• PNF and Movement
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• 제19권1호
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• pp.87-95
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• 2021

Purpose: The purpose of this study was to determine the effects of talus stability taping during gastrocnemius stretching on ankle passive dorsiflexion, talus posterior glide, and balance in subjects with limited ankle dorsiflexion. Methods: Fifteen subjects (eight males and seven females) with limited ankle dorsiflexion participated in this study. Ankle passive dorsiflexion range of motion (ROM), talus posterior glide, and the lower quarter Y-balance test (YBT-LQ) were measured pre-stretching, after applying gastrocnemius stretching (GS), and after applying gastrocnemius stretching with talus stability taping (GSTST). The two types of stretching were performed at random. Results: Ankle passive dorsiflexion ROM was significantly increased by both types of stretching (p < 0.05), and ROM was significantly more increased post-GSTST than post-GS (p < 0.05). In addition, talus posterior glide was significantly increased post-GSTST than pre-stretching and post-GS (p < 0.05). However, there was no significant difference between post-GS and pre-stretching (p > 0.05). YBT-LQ score was significantly increased post-GSTST than pre-stretching (p < 0.05). Conclusion: Gastrocnemius stretching with talus stability taping is an effective method for subjects with limited ankle dorsiflexion to improve ankle passive dorsiflexion, talus posterior gliding, and balance.

• 대한정형도수물리치료학회지
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• 제28권3호
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• pp.51-59
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• 2022

Background: This study aimed to investigate the effect of mobilization with movement (MWM) applied to the ankle joint, on the craniovertebral angle (CVA), pressure pain threshold, and neck disability index (NDI) in asymptomatic adults with a forward head posture (FHP). Methods: A total of 32 subjects with FHP were assigned to either the MWM group (N=16) or the cranio-cervical flexion exercise (CCFE) group (n=16). The CVA, pressure pain threshold and NDI were measured before and 4 weeks after the intervention. Results: A significant improvement in the CVA was observed in the MWM group (p<.05), whereas no significant changes (p>.05) were observed in the CCFE group. Both groups showed significant differences in the pressure pain threshold and NDI before and after the intervention (p<.05). Conclusion: The results of the study suggest that MWM applied to the ankle joint can effectively improve the CVA, pressure pain threshold, and NDI of adults with a forward head posture. Based on this study, the ankle MWM technique for dorsiflexion can be used as an objective research method for additional studies targeting FHP patients in the future.

• Journal of Trauma and Injury
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• 제20권2호
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• pp.130-137
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• 2007

Purpose: Ultrasound is of proven accuracy in abdominal and thoracic trauma and may be useful for diagnosing extremity injury in situations where radiography is not available, such as disasters and military and space applications. However, the diagnosis of fractures is suggested by history and physical examination and is typically confirmed with radiography. As a alternative to radiography, we prospectively evaluated the utility of extremity ultrasound performed by trained residents of emergency medicine (EM) one patient with wrist and ankle extremity injuries. Methods: Initially, residents of EM performed physical examinations for fractures. The emergency ultrasound (EM US) was performed by trained residents, who used a portable ultrasound device with a 10- to 5-MHz linear transducer, on suspected patients before radiography examination. The results of emergency ultrasound and radiography and the final diagnosis were recorded, and correlation among them were determined by using Kappa s test Results: Thirty-nine patients were enrolled in our study. The average age was $36.6\;{\pm}\;19.3$ years. There were radius Fx. (n=21), radius-ulna Fx. (n=1), ulna Fx. (n=1), and contusion (n=2) injuries among the wrist injury and lat.-med. malleolar Fx. (n=13), lat. malleolar Fx. (n=6), and med. malleolar Fx. (n=3) injuries among the ankle injury. Comparing EM US with radiography, we found the sensitivity, specificity, positive predictive value, and negative predictive value of EM US for Fx. diagnosis to be 100%, 66.7%, 97.3%, 100% and those of radiography to be 97.2%, 100%, 100%, and 75%, respectively. Kappa s test for a correlation between the Fx. diagnosis of EM US and the final diagnosis of Fx was performed, and Kappa's value was 0.787 (P = 0.004).Conclusion: EM US for Fx. can be performed quickly and accurately by EM residents with excellent accuracy in remote locations such as disaster areas and in military and aerospace applications. EM US was as useful as radiography in our study and had a high correlation to the final diagnosis of Fx. Therefore, ultrasound should performed on patients with extremity injury to determine whether extremity evaluation should be added to the FAST (focused abdominal sonography trauma) examination.

