• 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.

• 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.

• 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.

• Korean Journal of Applied Biomechanics
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• v.15 no.1
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• pp.155-176
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• 2005

There is some evidence that one of major factors to produce plantar fasciitis depends on the magnitude of the foot arch strain. The orthotics that can reduce the foot arch strain during locomotion may be effective to prevent or treat plantar fasciitis. Therefore, the purpose of this study was to investigate the effect of control condition and three types of foot orthotics on 3-dimensional foot arch strain that can produce plantar fasciitis during treadmill level and uphill walking and running. Sixteen male subjects are recruited and the arch length and height strain according to three types of foot orthotics with respect to control condition were measured by using two digital video cameras. The first hypothesis which the comfort of foot orthotics would be increased from arch pad, half length orthotics to full length orthotics was mostly accepted. It suggested that the types of the foot orthotics could be properly prescribed according foot regions that is pain or abnormal. The second hypothesis which the foot arch strain can be reduced by foot orthotics during level heel-toe walking and running and the third hypothesis which the foot arch strain can be reduced by foot orthotics during uphill heel-toe walking and running were rejected. The foot arch length and height strain during walking and running showed small and subject-specific characteristics and could not be optimal biomechanical variable to prove the overall comfort. The forth hypothesis which the foot arch strain cannot be reduced by foot orthotics during uphill toe walking and running was accepted. With the foot arch length and height strain during uphill toe walking and running the windlass mechanism suggested by Hicks can be explained successfully and excessive uphill toe walking and running can be one of cause of plantar fasciitis. The dynamic investigation on the foot arch such as walking and running should be carefully observed with integrated insights considering ligaments and foot bones as well as plantar fascia, extrinsic muscles and tendons, and intrinsic muscles and tendons.

• Korean Journal of Applied Biomechanics
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• v.20 no.4
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• pp.381-386
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• 2010

This study examined the changes in the walking pattern during level walking under low illumination conditions. Fourteen male subjects ($22.1{\pm}2.21$ years, $174{\pm}3.74\;cm$, $68.86{\pm}10.81\;kg$) with normal vision and no disabilities were enrolled in this study. All experiments were performed on a level walkway with three conditions: normal walking (preferred & low speed) and walking with low illumination. 3D motion capturing system was used for acquisition and analysis of the walking motion data with a sampling frequency of 120Hz. The walking speed, normalized jerk(NJ) at the center of mass(COM), wrist and heel, knee and elbow joint angle, ratio of the knee joint angle to elbow joint angle and the toe clearance on stance phase were used to compare the differences in walking pattern between the two illumination conditions, The results showed that the walking speed and joint angles decreased in low illumination, whereas the NJ and toe minimum clearance increased. In low illumination, most variables were similar to effects of low speed walking, but toe clearance was different from the effects of low speed. These results can be used as primary data for examining the changes in the level walking pattern of young adults under low illumination. Further study will be needed to compare these results in young adults with those in the elderly.

• The Journal of Korean Physical Therapy
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• v.25 no.5
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• pp.297-302
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• 2013

Purpose: This study was conducted in order to investigate the kinematic gait parameter of lower extremities with different gait conditions (level walking, stair, ramp) in hemiplegic patients. Methods: Ten hemiplegic patients participated in this study and kinematic data were measured using a 3D motion analysis system (LUKOtronic AS202, Lutz-kovacs-Electronics, Innsbruk, Austria). Statistical analysis was performed using one-way repeated measure of ANOVA in order to determine the difference of lower extremity angle at each gait phase with different gait conditions. Results: Affected degree of ankle joint in the heel strike phase showed significant difference between level walking and climbing stairs, and toe off phase showed significant difference between level walking and climbing stairs, ramps, and climbing stairs. Affected degree of knee joint showed no significant difference in all attempts. Affected degree of hip joint in the toe off phase showed significant difference between level walking, ramps and stairs, and climbing ramps. Swing phase showed significant difference between sides for level walking and stairs, climbing ramps. Affected ankle joint of heel strike and toe off, and affected hip joint of toe off and the maximum angle of swing phase in the angle was increased. Unaffected side of the ankle joint, knee joint, and hip joint showed a significant increase in walking phase. Conclusion: These findings indicate that compared with level walking, different results were obtained for joint angle of lower extremity when climbing stairs and ramps. In hemiplegia patient's climbing ramps, stairs, more movement was observed not only for the non-affected side but also the ankle joint of the affected side and hip joint. According to these findings of hemiplegic patients when climbing stairs or ramps, more joint motion was observed not only on the unaffected side but also on the affected side compared with flat walking.

