Earticle

The purpose of this study is to provide foot classification on young men and women by factor analysis. The sample for this work was chosen from data which were collected and measured by Size Korea during two years (2003~2004). In order to analyze and compare features of the foot of young men and women, analysis was performed about 911 subjects (male: 467, female: 444) on 24 parts such as height (8 parts), width (5 parts), thickness (1 part), circumference (3 parts), length (3 parts) and angle (4 parts). The result of this study can be applied in manufacturing and design of shoes and socks. Also, it will enable us to have fruitful information on considerable items during manufacturing and design of shoes and socks.

Objective To identify the effect of serial casting combined with Botulinum toxin type A (BTX-A) injection on spastic equinus foot. Method Twenty-nine children with cerebral palsy who had equinus foot were recruited from the outpatient clinic of Rehabilitation Medicine. The children were divided into 2 groups, one of which received serial casting after BTX-A injection, and the other which only received BTX-A injection. Serial casting started 3 weeks after the BTX-A injection, and was changed weekly for 3 times. Spasticity of the ankle joint was evaluated using the modified Ashworth scale (MAS), and the modifi ed Tardieu scale (MTS). Gait pattern was measured using the physician’s rating scale (PRS). Results Th e degree of ankle dorsifl exion and the MAS improved signifi cantly until 12 weeks following the BTX-A injection in the serial casting group (p<0.001), while the BTX-A injection-only group improved until 6 weeks following injection (p<0.05). The combined group showed a significantly greater increase in the degree of dorsifl exion compared to the BTX-A injection-only group at post-injection weeks 6 and 12 (p<0.05). Th ree children (11.5%) suff ered from foot ulcers as a complication caused by the serial casting. Conclusion Our study demonstrated that the eff ect of BTX-A injection with serial casting was superior and lasted longer than the effect of BTX-A injection only in patients with spastic equinus foot. We therefore recommend BTX-A injection with serial casting for the treatment of equinus foot. However, physicians must also consider the possible complications associated with serial casting.

-Foot Ulcer Risk, Foot Care Knowledge, and Foot Care Practice in Patients with Type 2 Diabetics

Purpose: The purpose of this study was to identify the factors contributing to diabetic foot ulcers (DFU) among patients with type 2 diabetes mellitus (DM). Methods: Data were collected from 131 patients who had been diagnosed with DM for more than six months. Patients recruited from three hospitals in Gwangju city were given both a foot examination to confirm the presence of a foot ulcer and an individual time of survey using questionnaires about foot care knowledge and self management behavior. Results: Factors contributing to DFU were male (adjusted odds ratio [aOR]=4.86, 95% confidence interval [CI]=1.16~20.44), history of DM-related hospitalization (aOR=4.56, 95% CI=1.17~17.84), duration of DM (aOR=13.75, 95% CI=2.31~82.66 for those with time since diagnosis of 11~15 years; aOR=6.37, 95% CI=1.09~37.36 for those with time since diagnosis of 16-20 years; aOR=12.97, 95% CI=2.26~74.32 for those with time since diagnosis of over 21 years), DM diet (aOR=0.13, 95% CI=0.03-0.64 for those who did not practice dietary control), and exercise (aOR=15.59, 95% CI=3.49~69.64 for those who did not engage in regular exercise). Conclusion: The factors identified in this study provided strategic information for developing educational program targeting patients with DM to prevent DFC.

