• Journal of Korean Neurosurgical Society
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• v.29 no.4
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• pp.528-535
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• 2000

Objective : To investigate objectively the postoperative improvement of gait disturbance in patients with cervical myelopathy through a gait analysis. Patients and Methods : Ten patients who underwent cervical decompression and fusion for cervical myelopathy caused by spondylosis, OPLL, or concomitant hypertrophy of ligamentum flavum were studied. Preoperatively, gait disturbance was present in all patients. The patients were evaluated by gait analysis using three dimensional motion analyzer to collect data of linear and kinematic parameters before surgery, 1 week and 3 months after surgery. Statistical analysis of the related pre-and post-operative data were performed. Results : In the linear parameters, average value of cadence, walking speed, stride length, step time, width and double support were increased postoperatively compare to preoperative value. In the kinematic parameters, average value of knee flexion during initial swing phase, plantar flexion of ankle and range of motion of hip joint were increased as well. These differences were statistically significant(p<0.05). Conclusion : This study suggests that gait analysis can be used as a method of quantitative analysis of postoperative gait improvement in patients with cervical myelopathy.

• Korean Journal of Applied Biomechanics
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• v.21 no.2
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• pp.223-230
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• 2011

The purpose of this study was to analysis the effect of form and hardness of outsoles on the motion of the lower extremity joints and on foot pressure during gait. The subjects were 15 women(mean age, $48.5{\pm}2.4$ years), who had no serious musculoskeletal, coordination, balance or joint/ligament problems within 1 year prior to the study. The pelvic tilt, joint angles at the lower extremities and the vertical ground reaction force(GRF) were compared during gait with 3 types of shoes (A, B, C) by using one-way repeated ANOVA(p<.05). During gait, the peak tilt angle and the range of motion(ROM) of the ankle and knee joints were found to be significantly different among the 3 types of shoes. The type C shoes showed a significantly lower mean second maximum vertical GRF than types A and B. The curved outsoles of type C shoes, which had a form and hardness different from those of A and B, was designed strategically for walking shoes to provide stability to the Additionally, type C induced the dispersion of eccentric pressure and made the center of pressure roll over to the center line of the foot.

• International Journal of Control, Automation, and Systems
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• v.4 no.3
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• pp.325-332
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• 2006

The dynamic responses of human standing postural control were investigated when subjects were exposed to long-term horizontal vibration. It was hypothesized that the motion of standing posture complexity mainly occurs in the mid-sagittal plane. The motor-driven support platform was designed as a source of vibration. The AC Servo-controlled motors produced anterior/posterior (AP) motion. The platform acceleration and the trunk angular velocity were used as the input and the output of the system, respectively. A method was proposed to identify the complexity of the standing posture dynamics. That is, during AP platform motion, the subject's knee, hip and neck were tightly constrained by fixing assembly, so the lower extremity, trunk and head of the subject's body were individually immovable. Through this method, it was assumed that the ankle joint rotation mainly contributed to maintaining their body balance. Four subjects took part in this study. During the experiment, the random vibration was generated at a magnitude of $0.44m/s^2$, and the duration of each trial was 40 seconds. Measured data were estimated by the coherence function and the frequency response function for analyzing the dynamic behavior of standing control over a frequency range from 0.2 to 3 Hz. Significant coherence values were found above 0.5 Hz. The estimation of frequency response function revealed the dominant resonance frequencies between 0.60 Hz and 0.68 Hz. On the basis of our results illustrated here, the linear model of standing postural control was further concluded.

• Journal of Korean Foot and Ankle Society
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• v.15 no.2
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• pp.51-57
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• 2011

Pilon fractures involving distal tibia remain one of the most difficult therapeutic challenges that confront the orthopedic surgeons because of associated soft tissue injury is common. To introduce and describe the diagnosis, current treatment, results and complications of the pilon fractures. In initial assessment, the correct evaluation of the fracture type through radiographic checkup and examination of the soft tissue envelope is needed to decide appropriate treatment planning of pilon fractures. Even though Ruedi and Allgower reported 74% good and excellent results with primary open reduction and internal fixation, recently the second staged treatment of pilon fractures is preferred to orthopedic traumatologist because of the soft tissue problem is common after primary open reduction and internal fixation. The components of the first stage are focused primarily on stabilization of the soft tissue envelope. If fibula is fractured, fibular open reduction and internal fixation is integral part of initial management for reducing the majority of tibial deformities. Ankle-spanning temporary external fixator is used to restore limb alignment and displaced intraarticular fragments through ligamentotaxis and distraction. And the second stage, definitive open reduction and internal fixation of the tibial component, is undertaken when the soft tissue injury has resolved and no infection sign is seen on pin site of external fixator. The goals of definitive internal fixation should include absolute stability and interfragmentary compression of reduced articular segments, stable fixation of the articular segment to the tibial diaphysis, and restoration of coronal, transverse, and sagittal plane alignments. The location, rigidity, and kinds of the implants are based on each individual fractures. The conventional plate fixation has more advantages in anatomical reduction of intraarticular fractures than locking compression plate. But it has more complications as infection, delayed union and nonunion. The locking compression plate fixation provides greater stability and lesser wound problem than conventional implants. But the locking compression plate remains poorly defined for intraarticular fractures of the distal tibia. Active, active assisted, passive range of motion of the ankle is recommended when postoperative rehabilitation is started. Splinting with the foot in neutral is continued until suture is removed at the 2~3 weeks and weight bearing is delayed for approximately 12 weeks. The recognition of the soft tissue injury has evolved as a critical component of the management of pilon fractures. At this point, the second staged treatment of pilon fractures is good treatment option because of it is designed to promote recovery of the soft tissue envelope in first stage operation and get a good result in definitive reduction and stabilization of the articular surface and axial alignment in second stage operation.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.3
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• pp.233-246
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• 2022

