• 대한족부족관절학회지
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• 제21권3호
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• pp.98-103
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• 2017

Purpose: The aim of this study was to analyze the factors related to nonunion in tibiotalar arthrodesis. Materials and Methods: Eighty cases of ankle arthritis treated with tibiotalar arthrodesis in our hospital from November 2008 to November 2015 with more than one year follow up were analyzed. Simple anteroposterior and lateral radiographs after 6 and 12 months of surgery were analyzed. Union was defined as more than 50% connection of the trabecular bone at the ankle joint surface in the anteroposterior and lateral radiographs. The nonunion group was defined as no signs of union with persistent pain 9 months after surgery. The surgical approach, type of used screw, preoperative and postoperative ankle alignment, body mass index (BMI), bone mineral density, and patients' prior history were compared between the two groups. Results: There were 69 union cases and 11 nonunion cases. In the patient factors, the gender and BMI was related to nonunion (p<0.05). The mean preoperative and postoperative ankle alignment in the nonunion group was $9.93^{\circ}{\pm}6.92^{\circ}$ and $5.43^{\circ}{\pm}3.35^{\circ}$ respectively, and $9.80^{\circ}{\pm}7.55^{\circ}$ and $5.63^{\circ}{\pm}3.45^{\circ}$ in the union group, respectively; the difference was not statistically significant (p>0.05). In the technical factors, the transfibular approach showed a better relationship but the association was not significant (p<0.05). In 40 cases of the transfibular approach, 12 cases used cancellous screws, and 4 cases showed nonunion due to screw breakage. Conclusion: Technical factors, such as the surgical approach and the type of screw used can be a risk factor in nonunion. In addition, patients' factors, such as gender and BMI, must be considered to reduce the nonunion rate.

• 대한족부족관절학회지
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• 제21권1호
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• pp.17-20
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• 2017

Purpose: The purpose of this study is to analyze the clinical features of plantar fascia rupture. Materials and Methods: We retrospectively reviewed 312 patients with plantar fasciitis between March 2008 and February 2013. We investigated age, sex, site, visual analogue scale (VAS), body mass index (BMI), characteristics of pain, awareness of rupture, and duration of symptoms. Acute rupture was defined as a rupture that occurred during exercise; chronic rupture was defined as a degenerative rupture after plantar fasciitis. We investigated the frequency of acute and chronic rupture. Results: Among 312 patients, 38 patients (12.2%) were diagnosed with plantar fascia rupture. Thirty-eight patients consisted of 14 men (36.8%) and 24 women (63.2%). The mean age of plantar fascia rupture was $58.29{\pm}12.54years$. The mean VAS score was 5.92 points (3~9 points). The mean BMI was $25.92{\pm}1.59kg/m^2$. Among the 38 patients, 2 patients had acute plantar fascia rupture and 36 had chronic plantar fascia rupture. In 34 patients-out of 36 chronic plantar fascia rupture, there were no subjective symptoms. Conclusion: Chronic rupture of the plantar fascia that occurred after plantar fasciitis was more common than acute rupture. Chronic rupture occurred at approximately 12% of patients treated with plantar fasciitis. In chronic rupture of the plantar fascia, there were no subjective symptoms of rupture. Therefore, we should doubt chronic rupture of plantar fascia when plantar fasciitis is prolonged.

• 대한족부족관절학회지
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• 제14권1호
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• pp.73-78
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• 2010