본 연구는 성장기에 있는 편평족 청소년들을 대상으로 인솔 착용과 복합 운동프로그램 참여에 따른 키 성장과 발육발달, 종골각 및 족형의 신체균형에 미치는 효과에 대한 원인을 알아보고자 하였다. 본 연구의 대상은 편평족 남자 청소년 총 30명으로 인솔을 착용하고 1주일에 3일 규칙적으로 복합 운동프로그램에 참여한 인솔+운동 집단 10명과 복합 운동프로그램만 참여한 운동 집단 10명, 그리고 통제 집단 10명을 무작위 선정하였다. 24주간 복합 운동프로그램은 준비운동, 본 운동, 정리운동으로 구성하였다. 인솔은 개인별 맞춤형 발 교정구로서 개인별 족문을 채취하여 판독한 후, 처방을 받아 착용하였다(김남익,2015). 연구 결과에 있어서 24주간 복합 운동프로그램과 인솔착용에 따라 신장, 체중, 유연성에서 주효과와 상호작용 효과가 나타났고 통제 집단에 비해 운동 집단과 인솔+운동 집단에서 유의한 차이를 보였 다. 종골각에 있어서 종골 각도(좌, 우), 종골각 수직 차이(좌, 우), 하지 각도(우), 하지각 수직 차이(우)에서 주효과와 상호작용 효과가 나타났다. 족부 형상에서는 발폭(좌, 우)과 아치폭(좌, 우)에서 주효과와 상호작용 효과가 나타났다.

The purpose of this study was to investigate the effects of the participation in the exercise program on the height growth, developmental development, and the balance of the body of the calcaneus angle and foot shapes of the pes planus adolescents in the growing period. The subjects of this study were 30 men with pes planus male youths who were randomly selected from the insole+exercise group, 10 exercise group, and 10 control group who participated in the combined exercise program regularly for 3 days a week. The combined exercise program for 24 weeks consisted of preparation exercise, warm-up, main exercise, and cool-down. The insole was personalized foot correction tool, and the individual foot gate was collected and read, and then the foot was prescribed. The results of this study showed that the main effect and interaction effect were shown in height, weight, and flexibility according to the combined exercise program and the insole wearing for 24 weeks, and the exercise group and the insole+exercise group showed significant differences compared to the control group. In the calcaneus angle, the main, interaction effect were shown in the calcaneus angle(left, right), the calcaneus angle vertical difference(left, right), the lower limb angle(right), and the lower limb angle vertical difference(right). In the foot shape, the main and interaction were shown in the foot width(left, right) and arch width(left, right).

구제역은 발생 시 살처분, 백신 접종과 같은 질병 방제 비용 발생, 생산성 감소, 동물과 축산물의 국제적인 교역 제한 등으로 국가 경제에 미치는 영향이 매우 큰 질병이다. 바이러스의 혈청형을 민감하고 정확 및 신속하게 구분할 수 있는 적합한 진단법은 구제역의 조기 예방 측면에서 지속적으로 요구되고 있다. 본 연구는 한국형 구제역 바이러스를 진단하는 방법으로, 기존 연구에서 민감성이 확인된 Immuno-PCR 진단법을 적용시킬 수 있는지를 확인하기 위해 진행되었다. Immuno-PCR을 진행하기 위해 한국에서 발병한 구제역 바이러스의 서열을 모두 확인한 뒤 적합한 서열을 선정해 항원으로 사용하기 위한 재조합 FMDV를 합성하였다. 이들을 발현시켜 항원으로 삼아 다클론 항체 및 단일클론 항체를 만들었으며, 자성입자와 올리고머를 각각 항체에 고정시켜 본 실험에 사용하였다. Western blot과 ELISA 반응과 real-time PCR 결과를 토대로 immuno-PCR을 이용하여 한국형 구제역 바이러스(A형)를 검출해낼 수 있다는 결과를 도출하였다. 연구의 결과는 본 진단법이 차후 한국형 구제역 바이러스를 더 민감하게 검출할 수 있는 진단법의 토대가 될 것이라 여겨진다.

In the case of foot-and-mouth disease (FMD), there is a great deal of impact on the national economy due to the disposal of diseases, the cost of disease control such as vaccination, reduction of productivity, and restriction of international trade of livestock products. Therefore, appropriate diagnostic methods for sensitive, accurate and rapid identification of virus serotypes are continuously required in terms of early prevention of FMD. This study was conducted to confirm the feasibility of immuno-PCR diagnostic method for the more sensitive detection of Korean FMD virus (FMDV). We synthesized a partial FMD type A viral gene. Protein antigen, monoclonal and polyclonal antibodies of FMDV were cloned, expressed and purified and then magnetic particles were attached to polyclonal antibodies and and oligomers to monoclonal antibodies for the immnuno-PCR. We confirmed the antigen-antibody and oligomer reaction using ELISA, Western blot, and real-time PCR. These results show that Korean FMDV can be detected by using difference of Ct values ​​between positive group and negative group using immuno-PCR.. The results of this study also suggest that this technique will be the basis of the diagnosis method to detect Korean FMDV more sensitively in the future.

