• Title/Summary/Keyword: Foot-Ankle Joint

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Investigating the Impact of Different Resisted Lateral Band Walking Strategies on Hip Abductor Muscle Activity

  • Sin Sil Kim;Sungbae Jo;Seung-gu Lee;Changho Song
    • Physical Therapy Rehabilitation Science
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    • v.12 no.1
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    • pp.1-11
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    • 2023
  • Objective: This study aimed to investigate the effects of squat posture, band position, and contraction type on the muscle activity of the hip abductors during resisted lateral band walking. Design: A cross-sectional survey study Methods: 24 healthy male subjects were recruited, and surface electromyography was used to measure the muscle activity of the gluteus maximus, gluteus medius, and tensor fascia lata of the dominant leg during lateral walking exercises. Resistance bands were applied to the knees, ankles, and feet in semi-squat and squat postures, and exercises were randomly performed under six different conditions. Results: The results showed significant differences in muscle activity in the gluteus maximus, gluteus medius, and tensor fascia lata according to posture, band position, and contraction type (p<0.05). The muscle activity of the hip abductors increased in the squat posture and with the band placed on the distal joint compared to the proximal joint (p<0.05). Additionally, muscle activity was higher in the eccentric contraction phase than in the concentric contraction phase (p<0.05). Contrary to previous studies, moving the resistance band from the ankle to the foot increased the muscle activity of the tensor fascia lata while the activity of the gluteus maximus and gluteus medius also increased. Conclusions: According to the results, squat posture with a resistance band placed on the feet and using an eccentric contraction phase were found to be the most effective methods for strengthening the hip abductors.

Gait Analysis of a Pediatric-Patient with Femoral Nerve Injury : A Case Study (대퇴신경 손상 환아의 보행분석 : 사례연구)

  • Hwang, S.H.;Park, S.W.;Son, J.S.;Park, J.M.;Kwon, S.J.;Choi, I.S.;Kim, Y.H.
    • Journal of Biomedical Engineering Research
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    • v.32 no.2
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    • pp.165-176
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    • 2011
  • The femoral nerve innervates the quadriceps muscles and its dermatome supplies anteromedial thigh and medial foot. Paralysis of the quadriceps muscles due to the injury of the femoral nerve results in disability of the knee joint extension and loss of sensory of the thigh. A child could walk independently even though he had injured his femoral nerve severely due to the penetrating wound in the medial thigh. We measured and analyzed his gait performance in order to find the mechanisms that enabled him to walk independently. The child was eleven-year-old boy and he could not extend his knee voluntarily at all during a month after the injury. His gait analysis was performed five times (GA1~GA5) for sixteen months. His temporal-spatial parameters were not significantly different after the GA2 or GA3 test, and significant asymmetry was not observed except the single support time in GA1 results. The Lower limb joint angles in affected side had large differences in GA1 compared with the normal normative patterns. There were little knee joint flexion and extension motion during the stance phase in GA1 The maximum ankle plantar/dorsi flexion angles and the maximum knee extension angles were different from the normal values in the sound side. Asymmetries of the joint angles were analyzed by using the peak values. Significant asymmetries were found in GA1with seven parameters (ankle: peak planter flexion angle in stance phase, range of motion; ROM, knee: peak flexion angles during both stance and swing phase, ROM, hip: peak extension angle, ROM) while only two parameters (maximum hip extension angle and ROM of hip joint) had significant differences in GA5. The mid-stance valleys were not observed in both right and left sides of vertical ground reaction force (GRF) in the GA1, GA2. The loading response peak was far larger than the terminal stance peak of vertical ground reaction curve in the affected side of the GA3, GA4, GA5. The measured joint moment curves of the GA1, GA2, GA3 had large deviations and all of kinetic results had differences with the normal patterns. EMG signals described an absence of the rectus femoris muscle activity in the GA1 and GA2 (affected side). The EMG signals were detected in the GA3 and GA4 but their patterns were not normal yet, then their normal patterns were detected in the GA5. Through these following gait analysis of a child who had selective injuries on the knee extensor muscles, we could verify the actual functions of the knee extensor muscles during gait, and we also could observe his recovery and asymmetry with quantitative data during his rehabilitation.

