• 대한인간공학회지
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• 제16권2호
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• pp.73-82
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• 1997

Daily exposure to constrained body postures and deviations from neutral postures over a long period may result in discomfort as well as pains and aches in the muscles, joints, tendons, and other soft tissues. Furthermore, it was known that poor body postures are a major cause of musculoskeletal disorders in industry. Therefore, in this study, comfort ranges of joint motions were obtained as a criterion for evaluating body postures and designing workplaces ergonomically, which were bases on subjects' perceived discomfort level estimated by magnitude estimation. Nineteen healthy male subjects participated in the laboratory study. They results showed that comfort ranges of joint motions occurred in the wrist, elbow, neck, and ankle were little less than their normal range of joint motions, but those in the back(L5/S1) and hip joint were much less than their normal ones. This fact implies that the back and jip movements are more stressful than the other joints movements. It is expected that comfort ranges of joint motions can be used as a valuable guideline when designing and evaluating workplaces.

• 대한족부족관절학회지
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• 제16권2호
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• pp.116-122
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• 2012

Purpose: Subtalar arthrodesis has been the gold standard for the painful subtalar joint disorders. Successful subtalar arthrodesis requires fusion of the 3 facet joints. The purpose of the study is to compare the clinical outcome of the posterior fixation (P2) and anterior-posterior (A1P1) fixation technique for subtalar arthrodesis which enhance anterior and middle facet fixation. Materials and Methods: The study is based on the 20 feet (19 patients) of the subtalar arthrodesis utilizing cannulated screws from September 2006 to September 2009 with at least 1-year follow-up. Two fixation techniques were utilized for the subtalar arthrodesis: 1) posterior fixation only (P2, 7 feet, 35%) and 2) anterior-posterior (A1P1) fixation method (13 feet, 65%). Visual Analog Scale Pain (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score (maximum: 94 points), the time for returning to daily living and the patient satisfaction were also evaluated. Results: Average follow-up period were 13.2 months (12-3 mo). The AOFAS score improved from preoperative average 45 (0-68) to 81.6 (62-94), while VAS score was decreased from average 8.0 (3-10) to 1.8 (0-5) at final follow-up. Ninety-five percent of the patients were satisfied with surgery. All the patients returned to daily living at average 7.2 months (2-15 mo) post-surgery. Radiographically, 2 techniques both showed 100% fusion of the posterior compartment of the subtalar joint. Postoperative complications were 1 case of low grade infection and 1 case of sural nerve neuralgia. Conclusion: The subtalar arthrodesis using A1P1 fixation technique showed better fusion rate of the anterior compartment of the subtalar joint compared to P2 fixation technique although the 2 techniques both showed similar favorable clinical outcome. Therefore the A1P1 fixation technique is found to be a viable option to address chronic painful subtalar joint disorders to enhance the anterior compartment fixation.

• The Journal of Korean Physical Therapy
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• 제21권4호
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• pp.57-63
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• 2009

Purpose: To better understand falls in elderly women, we measured differences in muscle activities of 4 lower extremity muscles (tibialis anterior, soleus, rectus femoris, biceps femoris) based on angle plantar-flexion in elderly women. Methods: Subjects were 15 healthy elderly women. No subjects had musculoskeletal or nervous disorders. EMGs were used to check muscle activity of lower extremity muscles. For statistic analysis, data were expressed as a percentage of maximal voluntary isometric contraction (%MVIC). We measured %MVIC for 5 sec under 4 conditions and did not use data for the first and last second. Muscle activities of the muscles of the lower extremities were measured based on the degree of plantar-flexion of the ankle joint. The 4 conditions corresponded to different degrees of: 0, 10, 20 and 30 degrees. This was done using a 50 cm board for measuring the degrees. Results: The tibialis anterior, soleus, and bicpes femoris showed increasing muscle activity associated with increasing degree of plantar-flexion of the ankle joint. All muscles showed a significant increase in muscle activities in association with increasing degrees. Rectus femoris showed a significant increase in muscle activity for 0 degrees and for the other degrees, but there were no further changes when plantar flexion of the ankle joint was over 10 degrees. Conclusion: Activities of the muscles of the lower extremities except rectus femoris were higher with increasing degree of plantar flexion. High muscle activity may result in muscle fatigue. Thus, increasing degree of plantar flexion may be risk factors of falls in elderly women.

