This paper describes the possibility of analyzing gait pattern from the variation of the lower leg electrical impedance. This impedance is measured by the four-electrode method. Two current electrodes are applied to the thigh and foot, and two potential electrodes are applied to the lateral aspect, medial aspect, and posterior position of lower leg. We found the optimal electrode position for knee and ankle joint movements based on high correlation coefficient, least interference, and maximum magnitude of impedance change. From such features of the lower leg impedance, it has been made clear that different movement patterns exhibit different impedance patterns and impedance level.
Purpose: Chronic tophaceous gout is a painful and disabling inflammatory disease. Surgical treatment for chronic tophaceous gout is very difficult with many complications. This study evaluated the efficacy of shortening scarf osteotomy on the treatment of chronic tophaceous gout in the 1st metatarso-phalangeal (MTP) joint. Materials and Methods: From January 2006 to December 2015, 14 patients (19 cases) who underwent axial shortening scarf osteotomy for chronic tophaceous gout were reviewed. All patients were male. The average age at the time of surgery was 59.6 years (42~66 years). The minimum follow-up was 24 months. Total removal of the tophi mass with the adhered medial capsule of the 1st MTP joint was attempted. Axial shortening scarf osteotomy was done on the 1st metatarsal shaft. The visual analogue scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was assessed preoperatively and postoperatively. The range of motion (ROM) of the 1st MTP joint was also compared pre- and postoperatively. Results: The average size of the extracted tophaceous mass was 32 mm. The mean amount of the length of metatarsal shortening was 4.9 mm. The mean ROM of the 1st MTP joint was improved from $30.4^{\circ}$ to $62.3^{\circ}$. The mean AOFAS forefoot score improved from 51.4 to 86.6 points. The mean VAS for pain improved from 4.6 to 0.3 points. Conclusion: The axial shortening scarf osteotomy used on chronic tophaceous gout could reconstruct the 1st MTP joint with an improved ROM and was free of pain. Axial shortening scarf osteotomy is suggested as a useful and effective method for the treatment of chronic tophaceous gout.
Journal of The Korean Society of Integrative Medicine
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v.5
no.3
/
pp.57-61
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2017
Purpose : The purpose of study was to find out the environmental risk factor that can be easily occurred imbalance muscle activities according to direction for using the ramp during one legged standing. Method : The subjects were 20 normal adults with a mean age of $23.15{\pm}2.14years$ and a Body Mmass Index (BMI) of $22.74{\pm}1.07$. Participants were measured muscle activities on vastus medialis, vastus lateralis, tibialis anterior, peroneus longus during one legged stance at four conditions ramp (down ramp, up ramp, medial ramp, lateral ramp). The statistical analyses were performed using IBM SPSS(Ver. 23) and p-value less than .05 were considered statistically significant for all cases. Result : In this study, the activity of the lower extremity muscle and the ratio of the vastus medial and lateral muscles according to the direction of use of the ramp were investigated. The changes in the muscle activity of the lower limbs along the direction of the ramp were significantly different between the vastus medial muscle and the peroneus longus muscle. Conclusion : For a short time on a ramp or a pedestrian crossing, a clerk in a ramp can move or stand by placing the lower limbs in various directions, but if performed in consideration of the individual's disease characteristics or unstable foot position, It is thought that there will be an effect to prevent on the ankle and knee unstability.
