• Archives of Plastic Surgery
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• 제37권4호
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• pp.457-460
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• 2010

Purpose: The great toe presents a reconstructive challenge for plastic surgeons. The big toe has much importance not only for the gait and the stability, but also for appearance aspects. Few reports have documented the reconstruction of big toe defects and we report a unique case of free flap reconstruction technique. Methods: A 41-year-old man with right great toe open fracture with soft tissue necrosis was referred from the orthopedic surgery department. On physical examination, there was the skin necrosis circumferentially and the fratured bone was severely fragmented. The metatarsophalangeal (MTP) joint of the big toe was intact. After the wound debridement, we harvested the innervated anterolateral thigh flap and transposed to the defected area. After five months, we finally retouched the flap by the dorsal defatting and distal debulking. Results: He had an uneventful postoperative course without infection, dehiscence and flap necrosis. He has remained asymptomatic for eight months without any recurrence such as the osteomyelitis. Finally, he kept the normal gait and posture with weight bearing on the reconstructed great toe and foot. Conclusion: The anterolateral thigh flap is described for the reconstruction of the great toe. It involves two stage procedure with the minimal donor site morbidity and provides a good cosmetic result.

• 척추신경추나의학회지
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• 제14권2호
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• pp.77-88
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• 2019

Objectives : The purpose of this study was to show the effectiveness of Chuna Manual Therapy applied to a osteoporosis patient with gait disturbance due to lower limb fracture surgery. Method : We focused on Chuna therapy accompanied with acupuncture, herbal medicine, moxibustion, cupping treatment and rehabilitation exercise. This case was assessed using the Visual Analogue Scale (VAS), Pain Free Walking Distance (PFWD), Berg Balance Scale (BBS), and Modified Barthel Index (MBI). Result : This patient showed improvement on the VAS from 6 to 3, PFWD from 0 m to 2000 m using a walker and 50 m by self-walking, BBS from 2 to 28, and MBI from 56 to 89. Moreover the walking state improved from gait disturbance to self-walking. Conclusion : This study suggests that Chuna therapy could be used to improve gait disturbance in patients with osteoporosis and lower limb fracture surgery.

• 한국전문물리치료학회지
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• 제14권4호
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• pp.84-90
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• 2007

The purpose of this study was to assess the test-retest reliability of heart rate (HR) and velocity measurements during peak effort and free treadmill walking tests in older patients with gait-impaired chronic hemiparetic stroke and control group. Twenty-two adults (13 men, 9 women; mean age, $73.7{\pm}5.2$ yrs) with chronic hemiparetic stroke are the experimental group. Nineteen elderly people (5 men, 14 women; mean age, $72.3{\pm}3.5$ yrs) were recruited as control group. Patients had mild to moderate chronic hemiparetic gait deficits, making handrail support necessary during treadmill walking. Free and peak effort treadmill walking tests were measured and then repeated at least two days later. Reliability was calculated from HR and walking velocity during free and peak effort treadmill walking test. Among the people who had strokes, HR [ICC(2,1)=.85, r=.86] and velocity [ICC(2,1)=.93, r=.93] were good parameters during free testing. Maximal testing generated good results for HR [ICC(2,1)=.81, r=.82] and velocity [ICC(2,1)=.96, r=.96] with the chronic hemiparetic stroke. In elderly people, HR [ICC(2,1)=.59, r=.62] and velocity [ICC(2,1)=.77, r=.76] were moderately reliable during free testing. Maximal testing produced moderate parameters for HR [ICC(2,1)=.74, r=.74] and velocity [ICC(2,1)=.66, r=.66] in the elderly. This study provides that free and maximal treadmill testing produce highly reliable HR and velocity measurements in adults with chronic hemiplegia using minimal handrail support.

