• Journal of the Korean Society of Radiology
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• v.82 no.3
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• pp.541-550
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• 2021

The below-the-knee arterial tree is the thinnest of all the leg vessels and is an important path for blood flow to the foot. Hence, lesions including stenosis, especially obstruction, may lead to critical limb ischemia which represents the most severe clinical manifestation of peripheral arterial disease. It is characterized by the presence of ischemic rest pain, ischemic lesions, or gangrene attributable to the objectively proven arterial occlusive disease. Typically, the atherosclerotic disease process involving the below-the-knee arterial tree is diffuse in the majority of patients. The cornerstone of therapy is vascular reconstruction and limb salvage. Revascularization should be attempted whenever technically possible, without delay, in patients presenting critical limb ischemia and when the clinical status is not hopelessly non-ambulatory. Therefore, endovascular treatment can become the gold standard for the full range of patients including below-the-knee, limiting the clinical role of the classically trained surgeons.

• Korean Journal of Applied Biomechanics
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• v.12 no.1
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• pp.47-61
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• 2002

The purpose of this study was to determined the force and moment of the ankle and the knee joint at different step length relative to the length of the lower extremity during a steady running. Six digital cameras(Qualisis) and a forceplatform(A.M.T.I) were used to obtain the kinematic data of the segments and kinetic data on the running at speed of 5.18m/s. The force and moment measured from six subjects participated in this study were limited to the support phase and their values were averaged at the moment of heel strike, mid stance, and toe off of a running for making a comparison between the condition 1(relative step length 1.1) and the condition 2(relative step length 1.4). It was concluded that internal forces except mediolateral force of the condition 2 were greater in the ankle and the knee joint than those of the condition 1, but all moments of condition 2 were greater from the descriptive statistic point of view. For the future study, it was needed to consider a number of subjects, a various running speed, and a individual step preference for applying generally results to the running strategy.

• Journal of Korean Physical Therapy Science
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• v.15 no.3
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• pp.55-63
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• 2008

Background : The Purposes of this study were to understand difference between free walking and obstacle over walking through the naked eye and motion analysis device, and to review merits of obstacle walking training as item of functional assessment in clinical situations. Methods : All participants were male and performed 3 types of walking methods: free walking, obstacle over walking with low block(height=10cm, width=8cm), and obstacle over walking with high block(height=20cm, width=8cm). All walking were performed 3 trials respectively. Results : In the naked eye, initial contact with toes occurred more than heel strike in obstacle over walking, and the flexion angle of hip and knee were increased in obstacle over walking. On interpretations though motion analysis device, cadence, gait speed and weight accept were significant statistically(p<.05). Cadence and gait speed were decreased, and weight accept duration was increased in obstacle over walking. Rotation among three pelvic motions was significant statistically(p<.05), flexion among three hip motions was significant statistically(p<.05) and flexion among three ankle motions was significant statistically(p<.05). Rotation and flexion among three ankle motions was significant statistically(p<.05). Conclusion : Both the naked eye and interpretations of the device presented many difference between free walking and obstacle over walking. In overcrossing obstacles, many participants appeared walking strategy by perform initial contact with toes. Knee flexion was most significant statistically(p<.05) in obstacle over walking with 20cm block.

• Korean Journal of Applied Biomechanics
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• v.31 no.2
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• pp.79-86
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• 2021

Objective: The purpose of this study was to identify the effect of reduced plantar cutaneous sensation on gait kinematics during walking with and without CAI. Method: A total of 20 subjects involved in this study and ten healthy subjects and 10 CAI subjects participated underwent ice-immersion of the plantar aspect of the feet before walking test in this study. The gait kinematics were measured before and after ice-immersion. Results: We observed a before ice-immersion on plantar cutaneous sensation, CAI subject were found to reduced ankle dorsiflexion, knee external rotation, hip adduction, and internal rotation compared to control subject. After ice-immersion, CAI subjects were found to reduce knee external rotation, hip adduction. However, no significant ankle joint kinematics. Conclusion: While walking, gait pattern differences were perceived between groups with and without plantar cutaneous sensation. The results of the study may explain the abductions in the hip angle movements in CAI patients at initial contact compared to healthy subjects in the control group when plantar cutaneous sensation was reduced. A change in proximal joint kinematics may be a conservative strategy to promote normal gait patterns in CAI patients.

• Physical Therapy Korea
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• v.11 no.1
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• pp.53-67
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• 2004

This simulation study investigated the characteristics of normal gait, $30^{\circ}$ crouch gait, $30^{\circ}$ crouch/equinus gait, $45^{\circ}$ crouch gait, $45^{\circ}$ crouch/equinus gait. The knee flexion angles were restricted using a specially designed orthosis. This study was carried out in a motion analysis laboratory of the National Rehabilitation Center. Fifteen healthy male subjects were recruited for the study. The purposes of this study were (1) to compare spatiotemporal parameters, kinematics, and kinetic variables in the sagittal plane among the different gait, (2) to investigate the secondary compensatory strategy, and (3) to suggest biomechanical physical therapy treatment methods. The pattern and magnitude observed in each condition were similar to those of normal gait, except the peak knee extension moment of the unrestricted ankle motion-crouch gait. However, the speed of the $45^{\circ}$ crouch gait was half that of a normal gait. The ankle joint moment in the crouch/equinus gait showed the double-bump pattern commonly observed in children with spastic cerebral palsy, and there was no significant difference in gait speed as compared with normal gait. The peak ankle plantar-flexor moment and ankle power generated during the terminal stance in the crouch/equinus conditions were reduced as compared with normal and $45^{\circ}$ crouch gaits (p<.05). The crouch/equinus gait at the ankle joint was an effective compensatory mechanism. Since ankle plantarflexion contracture can be exacerbated secondary to the ankle compensatory strategy in the crouch/equinus gait, it is necessary to increase the range of ankle dorsiflexion and the strength of plantarflexion simultaneously to decrease the abnormal biomechanical advantages of the ankle joint.

