• The Journal of Korean Physical Therapy
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• v.23 no.6
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• pp.55-59
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• 2011

Purpose: The aims of this study were to assess the degrees of foot abnormalities by comparing foot abnormalities after stroke using the FPI, and to investigate the relationship between the FPI and spasticity. Methods: 33 hemiplegic patients (patient group) and 39 healthy subjects (control group) were evaluated foot posture by the FPI. Spasticity in patient group was measured by the MAS. And the relationship between Foot posture and spasticity in patients group were investigated. Results: Hemiplegic feet in patients were supinated feet compare with non-hemiplegic feet in hemiplegic patients and the foot in control group. The degree of spasticity affected foot posture. Conclusion: Foot posture is related to stroke impairments, stroke patients with more severe spasticity have more severe foot abnormalities as supinated foot.

• Physical Therapy Korea
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• v.19 no.3
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• pp.115-123
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• 2012

It is important to assess foot posture when investigating the relationship between lower extremity dysfunctions and foot types. Although several measurements of static foot posture have been used, there is no consensus regarding clinical measurements for foot posture. The aim of this study is to explore the differences among navicular drift (NDt), foot posture index (FPI), arch index (AI), dorsal arch height ratio (DAHR), normal navicular height truncated (NNHt) and to discover the most effective measurement. After foot types were classified by navicular drop test (NDp), clinical measurements of NDt, FPI, AI, DAHR, and NNHt were performed on 64 subjects' feet. ANOVA analysis was used for the variance of the difference between the NDp and the five kinds of clinical measurements, and the level of significance was set at ${\alpha}$=.05. The results showed that all five clinical measurements demonstrated significant differences with navicular drop. In post-hoc, FPI and NNHt showed significant differences in all foot types. The five clinical measurements are suitable the classification of foot types through the NDp. Therefore, it could be possible to assess correct and objective foot posture by using FPI and NNHt.

• The Journal of Korean Physical Therapy
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• v.27 no.5
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• pp.311-314
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• 2015

Purpose: This study attempted to determine intra-rater reliability and inter-rater reliability for measurement of foot form using the FPI-6 (Foot Posture Index) in patients with hemiplegia caused by stroke. Methods: Twenty two stroke patients were recruited into the research and their foot posture was evaluated using the FPI. Two raters assessed 6 items sequentially in accordance with the FPI-6 manual. This procedure involved asking the subject to take several steps in-place, prior to settling into a comfortable stance position with double limb support. Subjects were instructed to stand still with their arms by their sides and look straight ahead. FPI-6 values ranged from -2 to +2 for each of the six criteria and from -12 to +12 for the total score, indicating a position for each foot either along the supinated (negative score) to pronated (more than +6) continuum of foot posture. Results: The results showed that intra-rater reliability and inter-rater reliability for a total FPI-6 score was high: 0.807-0.888. An almost perfect agreement between the two raters was identified in the foot's morphological classification (Somer's D=0.712; p<0.05). Intra-percentage agreement was high (88.6%). Conclusion: The FPI-6 is a quick, simple, and reliable clinical tool with demonstrated good to excellent intra-rater reliability and good inter-rater reliability when used in assessment of the stroke patient's foot.

• Physical Therapy Korea
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• v.28 no.3
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• pp.168-176
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• 2021

Background: The foot is a complex body structure that plays an important role in static and dynamic situations. Previous studies have reported that altered foot posture might affect knee joint strength and postural stability, however their relationship still remains unclear. Objects: The purpose of this study was to identify whether pronated foot posture has an influence on knee isokinetic strength and static and dynamic postural stability. Methods: Forty healthy young males aged 18 to 26 years were included. Foot posture was evaluated using the Foot Posture Index-6 (FPI-6), and the subjects were divided into two groups according to their FPI-6 scores: a neutral foot group (n = 20, FPI-6 score 0 to +5) and a pronated foot group (n = 20, FPI-6 score +6 or more). Biodex Systems 3 isokinetic dynamometer was used to evaluate knee isokinetic strength and hamstring to quadriceps ratio at three angular velocities: 60°/sec, 90°/sec, and 180°/sec. The static and dynamic postural stability in a single-leg stance under the eyes-open and eyes-closed conditions were measured with a Biodex Balance System. Results: There were no significant differences between the groups in knee isokinetic strength and static postural stability (p > 0.05), but there was a significant difference in the medial-lateral stability index (MLSI) for dynamic postural stability under the eyes-closed condition (p = 0.022). The FPI-6 scores correlated significantly only with the dynamic overall stability index (OSI) and the MLSI (OSI: R = 0.344, p = 0.030; MLSI: R = 0.409, p = 0.009) under the eyesclosed condition. Conclusion: Participants with pronated foot had poorer medial-lateral dynamic stability under an eyes-closed condition than those without, and FPI-6 scores were moderately positively correlated with dynamic OSI and dynamic MLSI under the eyes-closed condition. These results suggest that pronated foot posture could induce a change in postural stability, but not in knee isokinetic strength.