Purpose: The purpose of this study is to analyze the clinical and radiological results of minimally invasive percutaneous screw fixation in intra-articular calcaneal fractures and its complications. Materials and Methods: This study is based on 30 intra-articular calcaneal fractures that treated by index operation from June 2005 to November 2006 with at least 6 months follow-up. We assessed the clinical and radiological outcomes and complications. Results: According to Sanders classification, there were 8 in type IIA, 7 in type IIB, 3 in type IIIAB, 6 in type IIIBC, 6 in type IV. And according to Essex-Lopresti classification, there were 9 in the tongue type, 21 in the joint depression type. Average follow-up period was 14.6 months (range: 6-23 months). Average interval between from injury to operation was 2.3 days. Average AOFAS score was 87.7 (range: 52-92). Satisfactory results were obtained in 22 cases (73.3%) by AOFAS score and in 20 cases (66.7%) by VAS score (mean: 3.4). Radiological results improved from 8.7 to 20.3 degrees in the Bohler angle and from 40.2 mm to 52.1 mm in calcaneal height. Postoperative complications were 2 skin and soft tissue problems and 1 sural neuropathy. Conclusion: Minimally invasive percutaneous screw fixation may be useful alternative surgical method in the management of Sanders type II and III calcaneal fractures, which is possible to achieves the anatomical restoration and minimizes postoperative complication in patients with high risks of soft tissue compromise and allows relatively early operation.

• 한국전문물리치료학회지
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• 제12권1호
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• pp.11-21
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• 2005

The purpose of this study was to investigate how COP displacement of a hemiplegic foot in stance phase during gait is related to clinical balance measures and the recovery stage in hemiplegic stroke patients. Twenty-eight functionally ambulant hemiplegic patients who had suffered from strokes and thirty age-matched healthy subjects participated in this study. COP parameters were calculated. Clinical balance was measured using the Functional Reach Test (FRT) and Timed Up and Go Test (TUGT). The recovery stage, proprioception, and clonus of the ankles or lower extremities were also measured for physical impairment status. The COPx max-displacement in the medial-lateral side of the stroke patients was significantly longer than that of the normal group (p=.038). The COPy max-displacement in the anterior-posterior side of the stroke patients was significantly shorter than that of normal group (p<.001). Significant differences in the COPx and COPy displacement asymmetry index were found between the two groups (p<.01). The FRT was correlated with the COPx displacement (r=.552) and COPy displacement (r=.765). The TUGT was correlated with the COPy displacement (r=-.588) only. The recovery stage of the lower extremities was correlated with COPy displacement (r=.438). The results of the study indicate that the characteristic of COP displacement in hemiplegic feet in stance phase during gait is related to balance ability and recovery in stroke patients. COP parameters acquired by the mapping of foot pressure in stance phase during gait will provide additional useful clinical information. This information can be used by clinicians to assess objectively the pathologic gait with other diseases and to evaluate the therapeutic effects on gait in stroke patients.

• 한국전문물리치료학회지
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• 제24권1호
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• pp.41-50
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• 2017

Background: The Pediatric Balance Scale (PBS) was developed to assess of balance ability in children with balance problem. The PBS was translated into Korean and its reliability had been studied. However, it had need to be verified using psychometric characteristics including item fit and rating scale. Objects: The purpose of this study was to investigate the item fit, item difficulty, and rating scale of the Korean version of PBS using Rasch analysis. Methods: In total, 40 children with cerebral palsy (CP) (boy=17, girl=23) who were diagnosed with level 1 or 2 according to the Gross Motor Function Classification System participated in this study. The PBS was performed, and was verified regarding the item fit, item difficulty, rating scale, and separation index and reliability using Rasch analysis. Results: In this study, the 'transfer', and 'turning to look behind left and right shoulders while standing still' item showed misfit statistics. in total 40 children with CP. Also, 'transfer', 'standing unsupported with feet together' and 'standing with one foot in front' items showed misfit statistics in diplegia CP group. Regardless of the classification of CP, the most difficult item was 'standing on one foot', whereas the easiest item was 'sitting with back unsupported and feet supported on the floor'. The 4 rating scale categories of PBS were acceptable with all criteria. Both item and person separation indices and reliability showed acceptable values. Conclusion: The PBS has been proven reliable, valid and is an appropriate tool, but it needs to modify the items of PBS according to CP classification.