보건복지부 장애인구 통계에 의하면 지체장애인은 우리나라 장애인구의 절반에 달하는 높은 비율을 차지 하고 있다. 이는 누구나 다양한 장애 원인에 노출되어있음을 의미함과 동시에 그에 따른 사회적, 환경적 여건 개선이 필요함을 뜻한다. 이러한 사회적 요구는 패션 및 신발산업에 영향을 미치며 국가적 지원으로 이어지 고 있으나 이에 부합하는 환경의 조성은 아직 미흡한 실정이다. 따라서 본 연구의 목적은 지체장애인 중 족부 질환 장애인의 다양한 정형 신발의 유형을 분석하여 디자인 개발의 기초를 마련하는 데 있다. 연구 방법으로 최근 19년간 지체장애인과 족부, 신발 등이 언급된 관련 학위논문 및 학술지, 각종 기사와 웹 사이트 등의 선행연구들을 살펴보았다. 또한 사례연구를 위해 정형 신발업체 현장 방문을 통해 장애 사례와 정형 신발의 디자인 현황을 분석하였다. 연구의 범위는 여성용 정형 신발에 한정하여 유형을 분석하였다. 본 연구를 통한 연구결과는 다음과 같다. 첫째, 족부 질환 장애인들의 발은 물리적 압박을 피하고 질환에 따라 보정기구 사용 이 가능해야 한다. 따라서 정형 구두는 넉넉한 내부와 입구, 높은 뒤축을 가지고 있는 것으로 조사되었다. 둘째, 정형 신발의 독립적 착용이 가능하도록 간편한 여밈 방식과 착화의 방식이 매우 중요한 것으로 조사되 었다. 셋째, 족부 질환 장애인의 특성을 반영하여 개방형, 폐쇄형으로 분류되는 것이 정형 신발 유형 분류 방법으로 적절하며, 그중 폐쇄형이 가장 선호되는 것을 알 수 있었다. 넷째, 정형 신발의 유형은 각각 부츠와 슈즈, 로퍼의 하위 종류로 분류되고 그 종류마다 단화와 스니커즈 스타일로 분류됨을 알 수 있었다. 본 연구 결과는 정형 신발의 유형과 특징을 보완하여 소비자의 요구가 반영된 정형 신발 디자인 개발에 활용될 것이 다. 궁극적으로 장애인의 보행기능 향상과 이동성 증대를 통한 삶의 질 개선에 도움을 주고자 하는 데 의의가 있다.

According to the statistics of disability population of the Ministry of Health and Welfare, people with physical disabilities have a high percentage of people with disabilities in Korea. This means that everyone is exposed to various causes of disability and that social and environmental conditions need to be improved accordingly. These societal demands affect the fashion and footwear industries and lead to national support, but the environment that meets them is still insufficient. Therefore, the purpose of this study is to analyze the types of orthopedic footwear for people with physical disabilities and to provide the basis for design development. In this study, we reviewed previous researches of related theses, journals, various articles and websites referring to the handicapped, foot, and shoes for the past 19 years. In addition, we analyzed the cases of disability and the design of orthopedic shoes through on - site visit to orthopedic shoe manufacturer. The scope of the study was limited to women 's orthopedic shoes. The results of this study are as follows. First, feet of disabled people with foot problems should be able to avoid physical pressure and use correction devices according to the diseases. Therefore, orthopedic shoes were found to have ample interior, entrance, and high heights. Second, it was found that the simple closing method and the wearing method are very important for independent wearing of orthopedic shoes. Third, it is appropriate to classify the orthopedic shoe type classification as open type or closed type according to the characteristics of the disabled person. Among them, closed type is most preferred. Fourth, the types of formal shoes are classified into boots, shoes, and loafers, and they are classified into shoes and sneaker styles. The results of this study will be utilized in the development of orthopedic shoe design reflecting the needs of consumers by complementing the types and characteristics of orthopedic shoes. Finally, it is important to help improve the quality of life by improving mobility and increasing mobility of people with disabilities.