• Physical Therapy Rehabilitation Science
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• v.5 no.4
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• pp.178-184
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• 2016

Objective: Tension-type headache is caused by hormones, foods, irritants, stress, obesity, fatigue, and neck and head trigger points-prolonged abnormal posture. The purpose of this study was to evaluate the effects of relaxation approach on head posture, static postural stability, and headache in persons with tension-type headache. Design: Randomized controlled trial. Methods: Thirty-five persons with tension-type headache participated in this study. This study was a pretest-posttest with a control group design for a duration of 4 weeks (60 min/3 times/1 wk). The participants were randomly allocated to the relaxation approach group (n=18) and the control group with conventional rehabilitation including thermotherapy and transcutaneous electrical stimulation for the same period (n=17). Outcome measures involved forward head posture (FHP), foot pressure, neck disability index (NDI), and six-item headache impact test (HIT-6). Results: Relaxation approach and control groups improved significantly in the amount of forward head posture, neck disability index, and six-item headache impact test scores after training (p<0.05). The control group was found to be significantly different in the amount of FHP, backward foot pressure, NDI, and HIT-6 after training compared to before training (p<0.05). The relaxation approach group significantly improved in forward head posture, neck disability index, and six-item headache impact test compared with control group after training (p<0.05). Neck disability index and six-item headache impact test significantly improved after training compared with before training in the control group (p<0.05). However, the foot pressure was not significantly different between relaxation approach and control groups. Conclusions: This study suggests that treatment with relaxation approach combined with self-exercise would be effective in reducing the amount of forward head posture, neck disability and headache impacts.

• Korean Journal of Applied Biomechanics
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• v.27 no.1
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• pp.59-66
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• 2017

Objective: This study investigated the effect of a 16-week upright body exercise program on body balance and plantar pressure balance in elderly women. Method: The subjects included elderly women in B Metropolitan city who participated in an upright body exercise program twice weekly for 16 weeks. The subjects' physical characteristics (height, weight, body mass index [BMI]), posture balance, and foot plantar pressure were measured before and after the experiment. Results: The upright body exercise program showed positive changes in posture balance and foot plantar pressure balance in seven elderly women. Conclusion: The second version of the upright body exercise program improved and may prevent postural imbalance in elderly women. This program could be utilized to improve posture and foot balance in elderly persons.

• Korean Journal of Applied Biomechanics
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• v.25 no.1
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• pp.131-140
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• 2015

Purpose : The purpose of this study was to analyze the coordination of the trunk tilting angle and bilateral lower limbs according to the stirrups length during trot in equestrian. Methods : Participants selected as subject were consisted of adult male(n=7, mean age: $45.00{\pm}3.78yrs$, mean height: $172.50{\pm}2.44cm$, mean body mass: $76.95{\pm}4.40kg$, mean, mean leg length: $97.30{\pm}2.60cm$). They were divided into 3-types of stirrups lengths(67 cm, 72 cm, 77 cm) during trot. The variables analyzed were consisted of the trunk front-rear angle, lower limb joint(Right Left hip, knee, ankle), overall movement index(OMI) of the lower limbs(thigh, shank, foot) and asymmetry index(AI%) during trot. Results : The average angle in hip and knee joint showed more extended posture according to the increase of stirrups lengths and ankle angle showed more plantarflexion posture according to increase of stirrups length during 1 stride in trot. Also, average angle showed more extended posture in right hip and ankle joint than that of left. The angle of knee joint didn't show significant difference statistically between right and left. Also asymmetric index in average angle of hip, knee and ankle joint didn't show significant difference statistically in between lower limbs, but hip joint showed higher asymmetric index in stirrup length of 77 cm and ankle joint showed higher asymmetric index in stirrup length of 67 cm than that of the others respectively. The FR angle in trunk of horse-rider showed relative backward leaning motions at stirrup length of 67 cm and 77 cm than that of stirrup length of 72 cm during stance and swing phase. OMI in thigh, shank, and foot limbs didn't show significant difference statistically according to the stirrups length of right and left lower limbs, but left lower limbs showed higher index than that of right lower limb. Stirrup length of 72 cm in shank and foot limbs showed higher index than that of stirrup length of 67 cm and 77 cm. But stirrup length of 72 cm showed higher asymmetric index than that of stirrups length of 67 cm and 77 cm. Conclusions : When considering the above, 72 cm(ratio of lower limb 74.04%) stirrup lengths could be useful in posture correction and stabilization than 67cm(ratio of lower limb 68.69%) and 77 cm(ratio of lower limb 79.18%) stirrup lengths during trot in horse back riding.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.23 no.1
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• pp.63-72
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• 2017

