• 대한족부족관절학회지
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• 제17권2호
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• pp.115-120
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• 2013

Purpose: Calcaneal lengthening osteotomy is one option for the treatment of symptomatic flexible flatfoot in adults. The aim of the study was to evaluate the short term clinical and radiologic results and analyze its complications. Materials and Methods: Twelve feet who had undergone calcaneal lengthening osteotomy without flexor digitorum longus transfer between December 2009 and July 2011 were included. The mean age was 40.6 years (23~75 years). The mean followup was 17.3 months (13~25 months). Clinical outcome were assessed using American Orthopadics Foot ans Ankle Society (AOFAS) score and visual analogue scale (VAS) for pain. Four radiologic parameters were measured from weightbearing radiographs to evaluate the difference between preoperatively and postoperatively measures. To analyze the complications, calcaneocuboid joint subluxation and degenerative change were measured postoperatively. Results: The mean AOFAS score improved from 55.3 points preoperatively to 82.2 points at lastest follow-up (p=0.000). The mean VAS improved from 6.3 points preoperatively to 3.2 points postoperatively (p=0.002).All radiologic parameters, the mean talonavicular coverage angle on AP view, the mean talo-1st metatarsal angle on AP and lateral view and the mean calcaneal pitch angle, significantly improved after calcaneal lengthening osteotomy. Nine feets (75%) were shown the degenerative change in the calcaneocuboid joint at latest follow-up radiographs. Conclusion: Calcaneal lengthening osteotomy for the symptomatic flexible flatfoot in adults produced significant improvement in clinical and radiologic parameters, but calcaneocuboid joint osteoarthritis occurred postoperatively remained a major problem.

• 대한족부족관절학회지
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• 제17권1호
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• pp.40-44
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• 2013

Purpose: To study inter- and intra-observer reliabilities of computerized measurements of the angular parameters of hallux valgus deformity, using two different kinds of software tools for angle measurement on the digital radiography. Materials and Methods: On 35 digital radiographies of standing foot anteroposterior view of hallux valgus, two observers (A, B) independently measured hallux valgus angle (HVA) and 1-2 intermetatarsal angle ($IMA_{1-2}$) twice, using two methods. In method I, an angle was determined from duplicated lines to longitudinal axes made for bisecting line on the target bones with software tool. In method II, an angle was calculated automatically and directly from bisecting lines (longitudinal axes) made on the target bones. We compared two methods using paired t-test to determine significance of differences. Inter- and intraobserver reliabilities were evaluated using the intraclass correlation coefficients (ICC). Results: There were no significant differences between measurements of method I and II for each observer (p>0.05) and intraobserver reliability were good. (ICC>0.9) Inter-observer reliability for method I and II was good of the HVA (ICCs, 0.912 and 0.905) and moderate of the $IMA_{1-2}$ (ICCs, 0.505 and 0.537). There were interobserver differences in HVA of method I and II. Conclusion: No significant difference was found statistically between measurements of method I and II. Both methods I and II would be acceptable to measure angular parameters of hallux valgus deformity.

• 셀메드
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• 제10권1호
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• pp.6.1-6.7
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• 2020

In Ayurveda the eye is clarified as the most essential among all the indriyas (sensory organs), however because of changed way of life and quick pacing time we are experiencing such huge numbers of scatters, among them eye issue is most imperative as eye is the window of wellbeing. Our old acharyas (ancient scholars) have clarified about the different every day routine to be pursued for keeping up eye wellbeing, Padabhyang (foot massage) is one of them referenced in Ayurvedic dincharya (daily routine) and it has been depicted as Chakshushya (eye sight promoter) implies it improves our vision. So thinking about it, Padabhyang (foot massage) with and without snehan (oleation) was chosen for the present clinical preliminary to discover its adequacy in Timira (refractive error), result were statistically significant in subjective parameters but no change was found in objective parameter. We know, this restricted investigation has not secured every one of the angles but rather clinical preliminaries show empowering results. More study is necessary on large sample to draw the final inferences.

