The effect of landing technique on lower extremity joint kinematics and kinetics during single leg landing

( Jiyoung Jeong ),( Choongsoo S. Shin ) 한국체육학회 2016 국제스포츠과학 학술대회 Vol.2016 No.1

Purpose: The purpose of this study was to examine the effect of two different landing techniques (forefoot and rearfoot) on lower extremity joint kinematics and /kinetics during single leg landing. Method: Five males (age: 25.6±1.5 yrs, height: 174.6±3.4 cm, mass: 70.4±4.3 kg) were recruited. All participants performed single leg landing by stepping off a 30-cm platform in two different landing techniques; forefoot and rearfoot contact landing. Three dimensional hip, knee, and ankle joint kinematics and kinetics were calculated using motion capture system equipped with six infrared cameras sampled at 400Hz. Obtained kinematic and kinetic parameters were compared using a paired two-tailed Student’s t test at a significance level of 0.05. Result: At initial contact, there were significant differences in the ankle plantar(+)/dorsi(-) flexion angle (forefoot: 10.7±2.0°, rearfoot: -21.2±8.5°, p<0.001), the ankle inversion(+)/eversion(-) angle (forefoot: 2.3±1.5°, rearfoot: -0.1±1.1°, p=0.017), and the hip external(+)/internal(-) rotation angle (forefoot: 9.8±3.1°, rearfoot: -1.1±3.7°, p=0.001). The peak knee extension moment (forefoot: 0.222±0.021 Nm/(BW*Ht), rearfoot: 0.260±0.042 Nm/(BW*Ht), p<0.001), the peak knee valgus moment (forefoot: 0.078±0.005 Nm/(BW*Ht), rearfoot: 0.090±0.021 Nm/(BW*Ht), p<0.001), and the peak tibial internal rotation moment (forefoot: 0.012±0.004 Nm/(BW*Ht), rearfoot: 0.009±0.002 Nm/(BW*Ht), p<0.001) were significantly greater during rearfoot landing when compared to forefoot landing. The peak ankle plantarflexion moment was significantly smaller during rearfoot landing (forefoot: 0.239±0.058 Nm/(BW*Ht), rearfoot: 0.139±0.030 Nm/(BW*Ht), p<0.001), but the peak ankle varus moment was greater than forefoot landing (forefoot: 0.025±0.011 Nm/(BW*Ht), rearfoot: 0.041±0.013 Nm/(BW*Ht), p<0.001). Conclusion: The present study showed significant differences in 3D hip, knee, and ankle joint kinematics and kinetics between forefoot and rearfoot landing. The combination of the knee valgus and internal tibial rotation moment increase the risk of anterior cruciate ligament injury. Also, many ankle sprains occur during the combined movement of inversion and plantarflexion. Therefore, the results of this study suggest that altering landing technique may bring the lower extremity injury risks.

전족부에 발생한 색소 융모 결절성 활액막염 (1례 보고)

김준범,송인수,전재균,김태인,선동혁,이경태,Kim, Jun Beom,Song, In Soo,Chon, Je Gyun,Kim, Tae In,Sun, Dong Hyuk,Lee, Kyung Tai 대한족부족관절학회 2013 대한족부족관절학회지 Vol.17 No.1

Pigmented villonodular synovitis (PVNS) is a slowly, progressive, proliferative disorder of synovial tissue characterized by villous or nodular changes of synovial-lined joints, bursae, and tendon sheaths and most frequently affects the large joints, with the knee and hip. A few studies have been reported that occurred PVNS in small joint, but mainly in hands. It is a very rare condition that occurs in the small joints of the forefoot. We have experienced the case, which developed in small joint of the forefoot, and performed total synovectomy. After the operation, there was no recurrence. We report a case of PVNS in forefoot with a review of the literature.

내리막 보행시 발 전족부 부착형 아웃솔의 각도 변화가 척추기립근과 하지근의 근활성도에 미치는 영향

이행섭 ( Haeng Seob Lee ),채원식 ( Woen Sik Chae ),정재후 ( Jea Hu Jung ),김동수 ( Dong Soo Kim ),임영태 ( Young Tae Lim ),장재익 ( Jea Ik Jang ) 한국운동역학회 2014 한국운동역학회지 Vol.24 No.2

