• The Journal of Korean Physical Therapy
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• v.29 no.2
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• pp.95-100
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• 2017

Purpose: This study aimed to evaluate the changes in dorsiflexion and balance following proximal and distal tibiofibular joint manipulation in individuals with a history of lateral ankle sprain (LAS). Methods: Fifteen participants with a history of unilateral LAS, exhibiting a restriction in ankle dorsiflexion were included in this study. LAS ankle received a manipulation to the proximal and distal tibiofibular joint, while the opposite control ankle received no manipulation intervention. The outcome measures included ankle dorsiflexion and balance. Ankle dorsiflexion was measured using weight-bearing lunge test. Static and dynamic balances were measured using the overall, anterioposterior, and mediolateral balance index via the biodex balance system. Measurements were obtained prior to and following manipulation. Results: This study showed that ankle dorsiflexion and dynamic balance were improved following the manipulation compared to those prior to the manipulation (p<0.05). There was no significant change in static balance (p>0.05). Conclusion: The joint manipulation technique applied to the ankle of those with a history of LAS appears to improve ankle dorsiflexion and dynamic balance. This suggest that a manipulation to the proximal and distal tibiofibular joint could be provided as preliminary data regarding the prophylactic effects of recurrent LAS.

• Archives of Plastic Surgery
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• v.48 no.6
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• pp.699-702
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• 2021

Extensive bone loss associated with severe vascular injury remains a challenge for lower extremity reconstruction. The fibular free flap has been utilized for many decades to reconstruct long-segment tibial defects. We present an unusual scenario of unilateral weight-bearing, wherein we salvaged the sole lower extremity by transfer of the fractured ipsilateral fibula and a bipedicled skin flap. A 38-year-old man sustained a severe crush injury in the right leg with loss of circulation. His left lower leg had a soft tissue defect measuring 20×15 cm with an exposed comminuted fracture and a 17-cm tibial defect, along with a segmental fracture of the fibula. Subsequently, we reconstructed the tibial defect by transferring a 17-cm-long section of the ipsilateral fibula. We covered the soft tissue defect with a bipedicled skin flap. The patient eventually began to ambulate independently after surgery.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.4
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• pp.105-112
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• 2017

PURPOSE: The purpose of this research was to know the effect of visual feedback self exercise (VFSE) on postural control in stroke patients. METHODS: 26 CVA patients were participated. The experimental group (EG) 12 (46.2%) and the control group (CG) 14 (53.8%), 17 males and 9 females. The subjects preformed VFSE on training instrument 10 minutes for 20 times in 2-3 weeks. The test was done 3 times. RESULTS: There were no statistically significant differences of the general characteristics of subjects between EG and CG by sex, affected site, muscle tone, sensory deficit, unilateral neglects, and vestibular dysfunction. The postural control effects of VFSE, in the EG showed that there were statistically significant differences among the tests during VFSE. However in the CG there were no statistically significant differences among the tests during VFSE. Also there was statistically significant difference between EG and CG after VFSE (p<.05). On the right hemiplegic EG showed that there was statistically significant difference between premid test and pre-post test after VFSE. But, the left hemiplegic EG showed that there was no statistically significant difference between before and after VFSE with all of tests. CONCLUSION: CVA patients had significant different of body weight ratio between hemiplegic side and the other side. This research suggested that CVA patients need self exercise with visual feedback for the improvement postural control ability. Therefore Physical therapist should not only prescribe hand-on exercise but also need to teach them self sensory feedback exercise to help them improve their postural control.

• Physical Therapy Korea
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• v.15 no.4
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• pp.27-33
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• 2008

The purpose of this study was to investigate the changes of the center of pressure (COP) trajectory in healthy elderly subjects while crossing an obstacle before and after participation in Tai Chi training. Forty healthy elderly subjects participated either in a 12-week intervention of Tai Chi training or in a health education program. The participants were divided into two groups (the experimental group and the control group). Subsequently, the participants were pre- and post-tested on crossing over an obstacle from a quiet stance. Participants in the experimental group received Tai Chi training that emphasized the smooth integration of trunk rotation, a shift in weight bearing from bilateral to unilateral support and coordination and a gradual narrowing of the lower-extremity stance three times weekly. The participants in the control group attended a health education program one hour weekly and heard lectures about general information to promote health. Performance was assessed by recording the changes in the displacement of the COP in the anteroposterior (A-P) and mediolateral (M-L) directions using a force platform. Participants in the Tai Chi group significantly increased the A-P and M-L displacement of the COP after Tai Chi training (p<.05). No significant differences in the A-P and the M-L displacement of the COP between pre-testing and post-testing in the control group were found. This study has shown that participation in Tai Chi exercise increased the magnitude of the A-P and M-L displacement of the COP, thereby improving the ability of healthy elderly participation to generate momentum to initiate gait. These findings support the use of Tai Chi training as an effective fall-prevention program for the elderly.

