We report a case of a healthy 38-year-old man presenting with insufficiency fracture of proximal tibia associated with unrecognized osteoporosis. Radiologic bone DEXA (Dual Energy X-ray Absorptiometry) assessment revealed osteoporosis, but the patient displayed no apparent risk factors for insufficiency fractures and osteoporosis except for a history of smoking. Following right proximal tibial open reduction and internal fixation, the patient commenced smoking cessation and began taking alendronate. The patient was treated for gait rehabilitation, which included quadriceps strengthening exercises and his condition improved with independent walking. This report highlights an unusual site of proximal tibial insufficiency fractures and the potential effect of smoking on low bone mineral density in a young male patient.
Objective: The purpose of this study was to identify the effects of taping therapy and inner arch support on pes planus lower extremity alignment and gait. Method: The study was conducted on 13 women in their 20s who had pes planus and no gait problems. Independent variables were the condition of wearing basic socks (S1) and the condition of wearing socks with taping therapy and inner arch support (S2). The dependent variables were resting calcaneal stance position (RCSP), plantar pressure distribution during gait, and underlying and medial longitudinal arch angle measured using radiography. Statistical analysis was performed using the Wilcoxon test with SPSS 23.0 for comparison of S1 and S2. Results: In the RCSP measurement, the angle range of S2 changed to normal. Meary's angle appeared to be less than the angle of S1, indicating alleviation of the degree of pes planus. The calcaneal pitch angle increased at S2 from that at S1. The plantar pressure distribution was divided into four areas (toe, forefoot, midfoot, and hindfoot). At S2, the maximum pressure increased in the toe and midfoot. The maximum force increased significantly in the toe and midfoot but decreased significantly in the forefoot and hindfoot. In addition, the contact area increased overall especially at the midfoot and hindfoot. Contact time decreased in the toe and forefoot, but increased in the midfoot and hindfoot. Conclusion: Taping therapy and inner arch support showed structural improvement of the pes planus. In addition, the force and pressure applied to the foot during walking are distributed evenly in the area of the sole, thus positively affecting walking.
In the patients with hemiplegia caused by stroke and TBI. postural sway is increased and open displaced laterally over the non-affected leg, reflecting asymmetry in weight bearing on lower extremities during standing balance. Recovery of symmetric weight bearing and postural stability is an important aim in physical therapy. Plastic AFO has been used for hemiplegic patients in order to help their abnormal walking patterns. Past studies have mainly focused on the AFO influences on hemiplegic walking patterns without balance function approaches. The purpose of this study was to identify the immediate effects of plastic AFO and shoes on the static balance in hemiplegic patients. The scale for static balance were weight bearing on affected leg(%), sway area(mm2), sway path(mm), maximal sway velocity(mm/s), anteroposterior sway angle($^{\circ}$ ), and lateral angle($^{\circ}$ ). Seventeen hemiplegic patients participated in this study: 13 men and 4 women, with an average age of 50.18 years. Static balance was measured using BPM(balance performance monitor; dataprint software version 5.3) under four standing condition namely bare-foot standing. standing in shoes, standing with AFO, and standing in shoes with AFO. In order to assure the statistical significance of the results, an one-way ANOVA, the independent t-test. and a pearson's correlation were applied at the .05 level of significant. The results of this study were as follows: 1) There were statistically significant differences in weight bearing(%) on the static balance between affected leg and non-affected leg(p<.01). 2) There were statistically significant differences in sway reverse frequence(Hz) in standing with AFO between affected leg and non-affected leg(p<.05). 3) Sway area(mm2) on standing in shoes with AFO was lower than bare-foot standing(p<.05), Lateral sway angle($^{\circ}$ ) on standing in shoes with AFO was lower than bare-foot standing and standing in shoes(p<.05). 4) Weight bearing in affected leg was not significantly correlated with postural sway.
