• Journal of Biomedical Engineering Research
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• v.31 no.5
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• pp.344-350
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• 2010

The aim of this study was to investigate the characteristics of the flexion withdrawal reflex modulated during Lokomat treadmill walking in people with spinal cord injury. The influence of the limb position and movement were tested in 5 subjects with chronic spinal cord injury. EMG activities from tibialis anterior and moments of the hip joint elicited by the foot stimulation were examined during Lokomat treadmill walking. To trigger the flexion withdrawal reflex during Lokomat treadmill walking, a train of 10 stimulus pulses was applied at the skin of the medial arch. The TA EMG activity was modulated during gait phase and the largest TA reflex was obtained after heel-off and initial swing phase. During swing phase, TA EMG was 40.9% greater for the extended hip position (phase 6), compared with flexed hip position (phase 8). The measured reflex moment of the hip joint was also modulated during gait phase. In order to characterize the neural contribution of flexion reflex at the hip joint, we compared estimated moments consisted of the static and dynamic components with measured moment of the hip joint. The mean static gains of reflex hip moments for swing and stance phase are -0.1, -0.8, respectively. The mean dynamic gains of reflex hip moments are 0.25 for swing, 0.75 for stance phase. From this study, we postulate that the joint moment and muscle response of flexion withdrawal reflex have the phase-dependent modulation and linear relationship with hip angle and angular velocity for swing phase during Lokomat treadmill walking.

• Journal of Preventive Medicine and Public Health
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• v.52 no.4
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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.

• Korean Journal of Applied Biomechanics
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• v.14 no.2
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• pp.105-119
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• 2004

To enhance our understanding of the loads on the foot during treadmill running, we have used a pressure-sensitive insole system to determine pressure, rate of loading and impulse distributions on the plantar surface during treadmill running, both in minimally cushioned footwear and in cushioned shoes. This report includes pressure, rate of loading, impulse and contact time data from a study of ten subjects running on a treadmill at 4.0m/s. Among heel-toe runners, the highest peak pressures and highest rates of loading were observed under the centre of the heel and in the medial forefoot. The arch regions were only lightly loaded. Contact time was greater in the forefoot than in the heel. Two-thirds of the impulse recorded during the step was the result of forces applied through the forefoot, mostly in the region of the metatarsal heads. The distribution of loads in the shoe suggests that the load distributing properties of the cushioning system are most important in the centre of the heel, under the metatarsal heads and great toe. Shock attenuation is primarily required under the centre of the heel and to lesser extent under the metatarsal heads. Some energy dissipation may be desirable in the heel region because it causes shock to be absorbed with less force. All the 'propulsive' effort is applied through the forefoot. Therefore, this region should as resilient as possible.

• Toxicological Research
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• v.12 no.2
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• pp.223-230
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• 1996

The increased embryotoxicity of the antifolate drug pyrimethamine (PYM) with concomitant dietary dosing of folic acid (FA) was examined in mice. The preventive effects of folinic acid (FNA) on PYM embryotoxicity were also examined. Six groups were constructed: PYM I (pyrimethamine 80 ppm), PYM II (pyrimethamine 150 ppm), PYM II+FNA (pyrimethamine 150 ppm and folinic acid 12 mg/kg/day), PYM II+FA (pyrimethamine 150 ppm and folic acid 350 ppm), FA (folic acid 350 ppm) and a control group. The agents were administered for 7 days from day 6 throughout 12 of gestation. PYM and FA were administered with mashed feed and FNA was intraperitoneally injected. The high incidence of fetal realformations was observed in the PYM II group; these included kinky tail, open eyelids, club foot, cleft palate, absence of the pulmonary lobe, diaphragmatic hernia, fused sternebrae, fused cervical or thoracic vertebral arch, among others. All embryos of the PYM II+FA group were resorbed. No realformed fetuses were observed in the PYM II+FNA group. These results show that the concomitant dosing of FA augments PYM embryotoxicity. The preventive effects of FNA were also observed.

• Archives of Plastic Surgery
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• v.49 no.1
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• pp.80-85
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• 2022

The instep flap and medialis pedis flap are both originate based on the medial plantar artery. The medialis pedis flap is based from the deep branch and the instep flap is based from the superficial branch. To increase the axial rotation, it is acceptable to ligate the lateral plantar artery. However, this can partially affect the blood supply of the plantar metatarsal arch. We restored the blood flow with a vein graft between the posterior tibial artery and the ligated stump. From 2012 to 2020, 12 cases of heel reconstruction, including seven instep flaps and five medialis pedis flaps, were performed with ligation of the lateral plantar artery. The stump of the lateral plantar artery was restored with a vein graft and between the posterior tibial artery and the ligated stump. Patients were followed for 18 months. Long-term results showed the vascular restoration of the lateral plantar artery remained patent demonstrated by doppler ultrasonography. Restoring blood flow to the lateral plantar artery maintains good blood supply to the toes. If the patient in the future develops a chronic degenerative disease, with microvascular complications, bypass surgery can still be performed because of the patency of both branches.

• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.113-117
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• 2009

Purpose: To evaluate the short-term results of medial displacement calcaneal osteotomy without flexor digitorum longus transfer for flexible flatfoot deformity. Materials and Methods: Twenty four patients (25 feet) who had undergone medial displacement calcaneal osteotomy without flexor digitorum longus transfer for flexible flatfoot between July 2004 and May 2007 were included. The mean age was 43.6 years (16~78 years). The mean follow-up was 26 months (14~50 months). Clinical outcomes were assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue scale (VAS). Six radiographic parameters were measured from weightbearing radiographs to assess the difference between preoperative and postoperative radiographs. Results: The mean AOFAS score improved from 57.9 points preoperatively to 89.2 points at latest follow-up (p=0.000). The mean VAS improved from 62 points preoperatively to 23 points at latest follow-up (p=0.000). The mean talonavicular coverage angle on anteroposterior (AP) view changed from 20.2 degrees to 16.0 degrees (p=0.002). The mean calcaneal pitch angle on lateral view changed from 12.6 degrees preoperatively to 14.5 degrees at latest follow-up (p=0.001). Regarding these radiographic parameters, the difference between interobserver measurements was larger than that between pre- and post-operative measurements. The calcaneus was transferred medially by average 11.8 mm (p=0.003), which was 27.9% of the width of calcaneal tuberosity (p=0.000). The mean talo-first metatarsal angle on AP and lateral views, and navicular height on lateral view were not significantly changed. Conclusion: Medial displacement calcaneal osteotomy without flexor digitorum longus transfer for flexible flatfoot could lead to improve the clinical outcomes, although the restoration of medial longitudinal arch was not clinically significant.

• Archives of Plastic Surgery
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• v.33 no.4
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• pp.474-479
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• 2006

Purpose: To report of a series of successful reconstruction of soft tissue defect on distal leg with extensor digitorum brevis myo-cutaneous flap. Methods: Between April 2002 to December 2004, 7 patients with soft tissue defect on distal leg were operated with Extensor Digiotorum Brevis myocutaneous flap. 6 of these patients had osteomyelitis. Results: Extensor Digiotorum Brevis myocutaneous flap were used in 6 patients and reverse flow flap was used in one patient. Average follow up was 19 months. All flap were survived 100% without any complication and osteomyelitis were controled in all cases. Aesthetic and functional out come were excellent on both recipient and donor sites. Conclusion: The advantages of this flap are effectively control of local wound infection, constant and reliable anatomical structures, adequately thin flap. Technical easiness for raising flap and wide arch of rotation. Extensor Digitorum Brevis myo-cutaneous flap is one of ideal option for the reconstruction of distal leg and foot defects.

• Annals of Rehabilitation Medicine
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• v.39 no.6
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• pp.897-904
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• 2015

Objective To investigate differences in plantar pressure distribution between a normal gait and unpredictable slip events to predict the initiation of the slipping process. Methods Eleven male participants were enrolled. Subjects walked onto a wooden tile, and two layers of oily vinyl sheet were placed on the expected spot of the 4th step to induce a slip. An insole pressure-measuring system was used to monitor plantar pressure distribution. This system measured plantar pressure in four regions (the toes, metatarsal head, arch, and heel) for three events: the step during normal gait; the recovered step, when the subject recovered from a slip; and the uncorrected, harmful slipped step. Four variables were analyzed: peak pressure (PP), contact time (CT), the pressure-time integral (PTI), and the instant of peak pressure (IPP). Results The plantar pressure pattern in the heel was unique, as compared with other parts of the sole. In the heel, PP, CT, and PTI values were high in slipped and recovered steps compared with normal steps. The IPP differed markedly among the three steps. The IPPs in the heel for the three events were, in descending order (from latest to earliest), slipped, recovered, and normal steps, whereas in the other regions the order was normal, recovered, and slipped steps. Finally, the metatarsal head-to-heel IPP ratios for the normal, recovered, and slipped steps were $6.1{\pm}2.9$, $3.1{\pm}3.0$, and $2.2{\pm}2.5$, respectively. Conclusion A distinctive plantar pressure pattern in the heel might be useful for early detection of a slip event to prevent slip-related injuries.

• PNF and Movement
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• v.17 no.2
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• pp.215-222
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• 2019

Purpose: The objective of this study was to investigate whether augmented low-dye taping treatment, which consists of low-dye, reverse-six, and calcaneal-sling taping, is effective in alleviating the collapse of the medial longitudinal arch, which is used for physical balancing during one leg standing. Methods: The subjects comprised 27 students in their 20s whose navicular bone height was lowered by 10 mm or more when evaluated using the navicular drop test. Those with interference factors like deformities, fractures, or traumas were excluded. Frequency-division multiplexing was used to measure one leg standing, and the method to avoir the average each time after 3 times of measurement was applied. Results: Significant differences in the center of pressure (COP) path length, COP average velocity, and forefoot force were observed during left leg standing (p<0.05), but for right leg standing, only changes in forefoot force were noted. Conclusion: Based on the changes to the non-dominant leg in terms of COP path length, COP average velocity, and forefoot force, the immediate effect of augmented low-dye taping, which combines three types of anti-pronation taping, on one leg standing balance in people with flat feet was confirmed.

• Journal of Acupuncture Research
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• v.28 no.3
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• pp.73-84
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• 2011

Objectives : The purpose of this study is to evaluate the effect of 12 weeks-walking exercise with functional shoes on chronic low back pain. Methods : The subjects of this study were 18 females from thirty to sixty years old who had suffered from low back pain over 12 weeks. They wore S shoes with curved out-sole and soft material in arch of foot We asked them to walk wearing shoes for 1 hour a day over 4 days a week for 12 weeks. Improvement of the symptoms was evaluated by pain rating scale, Oswestry low-back pain disability index. We measured lumbar lordotic angle, Ferguson's angle, bone mineral density, body composition. The measurements were checked before and after exercise. Results : This study showed significant improvement in pain rating scale, oswestry low-back pain disability index, and body composition. And lumbar lordotic angle, Ferguson's angle and bone mineral density decreased. Conclusions : These results showed that walking exercise with functional shoes could decrease the symptoms of chronic low back pain. But, it's too difficult to conclude whether the efficacy was due to functional shoes or walking exercise because we didn't set the control group wearing general shoes.