• Physical Therapy Korea
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• v.11 no.2
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• pp.27-34
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• 2004

The purpose of this study was to identify the influence of wedged insole and foot progression angle (FPG) on lateral thrust of knee in healthy subjects. Fifteen healthy male subjects were recruited from Suncheon First College, in Suncheon. The subjects randomly walked at the comfortable velocity under five conditions: bare footed, medio-lateral $10^{\circ}$ wedged insoles, toe-in and toe-out gait. The lateral thrust was measured by a accelerometer with telemeter during walking. Data was collected while each subject walked for about 10 gait cycle on a flat, level walkway at their normal speed. The middle three gait cycle were used for averaged peak value of lateral acceleration. The three averaged peak value of lateral acceleration were collected under each condition at heel strike. The results showed that averaged peak value of lateral acceleration increased significantly in medial wedged insole and toe-in gait and decreased significantly in lateral wedged insole and toe-out gait as compared with bare footed (p<.05). These results suggest that wedged insole as well as walking strategy, such as foot progression angle, may prevent progression of degenerative knee osteoarthritis.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2003.10a
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• pp.24-24
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• 2003

For the elderly, achieving a close-to-normal ambulation is important for activities of daily life. Recent researches of SE(Silver Engineering) restoring physical ability would help the elderly by developing the advanced gait assisting devices and orthoses. For the applications using the advanced technologies, the gait characteristics of the elderly must be understood. However, a few studies were performed to investigate the physiological or pathological gaits. The purpose of this study is to provide the gait analysis data and also to investigate relationships between alignment of the lower limb, foot progression angle and knee joint moments in the healthy elderly. By participating a total of 20 healthy elderly persons in this study, the following facts were found: 1) Cadence showed 114.8 steps/min, gait speed showed 1.05 m/s, time per a stride showed 1.06 sec, time per a step showed 0.53 sec, single-supporting phase was 0.41 sec, double-supporting phase was 0.24 sec, stride length was 1.04m, Step length was 0.56m; 2) The maximum knee flexion angle through swing phase showed left 46.82$^{\circ}$, right 40.19$^{\circ}$ and the maximum knee extension angle showed left -1.32$^{\circ}$, right 2.01$^{\circ}$. Knee varus showed left 26.90$^{\circ}$, right 30.93$^{\circ}$; 3) The maximum knee flexion moment showed left 0.363 Nm/kg, right 0.464 Nm/kg, The maximum knee extension moment showed left 0.389 Nm/kg, right 0.463 Nm/kg. The maximum knee adduction moment showed left 0.332 Nm/kg, right 0.379 Nm/kg. The maximum internal rotational moment showed left 0.13 Nm/kg, right 0.140 Nm/kg; 4) The subjects who had varus alignment of the lower extremity had statistically higher in knee adduction moment in mid stance phase; and 5) The subjects who had large foot progression angle had statistically lower in knee adduction moment in late stance phase.

• 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.

• Korean Journal of Applied Biomechanics
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• v.23 no.1
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• pp.85-90
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• 2013

Efficient gait is compensate for a lack of exercise, but the wrong walking can cause disease that joints, muscles, brain and body structure(Scott & Winter, 1990). Also many researchers has been studied gait of positive mechanism using analytical methods kinetic, kinematic. This study is to identify nature of knee adduction moment, depending on different foot progression angle and the movement of rotation of pelvis and body. Health study subject conducted intended walking with three different angles. The subjects of this study classified three types of walking; walk erect, pigeon-toed walk and an out-toed gait. Ten university students of K without previous operation and disease record selected for this study. For accuracy of this study, three types of walking carried out five times with 3D image analysis and using analysis of ground reaction force to analyze nature of knee adduction moment and the movement of rotation of pelvis and body. Firstly, the HC(heel contact) section value of intended walk erect, pigeon-toed walk and an out-toed gait was not shown statistically significant difference but TO(toe off) section value was shown that the pigeon-toed walk statistically significant. The value of pigeon-toed walk was smallest knee adduction moment(p< 0.005). Secondly, X axis was the change of rotation movement body and pelvis when walk erect, pigeon-toed walk and an out-toed gait. Shown statistically Y axis was not shown statistically significant but Z axis statistically significant(p<0.05). These result show the significant differences on TO section when walking moment reaches HC, it decides the walking types and rotates the foot.

• Journal of Korean Physical Therapy Science
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• v.10 no.1
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• pp.90-101
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• 2003

Gait analysis can provide a better understanding of how the alignment of the lower limb and foot can contribute to force observed at the knee. Anatomic and mechanical factors that affect loading in the knee pint can contribute to pathologic change seen at the knee in degenerative pint disease and should be considered in treatment plan. The purpose of this study is to present the gait analysis data and to determine whether there is any relationships between alignment of the lower limb, foot progression angle and knee pint moments in elderly healthy women with 3-dimensional motion analyzer. The results were as follows; 1. Cadence showed 114.8 steps/min, gait speed showed 1.05 m/s, time per a stride showed 1.06 sec, time per a step showed 0.53 sec, single-supporting phase was 0.41 sec, double-supporting phase was 0.24 sec, stride length was 1.04 m, Step length was 0.56 m. 2. According to the parameters of kinematics, the maximal knee flexion angle through swing phase showed left $46.82^{\circ}$, right $40.19^{\circ}$ and the maximal knee extension angle showed left $-1.32^{\circ}$, right $2.01^{\circ}$. knee varus showed left $26.90^{\circ}$, right $30.93^{\circ}$. 3. Moment, one of kinetic parameters of knee pint the maximal flexion moment showed left 0.363. Nm/kg, right 0.464 Nm/kg and maximal extension moment showed left 0.389 Nm/kg, right 0.463 Nm/kg. The maximal. adduction moment showed left 0.332 Nm/kg, right 0.379 Nm/kg and the maximal internal rotatory moment showed left 0.13 Nm/kg, right 0.140 Nm/kg. 4. On sagittal plane, the maximal power of knee joint showed left 0.571 J/kg, right 0.629 J/kg. On coronal plane, the maximal power of knee joint showed left 0.11 J/kg, right 0.12 J/kg. On transverse plane, the maximal power of knee joint showed left 0.058 J/kg, right 0.072 J/kg. 5. The subject who had varus alignment of the lower extremity had statistically higher in knee adduction moment in mid stance phase. 6. The subject who had large foot progression angle had statistically lower in knee adduction moment in late stance phase. A relationship was observed between the alignment of the lower extremity and the adduction moment of the knee joint during stance phase. Hence, we need some research to figure, out the change of adduction moment according to the sort of knee joint osteoarthritis and the normal geriatrics as well. And we also require more effective, specific therapeutic program by making use of those background of researches.

