본 연구는 발가락 지방 소거 검사 시에 종종 저품질의 영상이 획득되는 경우에 주목하여 다양한 조절인자들을 조절하지 않아도 손쉽게 영상 품질을 향상하는 방법을 고안해보았다. 팬텀과 지원자를 대상으로 발 전용 코일만 사용한 경우와 추가 코일을 결합 사용한 경우의 영상을 획득 후 신호대 잡음비(SNR)를 측정하여 비교하였다. 시상면, 관상면, 축상면 모두 T2 Dixon을 시행하였고, 시상면의 경우 T2 지방 소거(FS)와 T1 지방 소거를 추가 시행하였다. 팬텀 검사에서 추가 코일을 결합 사용 시 SNR은 시상면의 경우 T2 Dixon water는 1.21배, T2 FS은 1.22배, T1 FS은 1.17배 향상되었다. 관상면 T2 Dixon water는 1.15배, 축상면 T2 Dixon water는 1.47배 향상되었다. 지원자 검사에서 추가 코일을 결합 사용 시 SNR은 시상면의 경우 T2 Dixon water는 2.07배, T2 FS은 5.17배, T1 FS은 3.20배 향상되었다. 관상면 T2 Dixon water는 1.20배, 축상면 T2 Dixon water는 1.37배 향상되었다. 추가 코일을 결합 사용하였을 때 모든 지방 소거 검사 및 모든 방향에서 SNR 향상의 결과를 얻을 수 있었다. 결론적으로 사용자의 고도 기술 및 추가 검사 시간이 필요하지 않고도 SNR을 향상할 수 있음을 의미한다.

Background: The toe-spread-out (TSO) exercise has been introduced as a strengthening exercise for the abductor hallucis muscle in subjects with hallux valgus. Visual biofeedback using ultrasound imaging during exercise, may increase the ability to selectively contract the abductor hallucis muscle, compared with exercise alone. Objects: The aim of this study was to investigate the effects of ultrasound imaging visual feedback during the TSO exercise with respect to its influence on the angle of the first metatarsophalangeal joint (1st MPJ) and the cross-sectional area (CSA) of the abductor hallucis muscle in subjects with hallux valgus. Methods: Twenty-five healthy young subjects with a mean average age of 22.5 years, and a standard deviation of 2.3 years, were recruited for this study. Hallux valgus was defined as an angles greater than 15° angle of 1st MPJ. Goniometric measurement was used to determine the angle of 1st MPJ. In addition, an ultrasound system was used to collect the CSA of the abductor hallucis muscle in each foot. The angle of the 1st MPJ and CSA of the abductor hallucis were measured in three positions; the resting position, during TSO exercise, and during TSO exercise in conjunction with real-time ultrasound imaging feedback. All data analyzed using a repeated analysis of variance with Bonferroni correction in order to compare the dependent variables in all three positions. Statistical level of significance was set up as p<.05. Results: The angle of the 1st MPJ was noted to be significantly reduced and the CSA of the abductor hallucis to be significantly greater during TSO exercise used in conjunction with ultrasound imaging visual feedback, compared to when the values were recorded during TSO exercise alone (p<.05). Conclusion: Based on these findings, it can be concluded that the application of ultrasound imaging visual feedback during TSO exercise is more effective in contracting selectively the abductor hallucis than the use of exercise alone.

The purpose of this study was to investigate the reliability and validity of goniometer measurements of the hallux valgus angle (HVA) compared to radiographic measurements, which are the current standard. Twenty subjects (10 female, 10 male) were recruited for this study (40 feet). The HVA of the subjects was measured using goniometer and radiographic measurement. In three trials, measurements were taken of each subject by two examiners using goniometer and radiographic measurements using radiography in a standing position. The reliability of the measurements was investigated using intraclass correlation coefficients (ICC(3,1)), and the validity was tested using the Pearson product-moment correlation coefficient and an independent t-test. The intra-rater reliability of left and right HVAs were poor (ICC=.409 and .341, respectively). The inter-rater reliability of left and right HVAs were poor and moderate (ICC=.303 and .501, respectively). Left and right HVAs measured using goniometer and radiographic measurements were also poor and moderate (Pearson r=.246 and .544, respectively). These results suggest that goniometer measurements of the HVA are inaccurate and have unacceptable validity compared to radiographic measurements.

The purposes of this study were to compare abductor hallucis (AbdH) muscle activity during toe curl exercise according to position of interphalangeal joint (IPJ). Fifteen healthy subjects with neutral foot were recruit for this study. All subjects performed toe curl exercise with towel while maintaining the IPJ in flexion (condition 1) and extension (condition 2). Toe curl exercise with towel was perform three trials for five second periods in each condition. Surface electromyography (EMG) activities were recorded from three muscles (AbdH, tibialis anterior, peroneous longus) in each condition. EMG activity was normalized to the value of maximal voluntary isometric contraction (%MVIC). The EMG activities acoording to position of IPJ were compared using a paired t-test. This study showed that the EMG activity of AbdH during toe curl exercise with IPJ extension significantly increased compared to those during toe curl exercise with IPJ flexion (p<.05). However, the EMG activity of tibialis anterior and peroneus longus were not significantly different between the conditions (p>.05). These results suggest that toe curl exercise with towel must be performed with extension of IPJ in order to strengthen intrinsic muscle in subjects with overuse injuries related to excessive pronation.

A two-month-old male calf weighing 70 kg with congenital metacarpophalangeal flexural deformity was referred to the Veterinary Medical Center of Chugbuk National University. The calf could not stand and walk normally that walked with the dorsal surface of the hoof with contraction of fetlock joint. The both forelimbs had been casted two times during 45 days before presentation. Midline of the palmar surface of the feltlock joint was incised to cut superficial flexor tendon, deep flexor tendon and interosseus muscle. Both forelimbs are healed well returned to normal function after tenotomy.

본 연구는 발가락 벌림 보조기(toe spreader)가 긴장성 발가락 굽힘 반사(Tonic Toe Flexion Reflex: TTFR)가 있는 양하지 뇌성마비 아동의 보행에 미치는 영향을 알아보고자 하였다. 12명의 TTFR이 있는 양하지 뇌성마비 아동을 대상으로 같은 날에 맨발과 발가락 벌림 보조기를 착용한 상태에서 보행분석을 실시하였다. 시간 거리 보행변수로 활보장(step length), 보장(step length), 보폭(step width)

This study was designed to identify the effects of walking conditions (normal walking vs. toe-walking) on electromyographic (EMG) activity of gastrocnemius, tibialis anterior, and soleus muscle. Seven healthy adult males participated in this study. The exclusion criteria were orthopedic or neurologic disease, congenital anomaly or acquired deformity, or pain in low back or lower extremities. The maximal voluntary isometric contraction for each muscle was used for the reference contraction, and EMG activity of each muscle during normal walking and toe-walking was expressed as a percentage of reference contraction. The gait cycle was determined with two foot switches, and gait was normalized as 100% gait cycle for each condition. The maximal values of EMG activity in terminal stance (30~50% of gait cycle) of each condition were compared for data analysis. No significant differences were found in EMG activity of the tibialis anterior and soleus (p>.05), whereas significant decrement was found in EMG activity of gastrocnemius during toe-walking compared to normal walking (p<.05). There is a limitation to generalize the results of this study, because small number of subjects participated for this study and only EMG was used for data collection. The treatment methods should be developed to improve gait efficiency by substituting the weakened muscles secondary to upper motor neuron, or by strengthening the distal muscles in lower extremity.