Purpose： The purpose of this study was to assess the tibialis anterior, soleus, gluteus maximus, transverse abdominis muscle activity of tibialis anterior, soleus, gluteus maximus, transverse abdominis according to pronated foot and supinated foot. Methods： Group of pronation and supination were taped using augmented low-day method to make pronated and supinated foot the three case were assessed by agnostic radiology for investigating foot structure. Results： 1) When supinated foot & pronated foot, tibialis anterior & gluteus maximus muscle activity was augmented in one step. 2) When supinated foot & pronated foot, soleus & transverse abdominis muscle activity was decreased in one step. 3) When supinated foot & pronated foot, tibialis anterior & gluteus maximus muscle activity was augmented in squat. 4) When supinated foot & pronated foot, soleus muscle activity was decreased in squat. 5) When pronated foot, transverse abdominis muscle activity was decreased in squat. 6) When supinated foot, transverse abdominis muscle activity was augmented in squat. 7) When pronated foot, transverse abdominis & gluteus maximus & tibialis anterior muscle activity was augmented in sit to stand. 8) When supinated foot, transverse abdominis & gluteus maximus & tibialis anterior muscle activity was decreased in sit to stand. 9) When supinated foot & pronated foot, soleus muscle activity was decreased in sit to stand. Conclusion： 1) Pronated foot & supinated foot effects on soleus, gluteus maximus, transverse abdominis muscle activity in one step. 2) Pronated foot & supinated foot effects on tibialis anterior, gluteus maximus, transverse abdominis muscle activity in squat. 3) Pronated foot & supinated foot effects on soleus, transverse abdominis muscle activity in sit to stand. Therefore we suggest the deformity of the foot effects on tibialis anterior, soleus, gluteus maximus, transverse abdominis muscle activity.

[서론] 본 연구의 목적은 고령자를 대상으로 소도구와 기구운동 형태의 차이가 신체조성, 기능성 체력 및 족압 균형에 미치는 영향을 규명하는데 있다. [방법] 본 연구를 위해 15명의 고령자가 참여하였으며 소도구 운동집단(n=7, 65.29±2.49yrs)과 기구 운동집단(n=8, 63.63±2.32 yrs)으로 나누어 12주 동안 주당 3회의 빈도로 세션 당 60분 동안 실시하였다. 운동 프로그램 전후 신체구성과 전신지구력, 근력, 근지구력, 유연성, 평형성, 민첩성 등의 기능적 체력을 측정하였다. 족압 균형은 족스케너를 이용하여 측정하고 전후좌우의 4분위로 구분하여 분석하였다. 운동형태와 운동전후에 따른 변인간 비교 분석을 위해 반복측정 이원변량분석(Two-way ANOVA with repeated measure)과 대응 t-test를 실시하였다. [결과] WHR은 시기 간에 유의한 차이가 나타났으며(p<.01), 2분 제자리 걷기와 의자 앉았다 일어서기는 운동전후 시기간에서만 유의한 차이가 나타났다. 30초 왼손과 오른손 덤벨들기는 집단간 및 시기간에서, 왼발펴고 허리굽히기는 집단간에서만 유의한 차이가 나타났다. 2.44m 걷기, 좌 눈감고 외발서기, 좌 눈뜨고 외발서기, 4m 보행 속도는 모두 시기간에서만 유의한 차이가 나타났고, 우 눈뜨고 외발서기는 유의한 상호작용이 나타났다. 다른 변인은 모두 집단간 및 시기간에 유의한 차이가 나타나지 않았다. 자세 안정성 변인인 족압은 모두 집단간 및 시기간에서 유의한 차이가 나타나지 않았다. [결론] 소도구와 기구 운동 프로그램은 신체구성의 경우 대부분 집단간 및 시기간에 유의한 영향이 나타나지 않았으나, 근력, 조정력 및 평형성 변인 중 일부분에서 시기간에서 유의한 차이가 나타났다. 즉, 소도구와 기구의 고령자 운동 프로그램은 유사한 효과가 있는 것으로 나타났다.

