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Effects of Combined Wedge on Angle and Moment of Ankle and Knee Joint During Gait in Patients With Genu Varus

  • Yang, Hae Sun;Choi, Houng Sik
    • Journal of International Academy of Physical Therapy Research
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    • v.7 no.2
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    • pp.1025-1030
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    • 2016
  • The purpose of this study was to investigate the effects of combined wedge on the range of motion in ankle and knee joint, ankle eversion moment and knee adduction moment, and center of pressure excursion of foot for genu varus among adult men during gait. This study was carried out with 10 adult men for genu varus in a motion analysis laboratory in J university. The subjects of the experiment were measured above 5cm width between the knees on contact of both medial malleolus of ankle while standing. The width of their knees in neutral position was measured without the inversion or eversion of the subtalar joint by the investigator. The subjects of the experiment were ten who were conducted randomly for standard insole, insole with $10^{\circ}$ lateral on rear foot wedge, insole at $10^{\circ}$lateral on rear foot and $5^{\circ}$ medial on fore foot wedge. Before and after intervention, changes on the range of motion in ankle and knee joint, ankle eversion moment and knee adduction moment, and center of pressure excursion were measured. In order to compare analyses among groups; repeated one-way ANOVA and $Scheff{\acute{e}}$ post hoc test were used. As a result, combined wedge group was significantly decreased compared to control wedge group in terms of knee varus angle in mid-stance(p<.05). Combined wedge group was significantly decreased compared to lateral wedge group in terms of ankle eversion moment in whole stance(p<.05). Combined wedge group was significantly decreased compared to lateral wedge group in terms of knee adduction moment in whole stance(p<.05). Combined wedge group was significantly decreased compared to lateral wedge in terms of center of pressure excursion in whole stance(p<.05). The results of this study suggest that combined wedge for genu varus decreased ankle eversion moment and knee adduction moment upon center of pressure excursion. We hypothesize that combined wedge may also be effective in the protection excessive ankle pronation.

The Effect of Various Wheelchair Handle Directions on Muscle Activity of Adult Male Trunks When Climbing Ramps

  • Ahn, Su-Hong;Lee, Su-Kyong
    • PNF and Movement
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    • v.17 no.3
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    • pp.379-389
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    • 2019
  • Purpose: This study examined the effects of wheelchair handle directions on the trunk muscle activity of adult males when climbing ramps. It also evaluated the wheelchair attendant's physical discomfort during tasks. Methods: Healthy males aged over 20 years were chosen and the direction of wheelchair handle grip was randomly selected. The grips included a general grip with ulnar deviation, a medial grip with wrist pronation, and a neutral grip with a neutral wrist. The trunk muscle activity was measured using surface electromyography. Furthermore, the physical discomfort of wheelchair attendants was subjectively evaluated using the Borg CR-10 Scale, which rates the perceived exertion. In addition, the SPSS 18.0 program was used perform repeated measure ANOVA to compare muscle activity and subjective discomfort during the interventions. The contrast test was also conducted with a significance level (α) of 0.05. Results: There was significant difference between the general grip and the medial grip in the rhomboid major muscle and the lumbar erector spinae muscle (p<0.05). In addition, there was significant difference between the general grip and the neutral grip in the rhomboid major muscle and the lumbar erector spinae muscle (p<0.05). Further, there was significant difference between the general grip and the neutral grip in subjective discomfort (p<0.05). Conclusion: In this study, adult male trunk muscle activity and subjective discomfort were lowest when using the neutral grip while climbing ramps. Accordingly, we suggest that neutral grips will help improve the function of the musculoskeletal system and reduce the subjective discomfort by putting less strain on the trunk muscles and maximizing efficiency with less force.