• 대한간호학회지
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• 제50권4호
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• pp.523-532
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• 2020

Purpose: The purpose of the study was to compare the effectiveness of multi interventional package (MIP) and lifestyle interventions (LI) on physiological parameters of women with metabolic syndrome, to compare the effectiveness of MIP and LI on biochemical parameters of women with metabolic syndrome and to compare the effectiveness of MIP and LI on socio-psychological parameters of women with metabolic syndrome. Methods: A quasi experimental nonequivalent control group design with two experimental groups and one control group was used to collect data from 60 self-help group women. Samples were selected by multistage sampling. Reflexology foot massage, dietary modification, moderate intensity exercise and structured education were given to MIP group and dietary modification, moderate intensity exercise and structured education were given to LI group for 12 weeks. Control group received routine care. Demographic and clinical data sheets were used to collect basic information. Knowledge was assessed by a knowledge questionnaire. Physiological (weight, body mass index, waist circumference and blood pressure) and biochemical parameters (HDL, triglycerides and FBS) were assessed before and after the intervention. Results: The study found significant change in the physiological and biochemical parameters of metabolic syndrome as well as knowledge among the MIP group and LI group compared to the control group (p <.001). Conclusion: MIP and LI are effective in controlling the parameters of metabolic syndrome. Hence the guidance may be provided to women with metabolic syndrome for adopting necessary lifestyle changes as well as reflexology foot massage to control the physiological and biochemical parameters of metabolic syndrome.

• 대한족부족관절학회지
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• 제23권1호
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• pp.18-23
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• 2019

Purpose: This study compared and analyzed the risk factors that affect a wound healing group and healing failure group. Materials and Methods: From 2010 to 2018, 39 patients who had suffered a single toe amputation were evaluated retrospectively. The patients were divided into two groups (wound healing group and healing failure group - within at least 3 months following the amputation). Regarding the possible risk factors, age, gender, Wagner and Brodsky classifications, duration of diabetes mellitus, whether the patient had peripheral arterial occlusive disease (PAOD) or cardiovascular disease, body mass index, HbA1c, total cholesterol, estimated glomerular filtration rate (eGFR), blood urea nitrogen (BUN), smoking, and alcohol were investigated. Results: The mean duration of diabetes mellitus was 140 months in the healing group and 227 months in the healing failure group, and the duration of diabetes was significantly longer in the failure group (p=0.009). A significant difference in eGFR was observed between the two groups ($59.17mL/min/1.73m^2$ in the healing group and $31.1mL/min/1.73m^2$ in the failure group) (p=0.022). Sixteen patients with PAOD were found, all 10 patients in the healing failure group were PAOD patients. Conclusion: To reduce the additional complications in single toe amputation patients, the underlying disease and appropriate treatment are the most important factors. In addition, a more proximal level of amputation also should be considered in cases of patients with PAOD, high BUN and low eGFR, and patients with long-term diabetes.

• 대한족부족관절학회지
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• 제27권1호
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• pp.12-16
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• 2023

Purpose: Postoperative exercise for acute Achilles tendon rupture is important for a patient's return to daily life and sports. On the other hand, the protocol requires considerable effort to educate patients and continuous checking. This study evaluated the outcome of a new simple and delayed rehabilitation protocol after Achilles tendon rupture repair. Materials and Methods: From July 2014 to November 2020, one hundred eighty-three patients were operated on by one surgeon. The exercise protocol was classified into two methods. One group (immediate protocol, control group) started immediate full weight bearing with a 20° plantar flexion range of motion from two days postoperatively. Ankle dorsiflexion was restricted to 0°. The other group (delayed protocol, case group) started full weight bearing with a controlled ankle motion boot from two weeks postoperatively. No range of motion exercise was allowed until six weeks postoperatively. Age, sex, body mass index, ankle range of motion, muscle power, time to return to previous physical activity, functional score, and complication rate were evaluated. The results of the two groups were compared using a Mann-Whitney test. Statistical significance was set as p<0.05. Results: The range of motion, double heel rising, and one-leg standing were achieved faster in the control group (p<0.05). However, single-heel rising, repeated single-heel rising, return to previous activity (work, run, and sport), and functional scores showed no statistical difference (p>0.05). Conclusion: Simple and delayed postoperative rehabilitation of acute Achilles tendon rupture without active range of motion exercises showed satisfactory functional results and a low complication rate.

