• Journal of Korean Foot and Ankle Society
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• v.4 no.2
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• pp.87-92
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• 2000

The tendinous ends of neglected achilles tendon rupture tend to retract and separate with atrophy due to gastrosoleus muscle contracture, leaving a wide gap occupied with fibroadipose scar tissue. It is almost impossible to perform simple end-to-end anastomosis after the intervening scar tissue being excised. Therefore many surgical procedures have been proposed to reconstruct the large gap. We treated three such cases by V-Y advancement flap and double Krackow suture technique, and their postoperative strength of triceps surae were evaluated with Cybex isokinetic strength testing. All patients returned to preinjury activities with satisfaction, but the ankle plantar flexor power showed about 20-30% deficit.

• International Journal of Contents
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• v.5 no.4
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• pp.35-39
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• 2009

The purpose of this study was to evaluate the changes in skeletal muscle architecture and qualitative properties by muscle contraction force when neuromuscular electrical stimulation (NMES) of 50% MVIC was applied. Sixteen subjects (8 male, 8 female) without neuromuscular disease volunteered to participate in the study. All subjects were divided into two subgroups: control (no electrical stimulation) group and 50% maximal voluntary isometric contraction (MVIC) group. NMES training program was performed in the calf muscle three times a week for 10 weeks. Before and after the experiments, the MVIC of ankle plantar flexor was measured by the use of dynamometer, and the ultrasonography in the gastrocnemius medialis muscle was measured. The following results were obtained; MVIC was significantly increased in the electrical stimulation groups. Pennation angle, muscle density, and white area index also considerably changed in the electrical stimulation groups. In conclusion, the NMES training of 50% MVIC, comparative low level, improved the skeletal muscle architecture and the qualitative properties as well as the muscle contraction force.

• PNF and Movement
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• v.6 no.3
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• pp.29-35
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• 2008

Purpose : To describes the important aspects of the foot and ankle movement and function used when git and balance strategy. Method : The foot and ankle was a very important roles in the lower limb movement and gait. This study summarizes the physiologic movement of knee to the PNF lower extremity patterns. Result : The ankle joint composed of the talocural joint, the subtalarl joint, transverse tarsal joint, talocalcaneonavicular joint. The onset of dorsiflexion muscle activity starts in pre swing gait patterns. First contract muscle is the extensor hallucis. Activity of tibialis anterior and extensor digitorum longus quickly follows in mid swing gait phase. During stance phase, the soleus and gastrocnemius muscle provided plantar flexor torque, which muscle reacts quickly to restrain ankle dorsiflexion, and contributes modulated control of the ankle motion in gait patterns. Conclusions : The understanding of ankle kinematics, could provide a good therapeutic approach for improving gait patterns in patients with various pathological condition.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.6
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• pp.2632-2640
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• 2012

The purpose of this study was to investigate whether medial gastrocnemius ultrasound imaging of the Delayed Onset Muscle Soreness (DOMS) has the possibilities as a measurement method. This study was conducted from April 21th 2011 to April 30th 2011. Thirty-five healthy subjects were included based on the absence of regular physical activity, and no history of recent trauma, musculoskeletal pathology, cardiovascular disease or drug intake. All subjects induced DOMS through climbing for 5 hours and we measured the visual analogue scale (VAS), creatine kinase (CK) and maximal voluntary isometric contraction (MVlC) of ankle plantar flexor prior to DOMS and at 24, 48 and 72 hours post DOMS and these measurements were compared with pennation angle of medial gastrocnemius measured by ultrasound imaging. Results of this study were as following. VAS, CK, and MVIC of ankle plantar flexor were found significant difference related measurement period (p<0.05) and pennation angle of medial gastrocnemius were found significant difference related measurement period (p<0.05). Furthermore, we confirmed that the flow of change between variables related measurment period was consistent. Through this study, we think that measuring the changes in pennation angle of medial gastrocnemius over time using ultrasound imaging will be able to be used as a new method measuring DOMS.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.12
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• pp.5789-5796
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• 2011

This study examined the effect of VT(Vibration Training) on the symptoms of DOMS (Delayed-Onset Muscle Soreness) before induced by eccentric exercise of the left leg triceps surae. Twenty one healthy adult men and women who had not participated in a regular exercise program for the lower extremities were assigned to one of two experimental groups: vibration training group, Control group. We measured the VAS(Visual Analogue Scale), ankle plantar flexor strength, triceps surae circumference, CK(Creatine Kinase) before and after exercise and 24, 48 and 72 hours after eccentric exercise. After inducing DOMS, VAS showed significant differences between groups at a point of time 48 hours, and showed significant differences within groups in accordance with the time of measurement(p<.05). Plantar flexor strength of groups with VT did not show significant difference between groups but, showed significant differences within groups in accordance with the time of measurement(p<.05). Triceps surae circumference of groups with VT did not show significant difference between groups but, showed significant differences within groups in accordance with the time of measurement(p<.05). CK of groups with VT did not show significant difference between groups but, showed significant differences within groups in accordance with the time of measurement(p<.05). As a result of the study, VT prior to eccentric exercise is effective to inhibit pain. So, this method can be suggested to prevent DOMS in doing an unfamiliar activites.