The Convergence Effects on the Grip Strength in Change of Shoulder Angle on Horizontal Plane (수평면에서 어깨각도변화에 따른 여대생의 악력에 대한 융복합적 연구)

  • Seo, Kyo-Chul;Park, Seung-Hwan;Cho, Mi-Suk
    • Journal of the Korea Convergence Society
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    • v.11 no.5
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    • pp.81-86
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    • 2020
  • The Purpose of this study is analysis characteristic of grasping power with each different shoulder horizontal angle. Twenty female university students with no shoulder dysfuction participated subject in three different positions of shoulder horizontal flexion with standing posture, shoulder 0° flexion, elbow 90° flexion, forearm 90° pronation, different positions is followed : shoulder 0° horizontal adduction shoulder 40° horizontal adduction, shoulder 40° horizontal abduction. The One-way repeated ANOVA test was used to determine the different in grip strength on three shoulder horizontal positions. On the average, in the hand grip strength, the horizontal neutral position is higher than horizontal adduction position with significant value. In particular, shoulder horizontal aduction was measured lowest grip strength between three positions.

A Biomechanical Comparison of Cushioning and Motion Control Shoes During Running (달리기시 쿠션형과 모션컨트롤형 런닝화 착용에 따른 생체역학적 비교)

  • Lee, Ki-Kwang
    • Korean Journal of Applied Biomechanics
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    • v.15 no.3
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    • pp.1-7
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    • 2005
  • Excessive pronation and impact force during running are related to various running injuries. To prevent these injuries, three type of running shoes are used, such as cushioning, stability, and motion control. Although there were may studies about the effect of midsole hardness on impact force, no study to investigate biomechanical effect of motion control running shoes. The purpose of this study was to determine biomechanical difference between cushioning and motion control shoes during treadmill running. Specifically, plantar and rearfoot motion, impact force and loading rate, and insole pressure distribution were quantified and compared. Twenty male healthy runners experienced at treadmill running participated in this study. When they ran on treadmill at 3.83 m/s. Kinematic data were collected using a Motion Analysis eight video camera system at 240 Hz. Impact force and pressure distribution data under the heel of right foot were collected with a Pedar pressure insole system with 26 sensors at 360 Hz. Mean value of ten consecutive steps was calculated for kinematics and kinetics. A dependent paired t-test was used to compare the running shoes effect (p=0.05). For most kinematics, motion control running shoes reduced the range of rearfoot motion compared to cushioning shoes. Runners wearing motion control shoe showed less eversion angle during standing less inversion angle at heel strike, and slower eversion velocity. For kinetics, cushioning shoes has the effect to reduce impact on foot obviously. Runners wearing cushioning shoes showed less impact force and loading rate, and less peak insole pressure. For both shoes, there was greater load on the medial part of heel compared to lateral part. For pressure distribution, runners with cushioning shoes showed lower, especially on the medial heel.

The Effects of Various Directions of Handle Grip on the Upper Limb Muscle Activity of Wheelchair Attendants during Ramp Climbing

  • Ahn, Su-Hong;Lee, Su-Kyoung
    • PNF and Movement
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    • v.16 no.3
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    • pp.415-424
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    • 2018
  • Purpose: This study aimed to determine the effects of various wheelchair handling directions on the upper limb muscle activities of wheelchair attendants while climbing a ramp. Methods: For the study participants, healthy males over 20 years of age were chosen, and the order of the direction of wheelchair handle grip was determined using a randomized method. The handling directions for pushing the wheelchair up a ramp included a general grip with ulnar deviation, a medial grip with wrist pronation, and a neutral grip with a neutral wrist. The muscle activities in the participants' upper limbs were measured using surface electromyography. For statistical data processing, SPSS 18.0 was used to perform repeated measures ANOVA in order to compare the muscle activity among the intervention groups. A contrast test was also conducted among the participants. The significance level (${\alpha}$) was set to 0.05. Results: There was a significant difference between groups using a general grip and a medial grip in the biceps brachii, triceps brachii, and flexor carpi radialis muscles (p<0.05). There was also a significant difference between using a general grip and a neutral grip in the biceps brachii and flexor carpi radialis muscles (p<0.05), and there was a significant difference between using a medial grip and a neutral grip in the biceps brachii and extensor carpi radialis brevis muscles (p<0.05). Conclusion: In this study, the wheelchair assistants' wrist muscle activity was the lowest with a neutral grip while ascending a ramp. Accordingly, this study proposes that wheelchair assistants push wheelchairs up ramps with a neutral grip.

