• Archives of Reconstructive Microsurgery
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• v.9 no.2
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• pp.114-119
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• 2000

The soft tissue defects including the Achilles tendon are complex and very difficult to reconstruct. Recently, several free composite flaps including the tendon have been used to reconstruct large defects in this area in an one-stage effort. Our case presents a patient reconstructed with free composite dorsalis pedis flap along with the extensor digitorum longus and superficial peroneal nerve for extensive defects of the Achilles tendon and surrounding soft tissue. A 36-year-old-man sustained an open injury to the Achilles tendon. He was referred to our department with gross infection of the wound and complete rupture of the tendon associated with loss of skin following reduction of distal tibial bone fracture. After extensive debridement, $6{\times}8cm$ of skin loss and 8cm of tendon defect was noted. Corresponding to the size of the defect, the composite dorsalis pedis flap was raised as a neurosensory unit including the extensor digitorum longus to provide tendon repair and sensate skin for an one-stage reconstruction. One tendon slip was sutured to the soleus musculotendinous portion, the other two were sutured to the gastrocnemius musculotendinous portion with 2-0 Prolene. The superficial peroneal nerve was then coaptated to the medial sural cutaneous nerve. The anterior tibial artery and vein were anastomosed to the posterior tibial artery and accompanying vein in an end to end fashion. After 12 months of follow-up, 5 degrees of dorsiflexion due to the checkrein deformity and 58 degrees of plantar flexion was achieved. The patient was able to walk without crutches. Twopoint discrimination and moving two-point discrimination were more than 1mm at the transferred flap site. The donor site healed uneventfully. Of the various free composite flaps for the Achilles tendon reconstruction when skin coverage is also needed, we recommand the composite dorsalis pedis flap. The advantages such as to control infection, adequate restoration of ankle contour for normal foot wear, transfer of the long tendinous portion, and protective sensation makes this flap our first choice for reconstruction of soft tissue defect including the Achilles tendon.

• Physical Therapy Korea
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• v.11 no.1
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• pp.53-67
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• 2004

This simulation study investigated the characteristics of normal gait, $30^{\circ}$ crouch gait, $30^{\circ}$ crouch/equinus gait, $45^{\circ}$ crouch gait, $45^{\circ}$ crouch/equinus gait. The knee flexion angles were restricted using a specially designed orthosis. This study was carried out in a motion analysis laboratory of the National Rehabilitation Center. Fifteen healthy male subjects were recruited for the study. The purposes of this study were (1) to compare spatiotemporal parameters, kinematics, and kinetic variables in the sagittal plane among the different gait, (2) to investigate the secondary compensatory strategy, and (3) to suggest biomechanical physical therapy treatment methods. The pattern and magnitude observed in each condition were similar to those of normal gait, except the peak knee extension moment of the unrestricted ankle motion-crouch gait. However, the speed of the $45^{\circ}$ crouch gait was half that of a normal gait. The ankle joint moment in the crouch/equinus gait showed the double-bump pattern commonly observed in children with spastic cerebral palsy, and there was no significant difference in gait speed as compared with normal gait. The peak ankle plantar-flexor moment and ankle power generated during the terminal stance in the crouch/equinus conditions were reduced as compared with normal and $45^{\circ}$ crouch gaits (p<.05). The crouch/equinus gait at the ankle joint was an effective compensatory mechanism. Since ankle plantarflexion contracture can be exacerbated secondary to the ankle compensatory strategy in the crouch/equinus gait, it is necessary to increase the range of ankle dorsiflexion and the strength of plantarflexion simultaneously to decrease the abnormal biomechanical advantages of the ankle joint.

• Proceedings of the Korea Contents Association Conference
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• 2005.05a
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• pp.156-164
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• 2005

The aim of this study was to analyze the isokinetic strength of ankle, lumbar and shoulder in fin swimmers. For this study, 7 male fin swimmers and 7 men general swimmers were selected. Isokinetic strength of ankle, lumbar and shoulder were measured by Biodex System 3,000. Statistical techniques for data analysis were a descriptive statistics and t-test. The results of this study were as following; The first, significant difference between two groups in right and left plantar flexion of ankle at $30^{\circ}/sec\;and\;180^{\circ}/sec$. But no significant difference was found between right and left in two groups. The second, significant difference between two groups in right dorsiflexion of ankle at $30^{\circ}/sec$. The third, significant difference between two groups in extension of lumbar at $60^{\circ}/sec$. The fourth, significant difference between two groups in right flexing of shoulder at $60^{\circ}/sec$ and $180^{\circ}/sec$. As result of this conclusion, the isokinetic strength of ankle and lumbar in fin swimming group showed significantly higher than non-fin swimming group.

• PNF and Movement
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• v.4 no.1
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• pp.45-50
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• 2006

Purpose : This study shows the movements of the ankle and the foot in walking stages, and helps to diagnose and treat the problems of the ankle and the foot. The foot in human is a mean of the transportation, body support, and shock absorber. However, the slightest changes in the anatomical position can cause a significant increase of the stress and force in the ankle and the foot. The regular compressive force in the ankle of the normal person is generated by the contraction of the gastrocnemius and popliteus muscles, and transmitted to the achilles tendon. The plantar flexion about 10 degrees occurs immediately after the heel strike, getting ready for the weight acceptance. The shear force about 80 % of the body weight is generated immediately after the heel off of the mid stance phase. In those who have a problem in the ankle, the compression force at the ankle decreased to 1/3 of the body weight, and the shear force decreased, and the compressive force was reached at their maximum level earlier than the normal people. Conclusion : Analysis of the movements at the ankle and the foot in walking phase can make the effort to diagnose and treat the ankle and foot with the problems. However, the further study is necessary.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.2
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• pp.138-142
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• 2002

