The Journal of the Society of Stroke on Korean Medicine
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제14권1호
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pp.23-30
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2013
■ Objectives This study is to examine change of gait parameters on shoes sole height(high heels, MBT shoes, house shoes) through gait analyzer. ■ Methods The subjects of this study were 12 women in their twenties. Gait analysis system is 5m in total length and gait is led to be comfortable. They put three kinds of shoes each and were led to walk 5m on gait analysis system. ■ Results There were significant differences in step length, single support and load response of gait parameters and in stride length and total double support at double support phase. ■ Conclusion Muscle activity differs in that different that shoes sole height and form because tibialis anterior muscle has strengthen and gastrocnemius has stretched. Therefore we think that patients with knee joint problem consider gait parameters when shoes select.
Lee, Sue Min;Son, Sung Min;Hwang, Yoon Tae;Park, Seol
The Journal of Korean Physical Therapy
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제34권5호
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pp.218-223
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2022
Purpose: This study sought to identify the effects of an insole applied for the flexible flat-foot condition on dynamic balance and ankle muscle activities during the Y-balance test (YBT). Methods: Thirteen flexible flat-footed adults and an equal number of normal-footed adults were enrolled. The dynamic balance of the subjects was measured using the YBT, which is a reach test. While they were reaching forward with their foot, the percentage maximum voluntary isometric contraction (MVIC) of the tibialis anterior, peroneus longus and medial and lateral gastrocnemius were measured and analyzed. The flat-footed group then applied the ready-made insoles and underwent the YBT again. A comparison of the distance and muscle activity was conducted using YBT, not only between the flat-footed and control group, but also between the flat-footed group before and after the application of the insole. Results: Between the groups, the anterior reach distance in the flat-footed group was significantly lower, but there were no significant differences observed in the posteromedial and posterolateral directions. With the insole, the reach distance of the flat-footed group was significantly increased in the anterior and posterolateral direction compared to the control group. With the insole, the lateral gastrocnemius activity significantly decreased compared to trials without the insole in the flat-footed group, but there were no significant differences in the other muscles. Conclusion: The insole for flat-footed subjects can maintain the medial arch of the foot, and it may help enhance functional and mechanical dynamic balance in people with flat feet.
Purpose: We used tibialis allograft for the reconstruction of ACL and used Hybrid femoral fixation utilizing $Endobutton^{(R)}$ and $Rigidfix^{(R)}$ for femoral fixation, and used $Retroscrew^{(R)}$ and additional fixation for tibial fixation to evaluate the clinical results. Materials and Methods: The ACL reconstruction were performed from February 2004 to February 2007 utilizing Hybrid femoral fixation and $Retroscrew^{(R)}$ and 32 patients, 32 cases which were available for year-long observation (12 to 25 months). The clinical results (Lysholm knee score, IKDC grade) and the radiologic results(bone tunnel expansion, Telos anterior displacement test) were evaluated. Results: The Lysholm knee score was improved from the average of $67.9{\pm}5.4$ points (range: 51~77) before operation and to $94.1{\pm}6.8$ points (range: 68~98) at the last follow up (p<0.05). 22 cases (69%) were evaluated normal (A), 9 cases (28%) were evaluated nearly normal (B) and only 1 case (3%) was evaluated not normal (C) at IKDC final evaluation and no case was evaluated abnormal. From $Telos^{(R)}$ stress x-ray evaluation, difference from the opposite knee was improved average 13.2 mm{\pm}5.8 (range: 6~21 mm) to average $3.4\;mm{\pm}2.8$ (range: 0~11 mm) after operation (p<0.05). The femoral and tibial tunnel were widened by 18.7% and 9.6% in the AP view and 12.4% and 8.5% in the lateral view, respectively (p<0.05). However, any statistic significance was not observed between bone tunnel expansion and knee joint functions (p>0.05). Conclusion: An ACL reconstruction with tibialis allograft using Hybrid femoral fixation and $Retroscrew^{(R)}$ enabled anatomical fixation of the graft tendon with satisfactory clinical results.