• Journal of Korean Foot and Ankle Society
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• v.27 no.4
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• pp.137-143
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• 2023

Purpose: Autologous osteochondral transplantation (AOT) is indicated for patients with a large osteochondral lesion of the talus (OLT), accompanying subchondral cyst, and the failure of bone marrow stimulation (BMS) procedures. Despite the many reports on the clinical results of surgical treatment for medial osteochondral lesions, those of lateral lesions are rare. This paper reports the intermediate-term clinical outcomes after AOT for lateral OLTs. Materials and Methods: Twenty-one patients with lateral OLTs were followed up for at least three years after AOT. The clinical evaluations comprised the Foot and Ankle Outcome Score (FAOS) and Foot and Ankle Ability Measure (FAAM). The radiographic assessment included the irregularity of the articular surface (subchondral plate), the progression of degenerative arthritis, and the changes in talar tilt angle and anterior talar translation. Results: The mean FAOS and FAAM scores improved significantly from 42.1 to 89.5 and 39.5 to 90.6 points, respectively, at the final follow-up (p<0.001). The radiological evaluation revealed two cases (9.5%) of articular step-off ≥2 mm and 1 case (4.8%) of progressive arthritis. The mean talar tilt angle and anterior talar translation improved significantly. As postoperative complications, there was one case of a local wound problem, one case of superficial peroneal nerve injury, and one case of donor site morbidity. At a mean follow-up of 62.3 months, no patient showed a recurrence of instability or required reoperation for OLT. Conclusion: AOT for the lateral OLTs demonstrated satisfactory intermediate-term clinical outcomes, including daily and sports activity abilities. Most OLT could be accessed through lateral ligament division and capsulotomy, and the incidence of iatrogenic complications, such as recurrent sprains or chronic instability, was minimal. AOT appears to be an effective and relatively safe treatment for patients with large lateral osteochondral lesions unresponsive to conservative therapy, with subchondral cysts, or with failed primary BMS.

• Korean Journal of Applied Biomechanics
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• v.30 no.1
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• pp.83-91
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• 2020

Objective: The study aimed to develop a functional performance index that evaluates the functional performance of Parkinson's patients, i.e., to integrate biomechanical measurements of walking, balance, muscle strength and tremor, and to use multiple linear regression with stepwise methods to identify the most suitable predictors for the progression of disease. Method: A total of 60 subjects were tested for sub-variables of four factors: walking, balance, isometric strength and hand tremors. Potential independet variables were extracted through correlation analysis of the sub-variables and dependent variables, Hoehn & Yahr scale. And then, a stepwise multiple regression analysis using the potential independent variables was performed to identify predictor of Hoehn & Yahr scale. Results: First, the results of the study showed that physical composition and gait had a relatively more correlated with the progression of the disease, compared to balance and hand tremor. Second, Parkinson's functional performance is characterized by dynamic pattern of walking, such as foot clearance and turning angle (TA) of walking, and a high-explained regression model is completed. Conclusion: The study emphasized the importance of walking variables and body composition in minor pathological features compared to Parkinson's patient's balancing ability and hand tremor. Specifically, it revealed that dynamic walking patterns functionally characterize patients. The results are worth considering when assessing functional performance related to the progression of the disease at the site.

• Journal of Korean Foot and Ankle Society
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• v.14 no.2
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• pp.146-150
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• 2010

Purpose: Pilon fracture has several serious complications such as joint stiffness, arthrosis and delayed angular deformity. We report short-term results of new treatment modality using distracted dynamic external fixators and early controlled ankle motion. Materials and Methods: Eight cases of severe pilon fractures for which we tried small plate fixation and additional distracted dynamic external fixators from July 2007 to June 2009 were included. Half passive continuous ankle joint motion was allowed under free hinged ring fixators after the operation. The external fixators were removed after two or three months from the surgery. We investigated joint space by radiograph, joint pain, range of motion, patient's satisfaction of treatment protocol. Results: Joints were distracted when external fixators were applied and mean 28% of space loss developed after removal of external fixators. In most of cases, satisfactory alignments were maintained. Regarding range of joint motion, mean dorsiflexion angle was 15 degrees and mean plantarflexion angle was 32 degree in the condition of wearing external fixators. There was mean 8% reduction of range of motion but no further progression of ankle stiffness after removal of external fixators. Dorsiflexion was not improved after that, but plantarflexion angle was improved 10% even after removal of external fixators. Patients were generally in compliance with the treatment protocols with high level of satisfaction. Conclusion: We got good results with distracted dynamic external fixators and early continuous half-passive joint motion for pilon fractures in terms of joint pain and range of motion. Therefore we suggest this new protocol as an alternative modality for severe pilon fractures.