• Journal of Preventive Medicine and Public Health
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• 제52권4호
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• pp.250-257
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• 2019

Objectives: Flatfoot, or low medial longitudinal arch, contributes to back and lower extremity injuries and is caused by weak abductor hallucis (AbdH) muscles. The purpose of this study was to investigate the effects of short foot exercise (SFE) alone or with neuromuscular electrical stimulation (NMES) on navicular height, the cross-sectional area (CSA) of the AbdH muscle, and AbdH muscle activity in flexible flatfoot. Methods: Thirty-six otherwise healthy people with flexible flatfoot were randomly assigned to a group that received SFE with placebo NMES treatment (the control group) or a group that received both SFE and NMES treatment (the experimental group). Each group received 4 weeks of treatment (SFE alone or SFE with NMES). Navicular height, the CSA of the AbdH muscle, and AbdH muscle activity were assessed before and after the intervention. Results: No significant differences were found in navicular height or the CSA of the AbdH muscle between the control and experimental groups, while AbdH muscle activity showed a statistically significant difference between the groups ($SFE=73.9{\pm}11.0%$ of maximal voluntary isometric contraction [MVIC]; SFE with $NMES=81.4{\pm}8.3%$ of MVIC; p<0.05). Moreover, the CSA of the AbdH muscle showed a statistically significant increase after treatment in the SFE with NMES group ($pre-treatment=218.6{\pm}53.2mm^2$ ; $post-treatment=256.9{\pm}70.5mm^2$ ; p<0.05). Conclusions: SFE with NMES was more effective than SFE alone in increasing AbdH muscle activity. Therefore, SFE with NMES should be recommended to correct or prevent abnormalities in people with flexible flatfoot by a physiotherapist or medical care team.

• PNF and Movement
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• 제20권3호
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• pp.409-416
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• 2022

Purpose: This study compared and analyzed the contractility of the abductor hallucis (AbdH), an intrinsic foot muscle, between flat feet and normal feet during a movement control test (single-leg small knee band test) using ultrasonography. Methods: A total of 23 subjects with (n = 11) and without (n = 12) flatfoot were included in the study. Each subject performed the short foot exercises (SFE) with a single-leg small knee bend (SLSKB) test, which is a functional movement. An ultrasound device was used to collect data regarding the changes in the contractility of the AbdH. Results: Intergroup comparison showed that dorsoplantar thickness was significantly reduced at baseline and during the SFE with SLSKB in the flatfoot group (p < 0.05). Intragroup comparison showed that the cross-sectional area significantly improved when the SFE was performed with SLSKB in the control group (p < 0.05). Conclusion: In this study, it was observed that the AbdH had inadequate contractility during the SLSKB test in subjects with flatfoot; therefore, it is important to train the contraction of the AbdH via functional movements during clinical interventions for subjects with flatfoot.

• Journal of Korean Foot and Ankle Society
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• 제19권4호
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• pp.176-180
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• 2015

Purpose: The aim of the current study is to report on the clinical and radiographic results after calcaneo-stop procedure in Korean children with symptomatic flexible flatfoot. Materials and Methods: Twenty-two children suffering pain along the medial aspect of midfoot with flexible flatfoot whose symptoms did not improve with conservative measures and therefore underwent calcaneo-stop procedure were identified retrospectively. Clinically, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and visual analogue scale (VAS) were evaluated. Radiographically, standing anteroposterior and lateral radiographs of the foot and Saltzman's alignment views were taken and talonavicular coverage angle, lateral talo-first metatarsal angle, and hindfoot alignment angles were measured and analyzed. Results: Clinically, AOFAS ankle-hindfoot scale improved from $70.3{\pm}5.6$ to $97.3{\pm}2.5$ and VAS improved from $6.4{\pm}1.6$ to $0.2{\pm}0.4$. Radiographically, talonavicular coverage angle improved from $28.3^{\circ}{\pm}12.3^{\circ}$ to $10.9^{\circ}{\pm}8.1^{\circ}$, lateral talo-first metatarsal angle improved from $-19.3^{\circ}{\pm}9.0^{\circ}$ to $-2.4^{\circ}{\pm}8.1^{\circ}$, and hindfoot alignment angle improved from valgus $11.9^{\circ}{\pm}10.0^{\circ}$ to $3.5^{\circ}{\pm}4.3^{\circ}$ at minimum 2-year follow-up. No complications occurred postoperatively. Conclusion: Calcaneo-stop procedure is a simple and very effective procedure for management of pediatric symptomatic flexible flatfoot that does not respond to conservative treatment.

• Journal of Korean Clinical Health Science
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• 제4권3호
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• pp.634-643
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• 2016

Purpose. The purpose of this study was to progress the effect of gastrocnemius strength when groups are applicated on low-dye taping group and without taping group of flatfoot with arch-recovery exercise. Methods. Subjects were measured navicular drop test to confirm of 16 university student in J city, low-dye taping group and without taping group were applicated both with arch-recovery exercise, three times per a week for four weeks. The power track were measured four weeks, total 3 times. Comparative analysis of the control group and experimental group were investigated of gastrocnemius strength. Results. The results, we found that after of arch-recovery exercise were significantly increased than before of arch-recovery exercise in each foot. And application of low-dye taping(experimental group) in flatfoot with arch-recovery exercise were significantly increased than control group. Conclusions. In conclusion, the arch-recovery exercise application were effective to low-dye taping significantly increase the gastrocnemius strength of flatfoot.

