• Journal of Korean Foot and Ankle Society
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• v.25 no.4
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• pp.165-170
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• 2021

Purpose: This study sought to evaluate the clinical effectiveness of the shortening effect of the modified Weil osteotomy for the treatment of Freiberg's disease. Materials and Methods: We reviewed 21 cases treated with the modified Weil osteotomy for Freiberg's disease from November 2005 to June 2019. The average follow-up period was 32.5 months and the mean age of the patients was 38.3 years. The clinical results were analyzed using the American Orthopaedic Foot and Ankle Society (AOFAS) lesser metatarsophalangeal-interphalangeal scale, the visual analogue scale (VAS), and the range of motion (ROM) of the metatarsophalangeal joint. In the radiologic evaluation, the length of preoperative and postoperative metatarsal shortening was compared. Results: The average AOFAS lesser metatarsophalangeal-interphalangeal scale showed an improvement from 60.5 preoperatively to 90.9 at the latest follow-up. VAS showed a decrease from 5.4 preoperatively to 0.9 at the latest follow-up. ROM of the affected metatarsophalangeal joint increased from 40.2 degrees preoperatively to 58.6 degrees at the latest follow-up. The mean length of metatarsal shortening was 6.7 mm. There was no transfer metatarsalgia, osteonecrosis, and definite joint space narrowing. Conclusion: Modified Weil osteotomy with second layer cutting is an effective treatment option to restore the joint surface and painless joint motion for patients with Freiberg's disease.

• Journal of Korean Foot and Ankle Society
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• v.12 no.1
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• pp.47-54
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• 2008

Purpose: The isolated exercise therapy and its effect for the treatment of posterior tibial tendon dysfunction (PTTD) is not well known. The purpose of this study was to identify the clinical effect of stretching and strengthening exercise program on the patients' muscle function and range of motion, pain and gait in the management of the early stage PTTD. Materials and Methods: From October 2006 to March 2007, 14 patients with early stage PTTD (stage I or IIa) without surgical intervention were randomly assigned into two groups and we analyzed their clinical results. All patients were female and one who have sprained the same ankle during the program and one who withdrew from the program due to her private reason were excluded. At the last, the exercise group (EG) was seven and the control group (CG) was five. Mann-Whitney U test was used for the comparison of pain, ROM, muscle power, AOFAS score and 5 minute walking test of both groups. Wilcoxon-signed rank test was used for the comparison between the pre and post exercise program in EG. Results: The pain was significantly reduced in EG compare to CG and only the dorsiflexion was significantly increased in EG in the analysis of ROM. The dorsi flexion and plantar flexion power were significantly increased in EG. Conclusion: Our 6 weeks stretching and strengthening exercise program showed noticeably improved clinical result, and therefore it is recommended as one of the useful treatment option in the management of early stage PTTD.

• Korean Journal of Applied Biomechanics
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• v.31 no.4
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• pp.241-248
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• 2021

Objective: The purpose of this study was to investigate the difference in muscle strength, kinematics, and kinetics between injured and non-injured sides of the leg after Achilles Tendon Rupture surgery during walking and running. Method: The subjects (n=11; age = 30.63 ± 5.69 yrs; height = 172.00 ± 4.47 cm; mass = 77.00 ± 11.34 kg; time lapse from surgery = 29.81 ± 10.27 months) who experienced Achilles Tendon Rupture (ATR) surgery participated in this study. The walking and running trials were collected using infrared cameras (Oqus 300, Qualisys, Sweden, 100 Hz) on instrumented treadmill (Bertec, U.S.A., 1,000 Hz) and analyzed by using QTM (Qualisys Track Manager Ver. 2.15; Qualisys, U.S.A). The measured data were processed using Visual 3D (C-motion Inc., U.S.A.). The cutoff frequencies were set as 6 Hz and 12 Hz for walking and running kinematics respectively, while 100 Hz was used for force plate data. Results: In ATR group, muscle strength there were no difference between affected and unaffected sides (p> .05). In kinematic analysis, subjects showed greater ROM of knee joint flexion-extension in affected side compared to that of unaffected side during walking while smaller ROM of ankle dorsi-plantar and peak knee flexion were observed during running (p< .05). In kinetic analysis, subjects showed lower knee extension moment (running at 2.2 m/s) and positive ankle plantar-flexion power (running at 2.2 m/s, 3.3 m/s) in affected side compared to that of unaffected side (p< .05). This lower positive ankle joint power during a propulsive phase of running is related to slower ankle joint velocity in affected side of the subjects (p< .05). Conclusion: This study aimed to investigate the functional evaluation of the individuals after Achilles tendon rupture surgery through biomechanical analysis during walking and running trials. Based on the findings, greater reduction in dynamic joint function (i.e. lower positive ankle joint power) was found in the affected side of the leg compared to the unaffected side during running while there were no meaningful differences in ankle muscle strength and walking biomechanics. Therefore, before returning to daily life and sports activities, biomechanical analysis using more dynamic movements such as running and jumping trials followed by current clinical evaluations would be helpful in preventing Achilles tendon re-rupture or secondary injury.