Background: The purpose of this case study was to investigate into the effect of complex exercise program on the postural change, gait and balance ability in elementary school students with forward head posture. Methods: Four patients with forward head posture were recruited. They were evaluated pre-treatment, and after 6weeks, using neck disability index (NDI), numeric pain rating scale (NPRS), balance ability, foot pressure (fore foot/rear foot peak pressure ratio, F/R ratio), gait ability (cadence, toe out angle, stance phase). Results: First, the angle of forward head posture (craniovertebral angle; CVA and cranialrotation angle; CRA) was decreased in all subjects. The NPRS and NDI were decreased in all subjects. Also, The cadence, toe out angle and F/R ratio were increased in all subjects. The stance phase of gait cycle was positively change in all subjects. Lastly, the static balance ability improved in all subjects. Conclusion: According to the results above, the complex exercise program for students with forward head posture can help improve the postural change, gait and balance ability. Also, the complex exercise program was able to select interventions depending on the patient's condition and the desired goal.

• Journal of The Korean Society of Integrative Medicine
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• v.5 no.4
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• pp.41-48
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• 2017

Purpose : The purpose of this study was to verify the relationships among the knee adduction moment, hip rotation range, strength of hip rotators, and Foot Posture Index of healthy young adults. Method : Thirty-two healthy adults(24 male, 8 females) participated in this study. Subjects performed 5 walking trials to evaluate the knee adduction moments using a three-dimensional motion analysis system. Hip rotation ranges and hip rotator strengths were measured using a standard goniometer and a handheld dynamometer, respectively. The mean of three trials of clinical tests was used for data analysis. Results : The first peak knee adduction moment was significantly correlated with the hip rotation ranges and hip rotator strengths (P<.05). The second peak knee adduction moment was showed significant correlations with hip external rotation and rotation ratio. There were no correlations between Foot Posture Index and all knee adduction moments (P>.05). Conclusion : This study suggests that imbalances of the range of motion and strength of the internal and external rotation of the hip joint can affect knee adduction moments. The impact may exacerbate musculoskeletal disorders such as osteoarthritis of the knee. Therefore, further studies should be conducted to evaluate the effects of clinical interventions to correct these imbalances on the reduction of the knee adduction moments in patients with knee osteoarthritis.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.1
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• pp.91-99
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• 2019

PURPOSE: This study was conducted to evaluate the activity of trunk muscles according to width of the foot and posture of the arm during sit to stand (STS). METHODS: Thirty subjects were recruited and examined for variation in muscle activity of the erector spine, gluteus maximus, gluteus medius and external oblique during different STS conditions; namely, the cross arm basic sit to stand (CBSTS), overhead basic sit to stand (OBSTS), cross arm wide sit to stand (CWSTS), and overhead wide sit to stand (OWSTS). Repeated measures ANOVA (Analysis of Variance) was used for analysis. RESULTS: Erector spinae muscle activity showed a significant increase in the OBSTS condition (p<.05) and external oblique muscle activity showed a significant increase in the OWSTS condition ((p<.05). There was no significant difference in the activity of the gluteus maximus and gluteus medius under any conditions (p>.05). CONCLUSION: During evaluation of the performance of the STS, the CWSTS condition will be useful to decrease the muscle activity of the erector spinae and the OWSTS condition will be useful to increase the muscle activity of the external oblique. The results of this study can be used as an index to find a suitable exercise method for subjects who have back pain or to strengthen the abdomen.