• 대한통합의학회지
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• 제2권3호
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• pp.57-63
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• 2014

Purpose : The purpose of this study was to identify the muscle activity of leg during stair down in the subjects with flatfoot and normal foot. Methods : The fourteen subjects with the flatfoot group and the fifteen subjects with the normal foot group volunteered for this study. All subjects descended the stairs that the height was 20cm and consisted 25 stairs. The target muscles for recording muscle activity were posterior fiber of gluteus medius, vastus medialis and vastus lateralis oblique, semitendinosus and biceps femoris, tibialis anterior, and medial and lateral fiber of gastrocnemius muscles. The muscle activity was recorded using the wireless EMG system. Results : The flatfoot group had significantly lower the muscle activity of posterior fiber of gluteus medius than the normal foot group in stance phase during stair down(p<.05). The flatfoot group had significantly higher the muscle activity of biceps femoris and tibialis anterior than the normal foot group in swing phase during stair down(p<.05). Conclusions : This study proposed that the subject with flatfoot should train the strengthening exercise for posterior fiber of gluteus medius.

• Korean Journal of Acupuncture
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• 제25권4호
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• pp.1-15
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• 2008

Objectives : This study is designed to investigate the association between Samcho-gyeong(TE) and the lower branch of Meridian system. Methods : The base of the study was established by searching for the historic conception of Samcho. Thereafter the meaning of lower correlation was considered and the property of lower part of Samcho Meridian system studied. Results : Samcho is a kind of Yug-Bu(Six hollow viscera, 六腑). It is a functional internal organ, which has been continuously controversial in history. It covers wide range of the internal organs and plays various kinds of roles. Samcho and Simpo lack in interrelation of obverse and reverse. The conception of Sanghap(Upper correlation, 上合) in Naegyeong supplements the deficiency. To establish the conception of Sanghap between Yug-Bu and Hand meridians, there should be established the conception of Hahap(Lower correlation, 下合) between Yug-Bu and foot meridians for treating lower parts. The existence of Hahaphyeol(Lower confluent points, 下合穴) reveals that there were a lot of limits in treating JungHa-cho(Middle and Lower energizers, 中下焦) diseases only with the acupoints of the Hand meridians. Jogsamcho(Triple energizer of foot, 足三焦) meridian written in Taeso(太素), corresponds to the lower leg, and it is believed that it engages in treating diseases in the trunk of the body and Hacho(Lower energizer, 下焦). Conclusions : Therefore, it is believed that the lower part of meridian of Samcho can deal with the symptoms of lower back pain, leg pain, bladder disease, and so on. This study is meaningful in that it expands the range of treatment in acupoints of the regular meridians.

• 한국전문물리치료학회지
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• 제31권1호
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• pp.40-47
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• 2024

Background: Single-leg squat (SLS)s are commonly used as assessment tool and closed kinetic exercises are useful for assessing performance of the lower extremities. Pronated feet are associated with foot pressure distribution (FPD) during daily activities. Objects: To compare the FPD during SLSs between groups with pronated and normal feet. Methods: This cross-sectional study included 30 participants (15 each in the pronated foot and control groups) are recruited in this study. The foot posture index was used to distinguish between the pronated foot and control groups. The Zebris FDM (Zebris Medical GmbH) stance analysis system was used to measure the FPD on the dominant side during a SLS, which was divided into three phases. A two-way mixed-model ANOVA was used to identify significant differences in FPD between and within the two groups. Results: In the hallux, the results of the two-way mixed-model ANOVAs revealed a significant difference between the group and across different phases (p < 0.05). The hallux, and central forefoot were significantly different between the group (p < 0.05). Moreover, significant differences across different phases were observed in the hallux, medial forefoot, central forefoot, lateral forefoot, and rearfoot (p < 0.05). The post hoc t-tests were conducted for the hallux and forefoot central regions. In participants with pronated foot, the mean pressure was significantly greater in hallux and significantly lower, in the central forefoot during the descent and holding phases. Conclusion: SLSs are widely used as screening tests and exercises. These findings suggest that individuals with pronated feet should be cautious to avoid excessive pressure on the hallux during the descent-to-hold phase of a SLS.

• 대한족부족관절학회지
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• 제13권1호
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• pp.109-112
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• 2009

Calciphylaxis is a rare disease that appear in patients with secondary hyper-parathyroidism or chronic renal failure or that show defect in calcium phosphate metabolism which is characterized by fibrin deposit or calcification of medial wall of vessels causing gradual ischemic skin necrosis. Calciphylaxis is a disease with poor prognosis as skin necrosis can progress rapidly. If left untreated, calciphylaxis will progress to sepsis with high mortality. The treatment is controversial but kidney transplantation or parathyroidectomy is suggested to recover calcium-phosphate metabolism. The authors have experienced calciphylaxis in a patient with chronic renal failure caused by DM nephropathy with characteristic skin lesion and rapid skin necrosis. We describe this case with documentary reviews.

• 대한족부족관절학회지
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• 제28권1호
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• pp.36-39
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• 2024

Lupus panniculitis is a rare disease that may present with similar clinical manifestations to an infection, such as cellulitis or abscess. This paper reports a case of a 25-year-old woman with systemic lupus erythematosus who underwent surgical intervention initially with the suspicion of an abscess but who was eventually diagnosed with lupus panniculitis. Despite the low incidence of lower leg involvement of panniculitis, clinicians should be aware of the possibility of an etiology other than infection when encountering patients with inflammatory diseases. Moreover, a skin biopsy and magnetic resonance imaging with a diffusion-weight image may be helpful.