• Archives of Reconstructive Microsurgery
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• 제9권2호
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• pp.147-153
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• 2000

Soft tissue defects of the dorsum of foot and ankle can be covered from skin graft to free tissue transfer. The extent of injury which may be complex including the exposure of paratenons or bones requires free flap reconstruction. Some of the precautions for reconstruction are providing minimal bulkiness and well conforming to irregular contour thus making normal footwear possible. Though the muscle flap having its advantages and versatility, the fascial flap such as temporoparietal fascial flap has been considered the choice for reconstruction of the dorsum of foot and ankle. The purpose of our study is to utilize the advantages and versatility of the muscle flap as a first choice for reconstruction for the defects involving the dorsum of foot and ankle. The gracilis muscle with its anatomic and donor characteristics, it can be utilized to maximal effect by expanding its slim muscle width removing the epimysium and reducing its bulk by muscle atrophy through denervation. We present our experience with ten cases of reconstruction for the dorsum of foot and ankle using the gracilis muscle free flap. Results were satisfactory without flap loss, skin loss and infection. The contour and aesthetic aspect of the foot was satisfactory. Gait analysis showed near normal gait without limitations from everyday activities. Normal footwear was tolerable in all the cases. The keys to consider in the reconstruction of the dorsum of foot and ankle are appropriate bulkiness, conforming to its contour and able to apply normal footwear. With minimal donor morbidity and satisfying results, the extended gracilis muscle should be considered as the first line for reconstruction of the ankle and dorsum of foot.

• 한국운동역학회지
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• 제17권4호
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• pp.1-8
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• 2007

The purpose of this study was to investigate the difference in the stride-to-stride variability between two treadmill conditions; traditional treadmill and special treadmill whose speed can be adjusted automatically by subject's walking speed. Eight male subjects (25.1 years, 172.7 cm, 66.6 kg) were participated in treadmill walking experiment. First, preferred walking speed (PWS) of each subject was determined. Second, each subject performed walking experiment with fixed PWS condition and with free PWS condition for 10 minutes. 3D motion capture system (Motion analysis Corp., USA) with 6 cameras was used to collect motion data with sampling frequency of 120Hz. Temporal and spatial variables for stride-to-stride variability were calculated. Coefficient of variance (CV) which quantifies the amount of variability and Detrended Fluctuation Analysis (DFA) which explains the structure (self-similarity) of the variability were used for analysis. Results showed that the amount of variability during free PWS condition was greater than that of fixed PWS condition. DFA results showed that there was a statistical difference between two treadmill conditions for the variables of step length, stance time, and double support time. From these results, it is possible that traditional treadmill study might give incorrect conclusion about gait variability study. Further study is necessary to clarify these matters by considering the number of subjects, experimental time, and gait variables for the study of stride-to-stride variability.

• 제어로봇시스템학회:학술대회논문집
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• 제어로봇시스템학회 2003년도 ICCAS
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• pp.645-650
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• 2003

Legged robots can avoid an obstacle by crawling-over or striding, according to the obstacle’s nature and the current state of the robot. Thus, it can be observed that the mobility efficiency to reach a destination is improved by such action. Moreover, if robots have many legs like 4-legged or 6-legged types, then the robot movement range is affected by the order of swing leg. In this paper, the avoidance action of a quadruped robot is generated by a neural network (NN) whose inputs are information on the position of the destination, the obstacle configuration and the robot's self-state. To realize a free gait in static walking, the order of swing leg is determined using an another NN whose inputs are the amount of movements and the robot’s self-state. The design parameter of the latter NN is adjusted by using genetic algorithm (GA).

• 제어로봇시스템학회논문지
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• 제21권5호
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• pp.407-412
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• 2015

This paper presents the design of a lab-built powered knee prosthesis based on a BLDC motor, a sensored impedance control using a force sensor, and a sensorless impedance control through torque estimation. Firstly, we describe the structure of the lab-built powered knee prosthesis and its limitations. Secondly, we decompose the gait cycle into five stages and apply the position-based impedance control for the powered knee prosthesis. Thirdly, we perform an experiment for the torque estimation and the sensorless impedance control of the prosthesis. The experimental results show that we can use the torque estimation to control the low impedance during the swing phase, although the estimated torque data has a delay compared with the measured torque by a load cell.

