• Journal of Haehwa Medicine
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• v.10 no.1
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• pp.221-235
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• 2001

According to the literature study on Nae-gwan and Kongson, reviewing the oriental medical books from Hung-Ti-Nei-Ching $\ll$黃帝內經$\gg$ to recent books and other 35 kinds of literatures, the following results are obtained. 1. The location of Nae-gwan is the superior 2 cun Tae-nung point between Tendon of flexor carpiradials and Tendon of palmaris longus; the location of Kongson is the 1st Metatarsal, medial, dented and posterior 1 cun T'aebaek point. 2. The effects of Nae-gwan are relaxing mind, nutrition of heart, peaceful chest, invigorate vital energy, transmitting triple energy; the effects of Kongson are steadying spleen harmonious stomach clearing away dampness, controlling ch'ung-im, regulating blood. 3. Nae-gwan is often used for circulatory organs disease, digestive organs disease, neuropsychiatry disease; Kongson is often used for digestive organs disease, urinary organs disease, neuropsychiatry disease, therefore, these double points are used for internal disease wholly. 4. The Needle-steadying depth of Nae-gwan is 0.5-1 cun, Kongson is 0.3-2 cun; the Moxibustion dosage of Nae-gwan is 3-7 zhuang, Kongson is 3-5 zhuang. 5. Nae-gwan belongs to pericardium Merdian, Kongson belongs to Spleen Meridian, therefore, these double points are combined in yin Meridian upper and lower sides. These points can be used for treating front body part, such as heart, chest and stomach.

• Journal of Korean Foot and Ankle Society
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• v.24 no.3
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• pp.113-119
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• 2020

Purpose: A flatfoot that fails to form a longitudinal foot arch is a common lower limb deformity in children. This study evaluated the structural and functional effects of the insole for pediatric flexible flat foot (PFFF). Materials and Methods: Twenty-nine PFFF patients (20 boys and 9 girls, 58 feet) with bilateral symptomatic flatfoot deformities between February 2017 and May 2019 were included in this study. Sixteen patients (32 cases, study group) were treated with a pressured based 3-dimensional printing insole, and 13 patients (26 cases, control group) were followed up regularly without any treatment. Flatfoot was diagnosed by a lateral talo-first metatarsal angle of more than 4° in convex downward and talocalcaneal angles of more than 30° and a calcaneal pitch of less than 20°. The foot pressures, including the midfoot pressure, total foot pressure, and the ratio of the midfoot pressure to the total foot pressure, were evaluated by pedobarography. The clinical scores were assessed using the visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS), and Pediatrics Outcomes Data Collection Instrument (PODCI) scores. Results: The mean age of the study group was 9.16 years, and the mean age of the control group was 7.73 years. The mean follow-up period was 16 months. The change in the lateral talocalcaneal angle was -4.664°±1.239° in the study group and -0.484°±1.513° in the control group. A significant difference in the amount of change of the lateral talocalcaneal angle was observed between the two groups (p=0.034). The midfoot pressures were similar in the two groups. Conclusion: Pressure based customized 3-dimensional printing insole in PFFF may have some effect on the hindfoot bony alignment, but it does not affect the changes in midfoot pressure.

• 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.

• Physical Therapy Korea
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• v.18 no.4
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• pp.19-25
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• 2011

The aims of this study were to investigate the correlation between the electromyographic (EMG) activity of the abductor hallucis (AbdH) and the amount of pressure measured by a pinch gauge (PG), and to compare the EMG activity of AbdH and the pressure measured by the PG during short foot (SF) exercise in subjects with pes planus and in subjects with a neutral foot alignment. Fourteen subjects were recruited for this study (pes planus group=7; neutral foot alignment group=7). A surface EMG was used to collect AbdH activity, and a PG was positioned under the first metatarsophalangeal joint to measure the pressure produced by the first metatarsal head during the SF exercise. The AbdH activity and the pressure measured by the PG showed a positive good correlation (r=.80, p<.05). The EMG activity of the AbdH and the pressure measured by the PG were significantly lower for subjects with pes planus than for subjects with a neutral foot alignment (p<.05). Based on these findings, the PG can be recommended as an effective instrument for evaluating the performance of the AbdH. It may also be beneficial for monitoring how well the SF exercise is performed, and for providing visual feedback to patients with pes planus during SF exercise in a clinical setting.