• 대한통합의학회지
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• 제9권4호
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• pp.85-89
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• 2021

Background : Klippel-Trenaunay-Weber syndrome (KTS) is a rare congenital medical condition characterized by complex vascular malformation. KTS consists of a classic triad of capillary malformation (hemangioma), venous malformations and bone or soft tissue hypertrophy causing limb asymmetry. The aim of this report is to describe management for gait disturbance and foot pain in a Patient with KTS using custom-made total contact insole. Case presentation : A 32-year-old man with KTS presented with a 3-year history of gait disturbance on hard surface due to right first toe pain and Achilles tendon tightness. The patient had soft tissue hypertrophy, varicose veins and port-wine stains over the right lower limb associated with KTS. True leg length discrepancy was 2 cm. We prescribed custom-made total contact insole to protect his deformed foot and correct leg length discrepancy. The insole of right side included wedge shaped heel lift and the insole of left side included full length lift to add extra support on unaffected side. Also, we provided compression stocking and physiotherapy including manual lymphatic drainage for lymphedema and stretching exercise for tightness in right lower extremity. At 3 years follow-up, postural alignment including pelvic obliquity was improved using a custom-made total contact insole. The degree of scoliosis and foot pain were also reduced. Conclusion : An individualized and multidisciplinary approach is essential regarding the complexity of comorbidities in patients with KTS. For patients with KTS, orthotic management should be considered to prevent and correct deformities related to KTS. Active orthotic management, compression stocking and physiotherapy can enhance the quality of life and function in patients.

• 국제물리치료학회지
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• 제9권2호
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• pp.1486-1489
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• 2018

This study aimed to investigate the influence of walking on crural muscle tone and stiffness in individuals with bilateral pronated foot. This study consisted of 16 healthy male. Subjects were divided into a pronated foot group (n = 8) and a normal foot group (n = 8). The navicular drop test on both foot and muscle tone and stiffness in tibialis anterior muscle, medial gastrocnemius muscle, and peroneus longus muscle of both lower extremities were measured before and after 30 min of walking. In this study, the measured navicular drop test before walking was significantly different between pronated foot group and a normal group(p < .05). After 30 min of walking, significantly, increased medial gastrocnemius muscle stiffness of the non-dominant leg was found in the pronated foot group (p < .05). However, there was no significant difference in medial gastrocnemius muscle stiffness between the two groups (p > .05). Based on this study, pronated foot needs to be managed to prevent the abnormally increased medial gastrocnemius muscle stiffness.

• Archives of Reconstructive Microsurgery
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• 제7권2호
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• pp.165-174
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• 1998

Large soft tissue defect of the ankle and foot can present a difficult reconstructive problem to the surgeon. Local musculocutaneous, local fasciocutaneous or free flap is usually the first choice for providing soft tissue coverage. However, in certain situations, local flaps from the same leg and free flap may not be suitable. These include extensive soft tissue injury, where no suitable recipient vessels can be found, previous local fasciocutaneous flap or free flap failure. In such cases, we have utilized the septocutaneous(fasciocutaneous) branch flap of posterior tibial artery from the opposite healthy limb. We present 5 cases of cross leg flaps, which have been modernized with current understanding of vascular anatomy and current fixation technology. All cross leg flaps were based on the axial blood supply of the fasciocutanous branch of the posterior tibial artery. Cross-clamping with bowel clamp was used to create intermittent periods of ischemia. Adjacent lower extremity joints were exercised during the periods of attachment. The results have been quite encouraging. We conclude that the cross leg flap using septocutaneous flap and cast immobilization can be successfully and expeditiously used to cover defects of the ante and foot.

• Archives of Reconstructive Microsurgery
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• 제10권2호
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• pp.118-123
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• 2001

Introduction : We report advantages of distally based superficial sural artery flap in the soft tissue defect in lower leg, ankle and foot. They are easier and less complicated technique than others. Material & Method : Total 26 patients were operated and their soft tissue defect site were 10 cases of anterior tibial surface, 6 cases of Achilles tendon area, 3 cases of lateral and medial surface of tibia, 3 cases of foot dorsum surface, 3 cases of sole, 1 case of medial aspect of ankle. Average pedicle distance was 12.8 cm(range $8{\sim}21cm$) and follow up period was mean 18 months. Result : We obtained 24 cases of excellent and good results. The two cases were reported low complication rate, which were one case of skin necrosis covered full thickness skin graft, and the other case of infection. Conclusion : The advantage of distally based superficial sural artery flap in soft tissue defect are long distant pedicle, short operation time, easy elevation of pedicle, constant and reliable blood supply and good cosmetic result with thin-thickness flap.

• 한국운동역학회지
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• 제13권2호
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• pp.161-173
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• 2003

This study was performed to investigate the kinematic and kinetic differences between functional walking shoe(FWS) and general sports shoe(GSS). The subjects for this study were 4 male adults who had the walking pattern of rearfoot strike with normal feet. The movement of one lower leg was measured using force platform and 3 video cameras while the subjects walked at the velocity of 2/1.5 m/s. The findings of this study were as follows 1. The angle of lower leg-ground and angle of knee with FWS was greater than with GSS at the moment of strike the floor and the moment of second peak ground reaction force. The decreasing rate of angle of ankle was smaller in FWS from the strike phase to the second peak ground reaction force. These mean upright walking and round walking along the shoe surface. 2. The maximal Increased angle of Achilles tendon and the minimal decreased angle of rearfoot were smaller in FWS very significantly(p<0.001). Thus FWS prevent the excessive pronation of ankle and have good of rear-foot control. 3. The vortical ground reaction force and the rate of it to the BW were smaller in FWS statistically(p<0.001). The loading rate was smaller in FWS, too, and thess represent the reduction of load on ankle joint and prevention of injuries on it.