The purpose of this study was to evaluate the effect of angle change of forefoot`s adhesive outsole on the electromyographic activity (EMG) of the erector spinae and selected lower limbs muscle during downhill walking over -20o ramp. Thirteen male university students (age: 25.4±3.9 yrs, height: 176.2±5.1 cm, weight: 717.4±105.0 N) who have no musculoskeletal disorder were recruited as the subjects. To assess the myoelectric activities of selected muscles, six of surface EMG electrodes with on-site preamplification circuitry were attached to erector spinae (ES), rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA), lateral gastrocnemius (LG), and medial gastrocnemius (MG). To obtain maximum EMG levels of the selected muscles for normalization, five maximum effort isometric contraction were performed before the experimental trials. Each subject walked over 0o and 20o ramp with three different forefeet`s EVA outsole (0, 10, 20o) in random order at a speed of 1.2±0.1 m/s. For each trial being analyzed, five critical instants and four phases were identified from the recording. The results of this study showed that the average muscle activities of MG and LG decreased in 20o shoes compared to 0o and 10o ones in the initial double limb stance (IDLS). In initial single limb stance (ISLS) phase, the average muscle activities of ES increased with the angle of forefoot`s adhesive outsole, indicating that the increment of shoes` angle induce upper body to flex anteriorly in order to maintain balance of trunk. In terminal double limb stance (TDLS) phase, average muscle activities of TA significantly increased in 20o outsole compared to 0o and 10o ones. There was no external forces acting on the right foot other than the gravity during terminal single limb stance (TSLS) phase, all muscles maintained moderate levels of activity.

전족부 거대신경초종: 증례 보고

서은석,이주한,전숙하,Seo, Eun-Seok,Lee, Joo-Han,Jeon, Suk-Ha 대한족부족관절학회 2014 대한족부족관절학회지 Vol.18 No.4

A schwannoma is a benign neurogenic tumor derived from Schwann cells. A rare case of a large painful schwannoma in the foot with metatarsal deformity was presented. Due to suspicion of malignancy, amputation had been recommended previously. We report on a rare case of a large forefoot schwannoma causing pain and paresthesia of the forefoot.

High-heeled 신발과 High-forefoot 신발 착용시의 보행 변화 고찰

송선홍,유종윤,하상배 大韓再活醫學會 1997 Annals of Rehabilitation Medicine Vol.21 No.5

Forefoot disorders and conservative treatment

( Chul Hyun Park ),( Min Cheol Chang ) 영남대학교 의과대학 2019 Yeungnam University Journal of Medicine Vol.36 No.2

Forefoot disorders are often seen in clinical practice. Forefoot deformity and pain can deteriorate gait function and decrease quality of life. This review presents common forefoot disorders and conservative treatment using an insole or orthosis. Metatarsalgia is a painful foot condition affecting the metatarsal (MT) region of the foot. A MT pad, MT bar, or forefoot cushion can be used to alleviate MT pain. Hallux valgus is a deformity characterized by medial deviation of the first MT and lateral deviation of the hallux. A toe spreader, valgus splint, and bunion shield are commonly applied to patients with hallux valgus. Hallux limitus and hallux rigidus refer to painful limitations of dorsiflexion of the first metatarsophalangeal joint. A kinetic wedge foot orthosis or rocker sole can help relieve symptoms from hallux limitus or rigidus. Hammer, claw, and mallet toes are sagittal plane deformities of the lesser toes. Toe sleeve or padding can be applied over high-pressure areas in the proximal or distal interphalangeal joints or under the MT heads. An MT off-loading insole can also be used to alleviate symptoms following lesser toe deformities. Morton’s neuroma is a benign neuroma of an intermetatarsal plantar nerve that leads to a painful condition affecting the MT area. The MT bar, the plantar pad, or a more cushioned insole would be useful. In addition, patients with any of the above various forefoot disorders should avoid tight-fitting or high-heeled shoes. Applying an insole or orthosis and wearing proper shoes can be beneficial for managing forefoot disorders.

Free Flap Reconstruction in Patients with Traumatic Injury of the Forefoot

( Shin Hyuk Kang ),( Jeongseok Oh ),( Seok Chan Eun ) 대한외상학회 2019 大韓外傷學會誌 Vol.32 No.3

Many techniques have been developed for reconstruction of the hand; however, less attention has been paid to foot reconstruction techniques. In particular, reconstruction of the forefoot and big toe has been considered a minor procedure despite the importance of these body parts for standing and walking. Most of the weight load on the foot is concentrated on the forefoot and big toe, whereas the other toes have a minor role in weight bearing. Moreover, the forefoot and big toe are important for maintaining balance and supporting the body when changing directions. Recently, attention has been focused on the aesthetic appearance and functional aspects of the body, which are important considerations in the field of reconstructive surgery. In patients for whom flap reconstruction in the forefoot and big toe is planned, clinicians should pay close attention to f lap survival as well as functional and cosmetic outcomes of surgery. In particular, it is important to assess the ability of the flap to withstand functional weight bearing and maintain sufficient durability under shearing force. Recovery of protective sensation in the forefoot area can reduce the risk of flap loss and promote rapid rehabilitation and functional recovery. Here, we report our experience with two cases of successful reconstruction of the forefoot and big toe with a sensate anterolateral thigh flap, with a review of the relevant literature.

