• 대한족부족관절학회지
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• 제12권1호
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• pp.93-99
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• 2008

Purpose: To evaluate the result of the early exercise and rehabilitation after limited posterior operative treatment of the calcaneal fractures. Materials and Methods: Between May 2005 and December 2007, 43 cases with intraarticular calcaneal fractures were treated by open reduction with K-wires and Steinmann pins. Mean age and mean follow-up period were 42.5 years old and 15 months. All patients were treated with the same postoperative protocol, the early exercise of subtalar joint without short leg splint and cast was began after postoperative 1 day, non-weight bearing crutch ambulation did after 2 weeks, partial-weight bearing crutch ambulation did after 6 weeks, without crutch ambulation did after 10 weeks. The fractures was classified by Essex-Lopresti and Sanders classification using radiographs and the functional outcomes were evaluated by circle draw exercise, AOFAS score. Results: By Essex-Lopresti classification, the tongue type was 6 cases (14%), the joint depression type was 15 cases (35%), the combined type was 22 cases (51%). By Sanders classification, type II were 10 cases (23%), type III were 15 cases (58%), and type IV were 8 cases (19%). By AOFAS functional evaluation, the mean preoperative scores were 70.3 and 70.5 respectively, mean postoperative scores were 83.7 and 86.9 respectively. There were satisfactory results in 40 cases but 3 cases were unsatisfactory including on case of lateral impingement and 2 cases of traumatic arthritis of subtalar joint. Conclusion: We obtained satisfactory result of the early exercise of subtalar joint without short leg splint and cast and rehabilitation after limited posterior operative treatment of the calcaneal fractures.

• 대한물리의학회지
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• 제14권1호
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• pp.75-89
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• 2019

PURPOSE: This study measured the impact of a 12-week fall-prevention exercise program on balance, ambulatory ability, lower limb strength, and psychosocial characteristics in older adults diagnosed with dementia. METHODS: The participants comprised 31 older adults (9 men, 22 women) diagnosed with Alzheimer's or vascular dementia at a long-term care hospital located in Gunsan City. A fall-prevention exercise program was provided to the experimental group, while the control group was only provided with instruction and materials related to the fall-prevention exercise program. The participants were evaluated before the intervention, 6 weeks after the intervention, and 12 weeks after the intervention on static and dynamic balance abilities (using Timed Up and Go test: TUG, Tinetti-balance scale, one-leg standing test: OLS), gait (Tinetti-balance scale, 6-minute walk test: 6MWT), lower limb strength (sit to stand test; STS), and psychosocial characteristics (Short Form 36 Health Survey-Korean version, Korean Mini-Mental State Exam). RESULTS: An independent samples t-test and repeated measures analysis of variance were used for the statistical analysis. There were statistically significant improvements after the intervention (p<.05) in dynamic balance abilities (TUG and OLS using the left foot), gait (6MWT), and lower limb strength (STS) for the experimental group, but not for the control group. No difference was seen in psychosocial characteristics. CONCLUSION: Older adults with dementia who participated in the fall-prevention exercise program showed significant improvements in their static and dynamic balance abilities, lower limb strength, and ambulatory ability after the intervention.

• 대한족부족관절학회지
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• 제22권2호
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• pp.55-61
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• 2018

Chronic lateral ankle instability is a major complication of acute ankle sprains, which can cause discomfort in both daily and sports activity. In addition, it may result in degenerative changes to the ankle joint in the long term. An accurate diagnostic approach and successful treatment plan can be established based on a comprehensive understanding of the concept of functional and mechanical instability. The patients' history and correct physical examination would be the first and most important step. The hindfoot alignment, competence of the lateral ligaments, and proprioceptive function should be evaluated. Additional information can be gathered using standard and stress radiographs. In addition, concomitant pathologic conditions can be investigated by magnetic resonance imaging. Conservative rehabilitation composed of the range of motion, muscle strengthening, and proprioceptive exercise is the main treatment for functional instability and mechanical instability. Regarding the mechanical instability, surgical treatment can be considered for irresponsible patients after a sufficient period of rehabilitation. Anatomic repair (modified $Brostr{\ddot{o}}m$ operation) is regarded as the gold standard procedure. In cases with poor prognostic factors, an anatomical reconstruction or additional procedures can be chosen. For combined intra-articular pathologies, arthroscopic procedures should be conducted, and arthroscopic lateral ligament repair has recently been introduced. Regarding the postoperative management, early functional rehabilitation with short term immobilization is recommended.