This study was conducted to find out current status and characteristics, so that the result could provide basic data to establish prevention programs for hip fracture among the elderly. The data were coolected from 199 cases hospitalized in 4 university hospitals in Pusan during three years period from January, 1966 to December, 1998. The data were obtained from medical records and by using questionnaires through telephone contact or direct personal interview with the subjects or their family, and were analyzed with x2-test. The results were as follow: The mean age of elderly hip fractured cases was 75.7 years, and 61.8% were female. The average hospital stay of the cases was 30.8 days, and 73.9% survived. Femur neck fracture cases comprised 51.7% of the toral cases, while trochanteric fracture cases comprised 48.3%. The hip fracture occurred more frequently during the day, shown as 66.9%, and the most frequently due to trips(44.2%), followed by slips(322%), c1ash(14.6%), dizziness(7.5%), and 00 on. Femur neck fracture, however, occurred the most frequently due to trips(51.5%) and, on the other hand, trochanteric fracture due to slips(40.6%) and trips(36.5%). About two third of hip fracture(67.8%) occurred inside of the building. The most frequently mentioned location for hip fractures was rooms or floors(32.1%), followed by streets(24.1%), bathrooms(17.6%), stairways(13.1%), and so on. Trochanteric fracture, especially, more frequently occurred inside of the building(71.9%) as compared to femur neck fracture(64.1 %). The rate of independent indoor walking in femur neck fractured cases reduced from 88.3% to 74.8% after fracture incidences, while the rate reduced from 86.0% to 45.8% in trochanteric fracture cases. It indicated that trochanteric fractures affected the walking ability of the elderly more severely that femur neck fractures. In conclusion, hip fracture occurs as a combined result of aging characteristics, environmental factors, and health related characteristics. Future studies that investigaterisk factors of hip fracture in elderly are recommended.
The purpose of this study was to determine the differences in joint moment in the intact limb of uni-transfemoral amputees and to identify the implications of knee osteoarthritis. As an experimental method, three-dimensional gait analysis was performed on 10 uni-transfemoral amputees and 10 healthy males. Kinematics and kinetics at the hip, knee, and ankle joint were calculated. As a statistical method, independent t-tests were conducted to perform a comparison between the transfemoral amputee group and the control group. The results showed that the external knee adduction moment increased in the transfemoral amputee group (.22 Nm/kg) compared with that of the control group (.13 Nm/kg) at terminal stance (p=.008). External knee flexion moment also increased in the transfemoral amputee group (.24 Nm/kg) but this difference was not statistically significant. External hip flexion moment increased in the transfemoral amputee group (1.35 Nm/kg) compared with that of the control group (.45 Nm/kg) at initial stance, and external hip extension moment decreased in the transfemoral amputee group (-.26 Nm/kg) compared with that of the control group (-.76 Nm/kg) at terminal stance. Although external ankle plantarflexion moment of the transfemoral amputee group increased, it was not found to be statistically significant. The results suggest that the intact limb joint moment of the uni-transfemoral amputees during walking can be different from that of healthy subjects. In conclusion, it was found that there is a link between the increase of external knee adduction moment and the prevalence of knee osteoarthritis in uni-transfemoral amputees. This result is expected to provide some objective data for rehabilitation programs related to knee osteoarthritis in transfemoral amputees.
This study is designed to develop a walker to assist the elderly in safe, independent walking. To this end, problems were identified through analysis of the walker for the elderly and user observations were used to identify problems and needs. The product analysis showed that most elderly walkers tend to prioritize their functions. In addition, user observations showed that most users had positive perceptions about the function, but that structural aspects, such as operation methods and stability, had negative consequences. A total of five design guidelines were derived based on the problems and needs derived. The design guidelines were designed to focus on improving structural problems rather than functional parts, and to orientate safety over functional priorities. Five design guidelines derived from this study could be used as basic data for the manufacture of walkers that reflect the views and needs of the elderly in the future in the manufacture and design of walkers for the elderly.
Objective: This study was to investigate the effects of Task-oriented training for Gross Motor Function Measure (GMFM), gait and balance function in cerebral palsy. Design: Randomized controlled trials. Methods: Twenty four subjects were recruited by means of a convenience sampling from Kangseo-Gu G rehabilitation center. Subjects were 24 inpatients and were randomly divided into a task-oriented training group and a conventional group. Twelve patients were experimental group who executed the task-oriented training (5 times/wk) for 4 weeks. The task-oriented program mainly focused on the capabilities of independent walking, with the angle of inclination set at 0 degrees and walking at a self-selected comfortable speed. In addition, balance training included the one-legged standing with weight-shifting and task-oriented training. Twelve patients were control group who executed only general conventional therapy (5 times/wk) for 4 weeks. All subjects were evaluated about the motor function, gait and balance function. Subjects have conducted the measured variables, GMFM, GAITRite, PDM Multifunction Force Measuring Plate after treatment. Results: There was statistically significant increase of Gross Motor Function Measure scores of the experimental group and control group after 4 weeks (p<.05). There was statistically significant increase of gait and balance function of the experimental group after 4 weeks of task-oriented training (p<.05). The experimental group showed a significantly improvement in GMFM, gait, and balance compared to the control group (p<0.05). Conclusions: This study proved that task-oriented training after stroke can improve Gross Motor Function Measure, gait and balance. Thus this study can suggest that task-oriented training for gross motor function, gait and balance be effective on the cerebral palsy.
