• The Journal of Korean Physical Therapy
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• v.9 no.1
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• pp.127-145
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• 1997

The purpose of this study wa9 to analyse the gait patterns of two female children with hemiplegic cerebral palsy by using the three-dimensional video motion analysis technique. Case 1 has mild spastic hemiplegia on the right side while Case 3 has moderate spastic hemiplegia on the left side. A group of 10, normal female children of the same age(7-8 years old) were selected as the control group for comparison. Time and distance variables as well as the Center of Mass displacement, and the pelvic and joint motions in three anatomical planes were analysed for this purpose. The following observations were made through the analysis : Case 1 revealed an asymmetrical gait pattern in which the step length of the unaffected side was shorter than that of the affected side, which wan a result of the effort to minimize loading on the affected leg by shortening the swing phase of the unaffected leg. Case 1 scored similar phase ratios, cadence and walking velocity to the normal group. A slight posterior tilt of the pelvis was observed throughout the gait cycle. Less hip and knee flexion than the normal group was observed, and demonstrated hyperextension of the knee in the terminal stance phase. The main problem in case 1 originated from the insufficient dorsiflexion of the affected foot during the swing phase. Therefore, Case 1 has difficulty with foot clearance in the swing phase. Usually, this is compensated for by using exessive hip abduction and medial rotation in conjuction with trunk elevation as well as increased vortical displacement of the center of mass. Case 1 revealed a foot-flat initial contact pattern. Case 2 was characterized by a consistent retraction ef the affected aide of the body througout the gait cycle, As a result, an asymmetrical gait pattern with increased stance phase ratios of the unaffected side was observed. In spite of this the step lengths of both sieds were similar. Case 2 scored lower cadence and walking speed than the normal group with lower gait stability. The main problem in Case 2 originated from an excessive plantaflexion of the affected foot which, in turn, rebutted in high hip and knee flexion. Hyperextension of the knee was observed at mid-stance, and execessive anterior tilt of the pelvis throughout the gait cycle was noticed. A gait pattern with high hip abduction and medial circumduction was maintained for the stability in the stance phase and foot clearance in the swing phase. Case 2 revealed a forefoot-contact initial contact pattern.

• Physical Therapy Korea
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• v.20 no.1
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• pp.64-73
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• 2013

The purposes of this study were to develop a new orthosis controlling ankle and knee joint motion during the gait cycle and to identify the effects of the newly designed orthosis on gait kinematics and tempospatial parameters, including coordination of the extremities in stroke patients. Fifteen individuals who had sustained a stroke, onset was 16 months, participated in this study. Before application of the measurement equipment the subjects were accustomed to walking on the ankle-foot orthosis (AFO) or stance control knee with knee flexion assisted-oil damper ankle-foot orthosis (SCKAFO) for 5 minutes. Fifteen patients were investigated for 45 days with a 3-day interval between sessions. Measurements were walking in fifteen stroke with hemiparesis on the 3D motion analysis system. Comparison of AFO and SCKAFO are gait pattern. The difference between the AFO and SCKAFO conditions was significant in the gait velocity, step length of the right affected side, stance time of both legs, step-length asymmetry ratio, single-support-time asymmetry ratio, ${\phi}$-thigh angle and ${\phi}$-shank angle in the mid swing (p<.001). Using a SCKAFO in stroke patients has shown similar to normal walking speeds can be attained for walking efficiency and is therefore desirable. In this study, the support time of the affected leg with the SCKAFO was longer than with the AFO and the asymmetry ratio of single support time decreased by more than with the AFO. This indicates that the SCKAFO was effective for improving gait symmetry, single-support-time symmetry. This may be due to the decrease of gait asymmetry. Thus, the newly designed SCKAFO may be useful for promoting gait performance by improving the coordination of the extremity and decreasing gait asymmetry in chronic stroke patients.

• 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.

