• 대한인간공학회지
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• 제32권6호
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• pp.489-494
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• 2013

Objective: This study compared the effects of streamlined shoes on dynamic gait and foot plantar pressure in healthy young adults. Background: With the importance of ankle and lower extremity mechanism, streamlined shoes are contributing to a static gait factors. However, the study of dynamic gait factor is still insufficient. Method: Sixty subjects were randomly allocated to two groups: experimental group(n=30) and control(n=30), respectively. The experimental group performed streamlined shoes, whereas the control group applied usual shoes. Main outcome measurements were assessed contact time, step length and foot plantar pressure using gait analysis with the treadmill. Independent t-test was used to compare the both groups. Results: Compared with control group, contact time of forefoot, midfoot and hindfoot decreased significantly in experimental group(p<.05), Step length increased significantly in experimental group(p<.05). Foot plantar pressure of midfoot and hindfoot increased significantly in experimental group(p<.05), whereas that of forefoot did not show significantly in experimental group(p>.05). Conclusion: Our findings suggest that streamlined shoes was more effective than usual shoes in dynamic gait change including contact time and step length and foot plantar pressure in healthy young adults. Application: The results of streamlined shoes might help to control for the gait of industrial workers.

• 국제물리치료학회지
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• 제10권4호
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• pp.1934-1939
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• 2019

Background: Flexible flat foot is that the medial longitudinal arch collapses in weight bearing and returns normal arch when weight is removed and the weight bearing shifts toward medial part of the foot, which can cause pathological problems in the alignment of the lower extremities and the entire body. Objective: To compare the foot pressure for adults with flexible flat foot. Design: Quasi-Experimental Study Methods: 24 participants with flexible flat foot were recruited and were randomly divided into Visual feedback Short Foot Exercise (VSFE) group and Short Foot Exercise (SFE) group. To compare changes of foot pressure about pre and post intervention, the contact pressure measurement was conducted. Results: In the VSFE, significant differences were observed for the foot pressure of the 1^st toe, 1^st, 3^rd and 4-5^th metatarsal, midfoot, medial and lateral heel (p<.05). The foot pressure of the 3^rd and 4-5^th metatarsal, midfoot showed significant differences in the SFE (p<.05). The contact pressure of the 1^st toe, 3^rd metatarsal showed significant differences between the groups. Conclusions: Visual feedback short foot exercise can be useful for moving the pressure from medial to lateral part, and can prevent possible pathological problems.

• The Journal of Korean Physical Therapy
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• 제30권6호
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• pp.224-228
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• 2018

Purpose: The most common cause of plantar ulceration is an excessive plantar pressure in patients with peripheral neuropathy. Foot orthosis and therapeutic footwear have been used to decrease the plantar pressure and prevent the plantar ulceration in in diabetes patients. We investigated whether protective sock with functional insoles reduce plantar pressure while walking in 17 diabetes patients. Methods: An in-shoe measurement device was used to measure the peak plantar pressure while walking. Peak plantar pressure data were collected while walking under two conditions: 1) wearing diabetic sock and 2) wearing the protective sock with functional insoles. Each subject walked 3 times in 10-m corridor under three conditions, and data were collected in 3 steps in the middle of corridor with in right and left feet, respectively. Pared t-test was used to compare the peak plantar pressures in three plantar areas under these two conditions. Results: The protective sock with functional insoles significantly reduced the peak plantar pressure on the lateral rearfoot, but significantly increased the peak plantar pressure on the middle forefoot, and medial midfoot (p<0.05). However, there were not significant in medial and lateral forefoot, lateral midfoot, and medial rearfoot between diabetic sock and the protective sock conditions (p>0.05). Conclusion: The protective sock with functional insoles reduced plantar pressures in the rearfoot and supported the medial longitudinal arch. However, it is necessary to change the position of metatarsal pad in the insole design of forefoot area to prevent diabetic foot ulceration.

• 한국운동역학회지
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• 제26권1호
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• pp.115-126
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• 2016

Objective: The purpose of this study was to investigate plantar foot pressure and static balance according to the type of insole in the elderly. Methods: Thirteen elderly (mean age: $67.08{\pm}2.25years$, mean height: $159.63{\pm}9.64cm$, mean body weight: $61.48{\pm}9.06kg$) who had no previous injury experience in the lower limbs and a normal gait pattern participated in this study. Three models of insoles of the normal, 3D, and triangle types were selected for the test. The Pedar-X system and Pedar-X insoles, 3.3 km/h of walking speed, and a compilation of 20 steps walking stages were used to analyze foot-pressure distribution. Static balance test was conducted using Gaitview AFA-50, and balance (opening eyes, closing eyes) was inspected for 20 s. One-way ANOVA was conducted to test the significance of the results with the three insoles. p-value of less than .05 was considered statistically significant. Results: The mean foot pressure under the forefoot regions was the lowest with the 3D insole during treadmill walking (p<.05). The mean value under the midfoot was the highest with the 3D insole (left: p<.05, right: p<.01). The mean value under the rearfoot was the lowest with the 3D insole (p<.001). The maximum foot pressure value under the foot regions was the lowest on both sides of the forefoot with the 3D insole. A statistically significant difference was seen only in the left foot (p<.01). The maximum value under the midfoot was the highest with the 3D insole (p<.001). No statistically significant difference was detected on the values under the rearfoot. In the case of vertical ground reaction force (GRF), statistically significant difference was seen only in the left side rearfoot (p<.01). However, static balance values (ENV, REC, RMS, Total Length, Sway velocity, and Length/ENV) did not show significant differences by the type of insole. Conclusion: These results show that functional insoles can decrease plantar pressure and GRF under the forefoot and rearfoot. Moreover, functional insoles can dislodge the overload of the rearfoot and forefoot to the midfoot. However, functional insoles do not affect the static balance in the elderly.

