• Journal of Korean Foot and Ankle Society
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• v.27 no.1
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• pp.17-23
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• 2023

Purpose: Toe-in gait is defined as a style of walking in which the foot turns inward. It may be caused by an increase in femoral bone anteversion, tibia torsion, and metatarsus adductus. There are some conservative treatment approaches used to correct this condition. This review aimed to determine the effects of the toe-in gait on joint loading, kinematics, and kinetic parameters while walking. Moreover, it sought to determine the efficiency of various conservative treatments used to correct the condition. Materials and Methods: A literature search was conducted in the following databases: PubMed, Institute for Scientific Information (ISI), Web of Science database, EBSCO, and Embase, using the following keywords in toe, toe-in, toeing, in-toe, pigeon toe, and conservative treatment published between 1950 and 2021. The quality of the studies was evaluated using the Down and Black tool. Results: A total of 13 papers on the impact of toe-in gait on joint contact force, kinematics, kinetic parameters, and conservative approaches to management were found. The quality of the studies varied between a score of 11 and 22. The toe-in gait influences the joint contact forces and kinematics of the joints, especially the hip and pelvis. The effects of conservative treatment on the toe-in gait appear to be controversial. Conclusion: As the toe-in gait influences the joint contact force, it may increase the incidence of degenerative joint diseases. Therefore, treatment is recommended. However, there is no strong evidence on the efficacy of conservative treatments, and there are no recommendations for the use of these treatments in subjects with toe-in gait.

• PNF and Movement
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• v.17 no.2
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• pp.237-243
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• 2019

Purpose: The purpose of the present study was to investigate the effects of toe wedges on the gait ability of adolescents with spastic diplegic cerebral palsy. Methods: Six adolescents with spastic diplegic cerebral palsy participated in this study. During the participants walked with- and without toe wedges, the gait ability was analyzed using the electronic walkway system. Gait parameters, including velocity, cadence, step length, stride length, single support time, and double support time, were collected and analyzed. Results: When the participants walked with toe wedges, there were significant improvements in gait velocity, cadence, and double support time compared to those without toe wedges (p<0.05). However, there were no significant differences in step length, stride length, and single support time. Conclusion: Toe wedges may have a positive effect on the gait ability of adolescents with spastic diplegic cerebral palsy. However, it is necessary to conduct high-quality studies to identify the effects of toe wedges.

• PNF and Movement
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• v.21 no.1
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• pp.27-35
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• 2023

Purpose: Hallux valgus (HV) is one of the most common chronic foot disorders, occurring when the first toe deviates laterally toward the other toe. HV impairs muscle strength and affects gait function (postural sway and gait speed). Thus, this study aims to investigate using the FDM system the effect of wearing braces on gait while wearing a virtual reality (VR) device. Methods: This study was conducted on 28 healthy adults with HV of 15 degrees or more. To compare differences in walking, depending on whether a toe brace can be worn, the subject walked without wearing anything, walked after wearing the VR device, and walked after wearing the VR device and the toe brace, and the FDM system was used for the gait ability measurement analysis. Results: As a result of a one-way repeated analysis of variance, the walking speed-related variables (cadence, velocity, etc.) in the HV group were higher during comfortable walking. In addition, walking while wearing a VR device and walking while wearing a VR device and a toe brace demonstrated more significant values in terms of six gait parameters (double stance phase, loading response, stage, stage, stage, and stage). The maximum pressure of the forefoot was significantly reduced when walking while wearing a VR device and a toe brace compared to comfortable walking, but in all variables, there was no statistically significant difference between walking while wearing a VR device and walking while wearing a VR device and a toe brace. Conclusion: Orthosis with a VR device during gait (OVG) and gait with a VR device (GVR) affect gait in HV patients. However, there was no significant difference between GVR and OVG. Thus, it is necessary to conduct experiments on various HV angles and increase the duration of wearing the toe brace.

• 제어로봇시스템학회:학술대회논문집
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• 2002.10a
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• pp.107.4-107
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• 2002

One of the most important functions of a biped robot is to walk naturally like human. For the human being, toe is very important joint in order to walk naturally. Thus, for a biped robot, the existence of toe joint much affects gait pattern generation and contributes to natural walking, which is similar to the human gait or faster walking like running. Since a conventional biped robot has the feet which consist of soles without toes, it seems difficult to walk naturally. For realizing the gait to be similar to human one, toes are necessary to the biped robot. In this paper, the effect of the toe joint for gait pattern generation is studied. In order to find the effect of toe joint, a biped r...