• 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.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.7
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• pp.228-235
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• 2019

The purpose of this study was to investigate the effect of 6 weeks' accelerated rehabilitation with anti-gravity treadmill exercise on VAS, ROM, isokinetic myofunction, and dynamic stability after surgery of modified brostrom operation in chronic ankle instability patients. The subjects of this study were 12 chronic ankle instability patients who underwent modified Brostrom operation(MBO) by the same doctor. 6 weeks' accelerated rehabilitation program is scheduled to perform for 60min, everyday, and also anti-gravity program performed for 15~30min, everyday. The visual analog scale(VSA) and significantly decreased(p<.001) and ROM in all of dorsal flexion, plantar flexion, inversion and eversion significantly increased(p<.05) after 6 weeks' accelerated rehabilitation with anti-gravity treadmill exercise. Both inversion and eversion peak torque at $60^{\circ}/sec$(p<.001, p<.01) and at $180^{\circ}/sec$(p<.001) significantly increased after 6 weeks' accelerated rehabilitation with anti-gravity treadmill exercise respectively. In muscle defect, although inversion(p<.01) and eversion(p<.001) at $60^{\circ}/sec$ and inversion(p<.01) at $180^{\circ}/sec$ significantly decreased, eversion at $180^{\circ}/sec$ tended to decrease but did not change significantly after 6 weeks' accelerated rehabilitation with anti-gravity treadmill exercise. The dynamic stability significantly increased after 6 weeks' accelerated rehabilitation with anti-gravity treadmill exercise(p<.001). These results suggest that 6 weeks' accelerated rehabilitation with anti-gravity treadmill exercise has positive effect of VAS, ROM, isokinetic myofunction, and dynamic stability after surgery of modified brostrom operation in chronic ankle instability patients. Therefore, we consider that the accelerated rehabilitation with anti-gravity treadmill exercise, which is safely and fast method, has effect on more faster recovery of ankle stability, play ground and normal daily activities.

• Physical Therapy Korea
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• v.27 no.4
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• pp.241-249
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• 2020

Background: Prolonged standing during work causes a lower extremity pain and disorders. Patellofemoral pain syndrome (PFPS) is one of the common diagnoses of the knee pain. Although the etiology of PFPS is not completely understood, it is considered to be multifactorial. Objects: The purpose of this study was to investigate difference in strength of knee muscles, quadriceps:hamstring muscles strength ratio (Q:H ratio), asymmetry ratio of knee muscles strength and dorsiflexion range of motion (ROM) between standing workers with and without PFPS. Methods: Twenty-eight standing workers with PFPS and 26 age-, height-, and weight-matched standing workers without PFPS participated in this study. A tension sensor measured knee muscle strength, and motion sensor measured dorsiflexion ROM. The asymmetry ratio of knee muscles was calculated by a specific formula using the knee muscles strength of the dominant side and the sound side. An independent t-test was used to identify significant differences in the strength, ROM, Q:H ratio, and asymmetry ratio between the PFPS and normal groups. Results: The standing worker with PFPS have significantly lower dorsiflexion ROM (p < 0.000) and higher asymmetry ratio of the hamstring muscles strength (p < 0.000) compare to the standing worker without PFPS. No significant differences were seen in the strength of quadriceps muscle and hamstring muscles, Q:H ratio, and asymmetry ratio of quadriceps muscle strength. Conclusion: There was a significant difference in the asymmetry ratio of the isometric hamstring muscle strength. This finding suggests that the asymmetry ratio of isometric hamstring muscle strength may be more important than measuring only the hamstring muscle strength of the PFPS side. Furthermore, the results of this study showed a significant difference in dorsiflexion ROM between the standing industrial workers with and without PFPS. Dorsiflexion ROM and isometric hamstring muscle strength should be considered when evaluating the subjects with PFPS.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.30 no.2
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• pp.85-94
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• 2024

Background: This study aimed to investigate the effects of joint mobilization with movement (MWM) on pain, ankle joint range of motion, balance, and gait in patients who underwent total knee arthroplasty (TKA) and exhibited ankle joint inversion. Methods: We divided 35 patients who had undergone TKA into experimental and control groups. The intervention involved a 40-min session three times a week over 4 weeks. The control group received general physical therapy, ankle pumping exercises, Q-setting exercises, knee joint range of motion exercises, and gravity-controlled gait training. In addition to these treatments, the experimental group received MWM to evaluate knee pain, ankle joint angle, balance, and gait pre- and post-intervention. Results: Both groups experienced a decrease in pain levels, with no significant difference between the groups. Both groups also showed a significant decrease in ankle joint inversion angle, with notable differences between them. Additionally, both groups significantly increased their mean dorsiflexion angles and balance, with a significant difference observed between the groups. Although walking decreased in both groups, there was no significant difference observed between them. Conclusion: The group that received MWM treatment showed significant effects on inversion angle, dorsiflexion angle, balance, and gait. These results provide valuable insights into the potential benefits of MWM as a post-TKA intervention, while highlighting the importance of long-term follow-up studies on post-TKA lower limb alignment interventions.