Journal of The Korean Society of Integrative Medicine
/
v.8
no.1
/
pp.1-14
/
2020
Purpose : The purpose of this study was to investigate the effect of an exercise program with patella mobilization on range of motion, muscle strength, and gait in patients with total knee arthroplasty. Methods : Thirty patients under the age of 65 who visited the T hospital in Daegu Metropolitan City and underwent total knee arthroplasty surgery were selected for this study. Fifteen patients were randomly assigned to the experimental group and took part in an exercise program with patella mobilization, and fifteen patients were randomly assigned to the control group and took part in just the exercise program. Each group took part in their intervention three times a week for four weeks. The measurement tools used included a goniometer, handheld dynamometer, and 10-meter walking test. In the statistical analysis results, to compare the about pre and post test differences within each group, a paried t-test was used, and to compare the differences between each group, an independent t-test was used. Results : There was a significant difference (p<.05) in the range of motion, muscle strength of the quadriceps femoris and, hamstrings, and 10-meter walking test within each individual group and between the two groups before and after the intervention (p<.05). Conclusion : All the results for the experimental group were significant. Therefore, it is expected that an exercise program with patella mobilization will be helpful for the recovery of the knee joint in patients who have undergone total knee arthroplasty.
Purpose: The purpose of this study was to analyze the changes of the relative impulse of the foot when carrying 5 types of schoolbag during level walking. Methods: Forty-four normal subjects were divided into 5 groups according to the method of carrying a bag: carrying no bag (condition 1), a backpack (condition 2), a shoulder bag (condition 3), a cross bag (condition 4) and a one-hand bag (condition 5). To evaluate the partial relative impulse, 7 areas were measured on the sole of a foot: the hallux, toe, 1st metatarsal head (Met1) and the 2nd & 3rd metatarsal heads (Met2/3), the 4th & 5th metatarsal heads (Met4/5), mid foot and heel. Repeated one-way analysis of variance (ANOVA) and independent t-tests were used to analyze the statistical data. Results: In the right foot, the relative impulses in every areas revealed no significant difference (p>0.05), however, the relative impulses at Met1, Met2/3, Met4/5 and heel were significantly different between the different conditions (p<0.05). There were significant differences on comparing the relative impulse between left and right foot within one condition, the mid foot in condition 2, as well as the hallux and Met1 in condition 3 (p<0.05). In condition 4, the toe, Met1, Met4/5 and mid foot were significantly different (p<0.05). The values at the hallux, toe and Met1 in condition 5 also were significantly different (p<0.05). Conclusion: These findings showed that the symmetrical relative impulse of the foot was present in the case of carrying a backpack, but there was an extra load on specific regions and asymmetrical relative impulses in the case of carrying a shoulder bag, a across bag and a one-hand bag. (ED note: this abstract is not clear. You need to work on it.)
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.19
no.1
/
pp.49-54
/
2013
Background: The purposed of this study is to examine the static and dynamic plantar foot pressure in chronic low back pain patients and normal adults. Methods: The subjects were divided into a group of 30 patients with chronic low back pain and a control group of 30 healthy persons. While static posture and dynamic posture at comfortable walking speeds, the low back pain group and the control group measured their plantar foot pressure and the trajectory of their center of pressure (COP) using the Matscan(R) system. Independent t-tests were measured to compare differences in plantar foot pressure characteristics between the left side and right side of the low back pain group and the control group. Results: In the comparison of differences in plantar foot pressure characteristics between the left side and right side of the low back pain group and the control group, the anteroposterior (AP) displacement of COP showed significant differences (p<.05). Although the low back pain group and the control group did not show any significant differences in leg length, weight distribution, mediolateral (ML) displacement of COP, static contract area, dynamic contract areas (p>.05), increases in the contract area values were shown in the hind foot in general. Conclusion: In this study, it was shown that patients with chronic low back pain were walking with short AP displacement of the COP as a compensatory action to avoid pain.
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