• 재활복지공학회논문지
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• 제5권1호
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• pp.47-52
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• 2011

기능성 발보조기는 신발 착용 시 발바닥과 직접 접촉되어 비정상적인 신체 분절의 교정 및 발의 기능을 향상시킬 뿐만 아니라 체중 및 균형을 유지시키고 약화된 부위를 지지함으로써 사람의 직립자세 유지를 위한 균형 유지에 많은 도움이 된다. 이에 본 사례 연구에서는 보행 안정성을 비롯한 충격 흡수 기능을 수용할 수 있는 기능성 발보조기가 족부 형태 및 재질에 따라 신체의 균형유지에 미치는 영향에 대하여 연구하였다. 사람의 평균 무게 중심점의 흔들림 속도(sway velocity)를 이용한 균형감각 자세유지도의 고찰을 통해 족부형태별, 기능성 보조기의 재질에 따른 신체의 균형능력에 미치는 영향을 비교 평가한 결과, 안정한 상태에서 눈을 뜬 자세에서만 유의(p<0.006)한 결과를 나타냈으며, 이 자세에서 발의 형태별로 구분하여 통계 처리한 결과, 정상족(p<0.010), 편평족(p<0.000), 요족(p<0.003)의 순으로 나타났다. 그리고 기능성 발보조기의 재질에 따른 발의 형태별 균형에 미치는 영향을 분석한 결과, 연성재질은 정상의 발에서 그리고 경성재질은 편평족과 요족에 있어서 균형유지에 효과가 있는 것으로 나타났다.

• 대한족부족관절학회지
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• 제20권2호
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• pp.55-61
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• 2016

The cavus foot is a deformity characterized by an elevated medial longitudinal arch and a hindfoot varus with plantarflexed 1st ray. The etiology of cavus foot is usually related to neuromuscular disease or idiopathic cause. Thorough clinical and radiographic evaluation is required for differentiating etiology of the cavus. Most cases of cavus foot are stable and slowly progressive deformities which can initially be managed with conservative treatment including orthoses and physical therapies. Determining whether the deformity is flexible or rigid, the apex of the deformity and any muscle imbalances in foot and ankle is important for achievement of an adequately balanced plantigrade foot. Treatment should include systematic preoperative planning for selection of appropriate procedures for maintaining a functional and flexible foot with combinations of soft-tissue release, osteotomy, tendon transfer, and arthrodesis.

• 한국전문물리치료학회지
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• 제18권3호
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• pp.16-25
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• 2011

This study aimed to evaluate factors related to the ability of ambulatory patients with cerebral palsy (CP) to walk over vertical and horizontal obstacles. Twenty patients with spastic CP who were able to walk independently for at least 10 m with or without walking devices were recruited for the study. Participants were required to walk over small obstacles (1, 4, and 8 cm in height or width; total of 6 conditions). A 'fail' was recorded when either the lower limbs or the walking device contacted the obstacle. Linear regression analyses were used to determine the effects of age, sex, walking devices, eyeglasses, subtype (hemiplegia or diplegia), ankle foot orthoses, functional level, and score of body mass index on the ability of obstacle crossing. Fifteen participants (75%) failed to adequately clear the foot or walking device over obstacles in at least 1 condition. The chance of failure in crossing vertical obstacle was affected by the use of ankle foot orthoses, eyeglasses, gender, and CP subtype (p<.05). The failure rate crossing horizontal obstacle was affected by CP subtype. These findings suggest that rehabilitation procedures should (1) consider the clinical characteristics of patients in order to prepare them to be more independent while performing daily activities, and (2) incorporate environmental conditions that patients encounter at home and in the community.

• The Journal of Korean Physical Therapy
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• 제16권3호
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• pp.161-175
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• 2004

The purpose of this study was to determine the effect of HPAFO(Hinged Plastic Ankle Foot orthosis) and SPAFO(Solid Plastic Ankle Foot Orthosis) on standing balance and step moving in hemiplegia patients. Twenty hemiplegic patients were either inpatient or outpatient at the Rehabilitation medicine, MokPo J General Hospital and JeonJu J Medical Center from July 15, 2002 to September 15, 2002. Patients were able to ambulate independently for at least 10 meters and to stand independently for at least 10 minutes with balance measurement tool. The static balance and dynamic activity measurement was determined by SAKAI active balancer(Japan) with wearing HPAFO and wearing SPAFO. The static balance and dynamic activity analysis was analyzed by independent t-test. The results were as follows: 1. There were no significant difference in body weight bearing percent between wearing HPAFO and wearing SPAFO(p>0.05). 2. There were significant difference in whole path length between wearing HPAFO and wearing SPAFO(p<0.05). 3. There were significant difference in Effective Value Area between wearing HPAFO and wearing SPAFO(p>0.001). 4. There were significant difference in repeated functional time between wearing HPAFO and wearing SPAFO(p>0.001). 5. There were significant difference in cadence between wearing HPAFO and wearing SPAFO(p>0.001). The result of this study showed that wearing HPAFO and wearing SPAFO gave fair amount of improvement to static standing balance and dynamic movement ability of hemiplegic patients. The comparison result showed significant differences in between HPAFO and SPAHFO. The result of this study had a general limitation due to the restricted number of cases. The future study needs more detailed research and comparison with various variance between these two orthoses.