• Physical Therapy Korea
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• v.20 no.4
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• pp.55-64
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• 2013

The first purpose was to identify the plantar pressure distributions (peak pressure, pressure integral time, and contact area) during level walking, and stair ascent and descent in asymptomatic flexible flatfoot (AFF). The second purpose was to investigate whether peak pressure data during level walking could be used to predict peak pressure during stair walking by identifying correlations between the peak pressures of level walking and stair walking. Twenty young adult subjects (8 males and 12 females, age $21.0{\pm}1.7$ years) with AFF were recruited. A distance greater than 10 mm in a navicular drop test was defined as flexible flatfoot. Each subject performed at least 10 steps during level walking, and stair ascent and descent. The plantar pressure distribution was measured in nine foot regions using a pressure measurement system. A two-way repeated analysis of variance was conducted to examine the differences in the three dependent variables with two within-subject factors (activity type and foot region). Linear regression analysis was conducted to predict peak pressure during stair walking using the peak pressure in the metatarsal regions during level walking. Significant interaction effects were observed between activity type and foot region for peak pressure (F=9.508, p<.001), pressure time integral (F=5.912, p=.003), and contact area (F=15.510, p<.001). The regression equations predicting peak pressure during stair walking accounted for variance in the range of 25.7% and 65.8%. The findings indicate that plantar pressures in AFF were influenced by both activity type and foot region. Furthermore the findings suggest that peak pressure data during level walking could be used to predict the peak pressure data during stair walking. These data collected for AFF can be useful for evaluating gait patterns and for predicting pressure data of flexible flatfoot subjects who have difficulty performing activities such as stair walking. Further studies should investigate plantar pressure distribution during various functional activities in symptomatic flexible flatfoot, and consider other predictors for regression analysis.

• Journal of Korean Foot and Ankle Society
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• v.6 no.2
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• pp.139-143
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• 2002

Purpose: We analyzed the Metatarso-Phalangeal Oblique Angle(MPOA) of Diabetic foot. Materials and methods: We studied retrospectively 60 cases of diabetic foot in 52 patients, for the evaluation of the correlations between clinical outcomes and radiologic findings in the conservative management group (Group A; 36 cases) and the major operation group (Group B; 24 cases). We measured MPOA on AP view. The MPOA was defined as the intersection angle of the Metatarso-Phalangeal Break Line (a line passing from the second to fifth metatarsal heads) and the long axis of foot in sagittal plane. We performed the statistical analysis between MPOA and clinical outcomes. by independent t-test. Results: The mean of MPOA in group B, $70.79^{\circ}$ (range: $62.8^{\circ}-81.3^{\circ}$), was significantly higher than that in group A, $68.04^{\circ}$ (range: $62.0^{\circ}-76.4^{\circ}$). The mean of MPOA in patients of fore foot lesions(30 cases), $71.30^{\circ}$ (range: $62.0^{\circ}-71.5^{\circ}$), was significantly higher than that in patients of hind foot lesions(30 cases), $66.97^{\circ}$(range: $62.8^{\circ}-81.3^{\circ}$). Conclusions: We recognized the MPOA might be useful simple parameter in assessing the diabetic foot.

• Journal of Korean Foot and Ankle Society
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• v.16 no.1
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• pp.53-57
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• 2012

Purpose: To study computerized measurements of angular parameters on 100% and 150% resized digital radiography of hallux valgus deformity Materials and Methods: 30 digital radiography of standing foot anteroposterior view of hallux valgus patients were included. Two observers(A, B) independently measured hallux valgus angle (HVA), 1-2 intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) in two times on both 100%-size and 150% magnified images respectively, using computerized measurement software tools. The results were interpreted with the statistical software program, Statistical Analysis System, version 9.2. Results: In repeated measurements of each observer, measurements on 150% magnified image showed no differences of all three parameters and with 100%-size image, there were differences of HVA (observer A) and 1-2 IMA (observer B) (p>0.05). When testing interobserver reliability, both observers showed differences in measurement of HVA and DMAA (p<0.05), but no differences in measurement of 1-2 IMA in both images. Within the 95% confidence interval, limits of error of measurements between two observers on HVA, IMA and DMAA were $2.7^{\circ}$ $1.4^{\circ}$ and $5.0^{\circ}$ respectively in 100%-size images, and $2.6^{\circ}$, $1.6^{\circ}$ and $4.7^{\circ}$ respectively in 150% magnified images. Conclusion: In computerized measurements for angular parameters of hallux valgus with digital radiography, 150% magnified images showed intraobserver reliability. Both 100% and 150% magnified images failed to show interobserver reliability. Measurement of 1-2 IMA in both 100% and 150% images showed less interobserver error.