[INTRODUCTION] The purpose of this study was to investigate the comparison on body composition, functional fitness and foot pressure balance between props muscle-strengthening and machine muscle-strengthening in older persons. [METHODS] Participants were tested before and after the study to measure body composition, cardiorespiratory fitness, muscular strength, muscular endurance, flexibility, balance, timed Up and Go (TUG) and tandem gait for functional fitness. Also plantar pressure of foot scan for limits of stability test was measured by Biorescue(RM IGENIERIE Co., France) which has % quarterly sector (RF: right front, LF: left front, RB: right back, LB: left back). Fifteen volunteers were randomly divided into two group: Props resistance(PR) training group (n=7,65.29±2.49yrs) and machine resistance(MR) training group(n=8, 63.63±2.32 yrs). Training program were performed for 60minutes per session, 3 sessions per week for 12 weeks. Data were analyzed with ANOVA for repeated measures, t-test using SPSS program. [RESULTS] There were significant difference between period on WHR, 2 minutes walking and stand-up and sit-down from a chair. There were significant difference between group and period on 30 second arm curl, and between group on chair flexibility with straight left leg, 244cm reciprocating walking, tandem gait, stand on left foot with eyes closed, stand on left foot with eyes opened, 4m up and go test show significant difference between period, and stand on right foot with eyes opened show significant interaction. The others variables didn't show significant interaction. The others variables didn't show significant difference between group and period. All of posture stability variables didn't show significant difference between group and period. [CONCLUSION] We suggested that PR and MR training adaptations didn't show significant effects between group and period on almost of body composition variable, but some of muscular strength, coordination and balance show significant effects between period. PR training may be a more easy to use without machine weight facility.

Objective: The aim of this study is to identify foot shapes of Korean male farmers by classifying their foot types using 3D scan data and analyzing the characteristics of each type. Background: The increasing demands for anthropometric information for the design of machinery and personal protective equipment to prevent occupational injuries has necessitated an understanding of the anthropometric differences to be found among occupations. Static stooped posture and squatting posture are so common in Korean farmers that anthropometric deformation in foot especially seems to occur easily. Method: 366 Korean male farmers volunteered for this study from 16 different farming villages nationwide from 2009 to 2011. Subjects were categorized into 4 age groups from 40s to 70s. Their right feet were measured by using 3D foot scanner, the anthropometric dimensions were composed of 40 items. Results: The 8 major factors affecting the foot shapes were extracted. From these factors the foot shape of Korean male farmers was classified into 3 Foot types. Foot type 1 showed severe deformation in toe 1, type 2 had a narrow shape and type 3 had a wider width for its length. Conclusion: There were some differences in foot shape and types between farmers and the public. The most characteristic foot type in Korean male farmers was type 3. Application: The results of identifying foot shapes of Korean male farmers might provide the useful information for designing ergonomic farm work shoes.

The purpose of this study was to determine whether a relationship existed between foot type and the location of plantar callus in healthy subjects. Twenty-five healthy subjects with plantar callus were recruited for this study. Foot deformities were classified according to the operational definitions as 1) a compensated forefoot varus, 2) an uncompensated forefoot varus or forefoot valgus, or 3) a compensated rearfoot varus. The location of plantar callus was divided into two regions. Fourteen of the 19 feet with compensated forefoot varus and six of the 9 feet showed plantar callus at the second, third or fourth metatarsal head. Five of the 6 feet with uncompensated forefoot varus and twenty of the 16 feet with forefoot valgus showed plantar callus at the first or fifth metatarsal head. A significant relationship was found between foot type and location of callus (p<.01). The results support the hypothesis that certain foot types are associated with characteristic patterns of pressure distribution and callus formation. We believe diabetic patients with insensitive feet and with the types of foot deformity should be fit with foot orthoses and footwears that accommodate their respective deformity in a position as near to the subtalar joint as possible with the goal of preventing plantar ulceration.

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.

