• Journal of Chest Surgery
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• 제35권4호
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• pp.283-289
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• 2002

배경: 폐쇄성 혈관 질환을 가진 환자에서 폐쇄된 혈관 자체의 문제를 해부학적으로 해결하기에는 환자의 상태나 병변의 종류, 수술 위험도 등이 문제가 된다. 이때 환자의 연령이나 상태에 따라 선택할 수 있는 고식적인 치료 방법으로 extra-anatomic bypass나 교감신경 절제술 등이 있다. 우리는 이러한 고식적 치료의 장기 성적과 적응증에 관하여 관찰하고자 하였다. 방법: 1996년부터 2000년까지 고식적 치료가 필요했던 폐쇄성 혈관 질환을 가진 38명의 환자를 대상으로 수술의 결과를 후향적으로 고찰하였다. 남자가 32명, 여자가 6명 이었으며 평균 연령은 60.37$\pm$17.65세이다. 이 중 원인 질환으로는 동맥경화증이 32명으로 가장 많았으며, Buerger씨 병이 4명, Raynaud씨 증후군과 상대정맥 증후군이 각각 1명씩이었다. 결과: 수술은 extra-anatomic bypass가 40회, 요추 교감신경 절제술이 17회, 혈전제거술이 7회, 대퇴동맥 혈관 간치술이 1회 등이었고, 혈관 우회술 없이 요추 교감신경 절제술 혹은 혈전 제거술만을 시행한 환자는 7명이었다. 수술 후 6명에서 재수술이 필요하였는데, 이 중 5명은 원위부 혈류 폐쇄 혹은 약화로 발목 관절이나 족지 절단 혹은 요추 교감신경 절제술을 시행한 경우이었고, 1명은 혈관 우회술 1달 후에 인조혈관 원위부의 동맥류가 발생하여 다시 우회술이 필요한 경우였다. 폐쇄성 혈관 질환에 대한 고식적 치료 3년 후의 1차 혈관 개통률은 78.29 $\pm$ 3.81%이었으며, 수술 방법과 혈관 개통률 사이의 통계적 유의성은 없었다. 결론: 여러 논란에도 불구하고 폐쇄성 혈관 질환 환자의 일부에서는 여러 고식적 수술이 이루어지는데, 적절한 환자의 선택과 수술 전후의 적절한 환자 교육, 추적 관찰이 이루어진다면 좋은 결과를 얻을 수 있을 것으로 생각된다.

• Archives of Plastic Surgery
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• 제33권6호
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• pp.784-788
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• 2006

Purpose: For the reconstruction of the ankle joint as well as the soft tissue defect in the distal lower leg, a free flap or a local flap has been used, and because of the condition of patients, if a complex microvascular surgery under general anesthesia could not be performed, it could be reconstructed by using the distally based lateral supramalleolar fascio-cutaneous island flap using the perforating branch of the peroneal artery in the ankle area. Methods: The study subjects were 4 male patients between 53 years and 73 years of age. 2 cases were tissue defect in the medial malleolus area due to systemic diseases such as gouty arthritis accompanied traffic accident, diabetes mellitus foot, atherosclerotic obliterans, etc., 1 case was the defect in the pretibia area, and 1 case was the defect underneath the lateral malleolus, which was reconstructed by the distally based lateral supramalleolar fascio-cutaneous island flap. The donor area was the skin harvested from the groin, and the full thickness skin graft was performed. The size of the flap varied from $4{\times}3cm$ to $9{\times}6cm$. As the flap border, the medial side was to the tibialis anterior tendon, the lateral side was to the fibula crest, and the proximal area was less than the fibula size. Results: The consequence is that, in total 4 cases, the congestion in the flap began from 12 hours after the surgery, and the progression of congestion was ceased on the 5th day after the surgery, and finally epidermal bulla and sloughing, partial necrosis was developed. After the end of necrosis, the defect area was reconstructed successfully by the second full thickness skin graft. Conclusions: Although the distally based lateral supramalleolar fascio-cutaneous island flap has the shortcoming of requiring the second skin graft, it has the advantages that it does not require a long complex microsurgery, the flap itself is thin, it is similar to the color of the skin in the recipient area, and it does not leave a big scar in the donor area. Therefore, it is thought that for the cases who could not undergo a long complex surgery due to systemic diseases or the cases of patients whose condition of the recipient area is not suitable for microsurgery, the lateral supramalleolar fascio-cutaneous island flap is very useful for the reconstruction of the distal lower leg and the ankle joint area.

