• 제목/요약/키워드: Ankle joint angle

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전위된 관절 내 종골 골절에서 확장된 족근동 접근법을 통한 Kirschner Wire 강선 지지대 고정술의 임상 및 영상학적 결과 (Clinical and Radiological Outcomes of 'Blocking Kirschner Wire Technique' in Displaced Intra-Articular Calcaneal Fractures via the Extended Sinus Tarsi Approach)

  • 이정길;강찬;김상범;이기수;황정모;안병국
    • 대한정형외과학회지
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    • 제56권3호
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    • pp.224-233
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    • 2021
  • 목적: 종골 골절 후 발생하는 부정유합으로 인해 체부의 폭이 증가하면 후족부 외측의 통증이 발생한다. 외측벽 돌출을 줄이기 위해 저자들이 고안한 K-강선(Kirschner wire) 지지대의 정복 유지 효과를 임상 및 영상학적 결과로 후향적으로 평가해 보고자 하였다. 대상 및 방법: 2015년 1월부터 2017년 12월까지 전위된 관절 내 종골 골절 환자 중 정복 유지를 위해 K-강선 지지대를 사용한 환자 22명(A군)과 K-강선 지지대를 사용하지 않은 환자 중 A군 환자와 1:2로 짝지은 44명의 환자들(B군)을 대상으로 하였다. 모든 수술은 확장된 족근동 접근법으로 시행되었으며 유관나사와 Steinmann 핀, K-강선을 이용한 내고정술을 시행하였다. 술 후 임상적 평가로는 미국족부족관절학회의 족관절-후족부 수치와 수술 후 운동능력의 회복 정도를 비교하였다. 영상학적 결과는 Böhler 각, Gissane 각, 종골의 높이와 폭, 관절 내 함몰 정도와 종골 외측벽의 돌출 정도를 비교하였다. 또한 두 군의 환자에서 수술 후 발생한 합병증도 분석해 보았다. 결과: 임상적 결과는 두 군 간에 유의미한 차이가 없었다(p=0.924, p=0.961). 영상학적으로 Böhler 각, Gissane 각, 종골의 높이와 폭, 관절 내 함몰 정도에는 유의한 차이가 없었지만(p=0.170, p=0.441, p=0.230, p=0.266, p=0.400), 종골 외측벽의 돌출 정도는 A군이 평균 1.78 mm, B군이 4.95 mm로 유의한 차이가 있었다(p=0.017). B군에서 비복 신경 포착과 통증을 동반한 외골종의 빈도는 더 많았지만 통계적으로 유의한 차이가 없었다(p=0.293, p=0.655). 결론: 임상적 평가 및 영상학적 평가의 대부분과 두 군의 합병증 비교에서 유의한 차이는 없었으나 종골 외측벽의 돌출 정도에 있어서는 A군에서 우수한 결과를 보였다. 저자들이 고안한 K-강선 지지대 수술법은 전위된 관절 내 종골 골절에서 외측벽 돌출의 정복 유지에 효과적인 수술 방법이 될 수 있을 것이다.

해부학적 잠김 압박 금속판을 이용한 원위 비골 골절의 치료 (Operative Treatment with Anatomically Preshaped Locking Compression Plate in Distal Fibular Fracture)

  • 정형진
    • 대한족부족관절학회지
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    • 제17권2호
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    • pp.130-135
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    • 2013
  • Purpose: Preshaped Locking compression plate(LCP) has holes with fixed angle between screw and plate and have advantage firm fixation because it has stability of angular and axial deformity. We evaluated usefulness of LCP after open reduction and internal fixation in distal fibular fracture. Materials and Methods: Between December 2011 and May 2012, 23 patients with fracture of distal fibula were followed up at least 12 months underwent open reduction and internal fixation with LCP. There were 15 males and 8 females with a mean age 39.8(20~69) years. According to Danis-Weber classification, there were 20 cases of type B and 3 cases of type C. There were 13 cases of isolated lateral malleolus fractures, 1 case of bimalleolar fracture, 6 cases of trimalleolar fractures and 3 cases of distal tibia fractures with proximal fibula fracture. Intraoperatively, we assessed whether preshaped LCP fit lateral margin of distal fibula or not and evaluated quality of reduction and postoperative complications. The cases were analyzed by radiological bone union time and clinical results according to the criteria of Meyer Results: Of all cases, complete bone union was achieved and average radiological bone union time was 7.3(6~12) weeks. The clinical results were excellent in 18 cases(78%), good in 5 cases(22%). There were 5 cases of plate with 3 holes, 13 cases of plate with 4 holes, 2 cases of plate with 5 holes, 1 case of plate with 6 holes and 2 cases of plate with 7 holes. The average number of screws at proximal fragement was 2.5 and at distal fragment was 3.5. In 14 cases (60.8 %), we needed re-bending of plate because the distance between plate and lateral cortical margin of distal fibula was more than 5 mm at anteroposterior X-ray after reduction. All cases have anatomical reduction and there were no complications of wound infections. There were no complaint about hardware irritation. Conclusion: At fractures of distal fibula,preshaped LCP had a excellent stability although far cortex was not fixed with screw and bending of plate. And there are less complications of hardware irritation and wound problems. But, Some complement would be needed because there were no complete fitting between precontour of LCP and lateral cortical margin of distal fibula.