• 대한족부족관절학회지
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• 제9권1호
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• pp.59-63
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• 2005

Purpose: To present the procedure and results of dorsal wedge osteotomy fixated by bioabsorbable polyglycolide pins for the treatment of symptomatic Freiberg's disease. Materials and Methods: From January 1997 to December 2002, six patients with Freiberg's disease underwent dorsal wedge osteotomy of the metatarsal neck to bring the healthy plantar part of the metatarsal head into articulation. Bioabsorbable polyglycolide pins were used for the fixation and short-leg walking cast was applied for 4 weeks. Results: All patients returned to full daily activities without pain in three months after the operation. Radiographically, solid healing of the osteotomy was observed at average ten weeks. The active range of motion of the metatarsophalangeal joint increased by a mean gain of 30 degrees, and no complication such as displacement, osteolysis or sinus formation was observed. Conclusion: Dorsal wedge osteotomy fixated by bioabsorbable pins for patients with symptomatic Freiberg's disease is effective procedure that provides relatively early range of motion exercise and avoids second procedure for implant removal.

• 대한족부족관절학회지
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• 제1권1호
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• pp.51-58
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• 1997

The purpose of this study is to evalute the efficacy af the Ilizarov external fixation for the surgical treatment. of the tibial plafond fractures. We reviewed retrospectively fourteen cases of tibial plafond fractures with moderate to severe soft. tissue damage, which were fixed with Ilizarov external fixator. Using the AO Muler classification, there were four Type C1 fractures, six Type C2 and four Type C3. In most, of the cases, the ankles were operated on with other associated fractures within a few days after injury. We reduced the fracture indirectly by soft issue taxis and fixed externally across the ankle joint. using the circular external fixator with tensioned wires and ankle hinge. In cases of inadequate closed reduction, we applied limited open reduction and internal fixation. Range of motion exercise began immediately. Postoperative follow-up averaged fourteen months (ranges, 8-30 months). Overall clinical results rated good or excellent in 7 cases, fair in 4 and poor in 3. There were three cases of pin tract infection which were resolved with short-term antibiotics and local care; one delayed wound closure in a patient. whose fracture was associated with Type III open wound; one wound slough in a patient associated with Type II open wound, which was closed later by skin graft; and one osteoarthritis. From this review, we concluded that cross-ankle circular external fixation with tensioned wires with or without. limited open reduction is a reasonable alternative for the treatment of the tibial plafond fractures with severe soft tissue damage.

• 대한족부족관절학회지
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• 제21권1호
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• pp.21-26
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• 2017

Purpose: To evaluate the clinical outcome of an operation with early rehabilitation from ankle fracture in accordance with the injury type. Materials and Methods: A total of 136 patients (70 males and 66 females) who underwent surgery and early rehabilitation for ankle fractures between December 2008 and December 2013 were retrospectively reviewed. The average age was 47.9 years, with a range of 18~79 years. The mean follow-up period was 28.7 months, with a range of 24~102 months. All patients were classified in accordance with the Lauge Hansen classification and anatomic fracture site. Moreover, the presence of ligament injuries were documented. A short-leg cast was applied postoperatively for two weeks; thereafter, patients began the range-of-motion exercises after cast removal. Full weightbearing was allowed at 2 weeks postoperatively. Each patient was assessed radiologically and clinically based on the OlerudMolander score, visual analogue scale (VAS) for pain, joint stiffness, and capability of single heel raising. Results: Seventeen patients (12.5%) complained of postoperative pain (VAS score 1~3), and the incidence was higher in patients with trimalleolar fractures or associated ligament injuries. Twenty-three patients (16.9%) complained of postoperative ankle stiffness. The mean Olerud-Molander score was 75.4/80 (range, 55~80). Olerud-Molander scores were lower in patients with ligament injuries than in those with fracture alone. There was no nonunion or fracture displacement even after early weightbearing walking. Conclusion: In this retrospective series, early rehabilitation after surgical restoration of ankle mortise by anatomical reduction and stabilization was shown to be successful. Earlier motion exercise and weightbearing walking can minimize fracture complications like joint stiffness or weakness in ankle fracture.

