• Korean Journal of Applied Biomechanics
• /
• v.31 no.2
• /
• pp.95-103
• /
• 2021

Objective: The aim of this study was to investigate the differences in spatiotemporal gait performance, function, and pain of lower-extremity according to foot morphological characteristics. Method: This case-control study recruited 42 adults and they were classified into 3 groups according to foot morphology using navicular-drop test: pronated (≥ 10 mm), normal (5~9 mm), and supinated (≤ 4 mm) feet. Spatiotemporal gait analysis and questionnaires including Foot and Ankle Ability Measure activities of daily living / Sports, Western Ontario and McMasters Universities Osteoarthritis Index, Lower Extremity Functional Scale, International Physical Activity Questionnaire, and Tegner activity score were conducted. One-way analysis of variance was used for statistical analysis. Results: The pronated feet group showed longer loading response and double limb support in both feet and increased pre-swing phase in non-dominant feet. The supinated feet group demonstrated a longer swing phase in non-dominant feet and single limb support in dominant feet. However, there was no significant group difference in function and pain of knee joint and lower-extremity between groups. Conclusion: Our results indicated that abnormal spatiotemporal gait performance according to foot morphology. Although there was no difference in lower extremity dysfunction and pain according to the difference in foot morphology, they have the possibility of symptom occurs as a result of continuous participation in activities of daily living and sports. Therefore, individuals with pronated or supinated foot should be supplemented by utilizing an orthosis or training to restore normal gait performance.

• Journal of The Korean Society of Integrative Medicine
• /
• v.9 no.4
• /
• pp.85-89
• /
• 2021

Background : Klippel-Trenaunay-Weber syndrome (KTS) is a rare congenital medical condition characterized by complex vascular malformation. KTS consists of a classic triad of capillary malformation (hemangioma), venous malformations and bone or soft tissue hypertrophy causing limb asymmetry. The aim of this report is to describe management for gait disturbance and foot pain in a Patient with KTS using custom-made total contact insole. Case presentation : A 32-year-old man with KTS presented with a 3-year history of gait disturbance on hard surface due to right first toe pain and Achilles tendon tightness. The patient had soft tissue hypertrophy, varicose veins and port-wine stains over the right lower limb associated with KTS. True leg length discrepancy was 2 cm. We prescribed custom-made total contact insole to protect his deformed foot and correct leg length discrepancy. The insole of right side included wedge shaped heel lift and the insole of left side included full length lift to add extra support on unaffected side. Also, we provided compression stocking and physiotherapy including manual lymphatic drainage for lymphedema and stretching exercise for tightness in right lower extremity. At 3 years follow-up, postural alignment including pelvic obliquity was improved using a custom-made total contact insole. The degree of scoliosis and foot pain were also reduced. Conclusion : An individualized and multidisciplinary approach is essential regarding the complexity of comorbidities in patients with KTS. For patients with KTS, orthotic management should be considered to prevent and correct deformities related to KTS. Active orthotic management, compression stocking and physiotherapy can enhance the quality of life and function in patients.

• Korean Journal of Applied Biomechanics
• /
• v.20 no.4
• /
• pp.469-477
• /
• 2010

The purpose of this study was to evaluate the effects of insole-equipped ankle-foot-orthoses (AFO) on gait. 10 healthy males who had no history of injury in the lower extremity participated in this study as the subjects. The foot of each subject was first scanned, and the insole fit to the plantar was made using BDI-PCO(Pedcad Gmbh, Germany). The subject then was made to walk on a treadmill under four experimental conditions: 1) normal walking, 2) walking wearing AFO, 3) walking wearing AFO equipped with the insole, 4) walking wearing pneumatic-ankle-foot-orthosis (pAFO) equipped with the insole. During walking, foot pressure data such as maximum force, contacting area, peak pressure, and mean pressure was collected using Pedar-X system (Novel Gmbh, Germany) and EMG activity of lower limb muscles such as gastrocnemius medial head, gastrocnemius lateral head, and soleus was recorded using MP150 EMG module (BIOPAC System Inc., USA). Collected data was then analyzed using paired t-test in order to investigate the effects of the insole. As a result of the analysis, when insole was equipped, overall contacting area was increased while both the highest peak pressure and the mean pressure were significantly decreased, and EMG activity of the lower limb muscles was decreased. On the contrary, the cases of wearing AFO showed the decreased contacting area and the increased pressures. Therefore, the AFO equipped with a proper insole fit well to the foot can help comfortable walking by spreading the pressure over the entire plantar.