Purpose: The purpose of this study was to evaluate the posterior cruciate ligament (PCL) reconstruction with single bundle, single-incision technique using Achilles tendon and tibialis anterior allograft with ligament remnant preservation. Materials and Methods: Twenty six patients underwent PCL reconstruction was included. There were 21 males and 5 females. Mean age was 32 years. Used graft was a fresh frozen Achilles tendon allograft (group I, 14 cases) and tibialis anterior allograft (group II, 12 cases). Arthroscopic PCL reconstruction was performed using transtibial, single-incision and single bundle technique with remnant preserving as possible. For clinical evaluation, range of motion, posterior drawer test, Lysholm score, Tegner activity scale, International Knee Documentation Committee (IKDC) grade and posterior stress radiograph were used. The mean follow-up period was 21.6 months (12-40 months). Associated injuries were 5 medial collateral ligament injuries, which were treated by conservative method. Results: Range of motion (ROM) was returned to normal range in 24 cases, but ROM deficit under $10^{\circ}$ flexion was 2 cases at final follow-up period. Preoperative posterior drawer test was 17 cases in grade II and 9 cases in grade III. At final follow-up 13 cases returned within normal grade, 7 cases grade I and 6 cases grade II posterior instability. Lysholm mean score was improved from preoperatively 62 to 90 at final follow-up period. Tegner activity mean scale improved from preoperatively 3.5 to 5.6 at final follow-up period. IDKC grade was grade A was 3 cases, grade B 17 cases, grade C 6 cases. In posterior stress radiograph, posterior displacement was improved from mean 12 mm preoperative to 4.5 mm at final follow-up. There were no statistical differences between two groups in clinical evaluations. There were two cases of re-rupture of graft at the bone-tendon junction in group I. Conclusion: We had successful results of PCL reconstruction with single-incision, single bundle technique using Achilles and tibialis anterior allograft without difference between two groups in patients with PCL injury. There were more re-rupture of graft in Achilles tendon group.
Purpose: The purpose of this study was to investigate the effect of microcurrent on fatigue of muscles in people who were flat-footed during gait. Methods: 10 flat-footed university students volunteered to participate in this study. 10 flat-footed subjects were divided into 2 groups, one group was experimental group of 5subjects(This group put on microcurrent induction shoes but the subjects were not able to feel the current.) and the other group was the control group of 5subjects(This group put on the general shoes which were similar in shape but microcurrent was not induced.) to perform double blind test and random sampling. Their gait muscle fatigue of 6 regions (vastus medialis, gastrocnemius, tibialis anterior, biceps femoris, erector spinae, and rectus abdominis muscle.) was measured by EMG MP150, Delsys Inc Boston, USA during walking and then they carried out the Harvard step with a platform (It was a arbitrarily made wooden platform of 100cm long, 50cm wide, 60cm high. They carried out climbing it for one second and descending it for one second by using the Metronome program, total 5minutes) for 5minutes. Right after that, the subjects walked on a treadmill at a speed of 4km/h for 10minutes and then their gait muscle fatigue of 6regions was assessed while they were walking on the ground as equally as before exercise. Results: The experimental group has resulted in lower average differences in gait muscle fatigue before and after exercise than those of the control group average 12.24Hz(P=0.009) at vastus medialis, average 8.52Hz(P=0.016) at gastrocnemius, average 9.16Hz(P=0.009) at tibialis anterior, average 8.66Hz(P=0.047) at biceps femoris, average 7.53Hz(P=0.016) at erector spinae, and average 7.80Hz(P=0.047) at rectus abdominis. All of the assessments of muscles have shown significant difference statistically. Conclusions: This result has shown that the use of micro current could decrease gait muscle fatigue of flat-footed people. It is recommended to use a microcurrent to reduce their gait muscle fatigue.
The purpose of this study was to investigate the improvement of muscle strength and gait ability of paralyzed lower extremity through convergent stimulation of tDCS(transcranial direct current stimulation) during mirror therapy with resistance exercise in chronic stroke patients. 12 patients with stroke were randomly assigned and divided into groupI(n=6) and groupII(n=6). GroupI provided NDT(neurodevelopmental treatment) and mirror therapy with sham tDCS, and groupII provided NDT and mirror therapy with tDCS. Each convergent stimulation was conducted 5 times a week, 30 minutes per session for a total of 4 weeks. All evaluation was conducted before intervention and performed after 4 weeks. Lower extremity strength showed a significant improvement in groupII compared to groupI(p<.05), and in comparison between groups by variance, significant difference in the quadriceps(p<.01) and tibialis anterior(p<.01). Gait ability showed a significant improvement in both groupI(p<.05) and groupII(p<.05), and significant difference in comparison between groups by variance(p<.01). In conclusion, mirror therapy with tDCS convergent stimulation had a positive improvement effect on paralyzed lower extremity to strength and gait ability through the overlapping interaction.
Fiftysix male weanling rats of the Sprague-Dawley strain weighing $52.6{\pm} 0.9g$ were fed with 77% starch-15% casein diet by ad libitum for four days to get them adapted and divided into eight groups. For three weeks, the body weight gain of rats was controlled in three different ranges. After the period of food restriction, the rats were recovered by being fed by ad libitum for seventeen days. During the experimental period, the amount of food intake and body weight were measured. And the experimental groups were compared when they reached at the same age and at the same body weight. Anterior Tibialis, Extensor Digitorum Longus, Soleus, Plantaris, Gastrocnemius were used as analytic items of skeletal muscle. Wet weight of muscle, muscle protein, water content were measured from each of five skeletal muscles. Sodium, potassium, magnesium content were measured from Anterior Tibialis, Extensor Digitorum Longus, Soleus ana Plantaris. Phosphorus was measured only from Gastrocnemius. The whole carcass protein except the skeletal muscles was also measured. During the period of food restriction, food intake was $311.7{\pm}19.5g$ for the control group. $130.2{\pm}1.5g$ for the second group and $161.7{\pm}2.1g$ for the third group. During the period of food restriction, body weight gain was $106.8{\pm}12.7g$ for the control group, $3.6{\pm}2.1g$ for the second group and $18.9{\pm}3.3g$ for the third group. Comparing the body weight when they reached at the age 66 days, the control group showed higher value than the other groups. In the concentration of electrolytes of skeletal muscles sodium and magnesium tend to increase and potassium and phosphorus tend to decrease by food restriction. But after their recovery, there was no significant difference between the groups. By the degree of food restriction, there was time difference in reaching at the same body weight. But when they reached at the same body weight, there was no significant difference in the value of electrolytes concentration. Regarding all the results of this study, the ages of rats which reached the same body weight were different by food restriction level during weanling. Once food·restricted rats reached the same body weight by recovery, the concentration of electrolytes and protein tend to become almost the same.