• The Journal of Korean Physical Therapy
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• 제24권2호
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• pp.157-162
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• 2012

Purpose: This study is to identify the effect of Ankle Joint Taping applied to patients with chronic hemiplegia on their gait velocity and joint angles. Methods: We randomly extracted a clinical sample from 30 patients with hemiplegia resulting from stroke and classified them into two groups of a control group including 15 patients offered a regular therapeutic exercise and a test group including 15 patients offered taping. We also conducted the comparative analysis and pretest of the affected ankle joint angles by the normal characteristics of all subjects, Time to up and go test (TUG), 3D movement analyzer before the intervention. We applied taping to a test group for eight hours a day, five days a week during two weeks and conducted the comparative analysis of the gait velocity and the affected ankle joint angles by a comparison between and within two groups of before and after the intervention by conducting a posttest after the intervention. The result is as followings. Results: It indicated that there was a significantly decreased time with the increased gait velocity that a test according to a result of comparing the gait velocity within two groups (p<0.05). It indicated that there was a significantly increased angle in a comparison within two groups of test that inversion angle of a control group according to a result of comparing the ankle joint angles by 3D movement analyzer within groups (p<0.05). Conclusion: We found that TUG will help patients walk independently because it met a test group's need in the change of the gait velocity between two groups by recording less than 14 seconds which is the standard of using assistive aids and also found that ankle joint taping will help the joints prevent their function change considering that a control group showed an increased inversion angle in the change of the ankle joint within two groups.

• 대한의용생체공학회:의공학회지
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• 제20권2호
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• pp.183-190
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• 1999

본 논문은 족하수 환자를 대강으로 휴대가 간편하고 사용이 편리한 피드백 제어형 전기자극기를 제안하는 데 그 목적이 있다. 이 시스템은 교통사고, 산업재해, 뇌졸중 등으로 인하여 하지마비를 동반한 환자에서 마비된 하지근의 위축 및 괴사를 방지하고 혈액순환을 증가시킬 뿐만아니라 보행을 보조하여 안정된 활동을 가능케 한다 피드백 제어형 전기자극기는 환자가 오랜 시간 보행시 전극의 임피던스 변화나 근피로에 의해 족하수증이 다시 발생하게 되면 관절각의 변화가 관절각 센서에 의해 검출되고 이때의 오차는 PID 제어에 의한 자극전압의 변화를 가져와 설정된 위치에 발목이 도달하도륵 자극레벨이 자동 조절된다. 자극조건은 자극주파수 40 Hz, 자극펄스 0.2 ms, 30∼80 V이다. 족하수 환자 5명을 대상으로 42일 동안 첫째 1주일 동안에는 하루에 15분을 자극하고, 다음 주기는 1주일 단위로 하루에 30분, 60분, 70분, 120분씩 점차적으로 시간을 증가하면서 자극하였다. 이때 근력은 27.7%가 향상되었고, 근 피로도는 22.9%가 감소되었다. 이런 결과를 종합할 때 피드백 제어형 전기자극기는 족하수 환자의 보행기능 및 운동기능을 회복하는 데 효과적이라 하겠다.

• 한국운동역학회지
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• 제19권2호
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• pp.399-406
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• 2009

본 연구의 목적은 롤러 신발과 조깅 신발 착용 후 보행 시 운동학적 변인에 대하여 비교 분석 하는데 있다. 이를 위해 하지 근골격계에 이상이 없는 중학생 8명을 피험자로 선정하여 3차원 동작 분석을 실시하였다. 분석 결과, 활보장, 인체무게 중심변위 및 선속도, 관절각 및 각속도에서 집단 간 통계적으로 유의한 차이를 보였다. 특히 롤러 집단의 경우 지지 시 발목 관절각이 증가하고 무릎각의 각속도가 감소하는 결과를 나타내었다. 이는 롤러 신발의 경우 장착된 휠에 의해 지지 시 적절한 배측굴곡이 이루지지 못하고, 불안정성을 극복하기 위해 무릎의 과도한 굴곡이 나타난 것으로 사료되어 진다. 이러한 운동학적 변인의 차이는 롤러 신발 보행 시 정상 패턴과는 다른 불안정한 보행 동작을 유발시키고 이러한 동작이 지속적으로 이루어진다면 하지 근골격계에 변화를 유발시켜 부상 유발의 가능성이 있을 것으로 생각된다. 따라서 본 연구 결과를 토대로 향후 보다 안정성 높은 롤러 신발을 개발할 수 있을 것으로 기대된다.

• 재활복지공학회논문지
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• 제9권2호
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• pp.137-144
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• 2015

본 논문은 하지의 움직임을 측정하고 분석할 수 있는 관성센서 기반 보행분석 시스템에 관한 것이다. 본 시스템 구현을 위해 자이로스코프, 가속도계 및 지자계 신호를 이용한 자세 방위 측정장치 모듈을 일체형으로 개발하였으며, 다수의 모듈을 환자의 분절에 부착하여 공간상에서 각 분절의 방위각을 제공할 수 있도록 하였다. 또한 재활과 관련된 많은 응용에 있어 중요한 생체역학 측정값인 신체 분절간의 관절각을 추출하는 알고리즘을 제안하였다. 개발한 자세 방위 측정장치 모듈의 성능을 평가하기 위하여 3차원 공간상의 변위 및 방위를 밀리미터 해상도로 제공할 수 있는 Vicon을 참조 측정 시스템으로 이용하였으며, yaw와 pitch에서 1.08, 1.72도의 평균 제곱근 오차를 얻을 수 있었다. 보행 분석 시스템의 성능 검증을 위하여 7개의 AHRS 모듈을 하지에 부착하고 고관절, 무릎, 발목에 대한 관절각을 계산하여, Vicon과의 비교 실험을 수행하였다. 실험 결과 본 연구에서 개발한 시스템은 뇌졸중 후 회복단계 동안 사지 및 보행 동작을 실시간으로 분석, 제공함으로서 재활의 효과, 난이도 조절 및 피드백 요소를 제공할 수 있을 것으로 판단된다.