• 재활간호학회지
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• 제6권1호
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• pp.70-78
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• 2003

This study was a quasi-experimental study of nonequivalent control group pretest-posttest design to investigate the effect of rhythmic dance movement training on the physical and psychological functions of the elderly. The data were collected from November, 2001 to February, 2002. The subjects for this study were 34 elderly who was over 65 years old and was living in J city. The elderly selected for this study were: free from heart and pulmonary disease and not regular exercise. The rhythmic dance movement training in watching video tape was rhythmic dance movement and education and supportive care. The rhythmic dance movement was 40-60 intensity, 8 weeks' period, three times a week, 60 minutes a day. The data were analysed by $X^2$-test, paired t-test and unpaired t-test and ANCOVA through SAS/PC program. The results of the study were as follows: 1. There was insignificant difference in the gait length experimental and control group. 2. There was significant difference in the gait speed between the two groups. 3. There was significant difference in the dynamic valance between the two groups. 4. There was no significant difference in the depression between the two groups. 5. There was no significant difference in the Quality of life between the two groups. As shown above, the results of the 8 weeks' rhythmic movement program for the elderly produced positive effects on gait speed, dynamic valance. And this program was expected that it was more effective in different intervention period, verified program. Also it was needed follow study.

• 재활간호학회지
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• 제5권2호
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• pp.193-204
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• 2002

This study was a quasi-experimental study of nonequivalent control group pretest- posttest design to investigate the effect of aerobic walking exercise program on the physical & psychological functions of home stayed stroke patients. The data were collected during the period of May 20th to August 15th, 2001. The subjects for this study were 40 hemiplegic stroke patients with the experimental group consisting of 19 patients and the control group being composed of 21 patients. The patients selected for this study were: (a)living in J city who had been diagnosed with stroke and at home after being discharged from the hospital, (b)suffering from stroke for 6 months to 5 years, (c)without recognition disorder with the MMSE-K score above 25, (d)below 2 on the modified Ashworth scale, (e)free from heart and pulmonary disease (f)able to walk beyond 15 minutes for themselves. The aerobic walking exercise program for the experimental group was aerobic exercise and education and supportive care. The aerobic exercise was 8 weeks' period, three times a week, 35 to 50 minutes a day. And the education and supportive care was consisted of one home visiting and 2 times telephoning a week. The data were analysed by $X^2$-test, paired t-test and unpaired t-test and ANCOVA through SAS/PC program. The results of the study were as follows: 1. There was insignificant difference in the gait length experimental and control group. There was significant difference in the gait speed between the two groups. 2. There was significant difference in the dynamic valance between the two groups. 3. There was significant difference in ADL score between the two groups. 4. There was no significant difference in the depression between the two groups. As shown above, the results of 8 weeks' the aerobic walking exercise program for home stayed stroke patients produced positive effects on gait speed, dynamic valance, ADL score. And this program was expected that it was more effective in different intervention period, verified program. Also it was needed follow study.

• Archives of Plastic Surgery
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• 제32권4호
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• pp.441-446
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• 2005

Sole reconstruction should consider both functional and aesthetic aspects; durable weight bearing surface, adequate contour for normal footwear, protective sensation and solid anchoring to deep tissue to resist shearing. The anterolateral thigh perforator free flap has such favorable characteristics as long pedicle, reliable perforators and minimal donor site morbidity. This flap can be safely thinned to 3-4 mm. It can also be elevated with sufficient bulk with muscles like vastus lateralis for complex defect. Between June 2002 and December 2004, 48 cases of sole reconstruction were performed with anterolateral thigh perforator free flaps. Follow up period ranged from 4 to 34 months with a mean of 14.7 months and with exception of one case, all flaps survived. One case of total flap loss was noted due to infection in a patient who was administered lifetime immunosuppressant. Partial necroses developed in three cases but were treated conservatively. Satisfactory aesthetic and functional results were achieved and acceptable gait recovery was noted. Seventy-eight percent of the patients regained protective sensation by 6 months and earlier sensory recovery was noted in sensate flap group. The authors also present a standardized protocol for preoperative patient evaluation and postoperative management and rehabilitation.