• 재활복지공학회논문지
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• 제9권2호
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• pp.145-151
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• 2015

본 연구에서는 3D 스캐닝에서 획득한 이미지 정보를 바탕으로 3차원 그래픽 제품설계와 3D 프린팅 기술을 적용한 보조기 제작방법을 제시하였다. 뇌성마비 환자를 대상으로 4가지 종류의 보조기를 기존의 수작업이 아닌 전산화된 작업 기술을 적용하여 제작해봄으로써 방법과 절차에 대한 기준을 마련하고, 이 기술이 임상적으로 사용 가능한지 여부에 대해 확인했다. 보조기 사용 시 환자만족도와 보조기 제작시간, 인장강도 등의 비교를 통하여 정량적, 정성적으로 제작방법의 적용 가능성을 검증한 결과 기존의 열가소성 수지가 표출했던 문제를 보완하고 대체가능한 방법이 될 가능성이 있음을 확인하였다.

• 제어로봇시스템학회논문지
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• 제17권8호
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• pp.814-823
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• 2011

Nowadays many neurological diseases such as stroke and Parkinson diseases are continually increasing. Orthotic devices as well as exoskeletons have been widely developed for supporting movement assistance and therapy of patients. Robotic knee orthosis can compensate stiff-knee gait of the paralyzed limb and can provide patients consistent assistance at wearable environments. With keeping a robotic orthosis wearable, however, it is not easy to develop a compact and safe actuator with fast rotation and high torque for consistent supports of patients during walking. In this paper, we propose a novel kinematic model for a robotic knee orthosis to drive a knee joint with independent actuation during swing and stance phases, which can allow an actuator with fast rotation to control swing motions and an actuator with high torque to control stance motions, respectively. The suggested kinematic model is composed of a hamstring device with a slide-crank mechanism, a quadriceps device with five-bar/six-bar links, and a patella device for knee covering. The quadriceps device operates in five-bar links with 2-dof motions during swing phase and is changed to six-bar links during stance phase by the contact motion to the patella device. The hamstring device operates in a slider-crank mechanism for entire gait cycle. The kinematics and velocity/force relations are analyzed for the quadriceps and hamstring devices. Finally, the adequate actuators for the suggested kinematic model are designed based on normal gait requirements. The suggested kinematic model will allow a robotic knee orthosis to use compact and light actuators with full support during walking.

• 대한물리의학회지
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• 제1권1호
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• pp.37-47
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• 2006

Purpose : The purpose is to assess the effects of muscle activity of normal person with contact laterally wedged insoles with strapping of varying elevations of 9, 15, 21mm. Methods : The subjects were adult males and women who had not experienced any knee injury. They were asked to performed from isometric contraction exerciese in four postures using lateral wedged. The normalized EMG activity levels(%MVC) of the vastus lateralis, vastus medialis, tibialis anterior, soleus for the four postures of the lower extremities were compared using one way repeted measures ANOVA. Results : Comparison of EMG amplitudes across all postures revealed no significant differences among all muscles(P>0.05). Conclusion : Further studies of the effect of wedged insole angle on knee varus torque in patients with medial-lateral knee osteoarthritis are needed.

• 한국전문물리치료학회지
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• 제9권3호
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• pp.11-21
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• 2002

The purpose of this study was to find the effect of rear foot wedge angle on peak plantar pressures on the forefoot during walking. Twenty normal healthy subjects (10 female, 10 male) were recruited. Peak plantar pressure was measured using pressure distribution platforms (MatScan system) in medial forefoot (under the first, second metatarsal head) and lateral forefoot (under the third, fourth, fifth metatarsal head). The subjects walked at the comfortable velocity under seven conditions; bare footed, $5^{\circ}$, $10^{\circ}$ and $15^{\circ}$ wedges under the medial and lateral sides of the hindfoot. The three averaged peak plantar pressures were collected at each condition at stance and toe off phases. The results showed that a significant increase in lateral forefoot plantar peak pressure investigated in the medial wedge and a significant decrease in lateral forefoot plantar peak pressure investigated in lateral wedge at stance phase (p<.05). These results suggest that rear foot wedge may be useful to modify the peak plantar pressure on the forefoot.

• Journal of Chest Surgery
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• 제45권6호
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• pp.396-400
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• 2012

Background: Surgery has been the classical treatment of pectus carinatum (PC), though compressive orthotic braces have shown successful results in recent years. We propose a non-operative approach using a lightweight, patient-controlled dynamic chest-bracing device. Materials and Methods: Eighteen patients with PC were treated between July 2008 and June 2009. The treatment involved fitting of the brace, which was worn for at least 20 hours per day for 6 months. Their degree of satisfaction (1, no correction; 4, remarkable correction) was measured at 12 months after the initiation of the treatment. Results: Thirteen (72.2%) patients completed the treatment (mean time, $4.9{\pm}1.4$ months). In patients who completed the treatment, the mean overall satisfaction score was $3.73{\pm}0.39$. The mean satisfaction score was 4, and there was no recurrence of pectus carinatum in patients who underwent the treatment for at least 6 months. Minimal recurrence of pectus carinatum after removal of the compressive brace occurred in 5 (38.5%) patients who stopped wearing the compressive brace at 4 months. Conclusion: Compressive bracing results in a significant improvement in PC appearance in patients with an immature skeleton. However, patient compliance and diligent follow-up appear to be paramount for the success of this method of treatment. We currently offer this approach as a first-line treatment for PC.

