• Korean Journal of Applied Biomechanics
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• v.31 no.1
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• pp.30-36
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• 2021

Objective: The objective of the present study was to analyze the relationship between strength of the lower extremity's joints and their local dynamic stability (LDS) of gait in elderly women. Method: Forty-five elderly women participated in this study. Average age, height, mass, and preference walking speed were 73.5±3.7 years, 153.8±4.8 cm, 56.7±6.4 kg, and 1.2±0.1 m/s, respectively. They were tested torque peak of the knee and ankle joints with a Human Norm and while they were walking on a treadmill at their preference speed for a long while, kinematic data were obtained using six 3-D motion capture cameras. LDS of the lower extremity's joints were calculated in maximum Lyapunov Exponent (LyE). Correlation coefficients between torque of the joints and LyE were obtained using Spearman rank. Level of significance was set at p<.05. Results: Knee flexion torque and its LDS was negatively associated with adduction-abduction and flexion-extension movement (p<.05). In addition, ratio of the knee flexion torque to extension and LDS was negatively related to internal-external rotation. Conclusion: In conclusion, knee flexion strength should preferentially be strengthened to increase LDS of the lower extremity's joints for preventing from small perturbations during walking in elderly women.

• Journal of Korean Foot and Ankle Society
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• v.17 no.2
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• pp.130-135
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• 2013

Purpose: Preshaped Locking compression plate(LCP) has holes with fixed angle between screw and plate and have advantage firm fixation because it has stability of angular and axial deformity. We evaluated usefulness of LCP after open reduction and internal fixation in distal fibular fracture. Materials and Methods: Between December 2011 and May 2012, 23 patients with fracture of distal fibula were followed up at least 12 months underwent open reduction and internal fixation with LCP. There were 15 males and 8 females with a mean age 39.8(20~69) years. According to Danis-Weber classification, there were 20 cases of type B and 3 cases of type C. There were 13 cases of isolated lateral malleolus fractures, 1 case of bimalleolar fracture, 6 cases of trimalleolar fractures and 3 cases of distal tibia fractures with proximal fibula fracture. Intraoperatively, we assessed whether preshaped LCP fit lateral margin of distal fibula or not and evaluated quality of reduction and postoperative complications. The cases were analyzed by radiological bone union time and clinical results according to the criteria of Meyer Results: Of all cases, complete bone union was achieved and average radiological bone union time was 7.3(6~12) weeks. The clinical results were excellent in 18 cases(78%), good in 5 cases(22%). There were 5 cases of plate with 3 holes, 13 cases of plate with 4 holes, 2 cases of plate with 5 holes, 1 case of plate with 6 holes and 2 cases of plate with 7 holes. The average number of screws at proximal fragement was 2.5 and at distal fragment was 3.5. In 14 cases (60.8 %), we needed re-bending of plate because the distance between plate and lateral cortical margin of distal fibula was more than 5 mm at anteroposterior X-ray after reduction. All cases have anatomical reduction and there were no complications of wound infections. There were no complaint about hardware irritation. Conclusion: At fractures of distal fibula,preshaped LCP had a excellent stability although far cortex was not fixed with screw and bending of plate. And there are less complications of hardware irritation and wound problems. But, Some complement would be needed because there were no complete fitting between precontour of LCP and lateral cortical margin of distal fibula.

• Korean Journal of Applied Biomechanics
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• v.25 no.4
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• pp.413-421
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• 2015

Objective : The purpose of this study was to investigate biomechanical changes of the lower limb including dynamic stability with changes in illumination (300Lx, 150Lx, and 5Lx) and slope (level and $15^{\circ}$ downhill) as risk factors for elderly falls. Method : Fifteen elderly females were selected for this study. Seven infrared cameras (Proreflex MCU 240: Qualisys, Sweden) and an instrumented treadmill (Bertec, USA) surrounded by illumination regulators and lights to change the levels of illumination were used to collect the data. A One-Way ANOVA with repeated measures using SPSS 12.0 was used to analyze statistical differences by the changes in illumination and slope. Statistical significance was set at ${\alpha}=.05$. Results : No differences in the joint movement of the lower limbs were found with changes in illumination (p>.05). The maximum plantar flexion movement of the ankle joints appeared to be greater at 5Lx compared to 300Lx during slope gait (p<.05). Additionally, maximum extension movement of the hip joints appeared to be greater at 5Lx and 150Lx compared to 300Lx during slope gait (p<.05). The maximum COM-COP angular velocity (direction to medial side of the body) of dynamic stability appeared to be smaller at 150Lx and 300Lx compared to 5Lx during level gait (p<.05). The minimum COM-COP angular velocity (direction to lateral side to the body) of dynamic stability appeared smaller at 150Lx compared to 5Lx during level gait (p<.05). Conclusion : In conclusion, elderly people use a stabilization strategy that reduces walk speed and dynamic stability as darkness increases. Therefore, the changes in illumination during gait induce the changes in gait mechanics which may increase the levels of biomechanical risk in elderly falls.