<P>This research developed a textile coil inductor, in which conductive yarn was wound spirally onto textile, and produced an energy harvesting module utilizing a cylindrical compression coil spring structure to allow a permanent magnet to spin in the center hole of the coil inductor. The study confirmed through a pilot test that the voltage increased as the number of laminated layers of the coil inductor increased. Five subjects were tested in the energy harvesting measuring experiment after producing a sports shoe insole-mounted energy harvesting module. While the subjects executed sports motions such as walking and running at five given frequencies, the peak-to-peak voltage was measured by an oscilloscope and the accumulated energy voltage of the calculated rms voltage (Vrms) and the peak power (mu W) were derived. The output voltage increased as the frequency increased and the average Vp-p (V) of the five subjects was 0.53 V, the average peak power (mu W) was 0.289 mu W, and the Vrms (V) was 0.065 V. This research is significant in that it suggests the possibility of an energy harvesting module based upon the textile coil inductor emerging from the former shoes' energy generator packaging method for heavy shoe types by developing a lightweight, flexible, and human friendly footgear module structure.</P>

Objective: This study collected data on muscle fatigue and ground reaction force during walking to provide a basis for development of custom-fitted outdoor walking shoes. The study analyzed an upright body exercise program using spine stabilization technique to determine the effect on foot plantar pressure in archers, demonstrate the effectiveness of upright body exercise, and develop a new, effective, and efficient training program. Method: A 12-week upright body exercise program was evaluated for the effect on plantar pressure in archers. Ten prize-winning archers (3 men, 7 women) in B metropolitan city, each with ${\geq}10years$ of experience, were given an explanation of the content and purpose of the program, and provided informed consent. Upright body exercise was performed 3 times a week for 12 weeks. A resistive pressure sensor was used to measure foot plantar pressure distribution and analyze quantitative information on variation in postural stability and weight shifting in dynamic balance during shooting, as well as plantar pressure in static balance with the eyes open and closed. Results: There were no significant differences in foot plantar pressure before and after participation in the exercise program. There was no statistically significant difference in foot plantar pressure in static balance with the eyes open or closed, or in foot plantar pressure in dynamic balance during shooting. Conclusion: An upright body exercise program had positive effects on foot plantar pressure in static and dynamic balance in archers by reducing body sway and physical imbalance during shooting and with eyes closed. This program is expected to help archers improve their posture and psychological state, and thereby improve performance.

We develope a assistant system of foot pressure distribution for improvement gait Pattern, adapted working speed, and minimitation of muscle fatigue of the sensory feedback type FES system(SEFES). This measurement system consist of mat type pressure sensor with piezo electric films. The pressure data signal multiflexed input scanning method processed A/D conversion after two step amplify and integrate. Matrix sensor interface to PC for pseudo color display by level of Pressure distribution data. This measurement system clinically evaluated in hemiplegic patients. It has produced acceptable results with optimal location of the food sensor's pressure point and avoid the muscle fatigue.

Brachydactyly type C (BDC) is characterized by shortening of the middle phalanges of the index, middle, and little fingers. Hyperphalangy of the index and middle finger and shortening of the first metacarpal can also be observed. BDC is a rare genetic condition associated with the GDF5 gene, and this condition has not been confirmed by genetic analysis so far in the Korean population. Herein, we present a case of a 6-yr-old girl diagnosed with BDC confirmed by molecular genetic analysis. The patient presented with shortening of the second and third digits of both hands. Sequence analysis of the GDF5 gene was performed and the pathogenic mutation, c.1312C>T (p.Arg438Cys), was identified. Interestingly,this mutation was previously described in a patient who presented with the absence of the middle phalanges in the second through fifth toes. However, our patient showed no involvement of the feet. Considering intrafamilial and interfamilial variability, molecular analysis of isolated brachydactyly is warranted to elucidate the genetic origin and establish a diagnosis.