케틀벨 스윙 시 적당한 케틀벨의 무게는 얼마일까? (What is the Appropriate Kettlebell Mass for a Kettlebell Swing?)

  • Kim, Bo Kyeong;Thau, Dao Van;Yoon, Sukhoon
    • 한국운동역학회지
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    • 제31권4호
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    • pp.308-313
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    • 2021
  • Objective: The purpose of this study was to investigate the effect of different kettlebell mass (30%, 40%, and 50% of the body mass) on kinematics and kinetic variables of kettlebell swing. Method: Total of 16 healthy male who had at least 1 year of kettlebell training experience were participated in this study (age: 31.69 ± 3.46 yrd., height: 173.38 ± 4.84 cm, body mass: 74.53 ± 6.45 kg). In this study, a 13-segments whole-body model (upper trunk, lower trunk, pelvis, both side of forearm, upperarm, thigh, and shank) was used and 26 reflective markers were attached to the body to identify the segments during the movement. A 3-dimensional motion analysis with 8 infrared cameras and 4 channeled EMG was performed to find the effect of kettlebell mass on its swing. To verify the kettlebell mass effect, a one-way ANOVA with a repeated measure was used and the statistical significance level was set at 𝛼=.05. Results: Firstly, in all lower extremity joints and thoracic vertebrae, a statistically significant change in angle was shown according to an increase in kettlebell mass during kettlebell swing (p<.05). Secondly, in both the up-swing and down-swing phases, the knee joint and ankle joint ROM showed a statistically significant increase as the kettlebell mass increased (p<.05) but no statistically significant difference was found in the hip joint and thoracic spine (p>.05). Lastly, the hamstrings muscle activity was statistically significantly increased as the kettlebell mass increased during up-swing phases (p<.05). Also, as the kettlebell mass increased in P4 of the down swing phase, the gluteus maximus showed a statistically significantly increased muscle activation, whereas the rectus femoris showed a statistically significantly decreased muscle activation (p <.05). Conclusion: As a result of this study, hip extension decreased and knee extension increased at 40% and 50% of body mass, and the spine also failed to maintain neutrality and increased flexion. Also, when kettlebell swings are performed with 50% of body mass, synergistic muscle dominance appears over 30% and 40% of body mass, which is judged to have a risk of potential injury. Therefore, it is thought that for beginners who start kettlebell exercise, swing practice should be performed with 30% of body mass. In addition, even in the case of experienced seniors, as the weight increases, the potential injury risk may increase, so it is thought that caution should be exercised when performing swings with 40% and 50% of body mass. In conclusion, it is thought that increasing the weight after sufficiently training with 30% of the weight of all subjects performing kettlebell swing is a way to maximize the exercise effect as well as prevent injury.

태권도 찍어차기의 무릎편 유형과 구부린 유형의 운동학적 비교분석 (Kinematic analysis of skill between flexed and extended type of knee during Jigeo-Cha-Gi in Taekwon-Do)

  • 김동규;류재청
    • 한국운동역학회지
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    • 제15권4호
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    • pp.25-42
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    • 2005
  • The study was to investigate kinematic difference between flexed and extended type of knee during Jigeo-Cha-Gi in Taekwon-Do. For this subjects participated were consisted of weights of fin (1), bantam (1) and welter class(1) of male 3 national representative level skilled in two type(flexed and extended type) of Jigeo-Cha-Gi. 3D cinematography analysis was performed for motion analysis and Kwon 3D ver. 3.1) was used for 3D coordinates & analysis variables calculation. In Temporal variable there was no significant difference statistically in all phases & total elapsed time between flexed and extended type, but flexed type was delayed more 0.016 sec than extended type. In displacement of COG there was significant difference in level of p<.05 showing longer mean 6.13 cm in case of flexed type than extended type in displacement of COG during all phase and too significant difference in level of p<.01 showing longer mean 4.4 cm in case of flexed type than extended type in displacement of COG in follow through phase. In velocity of COG there was significant difference in level of p<.001 showing higher mean 15.53cm/s in case of flexed type than extended type in velocity of COG(Y direction) during targeting phase and peak velocity(Y) was more fast 8.74 cm/s in extended type than flexed type. In velocity of leading leg in forward direction(Y) there was significant difference in level of p<.05 showing higher thigh mean value in case of flexed type than extended type but showing higher foot mean value in extended type at level of p<.001 than flexed type in velocity of COG(Y direction). In velocity of leading leg in vertical direction(Z) there was no significant difference in the second & third phase in case of vertical velocity level, but momentum transferred efficiently form proximal to distal endpoint. In front-back & right-left orientation angle of trunk there was possibility of more stable Jigeo-Cha-Gi in extended than flexed type by decreasing in right-left orientation angle of trunk. In relative angle of lower leg(hip, knee, ankle) there was significant difference in level of p<.001 showing longer mean 32.74 deg. in case of flexed type than extended type in hip joint during the second phase but maintained insufficient extended knee of mean 168 deg. in targeting phase.