Effects of Yuhyangjeongtong-san on the Carrageenin-induced Acute Inflammation and Adjuvant-induced Arthritis (유향정통산이 Carrageenin 유발 급성 염증과 Adjuvant 유발 관절염에 미치는 영향)

  • Ahn, Hee-Bin;Jeong, Su-Hyeon;Kim, Soon-Joong;Park, Dong-Soo;Seo, Il-Bok
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.3
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    • pp.55-68
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    • 2013
  • Objectives This study was to investigate the effects of Yuhyangjeongtong-san on the carrageenin-induced acute inflammation and adjuvant-induced arthritis in rats. Methods Acute inflammation was induced by injection of 2% carrageenin 0.15 ml into right hind foot of rats. Control group was carrageenin injected and taken distilled water, treated group was carrageenin injected and taken Yuhyangjeongtong-san by orally once. 2 hours after injection, plantar temperature and paw volume were measured. 3 hours after, counts of white blood cell (WBC) were performed. Arthritis was induced by injection of complete freund's adjuvant (CFA) into base of tail. Control group was CFA injected and taken distilled water, treated group was CFA injected and taken Yuhyangjeongtong-san by orally for 10 days. 0,5,10 day, body weight, thickness of ankle joint and paw edema were measured. 10 day, counts of WBC, $interleukin-1{\beta}$ ($IL-1{\beta}$) and tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) level were analysed. Histochemical study of NADPH-d and immunohistochemical study of c-fos were performed. Results In the carrageenin-induced acute inflammation, neutrophils of treated group were significantly decreased compared with control group. In the adjuvant-induced arthritis, paw edema, total counts of WBC and TNF-${\alpha}$ level in paw exudates were significantly decreased compared with control group, and the number of c-fos positive neurons of treated group was significantly decreased compared with control group. Conclusions On the basis of these results, we concluded that Yuhyangjeongtong-san have anti-arthritic and anti-inflammatory effects.

Acute effect of self-myofascial release using a foam roller on the plantar fascia on hamstring and lumbar spine superficial back line flexibility

  • Do, Kwangsun;Kim, Jaeeun;Yim, Jongeun
    • Physical Therapy Rehabilitation Science
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    • v.7 no.1
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    • pp.35-40
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    • 2018
  • Objective: The purpose of this study was to investigate the immediate effect of applying self-myofascial release (SMR) to the plantar fascia using a foam roller on hamstring and lumbar spine superficial back line (SBL). Design: Randomized controlled trial. Methods: Thirty-one healthy adults agreed to the method and purpose of the study. Selection and exclusion criteria were screened, and baseline measurements for the Toe Touch test and passive straight leg raise (PSLR) test were obtained. The participants were then randomly assigned to the SMR group or the sham group. After group assignment, the SMR group rolled the surface of the foot from the heel to the metatarsal head using a foam roller for 5 minutes. The sham group received passive mobilization of the ankle joint in the supine position. Afterwards, the Toe Touch test and the passive straight leg-raise test were re-assessed. Results: In the SMR group, the Toe Touch test results showed significant improvement (p<0.05). Left and right PSLR test results showed a significant increase (p<0.05). In the sham group, there was no significant difference between pre and post-test results. The SMR group showed a significant difference in the PSLR test and Toe Touch test compared to the sham group (p<0.05). Conclusions: The results of this study showed that SMR on the plantar fascia was immediately effective for improving the flexibility of the SBL of the lumbar spine and hamstring.

