• 대한족부족관절학회지
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• 제18권3호
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• pp.115-118
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• 2014

Purpose: The purpose of this study is to report on the result of repairing Achilles tendon using absorbable suture under nerve block. Materials and Methods: We retrospectively reviewed 20 patients with acute Achilles tendon rupture who were followed up for at least six months after the operation. We repaired Achilles tendon using two absorbable sutures using the Krackow technique for the proximal stump and the Kessler technique for the distal stump. A programmed postoperative management including non-weight bearing with a short leg cast for four weeks after the operation was applied for all patients. We evaluated clinical results using American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) for satisfaction, range of motion of ankle, functional recovery rate, and the starting time of single heel raise. Results: The mean VAS score for satisfaction and AOFAS score was 9.2 and 93.0, respectively. The affected ankle showed a mean dorsiflexion rate of 90% and plantar-flexion rate of 94% compared to the uninjured side. The single heel raise could start at a mean of 3.5 months after the operation. Conclusion: Treatment of Achilles tendon rupture with absorbable suture material using the hybrid suture technique of proximal Krackow and distal Kessler showed sufficient stability and minimal chronic inflammatory reaction.

• 대한정형외과학회지
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• 제56권2호
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• pp.157-163
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• 2021

목적: 아킬레스건의 황색종은 드물게 발생하며 증상이 심할 경우 수술적 치료가 필요한 경우가 있다. 전 절제술 후 재건술은 높은 수술의 숙련도를 요하며 다양한 합병증에 대한 우려가 있다. 본 연구에서는 양측 아킬레스건에 발생한 거대 황색종에 대해 자가 아킬레스건을 보존하는 쐐기형 절제술 후 추시 결과를 분석하고자 하였다. 대상 및 방법: 2010년 7월부터 2018년 5월까지 양측 아킬레스건에 발생한 황색종 환자 5명에 대해 자가 아킬레스건을 보존하는 쐐기형 절제술을 시행하였다. 평균 나이는 49세(범위, 40-55세)였고 추시 기간은 평균 21.4개월(범위, 12-31개월), 남자는 3명, 여자는 2명이었다. 수술 후 발생한 합병증을 기록하였으며 족관절 운동 범위, American Orthopaedic Foot & Ankle Society(AOFAS) ankle/hindfoot score, 치료 만족도 시각적 척도(visual analogue scale for overall satisfaction), single-limb heel raise 가능 여부, 그리고 직장으로의 복귀 시간을 측정하여 수술 후 임상적인 평가를 시행하였다. 결과: 1명에서 열개창(wound dehiscence)이 발생하였으며 추가적인 수술적 치료 없이 호전되었다. 마지막 추시에서 모든 환자들의 족관절의 운동 범위는 정상이었으며 AOFAS ankle/hindfoot score는 평균 91점(범위, 85-96점)이었고 치료 만족도 시각적 척도는 8-10점의 분포를 보였다. 직장으로의 복귀는 평균 27.6일(범위, 17-58일)이었으며 모든 환자는 single-limb heel raise가 가능하였다. 결론: 아킬레스건에 황색종이 발생하였을 경우 자가 아킬레스건을 보존하며 시행하는 쐐기형 절제술은 좋은 수술적 치료가 될 수 있을 것으로 판단된다.

• The Journal of Korean Physical Therapy
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• 제31권4호
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• pp.176-183
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• 2019

Purpose: The purpose of this study was to investigate the short term effects of ASEJ (ankle strengthening with emphasis on jumping) for 3weeks on strength, mechanical properties, and balance and to compare the balance with and without HH(high-heel) condition. Methods: ASEJ (a combined exercise of squat, heel raise up, and jumping) were performed for the subjects in 11 female ankle instability young females ($21.7{\pm}2.0yrs$ Cumberland ankle instability score $19{\pm}6.5$). To investigate the effect of ASEJ, investigator used dynamometer for measuring strength, MyotonPRO for measuring mechanical properties(tone, stiffness, and elasticity of the muscles), I-Balance test for static balance, and Y-balance test for dynamic balance between the condition with and without HH condition. All data were normally distributed and analyzed using the SPSS 22.0 statistical program. Comparing pre- and post-intervention and the condition with and without HH conditions data were examined using the paired t-test. The level of significance was chosen as 0.05 for all the analyses. Results: 3wks of ASEJ would strengthen leg muscles and increasing muscle tone and stiffness in most muscles however there was decreasing muscle elasticity of gastrocnemious. In addition, the ASEJ improves the static balance for ankle instability young females and increases the dynamic balance when wearing the heels especially. Conclusions: the ASEJ could recommend to improve the strength and balance for ankle instability young females. Also, measuring the balance with HH conditions well represents the risk of ankle damage in female.