Forefoot disorders and conservative treatment

박철현,장민철 영남대학교 의과대학 2019 Yeungnam University Journal of Medicine Vol.36 No.2

Forefoot disorders are often seen in clinical practice. Forefoot deformity and pain can deteriorate gait function and decrease quality of life. This review presents common forefoot disorders and conservative treatment using an insole or orthosis. Metatarsalgia is a painful foot condition affecting the metatarsal (MT) region of the foot. A MT pad, MT bar, or forefoot cushion can be used to alleviate MT pain. Hallux valgus is a deformity characterized by medial deviation of the first MT and lateral deviation of the hallux. A toe spreader, valgus splint, and bunion shield are commonly applied to patients with hallux valgus. Hallux limitus and hallux rigidus refer to painful limitations of dorsiflexion of the first metatarsophalangeal joint. A kinetic wedge foot orthosis or rocker sole can help relieve symptoms from hallux limitus or rigidus. Hammer, claw, and mallet toes are sagittal plane deformities of the lesser toes. Toe sleeve or padding can be applied over high-pressure areas in the proximal or distal interphalangeal joints or under the MT heads. An MT off-loading insole can also be used to alleviate symptoms following lesser toe deformities. Morton’s neuroma is a benign neuroma of an intermetatarsal plantar nerve that leads to a painful condition affecting the MT area. The MT bar, the plantar pad, or a more cushioned insole would be useful. In addition, patients with any of the above various forefoot disorders should avoid tight-fitting or high-heeled shoes. Applying an insole or orthosis and wearing proper shoes can be beneficial for managing forefoot disorders.

Forefoot disorders and conservative treatment

Park, Chul Hyun,Chang, Min Cheol Yeungnam University College of Medicine 2019 Yeungnam University Journal of Medicine Vol.36 No.2

Forefoot disorders are often seen in clinical practice. Forefoot deformity and pain can deteriorate gait function and decrease quality of life. This review presents common forefoot disorders and conservative treatment using an insole or orthosis. Metatarsalgia is a painful foot condition affecting the metatarsal (MT) region of the foot. A MT pad, MT bar, or forefoot cushion can be used to alleviate MT pain. Hallux valgus is a deformity characterized by medial deviation of the first MT and lateral deviation of the hallux. A toe spreader, valgus splint, and bunion shield are commonly applied to patients with hallux valgus. Hallux limitus and hallux rigidus refer to painful limitations of dorsiflexion of the first metatarsophalangeal joint. A kinetic wedge foot orthosis or rocker sole can help relieve symptoms from hallux limitus or rigidus. Hammer, claw, and mallet toes are sagittal plane deformities of the lesser toes. Toe sleeve or padding can be applied over high-pressure areas in the proximal or distal interphalangeal joints or under the MT heads. An MT off-loading insole can also be used to alleviate symptoms following lesser toe deformities. Morton's neuroma is a benign neuroma of an intermetatarsal plantar nerve that leads to a painful condition affecting the MT area. The MT bar, the plantar pad, or a more cushioned insole would be useful. In addition, patients with any of the above various forefoot disorders should avoid tight-fitting or high-heeled shoes. Applying an insole or orthosis and wearing proper shoes can be beneficial for managing forefoot disorders.

The Effect of Foot Landing Type on Lower-extremity Kinematics, Kinetics, and Energy Absorption during Single-leg Landing

( Jiyoung Jeong ),( Choongsoo S. Shin ) 한국운동역학회 2017 한국운동역학회지 Vol.27 No.3

Objective: The aim of this study was to examine the effect of foot landing type (forefoot vs. rearfoot landing) on kinematics, kinetics, and energy absorption of hip, knee, and ankle joints. Method: Twenty-five healthy men performed single-leg landings with two different foot landing types: forefoot and rearfoot landing. A motion-capture system equipped with eight infrared cameras and a synchronized force plate embedded in the floor was used. Three-dimensional kinematic and kinetic parameters were compared using paired two-tailed Student`s t-tests at a significance level of .05. Results: On initial contact, a greater knee flexion angle was shown during rearfoot landing (p < .001), but the lower knee flexion angle was found at peak vertical ground reaction force (GRF) (p < .001). On initial contact, ankles showed plantarflexion, inversion, and external rotation during forefoot landing, while dorsiflexion, eversion, and internal rotation were shown during rearfoot landing (p < .001, all). At peak vertical GRF, the knee extension moment and ankle plantarflexion moment were lower in rearfoot landing than in forefoot landing (p = .003 and p < .001, respectively). From initial contact to peak vertical GRF, the negative work of the hip, knee, and ankle joint was significantly reduced during rearfoot landing (p < .001, all). The contribution to the total work of the ankle joint was the greatest during forefoot landing, whereas the contribution to the total work of the hip joint was the greatest during rearfoot landing. Conclusion: These results suggest that the energy absorption strategy was changed during rearfoot landing compared with forefoot landing according to lower-extremity joint kinematics and kinetics.