• The Journal of Korean Physical Therapy
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• v.24 no.2
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• pp.163-169
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• 2012

Purpose: The present study was designed to investigate the effect of trunk control training on the labile surface on relative impulse and balance in stroke patients. Methods: A total of 21 participants were assigned to an experimental group (n=11) or a control group (n=10). In addition to conventional therapy, the experimental group received trunk control training on the swiss ball; 20 minutes, 4 times a week, for 8 weeks. Balance ability was evaluated by FRT (functional reaching test) and TUG (time up and go). In addition relative impulse in 6 areas of the foot (hallux, 1st metatarsal head, 2~3 metatasal head, 4~5 metatasal head, mid foot and heel) were measured using the F-scan system to evaluate locomotion ability during gait. Results: Significant differences in the relative impulse were observed in the areas of the 2~3 metatasal head during gait after exercise in both the control group and experimental group (p<0.05). Also, a significant increase was seen in the hallux after exercise in the experimental group (p<0.05), but no such significant increase was seen in the control group (p>0.05). Significant differences were observed in FRT and TUG in the experimental group but no such significant increase was observed in the control group (p>0.05). Conclusion: These results suggest that trunk control training on labile surface improves the balance in stroke patients and has a positive effect on locomotion ability.

• Journal of Korean Foot and Ankle Society
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• v.16 no.3
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• pp.169-174
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• 2012

Purpose: There are various methods proposed for the evaluation of the hindfoot alignment. However, due to structural calcaneus variances between patients, it is hard to assess this alignment definitively. Thus, this study proposes a new method for evaluating of the hindfoot alignment and its comparisons to the existing current methods. Materials and Methods: This study includes simple weight bearing hindfoot coronal view radiographs of 120 patients, taken between the time period of March 2008 to November 2009. Among the 120 patients, there was a 1:1 ratio of male to female with an average age of 40. The newly proposed method for evaluating this alignment is to draw a moment arm from the point where the sustentaculum tali meets the medial calcaneus border to the most prominent aspect of the lateral process of the calcaneal tuberosity. The angle produced via the intersection of this moment arm to the mid-longitudinal axis of the tibia is found and used to evaluate the hindfoot alignment. The inter and intra-observer reliability was evaluated using the coefficient of intraclass correlation. This study also investigates the comparisons between the newly proposed method to the traditionally used Saltzman et al hindfoot alignment evaluating technique. Results: The newly proposed method has higher inter and intra-observer reliability than the existing traditional Saltzman et al technique. Conclusion: This new method is recommended over the traditionally used Saltzman et al technique as it has a stronger confidence level and is appropriate for assessing hindfoot alignment in simple radiographs.

• Journal of Korean Foot and Ankle Society
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• v.18 no.4
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• pp.195-201
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• 2014

Purpose: The purpose of this study is to develop guidelines for clinical trial of the total ankle replacement system for premarket approval. Materials and Methods: We selected and analyzed nine peer-reviewed articles whose quality had been proven in a previous phase. Two investigators extracted parameters for guideline criteria, including number of cases, patient age, follow-up period, failure rate, radiographic osteolysis rate, residual pain rate, and percentage of satisfaction. In addition, the inclusion and exclusion criteria were analyzed and developed. Results: Eight level IV studies and one level II study were included. The average number of cases was 159 cases and the mean patient age was 63.5 years. The mean follow-up period was 4.2 years, ranging from two to nine. The average failure rate of total ankle replacement in mid- to long-term follow-up was approximately 13% (2%~32.3%). The rate of osteolysis was approximately 18%. Residual pain was common (21.4%~46%), but overall patient satisfaction was approximately 85.6% (67.5%~97%). Conclusion: The results could be used as criteria for designing the clinical studies, such as number of cases, patient age (over 60 years), and follow-up period (minimum two years). The clinical scoring system and 36-item short form health survey (SF-36) was the most commonly used method for clinical evaluation for total ankle arthroplasty. In addition, the overall results, including failure rate, osteolysis rate, and patient satisfaction, could be used as a parameter of guidelines for premarket approval.