• 한국체육학회지인문사회과학편
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• v.57 no.3
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• pp.345-356
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• 2018

Objective: The purpose of this study was to investigate the local stability of the lower extremity joints and muscle activation patterns of the lower extremity during walking between falling and non-falling group in the elderly women. Method: Forty women, heel strikers, were recruited for this study. Twenty subjects (age:72.55±5.42yrs; height:154.40±4.26cm; mass:57.40±6.21kg; preference walking speed:0.52±0.17m/s; fall frequency=1.70±1.26 times) had a history falls(fall group) within two years and Twenty subjects (71.90±2..90yrs; height:155.28±4.73cm; mass:56.70±5.241kg; preference walking speed: 0.56±0.13m/s) had no history falls(non-fall group). While they were walking on a instrumented treadmill at their preference speed for a long while, kinematic and EMG signals were obtained using 3-D motion capture and wireless EMG electrodes, respectively. Local stability of the ankle and knee joint were calculated using Lyapunov Exponent (LyE) and muscles activation and their co-contraction index were also quantified. Hypotheses were tested using one-way ANOVA and Mann-Whitey. Spearman rank was also used to determine the correlation coefficients between variables. Level of significance was set at p<.05. Results: Local stability in the knee joint adduction-abduction was significantly greater in fall group than non-fall group(p<.05). Activation of anterior tibials that acts on the foot segment dorsal flexion was greater in non-fall group than fall group(p<.05). CI between gastrocnemius and anterior tibials was found to be significantly different between two groups(p<.05). In addition, there was significant correlation between CI of the leg and LyE of the ankle joint flexion-extention in the fall group(p<.05). Conclusion: In conclusion, muscles that act on the knee joint abduction-adduction as well as gastrocnemius and anterior tibials that act on the ankle joint flexion-extention need to be strengthened to prevent from potential fall during walking.

• Korean Journal of Applied Biomechanics
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• v.26 no.2
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• pp.167-174
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• 2016

Objective: The purpose of this study was to determine the interrelationship between ranges of motion of the knee and ankle joints on the sagittal plane and the attenuation magnitude of impact shock at high frequency (9~20 Hz) in the support phase during downhill running. Method: Fifteen male heel-toe runners with no history of lower extremity injuries were recruited for this study (age, $25.07{\pm}5.35years$; height, $175.4{\pm}4.6cm$; mass, $75.8{\pm}.70kg$). Two uniaxial accelerometers were mounted to the tuberosity of tibia and sacrum, respectively, to measure acceleration signals. The participants were asked to run at their preferred running speed on a treadmill set at $0^{\circ}$, $7^{\circ}$, and $15^{\circ}$ downhill. Six optical cameras were placed around the treadmill to capture the coordinates of the joints of the lower extremities. The power spectrum densities of the two acceleration signals were analyzed and used in the transfer function describing the gain and attenuation of impact shock between the tibia and the sacrum. Angles of the knee and ankle joints on the sagittal plane and their angle ranges were calculated. The Pearson correlation coefficient was used to test the relationship between two variables, the magnitude of impact shock, and the range of joint angle under three downhill conditions. The alpha level was set at .05. Results: Close correlations were observed between the knee joint range of motion and the attenuation magnitude of impact shock regardless of running slopes (p<.05), and positive correlations were found between the ranges of motion of the knee and ankle joints and the attenuation magnitude of impact shock in $15^{\circ}$ downhill running (p<.05). Conclusion: In conclusion, increased knee flexion might be required to attenuate impact shock during downhill and level running through change in stride or cadence while maintaining stability, and strong and flexible ankle joints are also needed in steeper downhill running.

• Korean Journal of Applied Biomechanics
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• v.18 no.1
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• pp.21-30
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• 2008

The purpose of this study was to investigate the variability to compare local dynamic stability via a linear and nonlinear analysis during walking. Twenty four elderly males, 12 healthy elderly and 12 patients with osteoarthritise walked on a treadmill for 100 consecutive strides. Lyapunov exponent and correlation dimension and coefficient variation were calculated for the kinematic parameters to determine the dynamic stability during walking. The linear measures indicated that the healthy elderly demonstrated significantly higher variability in the ankle joint displacement. The nonlinear analysis revealed that COD for the knee joint angle were higher in patient with osteoarthritise. There were no coincidence in results between linear and nonlinear techniques over two groups. In light of nonlinear analysis, it was concluded that patients with osteoathritise showed higher local instability during walking.