Journal of the Korea Academia-Industrial cooperation Society
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제17권12호
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pp.363-370
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2016
The purpose of this study was to determine the effects of speed variations in treadmill training on the thickness of lower extremity muscles. A total of 36 university students were divided into three groups: MVTG (n=12), HVTG (n=12), and ATG (n=12). Subjects in MVTG underwent treadmill training with their own average speed; those in HVTG underwent treadmill training with 130% speed of their own average speed; and those in ATG underwent treadmill training with alteration of speed, between 100% and 130% of their own average speed. Treadmill training was performed for 60 minutes a day, three times per week, for a total of 6 weeks. Ultrasonography was used to compare the muscle thickness between rectus femoris, vastus lateralis, gastrocnemius, and tibialis anterior. The result was as follows: The rectus femoris, vastus lateralis, and gastrocnemius were significantly increased after the training period, and they also were statistically significant in interaction. Moreover, tibialis anterior was also significantly increased. Therefore, compared to the average-speed treadmill training, speed variations had a greater effect on thickening the lower extremity muscles. In the near future, we will conduct a study applying the findings from this study in a rehabilitation program for patients with gait disturbance due to nervous or musculoskeletal system disease.
Studies of attentional focus effects, have shown that the performer's attentional focus plays an important role in the performance and learning of motor tasks. We examined the influence of attentional focus on the performance of dual tasks (a postural task and a suprapostural task) and used electromyography (EMG) to examine whether the differences between external and internal focus were also manifest at the neuromuscular level. The subjects (n=40) stood on a balance board (postural task) and held a bar horizontally (suprapostural task). All of the subjects performed under different attentional focus conditions: external (balancer on balance board) or internal (feet) focus on the postural task, and external (balancer on bar) or internal (hand) focus on the suprapostural task. The mean displacement velocity of the bar and the percent reference voluntary contraction (%RVC) of the biceps brachii were reduced when the subjects adopted an external focus on the suprapostural task (p<.05). In addition, the mean displacement velocity of the balance board and %RVC of the tibialis anterior were reduced when the subjects adopted an external focus on the postural task (p<.05). When the subjects adopted an external focus on the suprapostural task, the mean displacement velocity of the balance board and %RVC of the tibialis anterior were also reduced (p<.05). When the subjects' attentional focus was on the postural task, there were no differences in the mean displacement and %RVC of the biceps brachii between attentional focuses. The performance of each task was enhanced when subjects focused on the respective task. The suprapostural task goals had a stronger influence on postural control than vice versa. These results reflect the propensity of the motor system to optimize control processes based on the environmental outcome, or movement effect, that the performer wants to achieve.
The purpose of this study was to investigate the correlation and characteristics between electromyographic (EMG) activities of lower leg muscles and the posturographic assessment of static balance control in normal adults. Twenty-four young, healthy adults(12 males, 12 females) participated in the study. Center of pressure (COP) parameters were obtained using force platform as total path distance, total sway area, X mean frequency and Y mean frequency for 20 seconds in the following conditions: (1) comfortable standing with eyes opened or closed, (2) uncomfortable standing (feet together) with eyes opened or closed, (3) virtual moving surround delivered using Head mount display (HMD) with four different moving patterns. The virtual moving patterns consisted of close-far, superior-inferior tilting (pitch), right-left tilting (roll), and horizontal rotation (yaw) movements. Surface electromyographic activites were recorded on the tibialis anterior, peroneus longus, medial and lateral heads of gastrocnemius muscles under each condition. Correlation between the posturographic measures and EMG activities were evaluated. Total path distance and total sway area of COP were significantly increased during uncomfortable standing. EMG activity of tibialis anterior was significantly more during uncomfortable standing and virtual moving surround stimulation than during comfortable standing. Total path distance and sway area of COP during comfortable standing with closed eyes showed significant positive correlation with the EMG activities of the lateral head of gastrocnemius muscle. Total path distances and total sway area of COP during muscle. Total path distances and total sway area of COP during presentation of virtual moving surround also had significant positive correlations with EMG activities of the lateral head of gastrocnemius muscle under close-far movement.
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