• 대한방사선기술학회지:방사선기술과학
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• 제29권4호
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• pp.225-228
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• 2006

목 적: 후족부의 병리학적 상태의 치료와 평가를 위해서는 관상면에서 종골과 경골이 연관된 배열상태의 정확한 평가가 필수적이다. 이전의 방사선학적 검사인 발과 발목의 전후방향, 측방향, 사방향 촬영과 종골 축방향 촬영 등의 X-선 촬영상은 관상면에서 종골과 경골이 연관된 배열상태를 증명하지 못했다. 이에 본 연구에서는 후족부 관상면 배열영상(hindfoot coronal alignment view)을 새롭게 소개하고자 한다. 검사방법 : 1) 양쪽 발을 지탱할 수 있는 방사선투과성의 스탠드형 보조기구를 제작한다. 2) 양측 발은 weight-bearing position이 되게 한다. 3) 각각의 발의 위치는 발의 종축이 보조기구 판과 수직이 되도록 자세를 유지한다. 4) silhouette tracing: 발뒷꿈치 outline과 둘째 발가락이 일직선상으로 지나도록 위치시킨다. 5) 중심 X-선: 발바닥 쪽을 향해 약 $15{\sim}20^{\circ}의 각도로 종골의 뒷쪽을 향해 입사한다. 결 과 : 1) 경골 축과 종골의 내측, 외측 결절의 영상이 함께 표출된다. 2) 종골이 회전되지 않아야 한다. 3) 거퇴관절강(talotibial joint space)이 함께 나타나야 한다. 결 론: CT나 MRI 영상에서도 관상면에서 후족부의 배열상태를 증명할 수 있지만, 환자의 체중이 주어지지 않기 때문에 발의 임상적인 증상을 보여주기에는 충분하지 못했다. 하지만 후족부 관상면 배열영상은 후족부의 inversion, eversion의 자세변화를 보여주고, 경골 원위부와 종골의 varus, valgus deformity의 치료를 위한 평가 자료로 좋은 검사방법이며, 비교적 자연스럽고 편안한 자세로 환자에게 큰 도움을 줄 것으로 사료된다.

• 대한정형도수물리치료학회지
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• 제12권1호
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• pp.16-26
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• 2006

The purpose of this study was to investigate the influence of the various knee angles and ground state on the muscular activities and fatigue of the ankle muscles by integrated electromyograms (iEMG) and median frequency of tibialis anterior (TA), peroneus longus (PL), flexor digitorum longus (FDL) and gastrocnemius (GC). Ten healthy male subjects were participated into stable and balance ball sessions at four angles of knee joint. The surface electromyograms (sEMG) were recorded from the TA, PL, FDL and GC on stable and balance ball with full weight bearing at four knee angles of $0^{\circ}$, $15^{\circ}$, $30^{\circ}$ and $45^{\circ}$. The time serial data of the surface electromyographic signals were transformed into integrated and frequency serial data by fast fourier transformation. On the stable ground, the iEMG signals of the TA, PL, FDL and GC were significantly higher at $45^{\circ}$ and $30^{\circ}$ of knee angles than $0^{\circ}$ and $15^{\circ}$ of knee flexion (p<0.05). On the balance ball, the iEMG of the TA, PL, FDL and GC were significantly higher at $45^{\circ}$ and $30^{\circ}$ of knee angles than $0^{\circ}$ and $15^{\circ}$ of knee flexion (p<0.05). The median frequency of the TA, PL, FDL and GC were significantly lower at $45^{\circ}$ and $30^{\circ}$ of knee angles than $0^{\circ}$ and $15^{\circ}$ of knee on the stable ground (p<0.05). On the balance ball, also the median frequency of the TA, PL, FDL and GC were significantly lower at $45^{\circ}$ and $30^{\circ}$ of knee angles than $0^{\circ}$ and $15^{\circ}$ of knee flexion (p<0.05). The iEMG of the TA, PL, FDL and GC were significantly higher on the balance ball at $0^{\circ}$, $15^{\circ}$, $30^{\circ}$ and $45^{\circ}$ of knee angles compared with stable ground. The median frequency of the TA, PL, FDL and GC were significantly lower on the balance ball at $0^{\circ}$, $15^{\circ}$, $30^{\circ}$ and $45^{\circ}$ of knee angles compared with stable ground. These results indicate that the ground conditions and angles of the knee joint involved to muscular activities and fatigue of ankles muscles, may performed at first on stable ground and then balance ball in order to $0^{\circ}$, $15^{\circ}$, $30^{\circ}$ and $45^{\circ}$ of knee flexion.