Effects of Artificial Leg Length Discrepancies on the Dynamic Joint Angles of the Hip, Knee, and Ankle During Gait

  • Kim, Yong-Wook;Jo, Seung-Yeon;Byeon, Yeoung-In;Kwon, Ji-Ho;Im, Seok-Hee;Cheon, Su-Hyeon;Kim, Eun-Joo
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.1
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    • pp.53-61
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    • 2019
  • PURPOSE: This study examined the dynamic range of motion (ROM) of the hip, knee, and ankle joint when wearing different shoe sole lifts, as well as the limb asymmetry of the range according to the leg length discrepancy (LLD) during normal speed walking. METHODS: The participants were 40 healthy adults. A motion analysis system was used to collect kinematic ROM data. The participants had 40 markers attached to their lower extremities and were asked to walk on a 6 m walkway, under three different shoe lift conditions (without an insole, 1 cm insole, and 2 cm insole). Visual3D professional software was used to coordinate kinematic ROM data. RESULTS: Most of the ROM variables of the short limbs were similar under each insole lift condition (p>.05). In contrast, when wearing a shoe with a 2 cm insole lift, the long limbs showed significant increases in flexion and extension of the knee joint as well as; plantarflexion, dorsiflexion, pronation, eversion, and inversion of the ankle joint (p<.05). Of the shoes with the insole lifts, significant differences in all ROM variables were observed between the left and right knees, except for the knee internal rotation (p<.05). CONCLUSION: As the insole lift was increased, more ROM differences were observed between the left and right limbs, and the asymmetry of the bilateral lower limbs increased. Therefore, appropriate interventions for LLD are needed because an artificial mild LLD of less than 2.0 cm could lead to a range of musculoskeletal problems of the lower extremities, such as knee and ankle osteoarthritis.

The Effects of Augmented Low-dye Taping on One Leg Standing Balance in People with Flat Feet (평발에 적용한 아규먼트 로우-다이 테이핑이 한 발 서기 균형에 미치는 영향)

  • Hwang, Yoon-Seong;Lee, Jeong-Mok;Kang, Ho-Jeong;Park, Ji-Seong;Park, Hae-Sol;Woo, Young-Keun
    • 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.

Changes of Muscle Activity on Functional Movement according to Foot Type (발의 형태에 따른 기능적 움직임의 근활성 변화)

  • Chae, Jung-Byung;Moon, Ok-Yun
    • PNF and Movement
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    • v.9 no.4
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    • pp.41-48
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    • 2011
  • Purpose : The purpose of this study was to assess the tibialis anterior, soleus, gluteus maximus, transverse abdominis muscle activity of tibialis anterior, soleus, gluteus maximus, transverse abdominis according to pronated foot and supinated foot. Methods : Group of pronation and supination were taped using augmented low-day method to make pronated and supinated foot the three case were assessed by agnostic radiology for investigating foot structure. Results : 1) When supinated foot & pronated foot, tibialis anterior & gluteus maximus muscle activity was augmented in one step. 2) When supinated foot & pronated foot, soleus & transverse abdominis muscle activity was decreased in one step. 3) When supinated foot & pronated foot, tibialis anterior & gluteus maximus muscle activity was augmented in squat. 4) When supinated foot & pronated foot, soleus muscle activity was decreased in squat. 5) When pronated foot, transverse abdominis muscle activity was decreased in squat. 6) When supinated foot, transverse abdominis muscle activity was augmented in squat. 7) When pronated foot, transverse abdominis & gluteus maximus & tibialis anterior muscle activity was augmented in sit to stand. 8) When supinated foot, transverse abdominis & gluteus maximus & tibialis anterior muscle activity was decreased in sit to stand. 9) When supinated foot & pronated foot, soleus muscle activity was decreased in sit to stand. Conclusion : 1) Pronated foot & supinated foot effects on soleus, gluteus maximus, transverse abdominis muscle activity in one step. 2) Pronated foot & supinated foot effects on tibialis anterior, gluteus maximus, transverse abdominis muscle activity in squat. 3) Pronated foot & supinated foot effects on soleus, transverse abdominis muscle activity in sit to stand. Therefore we suggest the deformity of the foot effects on tibialis anterior, soleus, gluteus maximus, transverse abdominis muscle activity.