• 한국운동역학회지
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• 제22권2호
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• pp.219-228
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• 2012

The purpose of this study was to investigate how induced fatigue of the ankle joint muscles affects the capability and recovery of postural control during single-leg stance in healthy adults. The study population included 22 randomly recruited men and women. Postural control was performed on single-leg stance with eyes open. Ankle joint muscle was fatigued by repeated heel raises. According to the results of this study, for the anteroposterior variables, both men and women showed significantly increased center of mass velocity and decreased center of pressure 95% edge frequency immediately after fatigue. For the mediolateral variables, both men and women showed significantly increased center of mass velocity and decreased center of pressure 95% edge frequency immediately after fatigue. For the total variables, both men and women showed significantly increased center of mass averaged-velocity immediately after fatigue, and also, the center of pressure 95% confidence ellipse area significantly increased in women. Postural control variables were not significantly different for men and women at any time (Pre, P0, P10, and P20). In conclusion, the gender does not affect the capability and recovery after induced fatigue of ankle joint muscles. The effect of fatigue found for the anteroposterior and the mediolateral variables in both men and women. Furthermore ankle joint muscle fatigue led to change of postural control strategy from an ankle joint strategy towards a hip joint strategy. These changes are believed to damage postural control. The ankle joint muscle recovered from fatigue within 20 min during single-leg stance.

• 대한족부족관절학회지
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• 제14권2호
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• pp.109-114
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• 2010

Purpose: The purpose of this study was to report the surgical outcome of reconstruction of neglected chronic Achilles tendon ruptures with various methods including Achilles tendon allograft. Materials and Methods: Between October 2003 and November 2008, 8 consecutive neglected chronic Achilles tendon ruptures with the defect gap of more than 4 cm underwent surgical reconstruction including V-Y advancement, gastrocnemius fascial turn-down flap, flexor hallucis longus transfer and Achilles tendon allograft. There were 7 males and 1 female who were evaluated at more than 18 months after surgery. At the time of followup, all patients were assessed with regard to postoperative complications, their self-reported level of satisfaction, the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale, 10 repetitive single heel rise, single leg hopping test, and ankle range of motion. Results: The AOFAS score increased from average 71.4 (50-87) to 96.4 (86-100). All patients were able to perform 10-repetitive single heel raise and single leg hopping at the latest follow up. No patient experienced wound complications and deep infection. Six patients were rated as 'excellent' and the other two as 'good'. Conclusion: Neglected chronic Achilles tendon ruptures could be successfully treated with careful selection of the reconstruction method according to the amount of defect gap. With an extensive defect, Achilles tendon allograft can be a good option when the reconstruction is not feasible otherwise.

• 대한의용생체공학회:의공학회지
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• 제34권2호
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• pp.80-90
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• 2013

Recently, functional insoles of wedge-type it is for the young to raise their height inserted between insole and heel cause foot pain and disease. Additionally, these have a problem with stability and excessively load-bearing during gait like high-heel shoes. In this study, we compared the changes in biomechanical characteristics of foot with different insole thickness then we will utilize for the development of the insole with the purpose of relieving the pain and disease. Subjects(male, n = 6) measured COP(center of pressure) and PCP(peak contact pressure) on the treadmill(140cm/s) using F-scan system and different insole thickness(0~50 mm) between sole and plantar surface during gait. Also, we computed changes of stresses at the foot using finite element model with various insole thickness during toe-off phase. COP moved anterior and medial direction and, PCP was increased at medial forefoot surface, $1^{st}$ and $2^{nd}$ metatarsophalangeal, ($9%{\uparrow}$) with thicker insoles and it was show sensitive increment as the insole thickness was increased from 40 mm to 50 mm. Change of the stress at the soft-tissue of plantar surface, $1^{st}$ metatarsal head represents rapid growth($36%{\uparrow}$). Also, lateral moments were increased over the 100% near the $1^{st}$ metatarsal as the insole thickness was increased from 0 mm to 30 mm. And it is show sensitive increment as the insole thickness changed 10 mm to 20 mm. As a result, it was expected that use of excessively thick insoles might cause unwanted foot pain at the forefoot region. Therefore, insole thickness under 30 mm was selected.