• 벤처창업연구
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• 제2권1호
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• pp.153-169
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• 2007

열작용에 의한 전자파의 안전성을 생각하는데 있어서는 , 이 30${\sim}$300MHz 부근의 주파수대가 가장 중요하고 기립 신장 방향의 공진 상태에서는 목, 슬 관절, 발목 등 가는 부분이 강하게 가열되는 위험이 있다. 이처럼 자기자극기는 시간적으로 변화하는 자계를 인체내부에 전계를 유도하여 무접촉성, 무침습적으로 깊고, 넓은 부위의 자극이 가능한 이점으로 말초신경, 뇌질환, 뇌신경, 근력, 요실금, 노인성, 근질환, 재활치료 등까지 근래에 와서 활발하게 연구가 활발히 진행 중이다. 마지막으로 초미니 자기신경 치료기를 말초신경계 질환치료에 적용하기 위하여 연구한 결과, 첫째로 자기루프 객체의 실린더 형태로 설계하고 동작전원과 제어장치를 구현하였고, 둘째로 루프 객체 실린더형이 프로브의 특성과 치료영역 범위와 치료펄스의 거리에 대한 유효영역을 구하였고, 셋째로 프로브의 형태에 따른 펄스포밍과 에너지 값을 구현하여, 병변에 따른 치료펄스를 구현할 수가 있었다. 특히, 특성실험을 통해 댐핑펄스 형태와 치료펄스 형태 등을 다양하게 구하게 되었다. 최근에 의학 발달로 무자극, 무침습에 따른 질환치료에 조금이라도 도움이 되고자 구현 하였다. 본 연구에서는 고진폭 치료펄스(전통적인 magneto-therapy)의 크게 대단한 강렬)는 짧은 시간에 치료효과를 극대화 하고, 미래에는 수요가 크게 확대 될 것으로 예측된다.

• 대한물리치료과학회지
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• 제19권3호
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• pp.49-56
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• 2012

Background : The purpose of this study is to understand the effects of ankle joint taping on balancing abilities of the elderly and to provide preliminary data on preventing falls among the elderly. Methods : In this study, 20 students(8 male, 12 female) in their 20s from D University as well as 14 elderly(4 male, 10 female) in their 70s from S community center have participated. The participants were well informed about the experiment and voluntarily participated. We measured the difference in balancing ability before and after taping between the two groups using methods such as standing on single-leg stance, TUG, and plantar pressure. Kinesio taping, a stop-watch, and the EMED-system were used as equipment along with the SPSS 12.0 program, with a significance level of 0.05, to test the difference before and after taping between the two groups. Result : First, the 70s group showed a significant increase in the dorsal flexion angle after taping. Second, the 70s group showed a significant increase in duration time of standing on one foot after taping. Third, the 70s group's TUG time was significantly shorter. Fourth, the maximum peak value for static and dynamic plantar pressure showed a significant decrease after taping; and dynamic plantar pressure area value decreased as well within significant range. Conclusion : The study has shown that taping is effective on static dynamic balancing ability of the elderly.

• 한국운동역학회지
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• 제20권4호
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• pp.395-406
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• 2010

The purpose of this study was to analyze the changes in kinematic and kinetic parameters of lower extremity joint according to rehabilitation period. Fourteen collegiate male athletes(age: $22.1{\pm}1.35$ years, height: $182.46{\pm}9.45cm$, weight: $88.63{\pm}9.25kg$) and fourteen collegiate athletes on functional ankle instability(age: $21.5{\pm}1.35$ years, height: $184.45{\pm}9.42cm$, weight: $92.85{\pm}10.85kg$) with the right leg as dominant were chosen. The subjects performed drop landing. The date were collected by using VICON with 8 camera to analyze kinematic variables and force platform to analyze kinetic variables. There are two approaches of this study, one is to compare between groups, the other is to find changes of lower extremity joint after rehabilitation. In comparison to the control group, FAI group showed more increased PF & Inversion at IC and decreased full ROM when drop landing. Regarding the peak force and loading rate, it resulted in higher PVGRF and loading. FAI group used more increased knee and hip ROM because of decreased ankle ROM to absorb the shock. And it used sagittal movement to stabilize. In terms of rehabilitation period, FAI group showed that landing patterns were changed and it increased total ankle excursion and used all lower extremity joint close to normal ankle. Regarding the peak force and loading rate, FAI group decreased PVGRF and loading rate. and also showed shock absorption using increased ankle movement. And COP variable showed that proprioception training increased stability during 8 weeks. The results of this study suggest that 8 weeks rehabilitation period is worthwhile to be considered as a way to improve neuromuscular control and to prevent sports injuries.