• Journal of Korean Foot and Ankle Society
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• 제9권1호
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• pp.110-112
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• 2005

We present the case of an adult flexible flatfoot that was managed with dynamic and multiplarnar approaches which consist of Young's tenosuspension, Evans osteotomy, posterior tibialis tendon advancement with flexor digitorum longus tendon transfer and Lapidus procedure.

• Journal of Korean Foot and Ankle Society
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• 제20권1호
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• pp.6-11
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• 2016

Flatfoot deformity, defined as loss of medial longitudinal arch, sometimes involves symptoms such as medial arch pain or Achilles tendon tightening, etc. Whether the etiology of deformity is congenital or acquired, i.e., posterior tibial tendon dysfunction, symptoms are largely resolved with conservative treatment including medication, orthoses, and activity modification. Surgery should be considered in cases of failure of conservative treatment and clinicians can select an appropriate technique among many surgical options including calcaneal osteotomy or flexor digitorum longus tendon transfer. Principles of corrective surgery include the recovery of alignment and the preservation of joint motion.

• Journal of Korean Foot and Ankle Society
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• 제18권3호
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• pp.93-99
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• 2014

Acquired adult flatfoot deformity is characterized by flattening of the medial longitudinal arch and dysfunction of the posteromedial soft tissues, including the posterior tibial tendon. When the non-operative treatment fails to result in improvement of symptoms, surgery should be considered. Operative techniques include flexor digitorum longus tendon transfer, calcaneal medial slide osteotomy, lateral column lengthening, and arthrodesis of the hindfoot. The principle of correcting the deformity while avoiding overcorrection and excessive stiffness is important in achievement of good outcomes in these patients.

• Journal of the Korean Society of Physical Medicine
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• 제9권4호
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• pp.355-361
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• 2014

PURPOSE: The purpose of this study was to determine the immediate effect of low-dye taping on balance performance in subjects with flexible flatfoot. METHODS: Fifteen asymptomatic volunteers who had flexible flatfoot (age, $21.7{\pm}1.81$years; height, $164.80{\pm}7.57cm$; weight, $56.47{\pm}10.48kg$) were participated for this study. Navicular drop test was used to evaluate pronation of foot in three different conditions; non-weight bearing position without low-dye taping, weight bearing position without low-dye taping, weight bearing position with low-dye taping. And balance performance (anterio/ posterior, medial/lateral, and overall) was evaluated using the Biodex Balance System in three different conditions; one-leg standing without low-dye taping, one-leg standing with low-dye taping, and one-leg standing with low-dye taping in one week later. Repeated-measures analysis of variance (ANOVA) was used to assess navicular height and balance performance across the three testing conditions. RESULTS: Significant and clinically meaningful improvement in navicular height was found after application of the low-dye taping. However, there was no statistically significant change in balance performance. CONCLUSION: The results of this study provide evidence to suggest that low-dye taping does not affect balance performance.

• Journal of Korean Foot and Ankle Society
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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.

• Journal of Korean Foot and Ankle Society
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• 제10권2호
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• pp.218-222
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• 2006

Purpose: We evaluate the results of subtalar arthroereisis with $Kalix^{(R)}$ implant (Newdeal, Lyon, France) that were performed in painful flatfoot deformity. Materials and Methods: We performed the subtalar arthroereisis on 16 feet of children symptomatic flexible flat feet after more than 6 months of conservative treatment. Average age was 11 years (8-14 years) old. We checked the functional status with AOFAS functional score in pre-operatively and at final follow-up. Radiologically, we took weight bearing anterior to posterior and lateral view of the feet, and measured the talo-$1^{st}$ metatarsal angle, calcaneal pitch angle, cuboid-surface height. Finally, we asked to patient's parents for satisfaction of the surgery. Results: Mean follow up period was 34.1 months. Average AOFAS score improved from preoperatively 71.9 to postoperatively 91.3. Only one patient has subtalar pain. Average lateral $1^{st}$ metatarsal angle reduced from $-18.2^{\circ}$ preoperatively to $-4.6^{\circ}$ at final follow-up. Average anterior to posterior $1^{st}$ metatarsal angle was reduced from $18.9^{\circ}$ preoperatively to $6.5^{\circ}$ at final follow-up. Average calcaneal pitch angle was increased from $8.6^{\circ}$ preoperatively to $12.6^{\circ}$ at final follow-up. Average cuoboid-surface height was improved from 12.1 mm preoperatively to 16.0 mm at final follow-up. All patients had excellent or good satisfaction. Conclusions: Subtalar arthroereisis with $Kalix^{(R)}$ implant is a viable surgical alternative for painful flatfoot deformity of children.