Purpose: To investigate the effect of intramuscular Botulinum toxin type A (BoNT-A) injection on gait and dynamic foot pressure distribution in children with spastic cerebral palsy (CP) with dynamic equinovarus foot. Materials and Methods: Twenty-five legs of 25 children with CP were investigated in this study. BoNT-A was injected into the gastrocnemius (GCM) and tibialis posterior (TP) muscles under the guidance of ultrasonography. The effects of the toxin were clinically assessed using the modified Ashworth scale (MAS) and modified Tardieu scale (MTS), and a computerized gait analysis and dynamic foot pressure measurements using the F-scan system were also performed before injection and at 1 and 4 months after injection. Results: Spasticity of the ankle plantar-flexor in both the MAS and MTS was significantly reduced at both 1 and 4 months after injection. On dynamic foot pressure measurements, the center of pressure index and coronal index, which represent the asymmetricalweight-bearing of the medial and lateral columns of the foot, significantly improved at both 1 and 4 months after injection. The dynamic foot pressure index, total contact area, contact length and hind foot contact width all increased at 1 month after injection,suggesting better heel contact. Ankle kinematic data were significantly improved at both 1 and 4 months after injection, and ankle power generation was significantly increased at 4 months after injection compared to baseline data. Conclusion: Using a computerized gait analysis and foot scan, this study revealed significant benefits of BoNT-A injection into the GCM and TP muscles for dynamic equinovarus foot in children with spastic CP.

Objective: The purpose of this study was to investigate plantar foot pressure and static balance according to the type of insole in the elderly. Methods: Thirteen elderly (mean age: $67.08{\pm}2.25years$, mean height: $159.63{\pm}9.64cm$, mean body weight: $61.48{\pm}9.06kg$) who had no previous injury experience in the lower limbs and a normal gait pattern participated in this study. Three models of insoles of the normal, 3D, and triangle types were selected for the test. The Pedar-X system and Pedar-X insoles, 3.3 km/h of walking speed, and a compilation of 20 steps walking stages were used to analyze foot-pressure distribution. Static balance test was conducted using Gaitview AFA-50, and balance (opening eyes, closing eyes) was inspected for 20 s. One-way ANOVA was conducted to test the significance of the results with the three insoles. p-value of less than .05 was considered statistically significant. Results: The mean foot pressure under the forefoot regions was the lowest with the 3D insole during treadmill walking (p<.05). The mean value under the midfoot was the highest with the 3D insole (left: p<.05, right: p<.01). The mean value under the rearfoot was the lowest with the 3D insole (p<.001). The maximum foot pressure value under the foot regions was the lowest on both sides of the forefoot with the 3D insole. A statistically significant difference was seen only in the left foot (p<.01). The maximum value under the midfoot was the highest with the 3D insole (p<.001). No statistically significant difference was detected on the values under the rearfoot. In the case of vertical ground reaction force (GRF), statistically significant difference was seen only in the left side rearfoot (p<.01). However, static balance values (ENV, REC, RMS, Total Length, Sway velocity, and Length/ENV) did not show significant differences by the type of insole. Conclusion: These results show that functional insoles can decrease plantar pressure and GRF under the forefoot and rearfoot. Moreover, functional insoles can dislodge the overload of the rearfoot and forefoot to the midfoot. However, functional insoles do not affect the static balance in the elderly.

The purpose of this study was to investigate the effects of foot type and ankle joint fatigue levels on the trajectories of center of pressure and center of mass during a single-leg stance. The study subjects included 24 healthy women (normal foot group, n=10; pronated foot group, n=14). Ankle joint muscle fatigue was induced by using an isokinetic dynamometer, where the fatigue levels were measured on plantar flexion and dorsiflexion at angular velocities of $30^{\circ}/s$ at 50% and 30% of the peak torque of ankle plantar flexion. Following assessments in the anteroposterior direction according to the level of fatigue, the pronated foot group showed decreased single-leg stance ability at 50% and 30% of the fatigue level. Moreover, the normal foot group showed better single-leg stance ability than the pronated foot group at 30% of the fatigue level. Following assessments in the mediolateral direction, we noted that the single-leg stance ability did not differ significantly according to the levels of fatigue or foot type. In conclusion, ankle plantar flexion at 50% and 30% of the peak torque reduced the ability of the pronated foot group to achieve a single leg stance in the anteroposterior direction. Moreover, the normal foot group showed better single-leg stance ability than the pronated foot group.