• Proceedings of the KIEE Conference
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• 2006.10c
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• pp.193-195
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• 2006

In this study, we developed an active controlled ankle-foot orthosis(AAFO) which can control the dorsiflexion/plantarflexion of the ankle joint during gait to prevent foot drop and toe drag for paralysis patients. To prevent dropping foot after heel strike, ankle joint was actively controlled to minimize forefoot collision with the ground. It was also controlled to provide toe clearance and to help push-off during late stance. The 3D gait analysis was performed on two healthy subjects equipped with the developed AAFO to compare with the normal gait and the conventional AFO gait. In the developed AAFO gait, differently from the conventional AFO gait, significant push-off was observed during pre-swing and the maximum flexion moment during pre-swing phase was similar to that of normal gait. A remarkable dorsiflexion also occurred during initial swing. These results indicated that the developed AAFO could have certain clinical benefits to prevent foot drop for paralysis patients, compared to conventional AFOs.

• PNF and Movement
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• v.9 no.3
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• pp.25-29
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• 2011

Purpose : We investigated the effect of anti-flexion taping at the proximal interphalangeal joints on the gait in stroke patients with clawing toe. Methods : Nineteen patients (mean age $63.26{\pm}9.16$ years) with clawing toe were studied. Gait performance was measured under two different conditions : (1) non-tape (2) application of tape. Gait velocity, step time and stride length were examined with the GAITRite system Results : Compared to the non-tape control condition, step time of the hemiparetic side increased significantly after the application of tape(p=0.03). There was no significant mean differences between the taped and control conditions for stride length of the hemiparetic side and velocity. Conclusion : Whilst the anti-flexion tape at the proximal interphalangeal joints changed the walking by providing significant step time effect, positive changes were noted in stride length of the hemiparetic side after tape application. These findings indicate that anti-flexion tape procedures do not significantly alter stride length of the hemiparetic side and velocity.

• Physical Therapy Korea
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• v.9 no.2
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• pp.43-50
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• 2002

This study was designed to identify the effects of walking conditions (normal walking vs. toe-walking) on electromyographic (EMG) activity of gastrocnemius, tibialis anterior, and soleus muscle. Seven healthy adult males participated in this study. The exclusion criteria were orthopedic or neurologic disease, congenital anomaly or acquired deformity, or pain in low back or lower extremities. The maximal voluntary isometric contraction for each muscle was used for the reference contraction, and EMG activity of each muscle during normal walking and toe-walking was expressed as a percentage of reference contraction. The gait cycle was determined with two foot switches, and gait was normalized as 100% gait cycle for each condition. The maximal values of EMG activity in terminal stance (30~50% of gait cycle) of each condition were compared for data analysis. No significant differences were found in EMG activity of the tibialis anterior and soleus (p>.05), whereas significant decrement was found in EMG activity of gastrocnemius during toe-walking compared to normal walking (p<.05). There is a limitation to generalize the results of this study, because small number of subjects participated for this study and only EMG was used for data collection. The treatment methods should be developed to improve gait efficiency by substituting the weakened muscles secondary to upper motor neuron, or by strengthening the distal muscles in lower extremity.

• The Journal of the Korea Contents Association
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• v.9 no.12
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• pp.674-682
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• 2009

The purpose of this study was to investigate the effect of aquatic gait training on plantar foot pressure, foot kinesiology and gait speed in right hemiplegic patients. The subject were 20 stroke patients who elapsed from 12 month to 24 month after stroke(aquatic gait training group(n=10), land gait training group(n=10)). This study measured plantar foot pressure, toe out angle, subtalar joint angle, gait speed from data of gate on 2m long measuring apparatus for RS-scan system(RS scan Ltd. German). This experiment performed in twice, before and after the aquatic gait training and land gait training. Collected data were statistically analyzed by SPSS Ver. 12.0 using descriptive statistics, paired t-test. Aquatic gait training group had more variety pressure area on their foot such as T1(Toe 1), HM(Heel medial), and HL(Heel lateral). But motion of subtalar joint flexibility and toe out angle decreased considerably and gate speed also increased. According to the result, aquatic gait training is considered as more effective way in foot stability and normal gait pattern than land gait training.

• The Journal of Korean Physical Therapy
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• v.22 no.1
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• pp.47-51
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• 2010

Purpose: The purpose of this study was to determine whether there are any differences, with and without a toe spreader (TS), in dynamic foot pressure distribution in children with spastic diplegic cerebral palsy. Methods: Dynamic foot pressure recording using the RSscan system were obtained during walking in 12 participants (male=7, female=5) with and without TS. Mean force was measured for four different plantar regions; great toe, forefoot, midfoot, hindfoot. Displacement of center of pressure (COP), velocity of COP displacement and stance time were also measured during gait. Results: TS walking exhibited statistically significant decrease of mean force under great toe and forefoot (p<0.05), compared with a barefoot walking. Also, TS walking exhibited statistically significant increase of antero-posterior displacement of COP (p>0.05). Conclusion: These findings indicate the potential clinical utility of toe spreader to correct dynamic foot pressure during stance phase in children with spastic diplegic cerebral palsy.

• Journal of the Ergonomics Society of Korea
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• v.26 no.2
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• pp.131-136
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• 2007

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.