• 한국운동역학회지
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• 제25권1호
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• pp.103-111
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• 2015

Objective : The purpose of this study was to evaluate the effect for running shoes with resilience of midsole on biomechanical properties. Methods : 10 healthy males who had no history of injury in the lower extremity with an average age of 26.5 year(SD=1.84), height of 172.22 cm(SD=4.44) and weight of 67.51 kg(SD=6.17) participated in this study. All subjects ran on the treadmill wearing three different running shoes. Foot pressure data was collected using Pedar-X system(Novel Gmbh, Germany) operating at 100 Hz. Surface EMG signals for biceps femoris, rectus femoris, vastus lateralis, medial lateralis, tibialis anterior, medial gastrocnemius, soleus and peroneus longus were acquired at 1000 Hz using Bignoli 8 System(Delsys Inc., USA). To normalize the difference of the magnitude of muscle contractions, it was expressed as a percentage relative to the maximum voluntary contraction (MVC). The impact resilience of the midsole data was collected using Fastcam SA5 system(Photron Inc., USA). Collected data was analyzed using One-way ANOVA in order to investigate the effects of each running shoes. Results : TPU midsole was significantly wider in contact area than EVA, TPE midsole in midfoot and higher in EMG activity than EVA midsole at biceps femoris. TPE midsole was significantly wider in contact area than EVA midsole in rearfoot and higher in peak pressure than EVA midsole in forefoot. EVA midsole was significantly higher in EMG activity than TPU midsole at tibia anterior. In medial resilience of midsoles, TPE midsole was significantly higher than EVA, TPU midsole. Conclusion : TPU midsole can reduce the load on the midfoot effectively and activate tibialis anterior, biceps femoris to give help to running.

• 대한족부족관절학회지
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• 제8권1호
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• pp.71-75
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• 2004

Purpose: The purpose of this study was to evaluate retrospectively the clinical results of closed reduction and percutaneous screw fixation for unstable injuries on stress radiographs in subtle injuries of Lisfranc joint. Materials and Methods: From June 1997 to March 2003, 6 cases of unstable injuries on stress radiograph in subtle injuries of Lisfranc joint were treated by percutaneous cannulated screw fixation after closed reduction. All cases were injuried by indirect force (twisting injury). The average diastasis between the 1st and 2nd metatarsal base was 3 mm (2-4 mm) on initial nonweight bearing AP radiograph. The average follow-up period was 20 months. Clinical evaluation was assessed according to the American Orthopedic Foot and Ankle Society (AOFAS) midfoot score. Results: The AOFAS midfoot score was average 86 (80-90) points. The average diastasis between 1st and 2nd metatarsal base was 2 mm (1-3 mm) on weight bearing AP radiograph in final follow up. The final diastasis was increased slightly than diastasis in initial postoperative radiographs. But the clinical results were good. There was no correlation between the degree of diastasis and the clinical results. On weight bearing lateral radiograph, the average difference with normal foot in the distance between plantar aspect of 5th metatarsus and medial cuneiform was 2 mm (0-3 mm). One case had mild arthritic change on the radiographs. Conclusion: When the Lisfranc injuries, especially in the subtle injuries were suspicious, the stress views are helpful to assess stability of the Lisfranc injuries and planning of treatment. For unstable injuries on stress radiographs in subtle injuries of Lisfranc joint, closed reduction and percutaneous screw fixation is useful method to expect good clinical results.

• 대한족부족관절학회지
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• 제19권4호
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• pp.181-187
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• 2015

Purpose: The purpose of this study is to retrospectively analyze the clinical results of screws and Kirschner wire (K-wire) fixation in patients with fracture dislocation of Lisfranc joint and the consequence of screw breakage. Materials and Methods: Sixty patients underwent Lisfranc joint open reduction and removal of internal fixators from January 2007 to December 2011. Forty-nine cases (81.7%) underwent operations with screw alone, and 11 cases (18.3%) underwent operations with both screws and K-wires. Type of internal fixators, duration of internal fixator removal, breakage of internal fixators and satisfaction with reduction were investigated. Additionally, American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scales were analyzed. Results: The internal fixator was broken in 5 cases (8.3%). The average duration of instrument removal was 154 days in the non-broken screw group and 268.6 days in the broken screw group (p<0.05). The average AOFAS midfoot scale was 77.4 in the non-broken screw group and 74.2 in the broken screw group. The most commonly damaged portion was the first tarsometatarsal (Lisfranc) joint. Conclusion: Treatment with screws and K-wires was effective in patients with fracture dislocation of Lisfranc joint. The appropriate time for screw removal should be considered.