Sihyun Ryu;Young-Seong Lee;Soo-Ji Han;Sang-Kyoon Park
Korean Journal of Applied Biomechanics
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v.33
no.1
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pp.25-33
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2023
Objective: The purpose of this study was to investigate the differences in static arch height and ankle stability according to the preference for insole height and hardness in the arch area. Method: The study participants were 20 adult males (age: 22.7 ± 1.8 yrs., height: 175.3 ± 4.3 cm, body weight: 72.5 ± 7.7 kg). First, the arch heights of all subjects were measured in static postures (sitting and standing). The inversion and eversion movements of the ankle joint were analyzed during walking (1.3 m/s & 1.7 m/s) and running (2.7 m/s & 3.3 m/s). The variables (static arch height, and inversion and eversion angle of ankle joint) were compared by classifying groups according to the preference for the height and hardness of the arch of the insole. First, it was divided into a high arch insole preference group (HAG, n=8) and a low arch insole preference group (LAG, n=12) according to the preference for the arch height of the insole. Second, it was divided into a high hardness insole preference group (HHG, n=7), medium hardness insole preference group (MHG, n=7), and low hardness insole preference group (LHG, n=6), according to the preference for the arch hardness of the insole. Results: First, the range of motion (ROM) of inversion-eversion at the ankle joint during walking was statistically smaller in HAG than in LAG (p<.05). Second, the arch height change of HHG was statistically greater than that of MHG and LHG (p<.05). Conclusion: In the case of flexible flat feet with a large change in arch height, providing a high hardness arch insole that can disperse foot pressure can improve comfort. It was found that people with high medial and lateral sway of the ankle joint preferred a low arch insole, but it is necessary to differentiate and compare the insole heights of the arch part in detail. In addition, in the case of fast motion such as running, the preference for the arch height and hardness of the insole was not related to the static arch height and ankle stability.
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.
This study aimed to determine the effects of the blockage of visual feedback on joint dynamics of the lower extremity. Fifteen healthy male subjects(age: $24.1{\pm}2.3\;yr$, height: $178.7{\pm}5.2\;cm$, weight: $73.6{\pm}6.6\;kg$) participated in this study. Each subject performed single-legged landing from a 45 cm-platform with the eyes open or closed. During the landing performance, three-dimensional kinematics of the lower extremity and ground reaction force(GRF) were recorded using a 8 infrared camera motion analysis system (Vicon MX-F20, Oxford Metric Ltd, Oxford, UK) with a force platform(ORG-6, AMTI, Watertown, MA). The results showed that at 50 ms prior to foot contact and at the time of foot contact, ankle plantar-flexion angle was smaller(p<.05) but the knee joint valgus and the hip flexion angles were greater with the eyes closed as compared to with the eyes open(p<.05). An increase in anterior GRF was observed during single-legged landing with the eyes closed as compared to with the eyes open(p<.05). Time to peak GRF in the medial, vertical and posterior directions occurred significantly earlier when the eyes were closed as compared to when the eyes were open(p<.05). Landing with the eyes closed resulted in a higher peak vertical loading rate(p<.05). In addition, the shock-absorbing power decreased at the ankle joint(p<.05) but increased at the hip joints when landing with the eyes closed(p<.05). When the eyes were closed, landing could be characterized by a less plantarflexed ankle joint and more flexed hip joint, with a faster time to peak GRF. These results imply that subjects are able to adapt the control of landing to different feedback conditions. Therefore, we suggest that training programs be introduced to reduce these injury risk factors.
We studied the postural response induced by plantar sole vibration with various frequencies(20, 60, 100Hz) and vibration zone(the anterior and posterior foot zone) of both soles during standing. Eight healthy young adults were exposed to 15s periods of plantar sole vibration while blindfolded. Body sway(COM, center of mass), the angle of neck, trunk, hip, knee, ankle and EMG of four lower limb muscles(tibialis anterior, lateral and medial gastrocnemial, soleus muscle) were recorded during 15s plantar sole vibration using 3D motion analysis system. Simulating each zone separately resulted in spatially oriented body tilts; oppositely directed backward and forward, respectively, the amplitude of which was proportional to the vibration frequency. EMG activity of lower limb muscles also varied according to the direction of the vibration zone and linearly according to the frequency. These findings led us to consider the plantar sole vibration as useful method of postural balance control and adjustment.