Purpose : The study aims to determine the effects of virtual and non-virtual realities in a normal person's mirror walk on gait characteristics. Methods : Twenty male adults (Age: 27.8 ± 5.8 years) participated in the study. Reflection markers were attached to the subjects for motion analysis, and they walked in virtual reality environments with mirrors by wearing goggles that showed them the virtual environments. After walking in virtual environments, the subjects walked in non-virtual environments with mirrors a certain distance away after taking a 5 min break. To prevent the order effect caused by the experiential difference of gait order, the subjects were randomly classified into groups of 10 and the order was differentiated. During each walk, an infrared camera was used to detect motion and the marker positions were saved in real time. Results : Comparison between the virtual and non-virtual reality mirror walks showed that the movable range of the leg joints (ankle, knee, and hip joints), body joints (sacroiliac and atlantoaxial joints), and arm joints (shoulder and wrist joints) significantly differed. Temporal characteristics showed that compared to non-virtual gaits, the virtual gaits were slower and the cycle time and double limb support time of virtual gaits were longer. Furthermore, spacial characteristics showed that compared to non-virtual gaits, virtual gaits had shorter steps and stride lengths and longer stride width and horizontally longer center of movement. Conclusion : The reduction in the joint movement in virtual reality compared to that in non-virtual reality is due to adverse effects on balance and efficiency during walking. Moreover, the spatiotemporal characteristics change based on the gait mechanisms for balance, exhibiting that virtual walks are more demanding than non-virtual walks. However, note that the subject group is a normal group with no abnormalities in gait and balance and it is unclear whether the decrease in performance is due to the environment or fear. Therefore, the effects of the subject group's improvement and fear on the results need to be analyzed in future studies.

• The Journal of Korean Obstetrics and Gynecology
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• v.29 no.4
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• pp.46-56
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• 2016

Objectives: The purpose of this study is to evaluate the clinical effects of Muscle Energy Technique (MET) for peroneal nerve palsy after normal delivery. Methods: Two patients with peroneal nerve palsy were treated with acupuncture, moxibustion, cupping and MET. MET was performed in piriform, gluteus medius, anterior tibial and adductor muscles. To evaluate the effect of MET, we analyzed Ankle dorsiflexion range of motion (ROM), Manual Muscle Test (MMT), Numerical Rating Scale (NRS) and Ankle Hindfoot Scale (AHS). Results: In Case 1, ROM score was changed from −5 to 20, and MMT score was changed from 0 to 4. NRS score was changed from 5 to 1, and her AHS score was changed from 54 to 94 after treatment. In Case 2, ROM score was changed from 0 to 20, and her MMT score was changed from 1 to 5. NRS score was changed from 4 to 1, and her AHS score was changed from 64 to 97 after treatment. Conclusions: MET may be a useful treatment for patients who, shortly after childbirth or while breastfeeding, strongly refuse to treat the irritation.

• Journal of Korean Academy of Nursing
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• v.30 no.5
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• pp.1318-1332
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• 2000

The purpose of this study was to determine the effect of walk training on leg strength, flexibility, postural stability, balance and gait in home bound elderly women. Eighteen elderly women of the experimental group aged between 70 and 90 years image who have normal vision, hearing and Romberg test. They participated in the 12 week walk training. The subjects of the experimental group practiced walk training 3 times a week for during 12 weeks. During the 40 minute workout, the subjects practiced 5 minutes of warming-up exercises, 30 minutes of conditioning exercises and 10 minutes of a cool-down exercise. The intensity for the conditioning phase was determined by subject' heart rates, which ranged from 60% to 70% of age-adjusted maximum heart rates. The body composition, leg strength, flexibility, postural stability, balance and gait were measured prior to and after the experimental treatment. The body fat, lean body mass, leg strength (ankle dorsiflexor, plantarflexor, inversor and eversir, knee flexor, extensior), flexibility (range of motion of ankle dorsiflexion, plantarflexion, inversion and eversion), and postural stability of the experimental group were significantly greater than those of the control group. Duration of standing on the right foot and that of standing on the left foot of the experimental group was greater than that of the control group. Total balance scores of the experimental group were significantly higher than those of the control group. Among 13 items for balance, the scores of experimental group in balance with eyes closes, turning balance, sternal nudge, neck turning, one leg standing balance and back extension were higher than those of the control group. Total scores of gait of the experimental group were significantly higher than those of the control group following the walking training. Scores of experimental group in step height, step length and walk stance while walking among 9 items for gait were significantly higher than those of the control group. The results suggest that walk training can improve physical fitness for prevention in home bound elderly women.