• Physical Therapy Korea
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• v.19 no.3
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• pp.20-30
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• 2012

The purpose of this study was to determine the effect of ankle joint mobilization with movement (MWM) on the range of motion (ROM) in the ankle, on the muscle strength of lower extremities, and on spatiotemporal gait parameters in chronic hemiplegic patients. Fifteen subjects with chronic stroke were divided into two groups: an experimental group (8 subjects) and a control group (7 subjects). Both groups attended two or three sessions of physical therapy each week. The experimental group also attended additional MWM training sessions three times a week for five weeks. For both groups, the ROM of the ankle, the muscle strength of the lower extremities, and the spatiotemporal gait parameters in paretic limbs were evaluated before and after the training period. The results showed that the experimental group experienced more significant increases than did the control group in terms of passive (6.10%) and active (21.96%) ROM of the ankle, gait velocity (12.96%), and peak torque, of the knee flexor (81.39%), the knee extensor (24.88%), and the ankle plantar flexor (41.75%)(p<.05). These results suggest that MWM training in patients with chronic stroke may be beneficial in increasing ROM in the ankle, muscle strength in the lower extremities, and gait speed.

• Physical Therapy Korea
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• v.22 no.4
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• pp.8-16
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• 2015

The purpose of this study was to evaluate the effects of mobilization of the sciatic nerve on hamstring flexibility, lower limb strength, and gait performance in patients with chronic stroke. This study was a randomized clinical trial with a crossover design. Sixteen subjects were recruited for this study. The subjects were randomly divided into two intervention groups and underwent either of the following two interventions: sciatic nerve mobilization or static stretching of the hamstring. We assessed hamstring flexibility, lower limb strength, and gait performance using a digital inclinometer, a hand-held dynamometer, and the 10-meter walk test, respectively. Subjects had a 24-hour rest period between each session in order to minimize carryover effects. Measurements for each test were assessed prior to and immediately after the intervention sessions. Using a two-way analysis of variance test with repeated measures, data from the two trials were analyzed by comparing the differences between both techniques. The level of statistical significance was set at .05. Sciatic nerve mobilization resulted in significantly better knee extensor strength (p=.023, from $15.32{\pm}5.98$ to $18.16{\pm}6.95kg$) and knee flexor strength (p=.011, from $7.80{\pm}4.80$ to $8.15{\pm}4.24kg$) in the experimental group than in the control group. However, no significant effects of static stretching of the hamstring were observed on hamstring flexibility from the ankle plantar flexion (p=.966) and ankle neutral positions (p=.210) and on gait performance (p=.396). This study indicated that the sciatic nerve mobilization technique may be more effective in muscle activation of the knee extensor muscle and knee flexor muscle than hamstring static stretching technique in patients with chronic stroke.

• Annals of Clinical Neurophysiology
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• v.13 no.1
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• pp.31-37
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• 2011

Background: Carpal tunnel syndrome (CTS) and tarsal tunnel syndrome (TTS) are thought to share a similar pathophysiology, compression of the median and plantar nerve by the carpal tunnel and flexor retinaculum. A few reports introduced the relationship between idiopathic CTS and TTS without definite evidence of coexistence. The current study was designed to analyze the electrophysiologic characteristics of combined idiopathic CTS and TTS by comparing with each idiopathic CTS or TTS. Methods: We retrospectively collected patients with combined idiopathic CTS and TTS (CTS-TTS group) from June 2001 to February 2009. Patients with each idiopathic CTS or TTS were collected as controls. Electrophysiologic data of median and plantar nerves were compared between CTS-TTS group and controls. Results: CTS-TTS group was composed of 31 patients. Control group of each CTS or TTS were 50 CTS and 49 TTS patients. In comparison of median nerve conduction study between CTS-TTS group and CTS control group, decreased compound muscle action potential amplitude (p<0.001), decreased median sensory nerve action potential amplitude (p<0.001) and sensory nerve conduction velocity at finger stimulation (p=0.013) were prominent in CTS-TTS group. Decreased medial plantar sensory nerve action potential amplitude (p=0.034) was indicated when CTS-TTS groups and TTS control group were compared. Conclusions: If the electrophysiology study of patients with CTS or TTS was suggestive of severe degree of nerve injury, concerns about the possibility of combined CTS and TTS would be helpful.

• The Journal of Korean Physical Therapy
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• v.19 no.5
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• pp.11-19
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• 2007

Purpose: The purpose of this study was to examine effect of trunk control using pelvic movements upon the foot pressure in patients with hemiplegia. Methods: Twelve males with hemiplegia were the procedure executed turnk control using pelvic movements. The foot pressure were measured using Parotec-system. Results: The data were analysed with paired t-test. First, there was a significant increase in external and internal sensors of dynamic foot pressure change of the hindfoot before and after therapy. Also there was significant increase in hallux (p<0.05). Second, there was a significant increase of affected side in support phase(p<0.05) and decreased of affected side in overlapping phase(p<0.05). Third, there was a significant increase in foot floor contact time and impulse pressure rate between affected and non affected side(p<0.05). Conclusion: The trunk control with pelvic movement had an significant effect on the legs by increase activities of hip flexors and abductors. Also had an effect on ankle dorsiflexion and plantar flexor by biomechanical movement.

• Journal of the Ergonomics Society of Korea
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• v.29 no.3
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• pp.357-364
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• 2010

This study proposes a lower-limb exoskeleton system that is controlled by a wearer's muscle activity. This system is designed by following procedure. First, analyze the muscle activation patterns of human leg while walking. Second, select the adequate actuator to support the human walking based on calculation of required force of knee joint for step walking. Third, unit type knee and ankle orthotics are integrated with selected actuator. Finally, using this knee-assistive system (KAS) and developed muscle stiffness sensors (MSS), the muscle activity pattern of the subject is analyzed while he is walking on the stair. This study proposes an operating algorithm of KAS based on command signal of MSS which is generated by motion intent of human. A healthy and normal subject walked while wearing the developed powered-knee exoskeleton on his/her knees, and measured effectively assisted plantar flexor strength of the subject's knees and those neighboring muscles. Finally, capabilities and feasibility of the KAS are evaluated by testing the adapted motor pattern and the EMG signal variance while walking with exoskeleton. These results shows that developed exoskeleton which controlled by muscle activity could help human's walking acceptably.