Purpose: To evaluate the results and prognosis of operative repair to acute rupture of achilles tend on associated sports injury. Materials and Methods: 21 cases were surgically treated and average follow-up period was 1 year and eight months. The forth decade was most common with $55\%$ and soccer was most common in sports with 5 cases. End-to-end suture of ruptured achilles tendon was performed, and paratendinous structure was wrapped sufficiently. Postoperatively. ankle was plantarflexed for 6 weeks with longleg cast. And then 2 weeks interval, short leg cast with equinous position was conversed to functional position. About 10 weeks after operation, ankle was recovered to right angle. Hooker scale was used to evaluate the results. Results: Compared to normal side, heel-floor distance of ruptures side was decreased 0.7 cm in average, and 0.8 cm was deceased after 20 times weight loaded dorsiflexion. Mid-calf circumference was deceased 0.3 cm, and active dorsiflexion and plantar flexion of ankle was decreased each 3 and 5degree. 16 cases showed ‘excellent’result and 5 cases showed ‘satisfactory’. There was no complication, such as re-rupture or infection at operation site. Conclusion: After end-to-end operative repair to achilles tendon, sufficient wrapping of paratendinous structure is efficient for healing and prevention of postoperative adhesion. And serial dorsiflex-ion cast change is considered to be a successful treatment for preventing residual equinus deformity.

• The Journal of the Institute of Internet, Broadcasting and Communication
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• v.23 no.1
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• pp.109-116
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• 2023

The purpose of this study was to investigate the influence of gender and load carriage difference on the lower extremity kinetics during stair descent. Ten healthy males and 10 healthy females were recruited (n=20). In the Maximum resultant velocity, it showed more velocity was decreased with difference by the change of gender (males>females) and load carriage (30%, 20%, 10%> 10%). And, resultant velocity showed interaction between gender and a load (load>gender). Main effect by gender during stair descent showed leg length was decreased in females than that of males at initial contact phase. Also, main effect by gender during stair descent showed more hip, knee flexed and plantar flexion of ankle joint in females than that of males. In the kinetics variables, main effect by gender during stair descent showed more higher reaction force of medial-lateral direction, and leg stiffness in males than that of females. We found that females successfully accommodated a load during stair descent by decreasing the range of motion of the hip joint angle and resultant velocity of movement. Males, on the other hand, require greater medial-lateral, vertical reaction force, and leg stiffness to accommodate a load, and control of momentum.

• Journal of Korean Physical Therapy Science
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• v.29 no.2
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• pp.28-37
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• 2022

Background: The purpose of this study was to investigate the effects of differences in the tension of Kinesio tape applied to the tibialis anterior muscle on muscle strength, joint range of motion and balance of ankle joint in young adults. Design: Randomized Controlled Trial. Methods: 41 young college students participated in this study. And the subjects were allocated randomly to two group. The experimental group had a tension difference (10%G, n=20). And there was no difference in tension in the control group (0%G, n=21). Jtech power track II, goniometer, and Biorescue were used to measure muscle strength, joint range of motion and balance. The paired t-test was performed to examine the differences within the groups before and after taping, and the independent t-test was performed to examine the differences between the groups. Result: 1) As a result of measuring muscle strength of each group, all measurements except 0%G of plantar flexion showed insignificant results. 2) Measurement of joint range of motion each group showed that neither 0%G nor 10%G was significant. 3) As a result of measuring the baladncing ability of each group there was a significant decrease in length, and average speed of the balancing capability (p<.05). 4) Comparisons between groups showed significant differences in the area among balance capability (p<.05). Conclusions: Based on these findings, the tension difference of Kinesio tape applied to the tibialis anterior muscle shows little effect on the muscle strength, range of motion, and balance of ankle joints. Given the current lack of research on the tension of kinesio tapes many studies are needed in the future to establish clear theories.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.7
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• pp.228-235
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• 2019

The purpose of this study was to investigate the effect of 6 weeks' accelerated rehabilitation with anti-gravity treadmill exercise on VAS, ROM, isokinetic myofunction, and dynamic stability after surgery of modified brostrom operation in chronic ankle instability patients. The subjects of this study were 12 chronic ankle instability patients who underwent modified Brostrom operation(MBO) by the same doctor. 6 weeks' accelerated rehabilitation program is scheduled to perform for 60min, everyday, and also anti-gravity program performed for 15~30min, everyday. The visual analog scale(VSA) and significantly decreased(p<.001) and ROM in all of dorsal flexion, plantar flexion, inversion and eversion significantly increased(p<.05) after 6 weeks' accelerated rehabilitation with anti-gravity treadmill exercise. Both inversion and eversion peak torque at $60^{\circ}/sec$(p<.001, p<.01) and at $180^{\circ}/sec$(p<.001) significantly increased after 6 weeks' accelerated rehabilitation with anti-gravity treadmill exercise respectively. In muscle defect, although inversion(p<.01) and eversion(p<.001) at $60^{\circ}/sec$ and inversion(p<.01) at $180^{\circ}/sec$ significantly decreased, eversion at $180^{\circ}/sec$ tended to decrease but did not change significantly after 6 weeks' accelerated rehabilitation with anti-gravity treadmill exercise. The dynamic stability significantly increased after 6 weeks' accelerated rehabilitation with anti-gravity treadmill exercise(p<.001). These results suggest that 6 weeks' accelerated rehabilitation with anti-gravity treadmill exercise has positive effect of VAS, ROM, isokinetic myofunction, and dynamic stability after surgery of modified brostrom operation in chronic ankle instability patients. Therefore, we consider that the accelerated rehabilitation with anti-gravity treadmill exercise, which is safely and fast method, has effect on more faster recovery of ankle stability, play ground and normal daily activities.