 2015. For approximately 5 months, acupuncture therapy was performed to relax the tension in both hips, Chuna therapy, and foot orthosis were applied to reduce the body's imbalance. Based on X-ray images, the Cobb angle had decreased from $14.73^{\circ}$ (pretreatment) to $1.90^{\circ}$ (posttreatment). This case report suggested that Korean medicine treatment could be an effective therapeutic choice for functional scoliosis.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.1
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• pp.1-9
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• 2020

PURPOSE: Many patients with stroke have difficulties in walking with foot-drop. Various types of ankle-foot orthoses (AFOs) have been developed, but their weight needs to be reduced with the assistance of the ankle dorsiflexor. Therefore, an elastic AFO (E-AFO) was devised that not only improves the stability and flexibility of the ankle but also assists with ankle dorsiflexion while walking. This study examined the effects of an E-AFO, on the walking patterns of foot-drop patients with stroke. METHODS: Fourteen patients walked with and without an E-AFO, and the gait parameters were assessed using the GAITRite system. The spatiotemporal data on the gait patterns of stroke patients with foot-drop were compared using paired t-tests; the level of statistical significance was set to α<.05. RESULTS: No significant differences were observed in the velocity (p=.066) and affecte+d step length (p=.980), but the affected and less-affected stance (p=.022, p=.002) and swing time (p=.012, p=.005) were significantly different. The E-AFO produced a significant difference in the less-affected step length (p=.032). CONCLUSION: The E-AFO has a significant effect on the walking patterns of individuals with foot-drop and stroke. The E-AFO could be a useful assistive device for gait training in stroke patients.

• Journal of Korean Neurosurgical Society
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• v.44 no.4
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• pp.240-244
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• 2008

Objective : Sotos Syndrome is characterized by macrocephaly, overgrowth, and developmental delay, and more than 300 patients have been reported worldwide to date. The authors reviewed the clinical characteristics of 8 patients with Sotos Syndrome in Korea for a new understanding and treatment strategies. Methods : The medical records of a total of eight Korean children with Sotos Syndrome were reviewed. All patients underwent developmental checkup, lumbar punctures for measurement of intracranial pressure (ICP), brain and spine magnetic resonance imaging and computerized tomography. Results : All 8 patients showed macrocephaly and the characteristic craniofacial features of Sotos Syndrome. Other clinical characteristics shown were overgrowth (7/8), developmental delay (7/8), congenital heart defect (3/8), flat foot (8/8), scoliosis (4/8), spina bifida (8/8), hydrocephalus (4/8), cavum vergae (3/8), and increased subdural fluid collection (5/8). Mean ICP measured via lumbar puncture was $27.35{\pm}6.25\;cm$ $H_2O$ (range 20 to 36 cm $H_2O$). Two patients received ventriculo-peritoneal shunt, and 1 patient underwent subduro-peritoneal shunt with improvement. Spinal orthosis was applied to 4/5 patients with scoliosis and 4/8 children with flat foot were provided with foot orthosis. Conclusion : In this first Korean study of 8 Sotos Syndrome patients we demonstrated the presence of spina bifida and increased ICP, which had not been previously described. The authors therefore suggest that all patients with Sotos Syndrome should undergo examination for the presence of spina bifida, and that shunt procedures would improve development and alleviate clinical symptoms.

• Annals of Rehabilitation Medicine
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• v.42 no.6
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• pp.863-871
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• 2018

Objective To evaluate the association between progression of curvature of scoliosis, and correction for functional component in patients with juvenile idiopathic scoliosis (JIS). Methods We retrospectively reviewed medical data of patients prescribed custom molded foot orthosis (FO) to correct inequality of RCSPA (resting calcaneal stance position angle), and chose 52 patients (26 females, 26 males) with Cobb angle ${\geq}10^{\circ}$ in radiology and uneven pelvic level at iliac crest by different RCSPA (${\geq}3^{\circ}$) as a factor of functional scoliosis. They had different hump angle ${\geq}5^{\circ}$ in forward bending test, for idiopathic scoliosis component. Their mean age and mean period of wearing FO were $79.5{\pm}10.6months$ and $18.6{\pm}0.70months$. Results Cobb angle was reduced from $22.03^{\circ}{\pm}4.39^{\circ}$ initially to $18.86^{\circ}{\pm}7.53^{\circ}$ after wearing FO. Pelvis height difference and RCSPA difference, were reduced from $1.07{\pm}0.25cm$ initially to $0.60{\pm}0.36$, and from $4.25^{\circ}{\pm}0.71^{\circ}$ initially to $1.71^{\circ}{\pm}0.75^{\circ}$ (p<0.01). Cobb angle improved most in 9 months. However, there was no significant improvement for those with more than $25^{\circ}$ of Cobb angle initially. Mean Cobb angle improved in all age groups, but patients less than 6 years had clinically significant improvement of more than $5^{\circ}$. Conclusion JIS can have functional components, which should be identified and managed. Foot orthosis is useful in correcting functional factors, in the case of pelvic inequality caused by different RCSPA, for patients with juvenile idiopathic scoliosis.

• Physical Therapy Korea
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• v.23 no.4
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• pp.27-37
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• 2016

Background: In previous studies regarding flexible pes planus, Foot orthosis, special shoes have been used as interventions for correcting malalignment and intrinsic muscles strengthening exercise have been regarded as interventions for foot function and supporting medial longitudinal arch during walking. However, some recent studies reported that strengthening extrinsic muscles as well as intrinsic muscles is more effective and active intervention for flexible pes planus. In particular, the tibialis posterior muscle of foot extrinsic muscles plays essential roles in maintaining the medial longitudinal arch during dynamic weight bearing and balance. In addition this muscle acts longer than other supination muscles during the stance phase in the gait cycle. Objects: This study aimed to investigate the effect of foot intrinsic muscle and tibialis posterior muscle strengthening exercise for plantar pressure and dynamic balance in adults with flexible pes planus. Methods: 16 young flexible pes planus adults (7 males, 9 females) were recruited and were randomized into two groups. The experimental group performed foot intrinsic muscle and tibialis posterior muscle strengthening training, the control group performed only foot intrinsic muscle strengthening training. All groups received strengthening training for 30 minutes five times a week for six weeks. Results: The experimental group had significantly lower plantar pressure of medial heel area than the control group in stand (p<.05). The experimental group had significantly higher dynamic balance ability than control group (p<.05). Conclusion: The results of this study provide evidence to suggest that foot intrinsic muscle and tibialis posterior muscle of extrinsic muscle strengthening exercises may improve plantar pressure distribution and dynamic balance ability in adults with flexible pes planus.