Differential effect of electroacupuncture analgesia depending on the point selection in a rat model of CFA-induced arthritis (CFA로 유도한 관절염에서 선혈(選穴)에 따른 전침(電鍼)의 진통효과 차이)

  • Yang, Bum-Sik;Koo, Sung-Tae;Kim, Kyoung-Sik;Sohn, In-Cheul
    • Korean Journal of Acupuncture
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    • v.22 no.1
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    • pp.95-108
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    • 2005
  • Objective : In the present study, the effect of electroacupuncture (EA) applied to several acupoints and non-acupoint in CFA-induced knee arthritis was examined. Methods : A common source of persistent pain in humans is arthritis. Arthritis was induced by injection of CFA $125\;{\mu}l$ into knee joint cavity under enflurane anesthesia. The rat subsequently showed swelling of the ankle and a reduced stepping force of the affected limb for the next several days. The reduced stepping force of the limb was presumably due to a painful knee. EA was applied to either of $LR_2,\;LI_4$, or non-acupoint on the contralateral forelimb for 30 min under gaseous anesthesia. After the termination of EA, behavioral tests measuring stepping force were periodically conducted during the next 4 h. Results : EA applied to $LR_2$ point produced a significant improvement of stepping force of the affected foot lasting for at least 2 h. However, neigher $LI_4$ point nor non-point produced any significant increase of weight bearing force. The improvement of stepping pressure was interpreted as an analgesic effect. The analgesic effect was specific to the acupuncture point since the analgesic effect on CFA-induced knee arthritic pain model could not be mimicked by EA applied to a point, $LI_4$ or non-acupoint. In addition, both NO production and iNOS protein expression increased by arthritis were suppressed by EA applied to $LR_2$ point. Conclusion : These data suggest that EA produces a potent analgesic effect in the rat model of CFA-induced knee arthritis. This analgesic effect is produced by applying EA to an acupoint at opposite side from the painful area in a stimulus point-specific way.

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The Assessment Study on which the Forms of Foot Arch and Planta have been changed according to the tilting of Scapular & Ilium (견갑골과 장골의 경사에 따른 족궁 및 발바닥의 형태변화에 관한 측정연구)

  • Moon, Sang-Eun
    • Journal of Korean Physical Therapy Science
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    • v.7 no.2
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    • pp.615-628
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    • 2000
  • This report is to study on the progress on which foot arch and planta has been changed according to body type based on 4 tilting of scapular & ilium. This study has been carried out to help contribute to some basic information like these. One was to find out how to assess and analysize the deformity of feet and ankle joint which may have the most impact on ideal alignment of anatomical posture. The other was to figure out how to diagnose and treat the deformity to get to the restoration. The results of this study is as followings; 1. The findings which had been made from 22 persons(50%) having left scapular and ilium forward tilt are as follows. 1) On the longitudinal length of the planta left parts of 18 persons(82%) are longer than the right one. On the transversel length of the planta right parts of 17 persons(77%) are longer than the left one. 2) On the size of medial longitudinal arch the left parts of 20 persons(91%) are more wider than the right one. 3) On the sign of supinated foot, the left parts of 18 persons(82%) are more common than the right one. 4) On the thickness of big toe, the left parts of 14 persons(64%) are thicker than the right one. 2. The findings which had been made from 15 persons(34%) having right scapular and ilium forward tilt are as follows. 1) On the longitudinal length of the planta right parts of 11 persons(73%) are longer than the left one. On the transversel length of the planta left parts of 13 persons(87%) are longer than the right one. 2) On the size of medial longitudinal arch the right parts of 13 persons(87%) are more wider than the left one. 3) On the sign of supinated foot, the right parts of 12 persons(80%) are more common than the left one. 4) On the thickness of big toe, the right parts of 7 persons(47%) are thicker than the left one. 3. The findings which had been made from 3 persons(7%) having left scapular and right ilium forward tilt are as follows. 1) On the longitudinal length of the planta right parts of 2 persons(67%) are longer than the left one. On the transversel length of the planta left parts of 2 persons(67%) are longer than the right one. 2) On the size of medial longitudinal arch the right parts of 3 persons(100%) are more wider than the left one. 3) On the sign of supinated foot, the right parts of 2 persons(67%) are more common than the left one. 4) On the thickness of big toe, the left parts of 2 persons(67%) are thicker than the right one. 4. The findings which had been made from 4 persons(9%) having right scapular and left ilium forward tilt are as follows. 1) On the longitudinal length of the planta left parts of 3 persons(75%) are longer than the right one. On the transversel length of the planta right parts of 2 persons(50%) are longer than the left one. 2) On the size of medial longitudinal arch the left parts of 3 persons(75%) are more wider than the right one. 3) On the sign of supinated foot, the left parts of 3 persons(75%) are more common than the right one. 4) On the thickness of big toe, the left parts of 3 persons(75%) are thicker than the right one.

