정상발과 평발에서의 목말밑 관절가동범위와 등쪽굽힘근의 근활성도 비교 = Comparison of Subtalar Joint Range of Motion and Dorsiflexor Muscle Activity Between Normal and Pes Planus Feet

다국어 초록 (Multilingual Abstract)

PURPOSE: The imbalance of pretibial muscles can be a factor contributing to the development of pes planus. However, no study has yet compared the muscle activity of the tibials anterior (TA) to that of the extensor digitorum longus (EDL). The purpose of this study was to determine whether there are differences in the electromyographic (EMG) TA and EDL amplitude indexes (AIs) between normal and pes planus feet.
METHODS: A total of 14 subjects with normal feet and 15 subjects with bilateral pes planus participated in this study. TA and EDL muscle activities were measured using a wireless EMG system and the angles of ankle dorsiflexion and eversion of the subtalar joint were measured using a universal goniometer during active ankle dorsiflexion in the prone position. AI was calculated as follows: amplitude_TA- amplitude_EDL / (amplitude_TA+amplitude_EDL) / 2×100.
RESULTS: The AIs of the TA and EDL were significantly lower in pes planus feet than in normal feet (p<.05). The angle of subtalar eversion was significantly greater in pes planus feet than in normal feet during active ankle dorsiflexon (p< .05). However, there was no significant difference in the angle of ankle dorsiflexion between normal feet and pes planus feet (p >.05).
CONCLUSION: This study showed that TA muscle activation was lower in pes planus feet than in normal feet, resulting from greater eversion range of motion during active ankle dorsiflexion. We suggest that the imbalance of ankle dorsiflexors must be considered in pes planus management.

참고문헌 (Reference)

1 고은경, "발목관절의 능동적 배측굴곡 시 정상과 망치 발가락 대상자의 전경골근과 장지신근의 근 활성도 비의 비교" 대한물리의학회 6 (6): 103-108, 2011

2 Smith-Oricchio K, "lnterrater reliability of subtalar neutral, calcaneal inversion and eversion" 12 (12): 10-15, 1990

3 Jennings MM, "The effects of sectioning the spring ligament on rearfoot stability and posterior tibial tendon efficiency" 7 (7): 219-224, 2008

4 Kaufman KR, "The effect of foot structure and range of motion on musculoskeletal overuse injuries" 27 (27): 85-93, 1999

5 Riemann BL, "The Effects of Sex, Joint Angle, and the Gastrocnemius Muscle on Passive Ankle Joint Complex Stiffness" 6 (6): 369-375, 2001

6 Root ML, "Normal and Abnormal Function of the Foot" 1977

7 Kendall FP, "Muscles: Testing and Function, with Posture and Pain" Lippincott Williams and Wilkins 1993

8 Neumann DA, "Kinesiology of the Musculoskeletal System" Mosby 2002

9 Ryan M, "Kinematic analysis of runners with Achilles mid-portion tendinopathy" 30 (30): 1190-1195, 2009

10 Jutta H, "Functional Anatomy for Physical Therapists" TPS 2015

11 Reynard F, "Foot varus in stroke patients: muscular activity of extensor digitorum longus during the swing phase of gait" 19 (19): 69-74, 2009

12 Razeghi M, "Foot type classification: a critical review of current methods" 15 (15): 282-291, 2002

13 Vittore D, "Extensor deficiency: First cause of childhood flexible flat foot" 32 (32): 28-32, 2009

14 Tiberio D, "Evaluation of functional ankle dorsiflexion using subtalar neutral position. A clinical report" 67 (67): 955-957, 1987

15 Koh EK, "Effects of foot orthosis and strengthening exercises on the talo-first metatarsal angle and muscle strength in subjects with pes planus" 2011

16 Hosl M, "Does excessive flatfoot deformity affect function? A comparison between symptomatic and asymptomatic flatfeet using the Oxford Foot Model" 39 (39): 23-28, 2014

17 Easley ME, "Current concepts review: Hallux valgus part 1: Pathomechanics, clinical assessment, and nonoperative management" 8 (8): 654-659, 2007

18 Pinney SJ, "Current concept review: Acquired adult flatfoot deformity" 27 (27): 66-75, 2006

19 Van Boerum DH, "Biomechanics and pathophysiology of flat foot" 8 (8): 419-430, 2003

20 Pohl MB, "Biomechanical and anatomic factors associated with a history of plantar fasciitis in female runners" 19 (19): 372-376, 2009

21 김태호, "6주간의 활지지 테이핑(arch support taping) 적용이 과도하게 엎침된 발의 발바닥압력과 발배뼈 높이에 미치는 영향" 대한물리의학회 6 (6): 483-490, 2011