• 한국전문물리치료학회지
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• 제12권3호
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• pp.11-21
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• 2005

The present study was aimed at investigating the effect of swimming training on brain function after focal cerebral ischemia in rats. Therefore, this study was examined on neurogenesis in dentate gyrus of hippocampus using 5-bromo-2'-deoxyuridine (BrdU) to label proliferating cells and assessed the neurological response following focal cerebral ischemia in rats using neurological motor behavioral test. In an observer-blinded fashion, twenty male Sprague-Dawley (280~310 g, 7 weeks old) rats were divided into four groups: MCAO plus swimming group (ME, $n_1$=5), MCAO plus control group (MC, $n_2$=5), SHAM plus swimming group (SE, $n_3$=5), SHAM plus control group (SC, $n_4$=5). The results of this study were as follows: 1) The limb placing time before and after swimming in the ME group were significantly longer than the MC group (p<.05), the SE group were significantly longer than the SC group (p<.01). 2) The balance beam scores before and after swimming in the ME group was higher than the SE group, the MC group was higher than the SC group but was not significantly different (p>.001). 3) The foot fault index before and after swimming training in ME group was significantly lower (i.e., improved) than the MC group (p<.001) and the SE group (p<.001), the SE group was significantly lower (i.e., improved) than the SC group (p<.001). 4) The mean number of BrdU-positive cells in the dentate gyrus in the ME group was significantly higher than the MC group (p<.001) and the SE group (p<.01). The MC group and the SE group was significantly higher than the SC group (p<.001). 5) There was significantly correlation between limb placing time and number of BrdU-positive cells on swimming training, there was positive correlation (r=.807, p<.0001) and between foot fault index and BrdU-positive cells number, there was negative correlation (r=-.503, p<.05). However, between balance beam scores and BrdU-positive cells number, there was no correlation. In conclusion, the present study demonstrates that the role of swimming training improves behavioral motor function probably by enhancing cell proliferation in that hippocampus. This study provides a model for investigating the stroke rehabilitation that underlies neurogenesis and functional ability.

• 대한족부족관절학회지
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• 제21권3호
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• pp.88-92
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• 2017

Purpose: The objective of this study was to confirm the results of the modified Lapidus procedure on moderate to severe hallux valgus patients with first tarso-metatarsal joint hypermobility. Materials and Methods: A retrospective study was conducted on 42 cases of 35 patients who underwent the modified Lapidus procedure between March 2006 and December 2014. A comparative analysis was performed on the preoperative and postoperative subjective satisfaction of patients and radiologic index. Moreover, the correlation between the follow-up time and patient's operative satisfaction, as well as between the proficiency of the operator and patient's operative satisfaction was analyzed. Complications were also evaluated. Results: Out of the total of 35 patients, 3 were male and 32 were female. The mean age was 61.3 years (range, 34~79 years), and the mean follow-up time was 22.1 months (range, 6~90 months). The overall satisfaction level was 67.6% and the mean hallux valgus angle improved from preoperative $40.5^{\circ}$ to postoperative $12.2^{\circ}$ (p<0.001). The mean 1, 2 intermetatarsal angle improved from preoperative mean of $16.9^{\circ}$ to postoperative mean of $7.6^{\circ}$ (p<0.001), and the sesamoid position improved significantly, from preoperative 2.7 to postoperative 0.9 (p<0.001). Furthermore, there was no correlation between the follow-up time and the American Orthopaedic Foot and Ankle Society (AOFAS) hallux scale; also no correlation between the year the operation took place and the AOFAS hallux scale. In terms of complications, we observed screw irritation in 6 cases, hallux varus in 2 cases, and recurrence of hallux valgus and nonunion in one case. Conclusion: Contrary to our concerns, the level of complications was not high; however, the satisfaction level of patients was also not very high. Therefore, careful selecting of patients and sufficient consultation time is needed before surgery. In addition, since the causes of postoperative dissatisfaction still remain unclear, further studies are necessary.