Short- to mid-term outcomes of radial head replacement for complex radial head fractures

  • Baek, Chung-Sin;Kim, Beom-Soo;Kim, Du-Han;Cho, Chul-Hyun
    • Clinics in Shoulder and Elbow
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    • v.23 no.4
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    • pp.183-189
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    • 2020
  • Background: The purpose of the current study was to investigate short- to mid-term outcomes and complications following radial head replacement (RHR) for complex radial head fractures and to identify factors associated with clinical outcomes. Methods: Twenty-four patients with complex radial head fractures were treated by RHR. The mean age of the patients was 49.8 years (range, 19-73 years). Clinical and radiographic outcomes were evaluated for a mean follow-up period of 58.9 months (range, 27-163 months) using the visual analog scale (VAS) score for pain, the Mayo elbow performance score (MEPS), the quick disabilities of the arm, shoulder and hand (Quick-DASH) score, and serial plain radiographs. Complications were also evaluated. Results: At the final follow-up, the mean VAS score, MEPS, and Quick-DASH score were 0.6±1.1, 88.7±11.5, and 19.4±7.8, respectively. The mean range of motion was 132.7° of flexion, 4.7° of extension, 76.2° of pronation, and 77.5° of supination. Periprosthetic lucency was observed in six patients (25%). Heterotopic ossification was observed in four patients (16.7%). Arthritic change of the elbow joint developed in seven patients (29.2%). Capitellar wear was found in five patients (20.8%). Arthritic change of the elbow joint was significantly correlated with MEPS (P=0.047). Four cases of complications (16.6%) were observed, including two cases of major complications (one stiffness with heterotopic ossification and progressive ulnar neuropathy and one stiffness) and two cases of minor complications (two transient ulnar neuropathy). Conclusions: RHR for the treatment of complex radial head fractures yielded satisfactory short- to mid-term clinical outcomes, though radiographic complications were relatively high.

Controlled active exercise after open reduction and internal fixation of hand fractures

  • Jun, Dongkeun;Bae, Jaehyun;Shin, Donghyeok;Choi, Hyungon;Kim, Jeenam;Lee, Myungchul
    • Archives of Plastic Surgery
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    • v.48 no.1
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    • pp.98-106
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    • 2021
  • Background Hand fractures can be treated using various operative or nonoperative methods. When an operative technique utilizing fixation is performed, early postoperative mobilization has been advocated. We implemented a protocol involving controlled active exercise in the early postoperative period and analyzed the outcomes. Methods Patients who were diagnosed with proximal phalangeal or metacarpal fractures of the second to fifth digits were included (n=37). Minimally invasive open reduction and internal fixation procedures were performed. At 3 weeks postoperatively, controlled active exercise was initiated, with stress applied against the direction of axial loading. The exercise involved pain-free active traction in three positions (supination, neutral, and pronation) between 3 and 5 weeks postoperatively. Postoperative radiographs and range of motion (ROM) in the interphalangeal and metacarpophalangeal joints were analyzed. Results Significant improvements in ROM were found between 6 and 12 weeks for both proximal phalangeal and metacarpal fractures (P<0.05). At 12 weeks, 26 patients achieved a total ROM of more than 230° in the affected finger. Postoperative radiographic images demonstrated union of the affected proximal phalangeal and metacarpal bones at a 20-week postoperative follow-up. Conclusions Minimally invasive open reduction and internal fixation minimized periosteal and peritendinous dissection in hand fractures. Controlled active exercise utilizing pain-free active traction in three different positions resulted in early functional exercise with an acceptable ROM.