• 한국운동역학회지
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• 제14권3호
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• pp.67-82
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• 2004

The purpose of this study was to evaluate the function and the safety of an additional weight shoe developed for the improvement of aerobic capacity, and to improve some problems found by subject's test for an additional weight shoe. The subjects employed for this study were 10 college students. 4 video cameras, AMTI force platform and Pedar insole pressure distribution measurement device were used to analyze foot motions. The results of the study were as follows: 1 The initial achilles tendon angle and initial rearfoot pronation angle of an additional weight shoe during walking were 183.7 deg and 2.33 deg, respectively, and smaller than a barefoot condition. Maximum achilles tendon angle and the angular displacement of achilles tendon angle were 185.35 deg and 4.21 deg respectively, and smaller than barefoot condition. Thus rearfoot stability variables were within the permission value for safety. 2. Maximal anterior posterior ground reaction force of additional weight shoe was appeared to be 1.01-1.2 B.W., and was bigger than a barefoot condition. The time to MAPGRF of an additional weight shoe was longer than a barefoot condition. Maximal vertical ground reaction force of additional weight shoe was appeared to be 2.3-2.7 B.W., and was bigger than a barefoot condition in propulsive force region. But A barefoot condition was bigger in braking force region. The time to MVGRF of an additional weight shoe was longer than a barefoot condition. 3. Regional peak pressure was bigger in medial region than in lateral region in contrast to conventional running shoes. The instant of regional peak pressure was M1-M2-M7-M4-M6-M5 -M3, and differed form conventional running shoes. Regional Impulse was shown to be abnormal patterns. There were no evidences that an additional weight shoe would have function and safety problems through the analysis of rearfoot control and ground reaction force during walking. However, There appeared to have small problem in pressure distribution. It was considered that it would be possible to redesign the inner geometry. This study could not find out safety on human body and exercise effects because of short term research period. Therefore long term study on subject's test would be necessary in the future study.

• 한국항해학회지
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• 제25권4호
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• pp.347-360
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• 2001

The purpose of this study is to find out the subjective and objective fatigue level and the characteristics of seamen's physical strength with the service period on board, to have a new understanding of the vocation, and to explore a physical exercising program for the seamen. The questionnaire survey for the seamen who had been in service on the ocean going vessels was conducted and the results are fumed out as the followings. Total number of seamen who had answered the questionnaire was 64 persons and the distribution status of service period group was identified as 16 persons for each of 4 groups； the group was classified as the group of less than 5 years, 5 - 10 years, 10 - 15 years, and more than 15 years. 1. Working conditions Working hours in a week was identified as 44－56 hours(45.3%) and the number of 45.3% of the seamen answered the working hours in week is more than 56 hours. The seamen of 25.0% are unsatisfied or very unsatisfied with their vocation. The seamen of 65.6% are smoking, and 45.3% of them drink. The seamen of 44.,3% drink once or more in a week. And the seamen of 67.2% do not take any exercise in a week. 2. Contribution to the seamen's fatigue and subjective symptom The most contributive factor to the seamen's fatigue was identified as the short of sleeping(21.5%), overwork(19.2%), poor working conditions (18.6%), and the friction in human relations also becomes one the contribution to the fatigue(14.0%). The subjective symptom by fatigue was identified as the feeling of languid, sleepy and tiredness of eyes. 3. Characteristics of the seamen's physical strength and Interrelations The grip strength and back strength of the seamen whose service period is less than 5 years were measured as 40.44kg and 127.8kg. The sit ups in the group of service period less than 5 years was measured as 36.84 times, and the vertical jump for the seamen in this group was measured as 46.55cm. The closed-eyes foot balance was measured as 33.64 seconds in the group of service period between 5 and 10 years, and side-step was measured as 35.31 times in the group of service period less than 5 years. The standing trunk flexion was measured as 10.54cm for the seamen whose service period is between 10-15 years, and the trunk extension was measured as 50.70cm for the seamen whose service period is less than 5 years. And the step test of the seamen whose service period is between 10-15 years was measured as 54.44 numbers, and the number of flickers of the seamen whose service period is less than 5 years was measured as 32.94.