• 한국융합학회논문지
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• 제9권10호
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• pp.371-376
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• 2018

본 연구는 전신진동 자극시 스쿼트의 형태에 따른 하지근육의 근활성 효과의 차이를 분석함으로써 전신진동운동의 효과를 규명하고 효율적인 운동을 위한 과학적 근거를 제시하는데 그 목적이 있다. 본 연구는 정형외과적 질환이 없는 건강한 20대 남성 10명을 대상으로 똑바로 선자세, 슬관절을 90도, 120도 굴곡시킨 일반적인 스쿼트 자세와 뒷꿈치를 들어 올린 혼합 스쿼트 자세의 진동자극 시 근활성도를 측정하였다. 근활성도는 외측비복근, 전경골근, 외측광근, 대퇴이두근에 근전도 전극을 부착한 후 RMS를 구하여 비교하였으며 진동 자극의 강도는 각 자세에서 볼륨 50, 80, 주파수 10, 25, 40Hz를 혼합하여 적용하였다. 분석 결과 외측비복근과 전경골근 외측광근에서 자세별 근활성도의 차이가 나타났고 뒷꿈치를 들어올린 자세에서 근활성 효과가 높음을 확인할 수 있었다. 이와 같은 결과는 전신진동 자극 시 스쿼트 자세와 강도에 따라 근활성 효과에 차이가 있으며, 운동의 효율을 극대화하기 위하여 목표 근육에 따라 다양한 자세와 강도가 적용되어야 함을 의미한다.

• Physical Therapy Rehabilitation Science
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• 제7권1호
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• pp.35-40
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• 2018

Objective: The purpose of this study was to investigate the immediate effect of applying self-myofascial release (SMR) to the plantar fascia using a foam roller on hamstring and lumbar spine superficial back line (SBL). Design: Randomized controlled trial. Methods: Thirty-one healthy adults agreed to the method and purpose of the study. Selection and exclusion criteria were screened, and baseline measurements for the Toe Touch test and passive straight leg raise (PSLR) test were obtained. The participants were then randomly assigned to the SMR group or the sham group. After group assignment, the SMR group rolled the surface of the foot from the heel to the metatarsal head using a foam roller for 5 minutes. The sham group received passive mobilization of the ankle joint in the supine position. Afterwards, the Toe Touch test and the passive straight leg-raise test were re-assessed. Results: In the SMR group, the Toe Touch test results showed significant improvement (p<0.05). Left and right PSLR test results showed a significant increase (p<0.05). In the sham group, there was no significant difference between pre and post-test results. The SMR group showed a significant difference in the PSLR test and Toe Touch test compared to the sham group (p<0.05). Conclusions: The results of this study showed that SMR on the plantar fascia was immediately effective for improving the flexibility of the SBL of the lumbar spine and hamstring.

• 대한간호학회지
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• 제36권2호
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• pp.341-352
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• 2006

Purpose: This study was conducted to develop & to determine the effect of an tailored falls prevention exercise for older adults. Method: Subjects consisted of 59 older adults (experimental group : 29, control group : 30) living at nursing homes. Experimental group participated in tailored falls prevention exercise for 16 weeks(3 times a week, 50 min every session). Data were collected before the exercise, 16 weeks & 24 weeks after the beginning of exercise. Results: 1) the experimental group significantly improved the muscle strength of hip extensor & flexor, knee extensor & flexor, ankle dorsiflexor, & plantar flexor compared to the control group. 2) the experimental group significantly decreased the mean time for 10 times chair stand. 3) the experimental group significantly increased the standing time on one leg and the number of heel raise for 30 seconds compared to the control group. In addition more older adults in the experimental group completed the tandem stance & semi-tandem stance for 10 seconds than the control group. 4) The experimental group significantly decreased the mean time of 6m walk and the fall frequency compared to the control group. Conclusions: This results suggest that tailored falls prevention exercise for older adults can improve muscle strength, static & dynamic balance and decrease the fall frequency of older adults.

• The Journal of Korean Physical Therapy
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• 제30권2호
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• pp.63-66
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• 2018

Purpose: The purpose of the current study was to examine the effects of exercise-induced fatigue of the plantar flexor muscle in the dominant ankle on the plantar flexor strength and postural control function of the contra-lateral side. Methods: Twenty-one young adults (male: 10, female: 11) volunteered to participate in this study. An exercise-induced fatigue protocol to induce fatigue was performed in the plantar flexor of the dominant ankle. For the fatigue protocol, the participants were instructed to raise their heels as high as possible in the position with one leg stance of the dominant lower limb, and the heel was then downed after holding for 1 second. The muscle strength of the contra-lateral plantar flexor was measured using a digital muscle strength test device, and the static and dynamic postural control were tested by acquiring the center of gravity velocity while performing one leg standing. A paired t-test was used to identify the differences between the pre- and post, and the data were analyzed using SPSS 12.0 software. Results: Comparison of the pre- and post-test data revealed a significant difference in the plantar flexor strength and dynamic postural control after exercise-induced muscle fatigue in the dominant side. On the other hand, there was no significant difference in the static postural control. Conclusion: These findings have practical implications, suggesting that unilateral muscle fatigue affects the ankle muscle strength and postural ability of the contralateral side.