• Journal of the Korean Society for Precision Engineering
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• v.17 no.4
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• pp.220-225
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• 2000

This paper develops a finite element model for studying occupant behavior of a mid-size truck equipped with a driver side airbag. The developed model simulates an occupant behavior using PAM-CRASH/PAM-SAFE in super computer SP2. The model is developed based on a sled test. A 50% hybrid dummy III is used for measuring head and chest accelerations and femur loads, and major injury coefficients such as HIC, CA and femur load. Inferior components such as foot rest, seat, kneebolster, crash pad, etc. are roughly modeled and defined by a rigid material model. And contact type II is used for detecting a contact with dummy. Contact type II definition uses force-deflection relationship of each body Such components as steering column which directly affect on the occupant injuy are modeled in detail and defined by an elastic-plastic material model. Airbag cushion is modeled using rivet elements. Airbag cover groove is modeled using rivet elements. Airbag tether is modeled as nonlinear bar elements. Airbag model has two vent holes to ventilating the exploded gas. Airbag is folded close to the real airbag folding procedure, and folded cautiously in order not to have initial penetration. A vehicle pulse acquired from 31mph frontal barrier test is used as input signal for the simulation. The simulation conditions are tuned to the sled test ones. The measured dummy accelerations and major injury coefficients, and filmed dummy behavior and airbag inflation process using high speed camera are compared to the simulation results to verify the developed finite element model.

• Korean Journal of Applied Biomechanics
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• v.22 no.1
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• pp.83-94
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• 2012

The purpose of this study was to analyse the effect of posture correction & stabilization according to horse rider's(n=10) skill levels of novice(0wk), mid-skill(12wk) & skill(24wk) in walk & trot. First, Mean posture of 3 times experiments; Anterior & posterior leaning posture of trunk showed rather unstable according to progress of the stages of TD1, TO, TD2 phase, and also shoulder & elbow angle, which effects to the distance from bit to rein, showed unstable riding posture. There was close relationship between shoulder and elbow Angle in walk and hip, knee & ankle angle in trot. Second, Posture correction & stabilization according to riding skill levels; Anterior & posterior leaning posture of trunk did not show significant difference statistically but showed approaching tendency to trunk's vertical line and showed significant difference(p<.05) according to improvement of skill levels in walk & trot horse riding. Hip angle showed significant difference according to progress of the stages of TD1, TO, TD2 phase(p<.05) and showed tendency maintaining the larger thigh flexion according to improvement of skill levels in walk & trot. Knee angle showed more stable posture by maintaining the larger flexion between thigh and shank according to improvement of skill levels in walk & trot(p<.05). Ankle angle also showed tendency maintaining the larger plantar flexion of foot according to improvement of skill levels in walk & trot. When considering the above, regular horse riding program could be useful in posture correction & stabilization according to improvement of skill levels of novice(0wk), mid-skill(12wk) & skill(24wk) in walk & trot.

• 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.

• Physical Therapy Korea
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• v.3 no.1
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• pp.65-72
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• 1996

The purpose of this study was to introduce rotation-plasty procedure and prosthetic ambulation training. The recent development of chemotherapy and diagnostic facility have permitted the orthopaedic surgeons to try limb saving procedures rather than amputations for the treatment of the malignant bone tumors. If the tumors around the knee joint were treated by mid-thigh amputation or hip disarticulation, it would impose the client with a great handicap for rehabilitation. Rotation-plasty procedure was first done by Borggreve, in 1930 for the congenital short femur. Recently this procedure was used a malignant bone tumor at the distal femur by Kotz and Salzer in 1982. In spite of its cosmetic problem of the distal stump, this procedure has the great functional advantage of converting the above-knee amputation to the below-knee amputation. The inverted foot was also good to control the prosthesis as a below-knee stump and heel functioned as a patella to support the body weight. This 15 years old girl case was had rotation-plasty due to osteosarcoma of the distal femur with 3rd postoperative chemotherapy, and admitted to Yonsei rehabilitation hospital for prosthetic ambulation training. Then, the case had excellent functional results of prosthetic ambulation training with rotaion-plasty after 3 months.