• 대한족부족관절학회지
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• 제21권4호
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• pp.156-164
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• 2017

Purpose: Foot and ankle disease (FAD) is a frequent cause of morbidity among the homeless population. Various conditions, exacerbated by malnutrition, poor lifestyle habits, psychiatric disorders, physical injuries, poor hygiene, and limited access to healthcare, have been described in this population. The purpose of this study was to investigate the cognition and management status of FAD in shelter based homeless people. Materials and Methods: Fifty-two male and twenty-five female volunteer homeless individuals were recruited from two homeless shelters. Each person completed a questionnaire assessing any presence of pain, pain management, as well as foot and ankle care status. A foot and ankle surgeon examined the physical status of the individual's foot and ankle, including tenderness and instability. A radiologic evaluation was done for 18 male and 11 female homeless people who agreed to participate in this test for the existence osteophyte or joint space narrowing representing osteoarthritis and some reference angles for hallux valgus, flatfoot and cavus foot. Results: Homeless people had higher prevalence of body mass index, diabetes, and smoking than the general population. The most prevalent infectious disease was fungal infection (male 78%, female 68%), with a low compliance of management for FAD. Conclusion: Although most of shelter-based homeless people showed an acceptable foot and ankle management status, the potential risk for FAD development and exacerbation of mild FAD was high.

• The Journal of Korean Physical Therapy
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• 제27권6호
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• pp.381-385
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• 2015

Purpose: This study was to identify the relationship between the game score and muscle strength in order to elucidate whether the obtained score for the dorsiflexor and plantar flexor muscles in the ankle joint using an EMG-based interactive game system can reflect muscle strength as measured conventionally. Methods: Forty adults were enrolled in the present study. They had no congenital deformities, and no neurological or orthopedic disorders in the 6 months prior to the start of the study. The Biodex were used to measure the isokinetic concentric maximal strength of the plantar flexor and dorsiflexor muscles in the ankle joint. EMG electrodes were attached to the tibialis anterior and gastrocnemius. Results: (1) There was a positive relationship between the obtained game score by the plantar flexor (sPF) and muscle strength of the plantar flexor (tPF) and dorsiflexor (tDF). In addition, the tPF affected the sPF, but the tDF did not. Thus, the higher the tPF, the higher the sPF. (2) There was no relationship between the obtained game score of dorsiflexor (sDF) and tPF or tDF. In addition, neither the tDF or tPF affected the sDF. Conclusion: The game score had a relationship with muscle strength, which is related to ankle instability and re-impairment. Thus we suggest that this game system can be used to predict the degree of weakness of muscle strength.

• 국제물리치료학회지
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• 제9권4호
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• pp.1631-1635
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• 2018

Stroke can cause leg weakness, sensory abnormalities, and balance disorders. The purpose of this study was to investigate the effect of elastic taping on postural sway in patients with stroke. This study randomly applied elastic taping to 20 patients with stroke in two ways. The center of pressure (COP) distribution was measured before and after the elastic taping. The measurement variables were COP area and length, and measurements were performed immediately after taping. The elastic taping on tibialis anterior muscle showed a significant decrease in COP area and length compared to that without elastic taping. The elastic taping on gastrocnemius muscles showed a significant decrease in COP area and length compared to that without elastic taping. There was no significant difference in COP area and length between the elastic taping on tibialis anterior muscle and gastrocnemius muscles. Our results suggested that applying elastic taping on the ankle joints is effective in decreasing postural sway after in patients with stroke.

• 대한인간공학회지
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• 제26권1호
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• pp.19-27
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• 2007

Despite the widespread use of laterally wedged insoles for patients with knee osteoarthritis and medially wedged insoles for controlling rearfoot pronation, an understanding of the effects of wedged insoles was limited and sometimes controversial. The objective of this study was to evaluate the effect of wedged insoles on the kinematics and kinetics of normal gait. Ten male subjects without history of lower limb disorders were recruited. Each subject performed four gait cycles under each of seven conditions; shod with 5$^{\circ}$, 8$^{\circ}$ and 15$^{\circ}$, 8$^{\circ}$ and 15$^{\circ}$ laterally wedged insoles. In order to determine statistical differences among seven conditions, the measured temporal spatial variables, angular displacements, joint moments, and ground reaction forces were compared with a one-way analysis of variance. Some significant changes induced by wedged insoles were apparent in joint moments and ground reaction forces. The medially wedged insole increased the laterally directed ground reaction force and varus moments at the ankle force and varus moments at the ankle and the knee.