• Physical Therapy Rehabilitation Science
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• 제9권1호
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• pp.10-17
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• 2020

Objective: Hallux valgus (HV) is a common musculoskeletal deformity that is accompanied with pain and continues to decrease one's quality of life and ability to perform daily life activities by affecting gait and static stability. Therefore, this study aimed to investigate the effect of the angle of HV (HVA) and to compare the one-legged stance and gait parameters in young adults with less HV and severe HV. Design: Cross-sectional study. Methods: Forty young adults were divided into two groups, where HVA ≥15° (n=20) was defined as HV, and HVA <15° (n=20) was defined as normal. For balance ability, the center of pressure (COP) path, velocity, length of axis of the COP path, deviation of the x-axis and y-axis, and percentage of foot pressure were measured, and gait, the foot rotation angle, step length, percentage of each phase of the gait cycle, time change from the heel to forefoot, and maximum pressure of the forefoot and midfoot were measured. Results: Significant differences were found in sway length and time change from heel to forefoot during walking between the normal and HV groups (p<0.05). Most parameters were not associated with the HVA, but parameters such as length of axis and time to change from heel to forefoot were significantly associated with the HVA (p<0.05). Conclusions: These results suggest that most one-legged stance and gait parameters were not significantly affected by the HVA in young adults; therefore, future studies are needed in order to address other dynamic parameters and other methods of gait analysis for detecting clinically meaningful conditions.

• 대한족부족관절학회지
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• 제18권2호
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• pp.62-67
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• 2014

Purpose: Reconstructive surgeries for equinocavovarus foot deformities are quite variable, including hind-midfoot osteotomy or arthrodesis, soft tissue procedure, tendon transfers, etc. Comprehensive evaluation of the deformity and its etiology is mandatory for achievement of successful deformity correction. Few studies in this field have been reported. We report on the clinical and radiographic outcome of reconstruction for cavovarus foot deformities. Materials and Methods: The study is based on 16 feet with cavovarus foot deformities that underwent bony and soft tissue reconstructive surgery from 2004 to 2008. We evaluated the etiologies, varieties of surgical procedures performed, pain score, functional scores, and patient satisfaction and measured the radiographic parameters. Results: The average age at the time of surgery was 39.4 years old, with a male/female ratio of 9/4 and an average follow-up period of 23.9 months (range, 12~49 months). The etiologies of the cavovarus deformity were idiopathic 7 feet, residual poliomyelitis 5 feet, Charcot-Marie-Tooth disease 2 feet, and Guillain-Barre syndrome and hemiplegia due to cerebrovascular accident sequela 1 foot each. Lateral sliding calcaneal osteotomies were performed in 12 feet (75%), followed by Achilles tendon lengthening and plantar fascia release in 11 feet (69%), and first metatarsal dorsiflexion osteotomy/arthrodesis and tendon transfer in 10 feet (63%). Visual analogue scale pain score showed improvement, from an average of 4.2 to 0.5 points. American Orthopaedic Foot and Ankle Society ankle-hindfoot score showed significant improvement, from 47.8 to 90.0 points (p<0.05). All patients were satisfied. Ankle range of motion improved from $27.5^{\circ}$ to $46.7^{\circ}$. In radiographic measurements, calcaneal pitch angle improved from $19.1^{\circ}$ to $15.8^{\circ}$, Meary angle from $13.0^{\circ}$ to $9.3^{\circ}$, Hibb's angle from $44.3^{\circ}$ to $37.0^{\circ}$, and tibio-calcaneal axis angle from varus $17.5^{\circ}$ to varus $1.5^{\circ}$ Conclusion: We achieved successful correction of cavovarus foot deformities by performing appropriate comprehensive reconstructive procedures with improved functional, radiographic measures and high patient satisfaction.

• 한국전문물리치료학회지
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• 제25권2호
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• pp.1-12
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• 2018

Background: It is very difficult for hemiplegic patients to effectively perform the sit-to-stand (STS) movements independently because of several factors. Moreover, the analysis of STS motion in hemiplegic patients has been thus far confined to only muscle strength evaluation with little information available on structural and environmental factors of varying chair height and foot conditions. Objects: This study aimed to analyze the change in biomechanical factors (ground reaction force, center of mass displacement, and the angle and moment of joints) of the joints in the lower extremities with varying chair height and foot conditions in hemiplegic patients while they performed the STS movements. Methods: Nine hemiplegic patients voluntarily participated in this study. Their STS movements was analyzed in a total of nine sessions (one set of three consecutive sessions) with varying chair height and foot conditions. The biomechanical factors of the joints in the lower extremities were measured during the movements. Ground reaction force was measured using a force plate; and the other abovementioned parameters were measured using an infra-red camera. Two-way repeated analysis of variance was performed to determine the changes in biomechanical factors in the lower extremities with varying chair height and foot conditions. Results: No interaction was found between chair height and foot conditions (p>.05). All measured variables with varying chair height showed a significant difference (p<.05). Maximum joint flexion angle, maximum joint moment, and the displacement of the center of mass in foot conditions showed a significant difference (p<.05); however the maximum ground reaction force did not show a significant difference (p>.05). Conclusion: The findings suggest that hemiplegic patients can more stably and efficiently perform the STS movement with increased chair height and while they are bare-foot.