• Journal of Korean Foot and Ankle Society
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• v.21 no.4
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• pp.144-150
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• 2017

Purpose: To assess the clinical and radiographic results and complications of arthroscopy-assisted reduction and percutaneous fixation for patients with tongue-type Sanders type II calcaneal fractures. Materials and Methods: Between August 2014 and December 2015, 10 patients who underwent surgery using subtalar arthroscopic assisted reduction and percutaneous fixation for tongue-type Sanders type II calcaneal fractures were reviewed. The mean age was 50.8 years (36~62 years), and the mean follow-up period was 24 months (12~40 months). The clinical results were evaluated using the visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score at the regular follow-ups, and the foot function index (FFI) at the last follow-up. The subtalar range of motion (ROM) was evaluated and compared with the uninjured limb at the last follow-up. The radiographic results were assessed using the Bohler's angle from the plain radiographs and the reduction of the posterior calcaneal facet using computed tomography (CT). The postoperative complications were assessed by a chart review. Results: The VAS and AOFAS ankle-hindfoot score improved until 12 months after surgery. The FFI was 15 (1.8~25.9) and subtalar ROM was 75.5% (60%~100%) compared to the uninjured limb at the last follow-up. The $B{\ddot{o}}hler^{\prime}s$ angle was increased significantly from $2^{\circ}$ ($-14^{\circ}{\sim}18^{\circ}$) preoperatively to $21.8^{\circ}$ ($20^{\circ}{\sim}28^{\circ}$) at the last follow-up. The reduction of the posterior facet was graded as excellent in five feet (50.0%) and good in five (50.0%) on CT obtained at 12 months after surgery. One foot (10.0%) had subfibular pain due to a prominent screw head. One foot (10.0%) had pain due to a longitudinal tear of the peroneal tendon that occurred during screw insertion. Conclusion: Subtalar arthroscopic-assisted reduction of the posterior calcaneal facet of the subtalar joint and percutaneous fixation is a useful surgical method for tongue-type Sanders type II calcaneal fractures.

• Korean Journal of Adult Nursing
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• v.20 no.6
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• pp.839-851
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• 2008

Purpose: This study was conducted to examine the effects of aroma-therapy combined with heat application on pain, ROM of lower limb joints, and discomfort from activities of daily living(ADL) among the patients with rheumatoid arthritis. Methods: Aroma blended oil was rubbed over the knees and ankles of 19 experimental group A and 20 B, and then heat therapy was given using an electric hot & wet poultice pad to only group A. There was no treatment on the 19 control group. There was measured for pain, ROM of lower limb joints and discomfort of ADL. The data was analyzed using SPSS Win 11.0 program. Results: In comparing the effects of pain reduction by time, the ROM of lower limb joints, and discomfort of ADL, there were significant differences among three groups. There was no significant difference between experimental group in pain scale by time, range of ROM of knee and ankle joint and discomfort of ADL. Conclusion: On the basis of results, aroma-therapy can be applied as a nursing intervention to reduce pain for not only rheumatoid arthritis patients but also for other patients with other diseases.

• Journal of Korean Foot and Ankle Society
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• v.22 no.4
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• pp.156-160
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• 2018

Purpose: Chronic tophaceous gout is a painful and disabling inflammatory disease. Surgical treatment for chronic tophaceous gout is very difficult with many complications. This study evaluated the efficacy of shortening scarf osteotomy on the treatment of chronic tophaceous gout in the 1st metatarso-phalangeal (MTP) joint. Materials and Methods: From January 2006 to December 2015, 14 patients (19 cases) who underwent axial shortening scarf osteotomy for chronic tophaceous gout were reviewed. All patients were male. The average age at the time of surgery was 59.6 years (42~66 years). The minimum follow-up was 24 months. Total removal of the tophi mass with the adhered medial capsule of the 1st MTP joint was attempted. Axial shortening scarf osteotomy was done on the 1st metatarsal shaft. The visual analogue scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was assessed preoperatively and postoperatively. The range of motion (ROM) of the 1st MTP joint was also compared pre- and postoperatively. Results: The average size of the extracted tophaceous mass was 32 mm. The mean amount of the length of metatarsal shortening was 4.9 mm. The mean ROM of the 1st MTP joint was improved from $30.4^{\circ}$ to $62.3^{\circ}$. The mean AOFAS forefoot score improved from 51.4 to 86.6 points. The mean VAS for pain improved from 4.6 to 0.3 points. Conclusion: The axial shortening scarf osteotomy used on chronic tophaceous gout could reconstruct the 1st MTP joint with an improved ROM and was free of pain. Axial shortening scarf osteotomy is suggested as a useful and effective method for the treatment of chronic tophaceous gout.