• Korean Journal of Applied Biomechanics
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• v.22 no.3
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• pp.315-324
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• 2012

The purpose of current study was to investigate the effects of the heights on the lower extremities, torso and neck segments for energy dissipation during single-leg drop landing from different heights. Twenty eight young healthy male subjects(age: $23.21{\pm}1.66yr$, height: $176.03{\pm}4.22cm$, weight: $68.93{\pm}5.36kg$) were participated in this study. The subjects performed the single-leg drop landing from the various height(30, 45 & 60 cm). Force plates and motion-capture system were used to capture ground reaction force and kinematics data, respectively. The results were as follows. First, the ROM at the ankle, knee, hip and trunk was increased with the increased heights but the ROM at the neck was increased in the 60cm. Second, the angular velocity, moment and eccentric work at the ankle, knee, hip, trunk, and neck was increased with the increased heights. Third, the contribution to total work at the knee joint was not significantly different, while the ankle joint rate was decreased and hip and neck rate was increased in the 60cm, and trunk rate was increased with the increased heights. Lastly, the increase in landing height was able to augment the level of energy dissipation not only at the lower extremities but also at the trunk and neck. The findings showed that drop landing affect trunk and neck with lower extremity joints. Therefore, we need to consider that trunk and neck strengthening including stability should be added to reduce sports injury during prevention training.

• 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.

• Korean Journal of Applied Biomechanics
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• v.19 no.1
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• pp.27-36
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• 2009

The purpose of this study was to identify effects of restricted trunk motion on the performances of the maximum vertical jump. Ten healthy males performed normal countermovement jump(NJ) and control type of countermovement jump(CJ), in which subjects were required to restrict trunk motion as much as possible. The results showed 10% decreases of jumping height in CJ compared with NJ, which is primarily due to vertical velocity at take off. NJ with trunk motion produced significantly higher GRF than RJ, especially at the early part of propulsive phase, which resulted from increased moments on hip joint. And these were considered the main factors of performance enhancement in NJ. There were no significant differences in the mechanical outputs on knee and ankle joint between NJ and RJ. With trunk motion restricted, knee joint alternatively played a main role for propulsion, which is contrary on the normal jump that hip joint was highest contributor. And restricted trunk motion resulted in the changes of coordination pattern, knee-hip extension timing compared with normal proximal-distal sequence. In conclusion these results suggest that trunk motion is effective strategy for increasing performance of vertical jumping.

• Korean Journal of Applied Biomechanics
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• v.29 no.4
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• pp.255-261
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• 2019

Objective: The purpose of this study was to investigate differences of shock attenuation strategies between double-leg and single-leg landing on sagittal plane using statistical parametric mapping. Method: Nine healthy female professional soccer players (age: 24.0±2.5 yrs, height: 164.9±3.3 cm, weight: 55.7±6.6 kg, career: 11.2±1.4 yrs) were participated in this study. The subjects performed 10 times of double-leg and single-leg landing from the box of 30 cm height onto force plates respectively. The ground reaction force, angle, moment, angular velocity, and power of the ankle, knee, and hip joint on sagittal plane was calculated from initial contact to maximum knee flexion during landing phase. Statistical parametric mapping was used to compare the biomechanical variables of double-leg and single-leg landing of the dominant leg throughout the landing phase. Each mean difference of variables was analyzed using a paired t-test and alpha level was set to 0.05. Results: For the biomechanical variables, significantly increased vertical ground reaction force, plantarflexion moment of the ankle joint, negative ankle joint power and extension moment of the hip joint were found in single-leg landing compared to double-leg landing (p<.05). In addition, the flexion angle and angular velocity of the knee and hip joint in double-leg landing were observed significantly greater than single-leg landing, respectively (p<.05). Conclusion: These findings suggested that negative joint power and plantarflexion moment of the ankle joint can contribute to shock absorption during single-leg landing and may be the factors for preventing the musculoskeletal injuries of the lower extremity by an external force.

• Korean Journal of Applied Biomechanics
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• v.22 no.4
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• pp.379-386
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• 2012

The aim of this study was to investigate and identify the differences in lower extremity energy dissipation strategies between drop-landing and countermovement-jump maneuvers. Fourteen recreational athletes(Age : $23.3{\pm}2.1years$, Height : $172.3{\pm}4.0cm$, Weight : $69.2{\pm}4.7kg$) were recruited and instructed to perform drop-landing from 45 cm height and countermovement-jump from 45 cm to 20 cm height. The landing phase was taken as the time between initial contact and peak knee flexion. A motion-capture system consisting of eight infra-red cameras was employed to collect kinematics data at a sampling rate of 200 Hz and a force-plate was used to collect GRF data at a sampling rate of 2000 Hz. Paired t-test was performed to determine the difference in kinematics and kinetics variables between each task. During the countermovement-jump task, all of lower extremity joint ROM and the hip joint eccentric moment were decreased and the ankle joint plantarflexion moment was increased than drop-landing task. In the eccentric work during countermovement-jump task, the ankle joint displayed greater while knee and hip joint showed lesser than drop-landing. Therefore, the knee joint acted as the key energy dissipater during drop-landing while the ankle joint contributed the most energy dissipation during countermovement-jump. Our findings collectively indicated that different energy dissipation strategies were adopted for drop-landing and countermovement-jump.