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Treatment of Distal Tibial Spiral Fractures Combined with Posterior Malleolar Fractures (후과 골절이 동반된 경골 원위부 나선상 골절의 치료)

  • Kim, Young Sung;Lee, Ho Min;Kim, Jong Pil;Chung, Phil Hyun;Park, Soon Young
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.4
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    • pp.317-325
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    • 2021
  • Purpose: This study compared the functional and radiologic outcomes of intramedullary nailing (IMN) and minimally invasive plate osteosynthesis (MIPO) for tibia fractures in distal tibial spiral fractures combined with posterior malleolar fractures, as well as the functional and radiologic outcomes with and without fixation for posterior malleolar fractures. Materials and Methods: From January 2010 to December 2018 the radiological and clinical outcomes of 30 skeletally mature patients with tibial spiral fractures (AO Foundation/Orthopaedic Trauma Association classification 42-A1, B1, C1) combined with posterior malleolar fractures were analyzed. Sixteen patients were treated with IMN, and 14 patients were treated with MIPO. Depending on the surgical methods, the radiologic and clinical outcomes were compared by evaluating the bone union time, postoperative alignment, postoperative displacement of the posterior malleolar fragment, and American Orthopaedic Foot and Ankle Society (AOFAS) score. Moreover, the functional and clinical outcomes with and without fixation for posterior malleolar fractures were compared. Results: The mean bone union time was 21.8 weeks in the IMN group and 23.1 weeks in the MIPO group (p=0.500). At the final follow up, the mean alignment was coronal angulation of 1.8°, sagittal angulation of 1.6° in the IMN group and coronal angulation of 1.2° and sagittal angulation of 1.7° in the MIPO group (conoral angulation: p=0.131, sagittal angulation: p=0.850). The postoperative and final radiologic evaluation showed no displacement of the posterior malleolar fragment and excellent joint congruity in all cases. At the final follow-up, the mean AOFAS score was 88.0 on average in the IMN group and 87.6 on average in the MIPO group (p=0.905). The ankle range of motion and AOFAS score were similar in the fixation group and no fixation group for posterior malleolar fractures. Conclusion: Both IMN and MIPO for tibial spiral fractures combined with posterior malleolar fractures result in satisfactory radiological and clinical outcomes.

Kinetic analysis of the lower limb in visual handicap children (시각장애 아동의 보행 시 하지의 운동역학적 분석)

  • Yi, Jae-Hoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.9
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    • pp.3952-3958
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    • 2011
  • This study was to investigate the difference in gait pattern between the visual handicap children and non handicap children in by analyze the biomechanical variation and pattern of lower limb. Therefore, we have made a choice of four visually handicapped children and two subjects, who had no medical disorder for the last six months. In order to collect the gait pattern data of each group, we have used six infrared cameras and one forceplate Also, we have used QTM program to collect the raw data and Visual3D program to calculate kinetic variable. The results were as follows, An/Posterior GRF of breaking phase and propulsion phase in stance phase was lower in visual handicapped children than that of non handicapped children and breaking phase was longer than propulsion phase. extension moment at the ankle was quite lower than general gait pattern and there was little variation at the knee joint which makes the results differ from the general gait pattern. However, hip joint moment was relatively higher than that of other joints. Mechanical variation of lower limb, in case of foot and shank, showed similar results. but generated very low mechanical energy. In thigh, the form of mechanical energy generation was slightly different in each group but generated more mechanical energy than other segments.