Objective: To quantitatively assess biochemical alterations in the cartilage of the subtalar and midtarsal joints in chronic lateral ankle instability (CLAI) patients with isolated anterior talofibular ligament (ATFL) injuries and combined calcaneofibular ligament (CFL) injuries using MRI T2 mapping. Materials and Methods: This study was performed according to regulations of the Committee for Human Research at our institution, and written informed consent was obtained from all participants. Forty CLAI patients (26 with isolated ATFL injuries and 14 with combined ATFL and CFL injuries) and 25 healthy subjects were recruited for this study. All participants underwent MRI scans with T2 mapping. Patients were assessed with the American Orthopedic Foot and Ankle Society (AOFAS) rating system. The subtalar and midtarsal joints were segmented into 14 cartilage subregions. The T2 value of each subregion was measured from T2 mapping images. Data were analyzed with ANOVA, the Student's t test, and Pearson's correlation coefficient. Results: T2 values of most subregions of the subtalar joint and the calcaneal facet of the calcaneocuboid joint in CLAI patients with combined CFL injuries were higher than those in healthy controls (all p < 0.05). However, there were no significant differences in T2 values in subtalar and midtarsal joints between patients with isolated ATFL injuries and healthy controls (all p > 0.05). Moreover, T2 values of the medial talar subregions of the posterior subtalar joint in patients with combined CFL injuries showed negative correlations with the AOFAS scores (r = -0.687, p = 0.007; r = -0.609, p = 0.021, respectively). Conclusion: CLAI with combined CFL injuries can lead to cartilage degeneration in subtalar and calcaneocuboid joints, while an isolated ATFL injury might not have a significant impact on the cartilage in these joints.
Chun, Dong-il;Hwang, Shu Chiang;Cho, Jae-ho;Choi, Sung-Woo;Kim, Yong Beom;Won, Sung Hun
Journal of Korean Foot and Ankle Society
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v.21
no.2
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pp.61-65
/
2017
Purpose: The purpose of this study was to determine the correlation and ratio between the calcaneal length and width for predicting the width of calcaneus. Materials and Methods: A total of 190 feet (190 patients) were included based on computed tomography scans. The length of calcaneus (CL) was measured on the line connecting the center of a circle tangent to the cortical margin in the anterior and posterior parts of the calcaneus in a sagittal plane (W1, W2). The width of the calcaneus was defined as the horizontal line of each part (W1, W2, W3) on the same axial plane. The relationship between the measurement was determined through a correlation analysis. The reliability was assessed based on intraclass correlation coefficients. Results: The CL and widths of calcaneus (W1, W2, W3) had a good positive correlation (r=0.848 [W1/CL], r=0.738 [W2/CL], r=0.769 [W3/CL]; p<0.001). The mean CL and widths ratios were 0.33 (W1/CL), 0.37 (W2/CL), and 0.37 (W3/CL). Using these ratios to estimate the widths by multiplying each ratio by the measured calcaneal length, we found a difference between the estimated calcaneal widths and the actual measured calcaneal widths values was 0.25 mm, 0.43 mm, and 0.16 mm. All measurements showed good-to-excellent inter- and intraobserver reliability. Conclusion: This study analyzed the correlation and ratio between the length and width of the calcaneus. The results will help orthopedic surgeons fixate screws in a stable manner to prevent iatrogenic injuries to the medial neurovascular structures of the calcaneus.
Purpose: Accurate clinical evaluation of the alignment of the calcaneus relative to the tibia in the coronal plane is essential in the evaluation and treatment of hindfoot pathologic condition. Previously described standard anteroposterior, lateral, and oblique radiographic methods of the foot or ankle do not demonstrate alignment of the tibia relation to the calcaneus in the coronal plane. The purpose of this study was to introduce hindfoot coronal alignment view. Material : 1) Both feet were imaged simultaneously on an elevated, radiolucent foot stand equipment. 2) Both feet stood on a radiolucent platform with equal weight on both feet. 3) Both feet are located foot axis longitudinal perpendicular to the platform. 4) Silhouette tracing around both feet are made, and line is then drawn to bisect the silhouette of the second toe and the outline of the heel. 5) The x-ray beam is angled down approximately $15^{\circ} to $20^{\circ} Result : 1) This image described tibial axis and medial, lateral tuberosity of calcaneus. 2) Calcaneus do not rotated. 3) The view is showed by talotibial joint space. Conclusion: Although computed tomographic and magnetic resonance imaging techniques are capable of demonstrating coronal hindfoot alignment, they lack usefulness in most clinical situations because the foot is imaged in a non-weight bearing position. But hindfoot coronal alignment view is obtained for evaluating position changing of inversion, eversion of the hindfoot and varus, valgus deformity of calcaneus.
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