In this study, 20 men and women in their 20s were divided into a footboard passive stretching group and a manual passive stretching group. After stretching was applied to the soleus for 5 weeks, a comparative analysis was performed on the range of motion(ROM) of the ankle joint to determine changes in the flexibility of the soleus. Both the footboard stretching group and manual stretching group first performed stretching for 15 sec, followed by a 10-sec break. One set consisted of performing the above process twice consecutively, and each group had to perform five sets in total. A goniometer was used as a measuring instrument. The results of the experiment were analyzed using a nonparametric analysis, Wilcoxon signed rank test, and Mann-Whitney test. SPSS WIN 18.0 was employed for the statistical analysis. In terms of the comparison of the flexibility before and after the experiment according to the different interventions, the application of footboard stretching to the soleus for 5 weeks resulted in $3.2^{\circ}$ right dorsiflexion (p=.009), $6.98^{\circ}$ right plantar flexion(p=.008), $4.14^{\circ}$ left dorsiflexion(p=.005), and $10.97^{\circ}$ left plantar flexion(p=.007), which were all statistically significant increases. The application of manual stretching led to $6.04^{\circ}$ right dorsiflexion(p=.005), $12.14^{\circ}$ right plantar flexion(p=.005), $7.00^{\circ}$ left dorsiflexion (p=.008), and $16.38^{\circ}$ left plantar flexion(p=.005). Therefore, both footboard stretching and manual stretching were effective in enhancing the flexibility of the soleus. However, statistically significant larger increases in the ROM of the ankle joint were observed in the manual stretching group.
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.
Park, Jung Hyun;Cho, Seung Hee;Kim, Rip;Na, Sang Hoon;Kang, Eun-sun;Yeom, Mi-young;Jang, Yeon
The Korean Journal of Pain
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제34권2호
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pp.185-192
/
2021
Background: It is known that some analgesics as well as pain can affect the immune system. The aim of this study was to investigate the analgesic effect and immunomodulation of pregabalin (PGB) in a mouse incisional pain model. Methods: A postoperative pain model was induced by hind paw plantar incision in male BALB/c mice. Mice were randomly divided into four groups (n = 8): a saline-treated incision (incision), PGB-treated incision (PGB-incision), sham controls without incision or drug treatment (control), and a PGB-treated control (PGB-control). In the PGB treated groups, PGB was administered intraperitoneally (IP) 30 minutes before and 1 hour after the plantar incision. Changes of the mechanical nociceptive thresholds following incision were investigated. Mice were euthanized for spleen harvesting 12 hours after the plantar incision, and natural killer (NK) cytotoxicity to YAC 1 cells and lymphocyte proliferation responses to phytohemagglutinin were compared among these four groups. Results: Mechanical nociceptive thresholds were decreased after plantar incision and IP PGB administration recovered these decreased mechanical nociceptive thresholds (P < 0.001). NK activity was increased by foot incision, but NK activity in the PGB-incision group was significantly lower than that in the Incision group (P < 0.001). Incisional pain increased splenic lymphocyte proliferation, but PGB did not alter this response. Conclusions: Incisional pain alters cell immunity of the spleen in BALB/c mice. PGB showed antinocieptive effect on mouse incisional pain and attenuates the activation of NK cells in this painful condition. These results suggest that PGB treatment prevents increases in pain induced NK cell activity.
Purpose: The purpose of the study was to identify the subtypes of idiopathic osteoarthritis of the tarsometatarsal joints based on accompanying hindfoot, midfoot, or foot deformities and their corresponding surgical options and also to evaluate the overall clinical results. Materials and Methods: The study included 59 patients (67 feet) with idiopathic tarsometatarsal joint osteoarthritis. Tarsometatarsal fusion was performed for tarsometatarsal joint and accompanied secondary change was divided into subtypes and various bony reconstruction was carried out. The patients were evaluated with the AOFAS midfoot score and FFI. The average patient age was 60.2 years with 40.6 months follow-up. Fifty-four feet (80.6%) had been treated with realignment fusion. Twenty-six feet had first and second tarsometatarsal joint fusion, and 20 feet had first tarsometatarsal fusion only. Six subtypes were identified based on associated foot deformities: 1) in-situ without deformities (18%), 2) pes planovalgus (45%), 3) rockerbottom (15%), 4) cavus foot (1%), 5) hallux valgus (12%), and 6) hallux valgus with pes planovalgus or rockerbottom (9%). Plantar-medial closing-wedge resection was used in 10 feet to correct rockerbottom. For pes planovalgus, a medial sliding calcaneal osteotomy was done. Lateral column lengthening with medial sliding calcaneal osteotomy was done for severe pes planovalgus, and triple arthrodesis was done for rigid pes planovalgus. Hallux valgus was corrected with the Lapidus procedure (85.7%). Results: AOFAS midfoot scores improved from preoperative 34.1 points to postoperative 83.9 points (p<0.05). The Foot Function Index postoperatively also showed significant improvement (p<0.05), with a high satisfaction rate (86.6%). There were 29 complications, most commonly sesamoid pain. Conclusion: Idiopathic tarsometatarsal OA feet can be classified into six categories. Pes planovalgus feet should be treated with medial sliding calcaneal osteotomy, lateral column lengthening, or triple arthrodesis in addition to tarsometatarsal joint realignment fusion. Rockerbottom and hallux valgus deformities should also be addressed.