• Korean Journal of Acupuncture
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• 제30권2호
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• pp.135-142
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• 2013

목적 : 본 연구는 노년층의 여성에게 신맥(BL62), 조해(KI6)혈에 대한 저주파자극이 뇌파에 어떠한 영향을 미치는지 알아보고 뇌 기능을 개선하는데 비화학적이고 비침습적인 자극 방법의 후보로써 가능성을 탐구해보고자 실시된 탐색적 연구이다. 방법 : 31명의 건강한 여성 피험자(평균연령, 54.5세)를 대상으로 이중맹검 무작위배정 임상연구가 12세션동안 실시되었다. 시험군에서는 감지할 수 없는 최대의 저주파자극이 실시되었으며(평균전류량, $0.04{\mu}A$), 대조군에서는 거짓자극이 실시되었다. 결과분석을 위해 12세션을 전후로 배경뇌파가 측정되었다. 결과 : 12세션의 자극이 실시된 후 대조군에 비해 실험군의 알파파 상대값은 11채널에서 유의한 증가를 보였으며(p<0.05), 감마파의 상대값은 7채널에서, 세타파의 상대값은 10채널에서 유의한 감소를 보였다. 결론 : 발목관절에 있는 신맥(BL62), 조해(KI6)혈에 대한 저주파 자극은 노년의 여성의 뇌에 베타, 세타, 감마파의 감소를 일으키는 반면 알파파를 선택적으로 증가시켜 뇌를 안정시키는 효과가 있는 것으로 보인다. 이러한 결과는 저주파자극이 향후 스트레스와 관련된 인지 문제를 치료하는 비침습적이고 비화학적인 도구로써의 가능성을 제공할 수 있을 것으로 보이며, 그 기전에 대한 추가적 연구가 필요할 것으로 보인다.

• 대한물리치료과학회지
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• 제28권2호
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• pp.30-39
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• 2021

Background: The purpose of this study was to compare the differences in gait and mobility according to the types of assistive device for ankle joint including ankle foot orthosis (AFO), non-elastic tape, elastic tape, and high ankle shoes in chronic hemiplegic stroke survivors. Design: A cross-over design. Methods: Twelve hemiplegic stroke survivors participated in this study, and they walked under 5 different conditions including bare feet, wearing a AFO, wearing a non-elastic tape, wearing a elastic tape, and wearing a high ankle shoes. During the participants walked, the spatio-temporal gait analysis and mobility examinations were performed. For the spatio-temporal gait analysis (gait velocity and cadence, step length, stride length, and single and double leg support time) and mobility examinations, the gait mat, TUG and TUDS were used. Results: As s results, on the AFO, non-elastic tape, elastic tape, and high ankle shoes, there were significantly differences in the all spatio-temporal gait parameters, TUG, and TUDS compared to barefoot (p<0.05). In particular, all spatio-temporal gait parameters, TUG, TUDS were significantly improved with AFO compared to barefoot. TUG was significantly improved with AFO compared to non-elastic tape, TUG and TUDS were significantly improved with AFO compared to elastic tape, gait velocity was significantly improved with non-elastic tape compared to high ankle shoes, gait velocity and TUG were significantly improved with elastic tape compared to high ankle shoes, and TUDS was significantly improved with non-elastic tape compared to elastic tape. Conclusion: The AFO, non-elastic tape, elastic tape, and high ankle shoes showed a positive effect on gait and mobility compared to barefoot, and among them, wearing AFO was most effective for improving gait and mobility of chronic hemiplegic stroke survivors.

• 대한물리치료과학회지
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• 제28권2호
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• pp.57-64
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• 2021

Background: During squat exercises, Ankle joint stability during squat movement transfers forces produced by unstable supports or various loads to the leg joints and trunk, reducing the risk of injury; therefore, a reference is needed for correct ankle joint posture during squat exercises. The purpose of this study was to examine the effect of ankle joint stability on quadriceps femoris and hamstring activation during squat exercises. Design: Quasi-experiment one group pretest-posttest design. Methods: The participants in this study were 20 volunteers who performed squat exercises with and without kinesiology tape. We measured quadriceps femoris and hamstring activation using surface electromyography. The ankle joint was stabilized with kinesiology tape using the ankle balance taping (ABT) method. A paired t-test was performed to compare differences between taping conditions. Results: Vastus medialis and vastus lateralis activation were greater following squat exercises with kinesiology tape than without; however, the difference was not significant. Medial and lateral hamstring activation was not significantly different between taping conditions. Conclusion: Although it is difficult to maintain stability using kinesiology tape alone, ankle joint stability is believed to affect quadriceps femoris muscle activity, which increases the effectiveness of the squat exercise.