• 대한물리의학회지
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• 제9권1호
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• pp.1-10
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• 2014

PURPOSE: The purpose of this study was to investigate the effects of flexible derotator of femur orthosis (FDO) during treadmill gait training on the quadriceps-angle (Q-angle), lateral pelvic tilt, gait speed, and number of steps in children with cerebral palsy. METHODS: Seven children with cerebral palsy who had rotational deformity of the lower extremities participated in this study. We used single group repeated measure design. The procedure consisted of baseline phase, intervention phase, and post-intervention phase. The baseline phase consisted of stretching and strengthening exercise and treadmill gait training without FDO. The treatment phase not only included the same procedures as those for baseline, but also included FDO during treadmill gait training. Postural alignment of the lower extremities was assessed with the Q-angle, and lateral pelvic tilt using the Dartfish software program. A 10-m walk test was used to evaluate gait speed and number of steps. RESULTS: For postural alignment, there was significant differences after the application of FDO (p<.05). For gait ability, there was significant differences in all phases (p<.01). CONCLUSION: These finding suggest that the application of FDO during treadmill gait training had a positive effect on the improvement of postural alignment and gait ability in children with cerebral palsy having rotational deformity.

• 대한족부족관절학회지
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• 제2권2호
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• pp.71-75
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• 1998

The fact that, under similar training activities performed in the same environment, march fractures develop in only a certain percentage of the trainees indicates that intrinsic factors are affecting the prevalence of these fractures. Among these intrinsic factors, the relation between foot arch type and the occurance of march fractures was investigated in this study. From 1997 to 1998, at one infantry medical company of infantry corps in Korea, 15 march fracture patients were detected among infantry soldiers. Quantitative measures of the foot arch (longitudinal) structure of 15(30feet) march fracture patients were established and compared with those of 15(30feet) normal person. The results were as follows. 1. From the lateral X-ray film, three parameters (i.e. calcaneal angle, forefoot angle, height to length ratio)were defined to describe the structure of the longitudinal arch of the foot. 2. The mean value of the calcaneal angle of march fracture group and normal control group showed 16.4 degree, 20.5 degree respectively. The difference between two groups was statistically significant (P>0.006), but those of forefoot angle and height to length ratio were not. 3. In the calcaneal angle twenty-six feet(87%) of march fracture group were lower than 17 degrees but twenty-five feet(83%) of normal control group were more than 17 degrees. That is, march fracture were more prevalent in feet with low calcaneal angle. 4. In the low arch foot, the orthotic device might relieve the energy load carried by the foot, thus reducing the incidence of march fractures, and should be analyzed in further study.

• Journal of Interdisciplinary Genomics
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• 제1권2호
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• pp.19-22
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• 2019

CATCH 22 syndrome is rare genetic disease that has various manifestations. Cervical vertebral anomaly, such as Klippel-Feil anomaly, is frequently observed in the patients with CATCH22 syndrome. We present the case of an 11-year-old female patient with CATCH22 syndrome and Klippel-Feil anomaly who had been treated torticollis using the customized soft neck collar. During the patient's first visit to our clinic, she presented with low ear set, skull deformity, intellectual disability, and tilting of the head to the left by approximately 25 degrees. Imaging studies revealed multisegmental fusion and C3 hemivertebrae of the cervical spine and left thoracic scoliosis at T4 with 50 degrees of Cobb's angle. We instructed passive stretching and applied the customized soft neck collar we invented. The ipsilateral aspect of the neck collar is designed to provide vertical support between the clavicle and mandibular angle and is adjustable in height. The Velcro was attached to the neck collar at the point of contact with the ipsilesional mandibular angle, which provides negative sensory feedback, inducing her to tilt neck to the contralesional side. We applied the neck collar for 2 hours a day. After 1 year of treatment, her neck inclination angle improved from 25 to 10 degrees. Providing negative sensory feedback using the customized soft neck collar can be one of the treatment options of postural management in patients with torticollis in cases of CATCH 22 syndrome combined with Klippel-Feil anomaly.

• 한국방사선학회논문지
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• 제13권2호
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• pp.153-158
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• 2019

이 연구의 목적은 3D 프린팅 기술로 만든 맞춤형 소지, 본인의 실제 소지 및 보조기 업체 석고 양성 소지를 이용하여 세 종류의 소지의 형상 차이를 CT와 3D 스캐너로 횡단면 넓이와 부피를 분산 분석하였다. PASC Progrm으로 실제 거리를 측정하는 (Caliper Toll) 기능을 이용하여 15.69 mm지점(Distal Interphalangel Joints(DIP))의 넓이를 각각 30회씩 측정하였고, 부피(Volume)에서 Meshmixer Program의 Configure Units을 이용하였다. 세 종류의 소지 횡단면 넓이에서는 유의한 차이를 볼 수가 없었고, 부피(Volume)에서 0.2 mm의 차이가 있었지만, 유의 수준보다 크게 나타났다. 따라서 본 연구의 결과는 의료분야에서 3D 프린팅 기술을 활용한 맞춤형 보조기 제작에 활성화될 것으로 보여준다.