Objective: It is to find factors related to stability through analysis of plantar pressure factors according to the level of instability when performing Snatch. Method: Foot pressure analysis was performed while 10 weightlifters performed 80% of the highest level of Snatch, and motion was classified and analyzed in 3 grades according to the level of instability. Results: First, in Bad Motion, the movement distance of the pressure center in the direction of ML and AP was larger significantly in Phase 2. Second, in Phase 2, the number of zero-crossing in the AP direction was larger statistically significantly in Good Motion. Third, in the bad motion in Phase 3, the number of zero-crossing in the ML direction showed a significantly larger value. Fourth, in Phase 4, it was found that the more stable the lock out motion, the greater the activity of foot controlling in the left and right directions. Fifth, Phase 3, the greater the Maximum/Mean foot pressure value, the more stable the pulling action. Sixth, in Phase 2, the foot pressure was concentrated with a wide distribution in the midfoot and rearfoot. Seventh, the triggering number of the forefoot region was small in the last pull phase. Eighth, the number of triggers in the toe area was significantly higher during Good Motion in Phase 4. Conclusion: Summarizing the factors of instability in Snatch, there was no significant difference in Phase 1 for each condition. In order to enhance the stability in Phase 2, the sensory control ability in the AP direction is required, and focusing the foot pressing motion with a wide distribution in the middle and rear parts increases the instability. In Phase 3, it was found that the more unstable, the more sensory control activity was performed in the ML direction, the stronger the forefoot pressing action should be performed for a stable Snatch. In Phase 4, It is important that the feet sensory control activity in ML directions and the control ability of the toes in order to have stable Lock out motion.
Purpose: The aim of this study was to evaluate the result of combined first metatarsal and calcaneal osteotomy for static cavovarus deformity of the foot. Materials and Methods: We performed a dorsal closing wedge $1^{st}$ metatarsal osteotomy and a lateral and upward displacement calcaneal osteotomy for 9 patients, 12 feet (6 male and 3 female). The mean age at the time of operation was 37 years and the mean followup period was 27 months. The causes of deformity were 2 poliomyelitis, 1 cerebral palsy, 1 Charcot-Marie-Tooth disease and 5 idiopathic type. Five lateral ligament reconstructions of the ankle and six percutaneous Achilles tendon lengthenings were added. The surgical results in terms of pain, function and alignment of the foot were evaluated by means of AOFAS ankle-hindfoot score and talo-$1^{st}$ metatarsal, calcaneus-$1^{st}$ metatarsal and calcaneal pitch angles were checked with weight bearing radiographs in lateral projection. Results: Talo-$1^{st}$ metatarsal and calcaneal pitch angles were reduced from the mean preoperative values of $21^{\circ}$ and $25^{\circ}$ to $12^{\circ}$ and $19^{\circ}$, respectively, at last followup. Also, calcaneus-$1^{st}$ metatarsal angle was increased from the mean $114^{\circ}$ to $114^{\circ}$. The mean AOFAS score was improved from 44.5 points preoperatively to 89.2 points at followup. There were 1 metatarso-cueiform joint nonunion, 1 sural nerve injury and 3 remaining symptomatic claw toes. Conclusion: Combined first metatarsal and calcaneal osteotomy appears to be an effective procedure for the treatment of adult static cavovarus foot.