• 대한족부족관절학회지
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• 제4권2호
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• pp.83-86
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• 2000

A vascular necrosis of the talus has frequently been reported following trauma because talus has no muscle insertions, sixty percent of the surface of the talus is covered by hyaline cartilage, takes only a small area for entrance of a blood supply. Osteonecrosis is also associated with a variety of nontraumatic disorders. There are many indications for steroid usage, patient with rheumatoid arthritis, systemic lupus erythematosus, chronic obstructive pulmonary disease, and status- post renal or cardiac transplantation may be on long- term steroid usage, osteonecrosis may develop. A vascular necrosis of the talus secondary to chronic steroid usage is an unusual case. Delay in detection of osteonecrosis may lead to fragmentation and collapse of the talar body. When pain on range of motion is present and conservative treatment have been exhausted, surgical treatment is indicated, that is, fusion of the ankle joint. However it is important that conservative treatment may prevent its various sequelae with early diagnosis because steroid - treated patients have a more operative risk and increased risk for postoperative infection. We report a rare case of corticosteroid induced avascular necrosis of talus after cardiac transplantation.

• 대한인간공학회지
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• 제35권1호
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• pp.39-52
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• 2016

Objective: This paper investigates gait changes according to different heel heights and speeds, and the interaction between the effects of the heel height and the speed during walking on stride parameters and joint angles. Furthermore, the relationship among heel height, speed and gait variables is investigated using linear regression. Background: Gait changes by heel height or speed have been studied respectively, but has not been reported whether there is an interaction effect between heel height and speed. It would be necessary to understand how gait changes when a person wears heels in different heights at various speeds, for example, high-heeled walking at fast speed, since it may cause unusual gait patterns and musculoskeletal disorders. Method: Ten females were asked to walk at five fixed cadences (94, 106, 118, 130 and 142 steps/min.) wearing three shoes with different heel heights (1, 5.4 and 9.8cm). Nineteen gait variables were analyzed for stride parameters and joint angles using two-way repeated measure analysis of variance and regression analysis. Results: Both heel height and speed affect movement of ankle, knee, spine and elbow joint, as well as stride length and Double/Single support time ratio. However, there is no significant interaction effect between heel height and speed. The regression result shows linear relationships of gait variables with heel height and speed. Conclusion: Heel height and speed independently affect stride parameters and joint angles without a significant interaction, so the gait variables are linearly amplified or diminished by the two factors. Application: Walking in high heels at fast speed should be careful for musculoskeletal disorders, since the amplified movement of knee and spine joint can lead to increased moment. Also, the result might give insight for animators or engineers to generate walking motion with high heels at various speeds.

• 대한산업공학회지
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• 제23권4호
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• pp.779-791
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• 1997

The purpose of this study is to measure a perceived joint discomfort in the seated and standing position, and to provide ranking systems of perceived joint discomfort. Nineteen mole subjects with no history of musculo-skeletal disorders participated in the experiment. Their physical characteristics were: age $-25.4{\pm}2.7$years, stature $-171.9{\pm}6.0cm$, and body weight $-67.1{\pm}7.0kg$. The results showed that the perceived joint discomforts were different depending upon the joints involved in motion and their movement directions (degree of freedom of motions), which implied that the human body motions and their degrees of freedom should be classified into several distinct classes that need to be assigned different weights of postural stress. Therefore, three ranking systems based on the perceived joint discomforts were suggested, which were classified by the degree of freedom of motions and joints, by only degree of freedom motions, and by joints involved in motion, respectively. In the seated position, the hip movement was the most stressful, the bock was the second, and the shoulder was the third. Likewise, in the standing postures, the hip was the most, the bock was the second, and the ankle was the third. It was expected that these joint motion ranking systems could be used by practitioners of health and safety to improve the comfort of working postures in industry.