• Journal of Korean Foot and Ankle Society
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• v.18 no.4
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• pp.173-177
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• 2014

Purpose: The purpose of this study is to evaluate the characteristics of hallux valgus with severe hallux valgus angle (HVA) and moderate intermetatarsal angle (IMA) after proximal chevron osteotomy. Materials and Methods: Between January 2008 and December 2010, 41 patients (48 feet) were treated with proximal chevron osteotomy and distal soft tissue procedure for symptomatic severe hallux valgus deformity ($HVA{\geq}40^{\circ}$). Patients were divided into two groups, group M (IMA< $18^{\circ}$) and group S ($IMA{\geq}18^{\circ}$). Mean age of patients was 55.7 years (34~70 years) in group M and 60.0 years (44~78 years) in group S. Mean duration of follow-up was 20.4 months (12~41 months) in group M and 18.5 months (12~35 months) in group S. Radiographic parameters, including HVA, IMA, sesamoid position, metatarsus adductus angle (MAA), and distal metatarsal articular angle (DMAA), were compared between groups. Clinical results were assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue scale (VAS). Recurrence rate at the last follow-up was compared between group M and group S. Results: Preoperative HVA and grade of sesamoid position did not differ between the groups. However, immediate postoperative HVA and grade of sesamoid position were significantly larger in group M. Preoperative MAA and DMAA were significantly larger in group M. No significant difference in AOFAS score and VAS was observed between the groups at the last follow-up. Ten of the 27 feet (37.0%) in group M and two of the 21 feet (9.5%) in group S showed hallux valgus recurrence at the last follow-up. Group M showed a significantly higher recurrence rate than group S. Conclusion: Recurrence rate for severe hallux valgus with moderate IMA is higher than that of severe hallux valgus with severe IMA.

• Korean Journal of Applied Biomechanics
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• v.17 no.3
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• pp.81-94
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• 2007

The purpose of this study was to critically review biomechanical studies on foot orthoses (FO) in normal and diseased foot and provide beneficial information obtained from researches until now and future researching focus. The search was performed by Medline and Embase database including studies published in English from January 1980 to April 2007. The searching terms were foot orthoses, foot orthotics, insoles and shoe insert. 57 studies including 54 journal articles and 3 abstracts were finally selected under the conditions of having clinical trials, FO, control condition, movement, scientific measuring system. The reviewed studies were divided into 10 categories according to subject characteristics; healthy normal, excessive pronation or flexible flat foot, rheumatoid arthritis, diabetes, medial knee osteoarthritis, forefoot varus, plantar fasciitis, patellofemoral syndrome, cavus foot and finite element model. In summary, first, soft and semirigid FOs with some degree of cushioning showed much higher comfort and efficacy than rigid FO. Second, no big differences between prefabricated and custom FO were shown. Third, the full length's FO was preferable to the half length's FO or simple arch supports. Fourth, the wearing of FO combining medial arch supports and metatarsal dome made positive roles to enhance comfort and functionality and redistribute plantar pressure under the foot. Fifth, for patients with knee-related diseases lateral wedges were preferable. Sixth, measuring systems were properly applied according to the types of foot diseases.

• Journal of the Korean Society for Precision Engineering
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• v.22 no.6 s.171
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• pp.213-221
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• 2005

An insole type local shear force measurement system was developed and local shear stresses in the foot were measured during level walking. The shear force transducer based on the magneto-resistive principle, was a rigid 3-layer circular disc. Sensor calibrations with a specially designed calibration device showed that it provided relatively linear sensor outputs. Shear transducers were mounted on the locations of four metatarsal heads and heel in the insole. Sensor outputs were amplified, decorded in the bluetooth transmission part and then transferred to PC. In order to evaluate the developed system, both shear and plantar pressure measurements, synchronized with the three-dimensional motion analysis system, were performed on twelve young healthy male subjects, walking at their comfortable speeds. The maximum peak pressure during gait was 5.00kPa/B.W at the heel. The time when large local shear stresses were acted correlated well with the time of fast COP movements. The anteroposterior shear was dominant near the COP trajectory, but the mediolateral shear was noted away from the COP trajectory. The vector sum of shear stresses revealed a strong correlation with COP movement velocity. The present study will be helpful to select the material and to design of foot orthoses and orthopedic shoes for diabetic neuropathy or Hansen disease.