Background: The MLA is supported by both the abductor hallucis (ABH) and the extrinsic muscles. Insufficient muscular support may lower the MLA when the body's weight is applied to the foot. The short foot exercise (SFE) is effective in increasing the height of the MLA for people with flat feet. Most of the research related to the SFE has simply evaluated the efficiency of the exercise using enhanced ABH electromyography (EMG) activation. Since the tibialis anterior (TA), peroneus longus (PER), and ABH are all involved in supporting the MLA, a new experiment design examining the EMG of the selected muscles during SFE should be applied to clarify its effect. Objects: Therefore, this study aimed to clarify the effect of the SFE in different ankle position on the MLA angle and the activation of both the intrinsic and extrinsic muscles and to determine the optimal position. Methods: 20 healthy subjects and 12 subjects with flat feet were recruited from Yonsei University. The surface EMG and camera were used to collect muscle activation amplitude of TA, PER, and ABH and to capture the image of MLA angle during SFE. The subjects performed the SFE while sitting in three different ankle positions-neutral (N), dorsiflexion (DF) at 30 degrees, and plantar flexion (PF) at 30 degrees. Results: ABH EMG amplitudes were significantly greater in N and DF than in PF (p<.05). Muscle activation ratio of TA to ABH was the lowest in PF (p<.05). MLA angle in both groups significantly decreased in PF (p<.01). The TA and ABH was activated at the highest level in DF. However, in PF, subjects significantly activated the ABH and PER with relatively low activation of TA. Conclusion: Therefore, researchers need to discuss which SFE condition most effectively use the arch support muscle for flat foot.
In this study, we developed an active ankle-foot orthosis(AAFO) which can control dorsi/ plantar flexion of the ankle joint to prevent foot drop and toe drag during walking. 3D gait analyses were performed on five healthy subjects under three different gait conditions: the normal gait without AFO, the SAFO gait with the conventional plastic AFO, and the AAFO gait with the developed AFO. As a result, the developed AAFO preeminently induced the normal gait compared to the SAFO. Additionally, AAFO prevented foot drop by proper plantarflexion during loading response and provided enough plantarflexion moment as a driving force to walk forward by sufficient push-off during pre-swing. AAFO also could prevent toe drag by proper dorsiflexion during swing phase. These results indicate that the developed AAFO may have more clinical benefits to treat foot drop and toe drag, compared to conventional AFOs, and also may be useful in patients with other orthotic devices.
Purpose: To estimate the prevalence of flat foot in the 1st grade primary school children in the Kang-Dong Gu, Seoul, Korea. Materials and Methods: We examined 1336 8 year old the first grade children (2672 feet) in primary school at 5 primary school for prevalence of flat foot and the associating factors in Kang-Dong Gu in April 2003. The group was examined with 2 mm-pannel in physical examination at erect position to put diagnosis of flat foot which showed no plantar arch. The height, weight, foot length and foot width were estimated in all children. We used obesity grading system of Korean Pediatric Association for overweight evaluation. Results: We enrolled 728 boys and 608 girls, and prevalences of each gender were 20.8% and 14.9%. The children who had flat foot were 243 and the prevalence of flat foot was 18.2%. The foot length ranges between 152 mm and 300 mm (mean value 183.6 mm, SD 10.6), and the foot width were between 50 mm and 107 mm (mean value 2.16 mm, SD 4.8). Of the 1336 children group, 1215 children (90.0%) were in range of normal weight, 72 children (5.4%) were in grade-1 overweight, 38 (2.8%) were in grade-2 overweigh and, 11 (0.8%) were in grade-3 overweight. The prevalence of flat foot of each overweight group were 16.3%, 34.7%, 39.5% and 45.5%. Overweight in children effected increased prevalence of flat foot. But there were no significant relationship with flat foot in other factors. Conclusion: Over all prevalence of flat foot of 8 year old children was 18.2% and most of patients were flexible flat foot. The prevalence of flat foot was influenced by overweight remarkably.
The tendinous ends of neglected achilles tendon rupture tend to retract and separate with atrophy due to gastrosoleus muscle contracture, leaving a wide gap occupied with fibroadipose scar tissue. It is almost impossible to perform simple end-to-end anastomosis after the intervening scar tissue being excised. Therefore many surgical procedures have been proposed to reconstruct the large gap. We treated three such cases by V-Y advancement flap and double Krackow suture technique, and their postoperative strength of triceps surae were evaluated with Cybex isokinetic strength testing. All patients returned to preinjury activities with satisfaction, but the ankle plantar flexor power showed about 20-30% deficit.
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