• 대한의용생체공학회:의공학회지
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• 제43권2호
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• pp.81-93
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• 2022

Proprioception training has been considered a secondary method to facilitate postural control ability. This study investigated the effects of two different proprioception training methods - the proprioceptive neuromuscular facilitation (PNF) and visual feedback-based joint position and force reproduction (VF) - on postural control advancements. Sixteen healthy people volunteered for this study, and they randomly grouped two. Each group participated in the PNF and VF training for three weeks. We evaluated each subject's proprioception levels and balance ability before and after the training. We used a clinometer and electromyogram (EMG) for VF training. The joint position reproduction test was also used to evaluate the position and force aspects of the proprioception level. We analyzed the trajectory of the center of pressure (COP) while subjects were standing on the firm floor and balance board with one leg using a pressure mat. The improvement of the position aspect of the proprioception level of the VF group (4.93±4.74°) was larger than that of the PNF group (-0.43±2.08°) significantly (p=0.012). The improvement of the anterior-posterior COP velocity of the PNF group (0.01±0.01 cm/s) was larger than that of VF group(0.002±0.01 cm/s) significantly (p=0.046). Changes of position error in the PNF group (rho=0.762, p=0.028) and tibialis anterior force reproduction error in the VF group showed a significantly strong relationship with balance ability variables. These results showed that different PNF and VF have different effects on improving two aspects of proprioception and their relationship with the balance ability. Therefore, these results might be useful for selecting proprioception or balance rehabilitation considering the clinical and patients' situation.

• 한국전문물리치료학회지
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• 제25권2호
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• pp.22-29
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• 2018

Background: Deficits of both ankle dorsiflexion range of motion (DFROM) and dynamic balance are shown in persons with chronic ankle instability and the elderly, with the risk of falls. Objects: This study aims to investigate the relationship between DFROM and dynamic balance in elderly subjects and young adults. Methods: Fifty-nine subjects were divided into three groups: ankle stability young group (SY), ankle instability young group (IY) and ankle stability older group (SO). We recruited three old subjects with ankle instability, but excluded them during a pilot testing due to the safety issue. DFROM was measured by weight bearing lunge test (WBLT) and dynamic balance was measured via star excursion balance test (SEBT) in anteromedial, medial, and posteromedial directions. The group differences in WBLT and SEBT and each group's correlation between WBLT and SEBT were detected using the R statistical software package. Results: The dorsiflexion range of motion was significantly different between the SY, IY, and SO groups. The SO group showed the highest DFROM and IY group showed the lowest DFROM (SY: $45.88{\pm}.66^{\circ}$, IY: $39.53{\pm}1.63^{\circ}$, SO: $47.94{\pm}.50^{\circ}$; p<.001). However, the SO group showed the lowest dynamic balance score for all SEBT directions (SY: $87.24{\pm}2.05cm$, IY: $83.20{\pm}1.30cm$, SO: $77.23{\pm}2.07cm$; p<.05) and there was no relationship between the dorsiflexion range of motion and dynamic balance in any group. Conclusion: Our findings suggest that ankle DFROM is not a crucial factor for dynamic stability regardless of aging and ankle instability. Other factors such as muscle strength or movement coordination should be considered for training dynamic balance. Therefore, we need to establish the rehabilitation process by measuring and treating ROM, balance, and muscle strength when treating young adults with and without ankle instability as well as elderly people.

• 대한소아치과학회지
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• 제36권2호
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• pp.298-304
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• 2009

X-linked hypophosphatemic rickets(이하 XLH로 기술)는 구루병의 일종으로 임상적으로는 비타민 D의 대량 투여로도 개선되지 않고 성염색체 우성 유전되는 유전성 질환이다. 저인산혈증성 구루병, 비타민 D저항성 구루병이라고도 불린다. 본 증례는 서울대학교병원 소아과에서 XLH로 진단받은 6세 6개월의 여아로, 상악 좌측 중절치의 매복을 주소로 소아치과에 의뢰된 환자이다. 환아는 XLH환자에서 전형적으로 보이는 보행 장애, 다리의 휨현상 작은 키, 손목, 무릎, 발목 관절의 종창 등이 관찰되었다. 또 치과적 특징으로 임상적으로 건전한 치아에서 자발적인 치근단 농양과 농루가 발생하였고 치아의 맹출 지연, 우상치 (taurodontism), 근단공의 폐쇄 지연, 확대된 치수강 등을 나타내었기에 이전 문헌 고찰을 통하여 XLH 환아의 특징을 살펴보고 본 환자의 의과적, 치과적 특성 및 매복된 치아의 치료에 대하여 보고하는 바이다.