• 지역사회간호학회지
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• 제12권2호
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• pp.375-389
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• 2001

The purpose of this study was to evaluate the effect of Self-foot Reflex Massage (SRM) programme on the physical condition and anxiety level of hypertension workers. The research was designed in the pre and post-test. Sample test was done in five workers with essential hypertension. They were divided in two groups:- Group A and Group B. The Self-foot Reflex Massage (SRM) was applied three times a week for Group A and five times a week for Group B. The SRM was given in 40 minutes each time for 4 weeks from the 1st of January to the 30th of April in 2001. In order to evaluate the effect on SRM. blood pressure, total cholesterol, triglyceride, HDL cholesterol and LDL cholesterol were measured as physical parameters and state trait anxiety inventory was used twice each time between before and after the exercise. The collected data was analysed by Mann-Whitney test with SPSS program. The results were as follows: 1. Average age for the subjects were 39.8 (ranged from thirty-two to fifty-three) and average period of hypertension history was 42 months (ranged from twenty to eighty-four). 2. There was no significant difference between two examined groups in blood pressure. But, there was a significant difference in SRM of pre and post-test for two groups. 3. There was no significant difference in blood cholesterol between two groups and between pre and post-test. 4. State trait anxiety showed significant difference between pre and post-test except the results between two groups. This result suggests that SRM is effective on the decrease of systolic and diastolic pressure and the relief of state trait anxiety except for the blood cholesterol. Therefore, blood cholesterol is needed further evaluation in large subjects and longer period. Further research is regarded as necessary to evaluate and to compare the precise effects of SRM on the foot reflex massage (FRM) in anxiety.

• 한국전문물리치료학회지
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• 제10권1호
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• pp.77-95
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• 2003

Many factors affect foot and ankle biomechanics during walking, including gait speed and anthropometric characteristics. However, speed has not been taken into account in foot kinematics and kinetics during walking. This study examined the effect of walking speed on foot joint motion and peak plantar pressure during the walking phase. Eighty healthy subjects (40 men, 40 women) were recruited. Maximal dorsiflexion and excursion were measured at the first metatarsophalangeal joints during walking phase at three different cadences (80, 100, and 120 step/min) using a three dimensional motion analysis system (CMS70P). At the same time, peak plantar pressure was investigated using pressure distribution platforms (MatScan system) under the hallux heads of the first, second, and third metatarsal bones and heel. Maximal dorsiflexion and excursion and excursion at the ankle joint decreased significantly with increasing walking speed. Peak plantar pressure increased significantly under the heads of the first of the first, second, and third metatarsal bones, and heel with increasing walking speed: three was no change under the hallux. There were no significant changes in maximal dorsiflexion or excursion at the first metatarsophalangeal joint. The results show that walking speed should be considered when comparing gait parameters. The results also suggest that slow walking speeds may decrease forefoot peak plantar pressure in patients with peripheral neuropathy who have a high risk of skin breakdown under the forefoot.

• 대한족부족관절학회지
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• 제20권4호
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• pp.176-181
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• 2016

Purpose: The purpose of this study was to evaluate the clinical and radiologic outcome of syndesmosis fixation using TightRope$^{TM}$ (Arthrex, Naples, FL, USA) in acute syndesmosis injuries. Materials and Methods: Twenty-five consecutive patients with acute syndesmosis injuries, treated using TightRope$^{TM}$, were reviewed. Patients were evaluated preoperatively and at the last follow-up (at least 12 months postoperatively). Clinical outcomes were assessed using American Orthopaedics Foot and Ankle Society (AOFAS) ankle-hindfoot score and self-subjective satisfaction survey. Three radiologic parameters were evaluated two times at the preoperative and final follow up from the nonweightbearing ankle anteroposterior radiographs. Results: The mean AOFAS ankle-hindfoot score was 95.5 at the final follow-up. According to the satisfaction survey, 21 patients chose excellent, and four patients chose good. All radiologic parameters, including the mean tibiofibular clear space, mean tibiofibular overlap, and mean medial clear space on nonweightbearing ankle anteroposterior view, significantly improved after surgery. Complications occurred in only one patient who experienced knot irritation with infection. Conclusion: The short-term surgical results of syndesmosis fixation using TightRope$^{TM}$ were good to excellent, both clinically and radiographically. These results suggest that the fixation using TightRope$^{TM}$ is a valid option for acute syndesmosis injury.

• 대한족부족관절학회지
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• 제27권1호
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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.