• Korean Journal of Applied Biomechanics
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• v.30 no.4
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• pp.321-335
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• 2020

Objective: The purpose of this study was to investigate the effect of neck traction and foot type on plantar pressure distribution during walking. Method: Total of 24 data were collected from women working with a computer for more than 6 hours every day. Three groups by foot type were divided: Pes Planus, normal foot, and Pes Cavus. Depending on the foot type and cervical traction, plantar pressure variables were measured; CA, MF, PP, and CT. Each variable was divided into 12 masks. MANOVA was performed for the difference of plantar pressure variables by foot type, and a paired t-test was performed for the cervical traction within groups. Results: The total CA decreased in the Pes Planus (p<.001) and Pes Cavus (p<.05) groups. MF increased in the big toe (p<.01) and 2nd toe (p<.05) of the normal foot, and MF-3rd metatarsal decreased (p<.01). The MF-2nd toe (p<.01) and 3rd toe (p<.05) of Pes Cavus decreased. The PP decreased in 2nd toe (p<.05), 3rd toe (p<.01), and 4th toe (p<.05) of the Pes Cavus. In normal foot, the PP-3rd metatarsal (p<.05) and PP-4th metatarsal (p<.01) reduced. In Pes Planus, PP decreased in the hindfoot (p<.05). In Pes Cavus group wearing a neck-tractor, the CT-hindfoot increased (p<.05). Conclusion: There was a significant change in the plantar pressure change by foot type after neck traction. When walking with a neck-tractor, the heel impact was alleviated in the Pes Planus, and the Pes Cavus showed the smooth and effective propulsion in the push-off. Overall, weight acceptance was effectively performed when walking with neck-traction. It was also found that the neck-tractor corrects the alignment of the neck, thereby creating a more stable gait pattern.

• 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.

• 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...

• The Journal of Korean Physical Therapy
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• v.34 no.1
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• pp.12-17
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• 2022

Purpose: Ankle dorsiflexion is an essential element of normal functions, including walking, activities of daily living and sport activities. The tibialis anterior (TA) muscle functioned as a dorsiflexor and as a dynamic stabilizer of the ankle joint during walking and jumping. This study aimed to compare TA muscle thickness using ultrasonography according to the four different toe and ankle postures for the selective TA strengthening exercise. Methods: This study were recruited 26 (males: 15, females: 11) aged 20-30 years, with no injury ankle and calf in the medical history, had normal dorsiflexion and inversion range of motion (ROM). The thickness of the TA muscle was measured by ultrasonography in the four different toe and ankle postures: 1. Ankle dorsiflexion with all toe extension and ankle inversion (ITEDF); 2. Ankle dorsiflexion with all toe flexion and ankle inversion (ITFDF); 3. Ankle dorsiflexion with all toe extension and neutral position (NTEDF); 4. Ankle dorsiflexion with all toe flexion and neutral position (NTFDF). One-way repeated analysis of variance (ANOVA) and Bonferroni correction were used to confirm the significant difference among conditions. The level of statistical significance was set at α=0.01. Results: TA muscle thickness with ITFDF was significantly greater than in any other ankle positions, including ITEDF, NTFDF, and NTEDF (p<0.01). Conclusion: Among the four toe and ankle postures, isometric contraction in ITFDF postures showed the greatest increase in thickness of TA rather than ITEDF, NTEDF, and NTFDF postures. Based on these results, ITFDF can be recommended in an efficient way to selectively strengthen TA muscle.