• Journal of Korean Neurosurgical Society
• /
• v.60 no.5
• /
• pp.597-603
• /
• 2017

Objective : Several surgical methods have been reported for treatment of ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine. Despite rapid innovation of instruments and techniques for spinal surgery, the postoperative outcomes are not always favorable. This article reports a minimally invasive anterior decompression technique without instrumented fusion, which was modified from the conventional procedure. The authors present 2 cases of huge beak-type OPLL. Patients underwent minimally invasive anterior decompression without fusion. This method created a space on the ventral side of the OPLL without violating global thoracic spinal stability. Via this space, the OPLL and anterior lateral side of the dural sac can be seen and manipulated directly. Then, total removal of the OPLL was accomplished. No orthosis was needed. In this article, we share our key technique and concepts for treatment of huge thoracic OPLL. Methods : Case 1. 51-year-old female was referred to our hospital with right lower limb radiating pain and paresis. Thoracic OPLL at T6-7 had been identified at our hospital, and conservative treatment had been tried without success. Case 2. This 54-year-old female with a 6-month history of progressive gait disturbance and bilateral lower extremity radiating pain (right>left) was admitted to our institute. She also had hypoesthesia in both lower legs. Her symptoms had been gradually progressing. Computed tomography scans showed massive OPLL at the T9-10 level. Magnetic resonance imaging of the thoracolumbar spine demonstrated ventral bony masses with severe anterior compression of the spinal cord at the same level. Results : We used this surgical method in 2 patients with a huge beaked-type OPLL in the thoracic level. Complete removal of the OPLL via anterior decompression without instrumented fusion was accomplished. The 1st case had no intraoperative or postoperative complications, and the 2nd case had 1 intraoperative complication (dural tear) and no postoperative complications. There were no residual symptoms of the lower extremities. Conclusion : This surgical technique allows the surgeon to safely and effectively perform minimally invasive anterior decompression without instrumented fusion via a transthoracic approach for thoracic OPLL. It can be applied at the mid and lower level of the thoracic spine and could become a standard procedure for treatment of huge beak-type thoracic OPLL.

• Korean Journal of Applied Biomechanics
• /
• v.21 no.4
• /
• pp.487-494
• /
• 2011

The purpose of this study was to evaluate the effects of metatarsal pad (MP) compared with barefoot and MP with using different insoles on gait. 15 healthy females who had no history of injury in the lower extremity with an average age of 22.7 year(SD=1.35), height of 160 cm(SD=3.4), weight of 48.8 kg(SD=5.52) and average foot size of 232.5 mm(SD=6.8) participated in this study as the subjects. The subjects walked on a treadmill under four different experimental conditions: 1) walking with barefoot, 2) walking wearing MP 3) walking wearing a soft insole with MP(SIMP), 4) walking wearing a rigid insole with MP(HIMP). During walking, foot pressure data such as force, contacting area, peak pressure, and mean pressure was collected using Pedar-X System(Novel Gmbh, Germany) and EMG activity of lower limb muscles such as tibialis anterior(TA), lateral gastrocnemius(LG), rectus femoris(RF), and musculus biceps femoris(MBF) was gathered using Delsys EMG Work System(Delsys, USA). Collected data was then analyzed using paired t-test in order to investigate the effects of each of experimental conditions. As a result of the analysis, when MP and HIMP were equipped, overall contacting area was increased while the force, peak pressure and the mean pressure were decreased. Especially, when the SIMP was equipped, every data were significantly decreased. In case of EMG, wearing MP, SIMP and HIMP made three muscles(TA, LG, RF)'s activity decrease. A result of the analysis will be able to apply for manufacturing functional shoes, diabetes shoes, senior shoes and lower extremity orthosis. Significance of the study due to a metatarsal pad and the insole is to analyze the changes in muscle strength.