• Archives of Reconstructive Microsurgery
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• v.10 no.2
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• pp.75-80
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• 2001

Purpose : We have evaluated the morbidity of donor site after transfer of free fibular osseous and osteocutaneous flap to defect site of bone and soft tissue due to chronic osteomyelitis of long tubular bone, open fracture with bony defect, bone or soft tissue tumor and congenital anomaly. Materials and methods : The 54 cases of 79 cases to be carried out from May, 1982 to May, 2001 which could be followed up were reviewed. There were forty nine in male and five in female. The mean age was 35(4 to 66)years old and mean follow up period is 21.3 month(12 to 72). We have retrospectively analyzed the various postoperative complications such as compartment syndrome, donor site infection, skin defect, hypesthesia, hammer toes, ankle instability and activity of daily living by help of questionnaire, telephone, physical examination, follow up x-ray study and chart. Results : In the total 54 cases the medication period for pain control after operation were classified into three groups under 2 weeks(49 cases), from 2 weeks to 6 weeks(3 cases) and over 6 weeks(2 cases). The postoperative morbidity were occurred in total 12 cases(compartment syndrome: 0, infection : 2, skin defect: 1, hypesthesia: 5, hammer toe: 2 ankle pain: 2 discomfort in activity of daily living: 0), and also the morbidity rates of donor site were 23.5% in osseous flap and 21.6% in osteocutaneous flap were occurred. There was no statistical significonce in morbidity between osseous and osteocutaneous free fibular flap transfer(P>0.05). Discussion : In general the morbidity of free fibular flap transfer was relatively high but it did not have any effect on daily activity of living. We think that the meticulous operation technique, detailed wound care and early range of motion exercise will reduce the morbidity of donor site of flap.

• Journal of Korean Foot and Ankle Society
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• v.15 no.4
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• pp.217-222
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• 2011

Purpose: The aim of this study was to evaluate the result of combined Weil and dorsal closing wedge osteotomy for Freiberg's disease. Materials and Methods: We performed combined Weil and dorsal closing wedge osteotomy of the second metatarsal under the diagnosis of Freiberg's disease in 7 patients, 7 feet (2 male and 5 female). The mean age at the time of operation was 29 years and the mean follow-up period was 31 months. Patients had no trauma history and no combined deformity of the foot. The surgical results were evaluated by VAS and weight bearing radiographs in antero-posterior and oblique projection. Results: According to Smillie staging system, there were 1 of stage II, 2 of stage III and 4 of stage IV patients. The osteotomy site was united at 8 weeks and the second metatarsal was shortened in length of average 2.8 mm. Remodeling of the metatarsal head was observed at 24 months. The mean VAS was decreased from 8.2 points preoperatively to 2.7 points at follow-up. And average range of motion of second metatarso-phalangeal joint was increased from 30o preoperatively to 45o at follow-up. There was no transfer metatarsalgia or arthritis of the metatarsal head during follow-up. Conclusion: Combined Weil and dorsal closing wedge osteotomy of the metatarsal appears to be an effective procedure for the treatment of Freiberg's disease with a view to shortening of metatarsal length and elevation of metatarsal head.

• The Korean Journal of Rehabilitation Nursing
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• v.6 no.2
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• pp.213-225
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• 2003

The purpose of this study is to develop and evaluate the health promotion program to increase the functional status of the in-house stroke patients. The subjects for the experiment are 38 in-house stroke patients in a health center and welfare centers suffering from hemiplegia. The experimental group consists of 19 stroke patients and the control group consists of another 19 stroke patients. The program was applied to the experimental group for 8 weeks. The subjects were given health education at the first week. At the second and the fifth week they were given counselling on health by home visit. At the third, the fourth, the sixth and the seventh week they were interviewed by phone about health, and at the last week they shared their experiences through group meeting. The results of the study are as follows: 1. The degree of ADL in the experimental group increased significantly, compared with that of the control group. 2. In the experimental group the degree of Range of Motion in shoulder abduction, elbow flexion, hip flexion and ankle dorsiflexion increased significantly, compared with that of the control group. 3. In the experimental group the degree of muscle strength in elbow flexion, knee extension, and ankle dorsiflexion increased significantly, compared with that of the control group. 4. Systolic pressure, diastolic pressure in the experimental group decreased significantly, compared with that the control group. 5. HWR in the experimental group didn't decreased significantly, compared with that the control group. 6. The degree of depression in the experimental group decreased significantly, compared with that the control group. 7. The degree of social adaptation in the experimental group increased significantly, compared with that the control group. The results above show that the health promotion program for this study was effective in promoting the performance of lifestyle for health improvement of the in-house stroke patients. Therefore, it is considered that the program can be used as an efficient nursing intervention for the in-house stroke patients who need continuous health-improving behaviors.