• The Journal of Korean Medicine
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• v.35 no.1
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• pp.50-57
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• 2014

Objectives: The purpose of this study was to examine whether Temporomandibular Joint Balance Appliance-Golf (TBA-G) can improve postural control ability of healthy adults. Methods: Twenty participants (10 male, 10 female) aged 20 to 39 years were involved. Postural control ability of all participants was assessed before and after applying TBA-G with Balance $Master^{(R)}$ system. Modified clinical test sensory interaction on balance (mCTSIB), unilateral stance, weight bearing and rhythmic weight shift were used to evaluate postural control ability. Results: After applying TBA-G, mCTSIB on a firm plate with eyes open increased from 0.2 to 0.23 (p<0.05) but directional control was improved in slow and moderate velocity of front/back rhythmic weight shift test (P<0.05). In two cases with postural imbalance, most of the postural control measures improved after applying TBA-G. Conclusions: The results suggest that TBA-G could improve balance control ability. A larger controlled trial is needed to determine more accurately the effect of TBA-G on balance control ability.

• Journal of Veterinary Clinics
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• v.16 no.2
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• pp.309-320
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• 1999

Medial patellar luxation in dogs is one of the most common patellar problems presented to the veterinary practitioner. It is observed in toy and miniature breed and the majority of cases is a congenital form. Because of extensor mechanism's instability, it causes deformity and disorder in the growth of the affected limb when the luxation is left without treatment As lameness is not easily detectable in puppies, early diagnosis and correction are essential for therapy. Up to now, there has not been any reports refering to the diagnostic methods and the optimal age for correction in young dogs. Thirteen 45-90 days old puppies, have grade I and/or II medial patellar luxation. Only by palpation, all 13 dogs were diagnosed of patelar luxation. Skyline radiographic view was useful to interpret patellar morphology and depth of trochlear groove only above 60 days old. However, it was difficult to make definite diagnosis patellar luxation. The caudocranial and lateral radiographic view as well as ultrasonographic skyline view were not showed of patellar luxation. 2 puppies had unilateral patellar luxation and 11 puppies had bilateral patellar luxation which more serious on the left than on the right. Only 3 puppies among 11 puppies with bilateral patellar luxation were observed of lameness degree 1. Regardless of grade of patellar luxation and lameness, we performed trochlear chondroplasty using a U-shape sculpture blade to minimize cartilage injury, transposition of tibia tuberosity with No. 1 Supramid to align extensor mechanism and lateral imbrication. After surgery, we examined the operated animal daily for 10 days and on 15, 30 and 60 days after surgery respectively. After operation, pain and fever became normal on 7 days, swelling on 10 days, respectively. On 10 days after surgery, dogs showed normal standing position, and normal walking was observed in 15 days after surgery. In force plate analysis, the operated legs were normal weight bearing at 30 days after operation. After surgery, not only patellar luxation and clinical signs have been gradually reduced but also bone growth have become normal without showing growth physeal plate injury. The survival rate of puppies over 62 days old was 100%, while 42-45 days old 37.5%. The above results suggest that optimal age for surgical correction of congenital medial patellar luxation is recommended over 60 days old. In conclusion, combination of trochlear chondroplasty, transposition of tibia tuberosity, and lateral retinacular imbrication is appropriate for over 60 days old puppies to efficiently correct patellar luxation.

• Journal of Veterinary Clinics
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• v.28 no.5
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• pp.467-472
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• 2011

This study was conducted to describe clinical presentation of pelvic fracture and compare clinical outcomes of each part of pelvic fractures in 54 client-owned dogs. There was an average of 3.61 pelvic fractures per dog and 47 dogs had more than two fractures. The average time until initial weight-bearing on the affected leg, hospitalization after surgery, and lameness score at final check in 31 dogs that underwent surgery were 7.04 days, 16.39 days, and 1.25, respectively, and there were no significant difference in the incidence of sacroiliac luxation, iliac fracture, and acetabular fracture among them. The length of hospitalization and the lameness score upon final check of the dogs with over two surgically repaired sites were significantly longer and higher than those of the dogs with one surgically repaired site (P = .043 and P = .008, respectively). Upon final check of the dogs with bilateral pelvic fracture that was surgically treated, the hospitalization and lameness score were significantly longer and higher than those of dogs with unilateral pelvic fracture that was surgically treated (P = .034 and P = .033), respectively. The number of pelvic fractures treated surgically appears to be a more influential factor influencing recovery from pelvic fractures than the location of the pelvic fractures.