Effect of Tiger Step on Lower Extremities during Uphill Walking (오르막보행 시 타이거스텝 하지 움직임에 미치는 영향)

  • Kang, Jihyuk;Yoon, Sukhoon
    • Korean Journal of Applied Biomechanics
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    • v.32 no.1
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    • pp.17-23
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    • 2022
  • Objective: The aim of this study was to investigate the effect Tiger-step walking on the movement of the lower extremities during walking. Method: Twenty healthy male adults who had no experience of musculoskeletal injuries on lower extremities in the last six months (age: 26.85 ± 3.28 yrs, height: 174.6 ± 3.72 cm, weight: 73.65 ± 7.48 kg) participated in this study. In this study, 7-segments whole-body model (pelvis, both side of thigh, shank and foot) was used and 29 reflective markers and cluster were attached to the body to identify the segments during the gait. A 3-dimensional motion analysis with 8 infrared cameras and 7 channeled EMG was performed to find the effect of tigerstep on uphill walking. To verify the tigerstep effect, a one-way ANOVA with a repeated measure was used and the statistical significance level was set at α=.05. Results: Firstly, Both Tiger-steps showed a significant increase in stance time and stride length compared with normal walking (p<.05), while both Tiger-steps shown significantly reduced cadence compared to normal walking (p<.05). Secondly, both Tiger-steps revealed significantly increased in hip and ankle joint range of motion compared with normal walking at all planes (p<.05). On the other hand, both Tiger-steps showed significantly increased knee joint range of motion compared with normal walking at the frontal and transverse planes (p<.05). Lastly, Gluteus maximus, biceps femoris, medial gastrocnemius, tibialis anterior of both tiger-step revealed significantly increased muscle activation compared with normal walking in gait cycle and stance phase (p<.05). On the other hand, in swing phase, the muscle activity of the vastus medialis, biceps femoris, tibialis anterior of both tiger-step significantly increased compared with those of normal walking (p <.05). Conclusion: As a result of this study, Tiger step revealed increased in 3d range of motion of lower extremity joints as well as the muscle activities associated with range of motion. These findings were evaluated as an increase in stride length, which is essential for efficient walking. Therefore, the finding of this study prove the effectiveness of the tiger step when walking uphill, and it is thought that it will help develop a more efficient tiger step in the future, which has not been scientifically proven.

Mid-Term Results of Modified Hoffman Procedure for Rheumatoid Forefoot Deformity (류마티스 전족부 변형에 대한 변형 Hoffman 술식의 중기 결과)

  • Kim, Yoon-Chung;Choi, Hyun Chul;Lee, Hyo Jin;Ahn, Jae Hoon
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.484-490
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    • 2021
  • Purpose: A rheumatoid forefoot deformity includes severe hallux valgus and claw toe of the four lateral toes. The authors intended to analyze the mid-term results of the modified Hoffman procedure for a rheumatoid forefoot deformity. Materials and Methods: Twenty-two feet of eighteen patients were followed up for more than two years after the modified Hoffman procedure. The mean age was 54.7 years, and the mean follow-up period was three years and four months. Clinically visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) MP-IP score were analyzed preoperatively and postoperatively. The postoperative complications, the satisfaction of patients, and the presence of plantar callosity were also analyzed. Radiographically, the hallux valgus angle, the 1st intermetatarsal angle, the 1st interphalangeal angle, the 1st interphalangeal joint arthritic change after the operation, and the dorsiflexion angle and the time to union of the 1st metatarsophalangeal joint were analyzed. Results: Clinically, the VAS and AOFAS score were respectively improved from 7.1 points and 30.3 points preoperatively to 1.5 points and 83.1 points postoperatively (p<0.001). All patients were satisfied with the results. Plantar callosity disappeared in all cases. Radiographically, the mean hallux valgus angle, the 1st intermetatarsal angle, and the 1st interphalangeal angle changed from 52.8°, 13.3°, and 7.5° preoperatively to 16.2°, 8.7°, and 14.6° postoperatively (p<0.001). The mean dorsiflexion angle of the 1st metatarsophalangeal joint was 17.2° postoperatively. The mean time to radiographic union of the 1st metatarsophalangeal joint was 11.1 weeks. There were two cock-up deformities of the lesser toe, one wound problem, and two hallux interphalangeal joint arthritis as a complication. There were no cases of nonunion of the 1st metatarsophalangeal joint. Conclusion: The modified Hoffman procedure appears to be a safe and satisfactory procedure for a rheumatoid forefoot deformity.