• Physical Therapy Korea
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• v.6 no.3
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• pp.11-21
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• 1999

Human balance is maintained through a complex process involving sensory detection of body motions, integration of sensorimotor information within the central nervous system, and execution of appropriate musculoskeletal responses. The basic task of balance is to position the body center of gravity (COG) over some portion of the support base. When the COG extends beyond the base of support, the person has exceeded the limits of stability (LOS). At this point, a step or stumble is required to prevent a fall. Automatic postural responses operate to keep the COG over the base of support. They are a set of functionally organized, long-loop responses that act to keep the body in a state of equilibrium. There are four commonly identified automatic postural responses, or strategies. These are ankle strategy, hip strategy, suspensory (knee) strategy, and stepping strategy. Thus, the purpose of this study was to evaluate the LOS using various knee strategies. Forty subjects participated in this study. The subjects were comprised of 20 males and 20 females who were without neurologic, orthopaedic or balance performance impairments. The LOS was measured with a Balance Performance Monitor (BPM) Dataprint Software Version 5.3. The results of this study were as follows: 1) Knee joint angle which is to increase stability of standing balance with using knee strategy was at mid-range. 2) There were statistically significant differences in anteroposterior LOSs according to the knee strategy. 3) There were no statistically significant differences in mediolateral LOSs according to the knee strategy. 4) There were statistically significant differences of anteroposterior LOSs with using knee strategy according to gender. 5) There were no statistically significant differences in mediolateral LOSs with using knee strategy according to gender.

• Journal of the Ergonomics Society of Korea
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• v.25 no.4
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• pp.115-119
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• 2006

To investigate the effects of independent suspension technology(IST) of hiking boot on the stability and load of foot, eight participants performed medial and lateral drop landing from 33.4cm height and 85cm distance to uneven surface while wearing normal & IST hiking boots. For the stability of foot during the drop landing, the balance angle & suspension angle and rearfoot angle was analyzed using high-speed video analysis. Also kinetic analysis using the force plate and insole pressure measurement was conducted to analyze vertical & breaking ground reaction force and pressure distribution. Not only the balance angle & suspension angle but also rearfoot angle was improved with IST boots for lateral drop landing. These results indicate the IST boots may have the suspension function which keeps the foot to be stable during landing. However the IST boots did not show any effect for medial landing. This might be related to the hardness of medial part of outsole. Therefore the softer outsole of medial part could be recommended. Furthermore the impact force & breaking force and insole pressure were reduced with IST boot. These results means that IST boot has not only cushioning effect but also good grip effect. Therefore the hiking boots applied the independent suspension function may help to reduce fatigue and prevent injury such as ankle sprain in hiking on uneven surface.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.15 no.1
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• pp.64-71
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• 2009

Purpose: to purpose prevent to dysfunction and decrease to pain level use to active therapeutic movement and sling manual, stability exercise in shortening hamstring chronic back patient. Methods: The patient's complain was Buttock and Lower Back Pain due to dysfunction posture work. The subject's initial Pain Scale was 60 of 100(VAS). The Subject Treatment to Sling Mobility exercise, Home exercise, ATM, Sling Stability exercise, sensory motor training During 8weeks for 18 times. Results: The result was Visual Analog Scale(VAS)was decreased 10 of 100 after treatment. Conclusion: Visual Analog Scale(VAS)was decreased 10 of 100 after treatment. Functional Leg Length Was recover to same level. Trunk Flexibility was increase to 18cm. Active Knee Extension ankle was decrease to $15^{\circ}$ limit range of motion due to Lt. Hamstring Shortening limit range of motion $30^{\circ}$. GPS(Gobal Postural System)test was recover to same level. This case study need to sufficient data and times.

• Archives of Reconstructive Microsurgery
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• v.7 no.2
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• pp.88-94
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• 1998

Free vascularized fibular transplantation is one of the most useful living bone reconstructive procedure in microsurgical field. Concerning about donor site morbidity, the donor has minor problems of ankle stability and muscle power weakness and transient peroneal nerve symptoms. That problems can be minimized with longitudinal splitted osteotomy on the donor fibula if the bone defect in recipient site is not so large. Half splitted fibula with peroneal arterial pedicle which contains nutrient artery and periosteal vessels, grafted bone can survive with those vascular supplies. Authors underwent five cases of half splitted free vascularized fibular transplantation from 1985. There were no evidence of devascularization in all cases, we can minimized donor morbidity with leaving half fibula intact on donor site. The problem of that technique is technically demanding in longitudinal splitting of bone without damage to peroneal nutrient vessels and periosteal soft tissues which attached to the bone. Authors can propose longitudinal half fibular transplantation is one of modification in free vascularized bone transplantation that minimize donor defect.