• Annals of Rehabilitation Medicine
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• 제42권6호
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• pp.863-871
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• 2018

Objective To evaluate the association between progression of curvature of scoliosis, and correction for functional component in patients with juvenile idiopathic scoliosis (JIS). Methods We retrospectively reviewed medical data of patients prescribed custom molded foot orthosis (FO) to correct inequality of RCSPA (resting calcaneal stance position angle), and chose 52 patients (26 females, 26 males) with Cobb angle ${\geq}10^{\circ}$ in radiology and uneven pelvic level at iliac crest by different RCSPA (${\geq}3^{\circ}$) as a factor of functional scoliosis. They had different hump angle ${\geq}5^{\circ}$ in forward bending test, for idiopathic scoliosis component. Their mean age and mean period of wearing FO were $79.5{\pm}10.6months$ and $18.6{\pm}0.70months$. Results Cobb angle was reduced from $22.03^{\circ}{\pm}4.39^{\circ}$ initially to $18.86^{\circ}{\pm}7.53^{\circ}$ after wearing FO. Pelvis height difference and RCSPA difference, were reduced from $1.07{\pm}0.25cm$ initially to $0.60{\pm}0.36$, and from $4.25^{\circ}{\pm}0.71^{\circ}$ initially to $1.71^{\circ}{\pm}0.75^{\circ}$ (p<0.01). Cobb angle improved most in 9 months. However, there was no significant improvement for those with more than $25^{\circ}$ of Cobb angle initially. Mean Cobb angle improved in all age groups, but patients less than 6 years had clinically significant improvement of more than $5^{\circ}$. Conclusion JIS can have functional components, which should be identified and managed. Foot orthosis is useful in correcting functional factors, in the case of pelvic inequality caused by different RCSPA, for patients with juvenile idiopathic scoliosis.

• 대한족부족관절학회지
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• 제24권3호
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• pp.113-119
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• 2020

Purpose: A flatfoot that fails to form a longitudinal foot arch is a common lower limb deformity in children. This study evaluated the structural and functional effects of the insole for pediatric flexible flat foot (PFFF). Materials and Methods: Twenty-nine PFFF patients (20 boys and 9 girls, 58 feet) with bilateral symptomatic flatfoot deformities between February 2017 and May 2019 were included in this study. Sixteen patients (32 cases, study group) were treated with a pressured based 3-dimensional printing insole, and 13 patients (26 cases, control group) were followed up regularly without any treatment. Flatfoot was diagnosed by a lateral talo-first metatarsal angle of more than 4° in convex downward and talocalcaneal angles of more than 30° and a calcaneal pitch of less than 20°. The foot pressures, including the midfoot pressure, total foot pressure, and the ratio of the midfoot pressure to the total foot pressure, were evaluated by pedobarography. The clinical scores were assessed using the visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS), and Pediatrics Outcomes Data Collection Instrument (PODCI) scores. Results: The mean age of the study group was 9.16 years, and the mean age of the control group was 7.73 years. The mean follow-up period was 16 months. The change in the lateral talocalcaneal angle was -4.664°±1.239° in the study group and -0.484°±1.513° in the control group. A significant difference in the amount of change of the lateral talocalcaneal angle was observed between the two groups (p=0.034). The midfoot pressures were similar in the two groups. Conclusion: Pressure based customized 3-dimensional printing insole in PFFF may have some effect on the hindfoot bony alignment, but it does not affect the changes in midfoot pressure.

• The Journal of Korean Physical Therapy
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• 제34권5호
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• pp.218-223
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• 2022

Purpose: This study sought to identify the effects of an insole applied for the flexible flat-foot condition on dynamic balance and ankle muscle activities during the Y-balance test (YBT). Methods: Thirteen flexible flat-footed adults and an equal number of normal-footed adults were enrolled. The dynamic balance of the subjects was measured using the YBT, which is a reach test. While they were reaching forward with their foot, the percentage maximum voluntary isometric contraction (MVIC) of the tibialis anterior, peroneus longus and medial and lateral gastrocnemius were measured and analyzed. The flat-footed group then applied the ready-made insoles and underwent the YBT again. A comparison of the distance and muscle activity was conducted using YBT, not only between the flat-footed and control group, but also between the flat-footed group before and after the application of the insole. Results: Between the groups, the anterior reach distance in the flat-footed group was significantly lower, but there were no significant differences observed in the posteromedial and posterolateral directions. With the insole, the reach distance of the flat-footed group was significantly increased in the anterior and posterolateral direction compared to the control group. With the insole, the lateral gastrocnemius activity significantly decreased compared to trials without the insole in the flat-footed group, but there were no significant differences in the other muscles. Conclusion: The insole for flat-footed subjects can maintain the medial arch of the foot, and it may help enhance functional and mechanical dynamic balance in people with flat feet.