• 대한족부족관절학회지
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• 제8권2호
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• pp.182-190
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• 2004

Purpose: To evaluate the clinical feature and the results of the treatment of Lisfranc joint fracture/dislocation with limited open reduction, pin fixation and Ilizarov external fixation. Materials and Methods: From June 2001 to May 2003, six patients with Lisfranc fracture/dislocation were treated. The average periods of follow-up was 23 months. After limited open reduction on the second tarso-metatarsal joint, we performed pin fixation of the above joint. On the other Lisfranc joint fracture/dislocation, closed reduction and the application of Ilizarov external fixator was done. This rigid system produced the early partial weight bearing and joint motion of the injured foot and ankle joint. The parameters used were radiographic evaluation, patient's clinical assesment and the AOFAS midfoot score. Results: We used the Myerson's criterier to evaluate the radiographic result. All cases could be achieved more than nearly anatomical reduction. Three cases of excellent and 3 cases of good result could be obtained in the evaluation of the patient's clinical assesment. The average AOFAS midfoot score was 87.2 ($76{\sim}95$) points. Conclusion: The treatment using Ilizarov external fixation on Lisfranc joint fracture/dislocation can be another useful method.

• 대한족부족관절학회지
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• 제24권2호
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• pp.75-80
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• 2020

Purpose: The purpose of this study is to evaluate the results of Kidner procedure combined with medial displacement calcaneal osteotomy (MDCO) in patients with the symptomatic accessory navicular with hindfoot valgus. Materials and Methods: From January 2014 to January 2019, fifteen patients (15 cases) who had undergone a Kidner procedure combined with MDCO for symptomatic accessory navicular with hindfoot valgus were included. Their mean age was 36.3 years old (19~61 years old) and there were 6 males and 9 females. The clinical results were evaluated using visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score, and postoperative subjective satisfaction. The radiographic results were evaluated using the talonavicular coverage angle and the anteroposterior talo-first metatarsal angle, the lateral talo-first metatarsal angle, the calcaneal pitch angle, and the hindfoot alignment angle. The postoperative complications were also evaluated. Results: The VAS and AOFAS midfoot scores continuously improved until 12 months after surgery. Subjective satisfaction after surgery was excellent in 10 cases and good in 5 cases. The hindfoot alignment angle significantly changed after surgery. Pain due to lateral impingement disappeared in five patients, and persisted in one patient. Five patients complained of irritation caused by their fixation devices, and all the symptoms improved after removal of the fixation devices. Conclusion: Kidner procedure combined with MDCO in patients with the symptomatic accessory navicular with hindfoot valgus showed good clinical results with satisfactory correction of hindfoot valgus. In particular, the clinical results showed continuous improvement until 12 months after surgery.

• 한국전문물리치료학회지
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• 제22권2호
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• pp.41-51
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• 2015

The purposes of this study were 1) to determine the effects of low-dye taping on peak plantar pressure following treadmill walking exercise, 2) to determine whether the biomechanical effectiveness of low-dye taping in peak plantar pressure was still maintained following removal of the tape during treadmill walking, and 3) to determine the trend towards a medial-to-lateral shift in peak plantar pressure in the midfoot region before and after application of low-dye taping. Twenty subjects with flexible flatfoot were recruited using a navicular drop test. The peak plantar pressure data were recorded during five treadmill walking sessions: (1) un-taped, (2) baseline-taped, (3) after a 10-minute treadmill walking exercise, (4) after a 20-minute treadmill walking exercise, and (5) after removal of the taping. The foot was divided into six parts during the data analysis. One-way repeated measures analysis of variance was performed to investigate peak plantar pressure variations in the six foot parts in the five sessions. This study resulted in significantly increased medial forefoot peak plantar pressure compared to the un-taped condition (p=.017, post 10-minute treadmill walking exercise) and (p=.021, post 20-minute treadmill walking exercise). The peak plantar pressure in the lateral forefoot showed that there was a significant decrease after sessions of baseline-taped (p=.006) and 10-minute of treadmill walking exercise (p=.46) compared to the un-taped condition. The tape removal values were similar to the un-taped values in the five sessions. Thus, the findings of the current study may be helpful when researchers and clinicians estimate single taping effects or consider how frequently taping should be replaced for therapeutic purposes. Further studies are required to investigate the evidence in support of biomechanical effectiveness of low-dye taping in the midfoot region.