인간공학적 방법을 이용한 사이클 선수의 경기력 평가 (우수선수의 경기력 벤치마킹을 중심으로...) (Cyclist's Performance Evaluation Using Ergonomic Method (Focus to Benchmarking Elite Cyclist's Performance))

  • 하종규;장영관;기재석
    • 대한안전경영과학회지
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    • 제12권1호
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    • pp.51-57
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    • 2010
  • Cycling that transform human energy into mechanical energy is one of the man-machine systems out of sports fields. Benchmarking means "improving ourselves by learning from others', therefore benchmarking toward dominant cyclist is necessary on field. The goals of this study were to provide important factors on multi-disciplines (kinematics, physiology, power, psychology) for a tailored-training program that is suitable to individual characteristics. Two cyclists participated in this study and gave consent to the experimental procedure. One was dominant cyclist (years: 21 yrs, height: 177 cm, mass: 70 kg), and the other was non-dominant cyclist (years: 21, height: 176, mass: 70). Kinematic data were recorded using six infrared cameras (240Hz) and QTM (software). Physiological data (VO2max, AT) were acquired according to graded exercising test with cycle ergometer and power with Wingate test used by Bar-Or et. al (1977) and to evaluate muscle function with Cybex. Psychological data were collected with competitive state anxiety inventory (CSAI-2) that was devised by Martens et. al (1990) and athletes' self-management questionnaire (ASMQ) of Huh (2003). It appears that the dominant's CV of ankle joint angle was higher than non-dominant's CV and dominant's pedaling pattern was consistent in biomechanics domain, which the dominant's values for all factors ware higher than non-dominant's values in physical, and physiological domain, and their values between cognitive anxiety and somatic anxiety were contrary to each other in psychology. Further research on multi-disciplines may lead to the development of tailored-optimal training programs applicable with key factors to enhance athletic performance by means of research including athlete, coach and parents.

기립균형시 슬관절 전략이 안정성 한계에 미치는 영향 (The Effect of Knee Strategy on Limits of Stability in Standing Balance)

  • 권혁철;정동훈
    • 한국전문물리치료학회지
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    • 제6권3호
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    • pp.11-21
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    • 1999
  • Human balance is maintained through a complex process involving sensory detection of body motions, integration of sensorimotor information within the central nervous system, and execution of appropriate musculoskeletal responses. The basic task of balance is to position the body center of gravity (COG) over some portion of the support base. When the COG extends beyond the base of support, the person has exceeded the limits of stability (LOS). At this point, a step or stumble is required to prevent a fall. Automatic postural responses operate to keep the COG over the base of support. They are a set of functionally organized, long-loop responses that act to keep the body in a state of equilibrium. There are four commonly identified automatic postural responses, or strategies. These are ankle strategy, hip strategy, suspensory (knee) strategy, and stepping strategy. Thus, the purpose of this study was to evaluate the LOS using various knee strategies. Forty subjects participated in this study. The subjects were comprised of 20 males and 20 females who were without neurologic, orthopaedic or balance performance impairments. The LOS was measured with a Balance Performance Monitor (BPM) Dataprint Software Version 5.3. The results of this study were as follows: 1) Knee joint angle which is to increase stability of standing balance with using knee strategy was at mid-range. 2) There were statistically significant differences in anteroposterior LOSs according to the knee strategy. 3) There were no statistically significant differences in mediolateral LOSs according to the knee strategy. 4) There were statistically significant differences of anteroposterior LOSs with using knee strategy according to gender. 5) There were no statistically significant differences in mediolateral LOSs with using knee strategy according to gender.

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드롭랜딩 시 backpack 중량 변화에 따른 충격 흡수 기전 (Shock Attenuation Mechanism in Drop Landing According to the Backpack Weight Changes)

  • 최치선;남기정;신인식;서정석;은선덕;김석범
    • 한국운동역학회지
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    • 제16권2호
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    • pp.25-35
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    • 2006
  • The purpose of this study was to investigate the shock attenuation mechanisms while varying the loads in a backpack during drop landing. Ten subjects (age: $22.8{\pm}3.6$, height: $173.5{\pm}4.3$, weight: $70.4{\pm}5.2$) performed drop landing under five varying loads (0, 5kg. 10kg. 20kg. 30kg). By employing two cameras (Sony VX2100) the following kinematic variables (phase time, joint rotational angle and velocity of ankle, knee and hip) were calculated by applying 2D motion analysis. Additional data, i.e. max vertical ground force (VGRF) and acceleration, was acquired by using two AMTI Force plates and a Noraxon Inline Accelerometer Sensor. Through analysing the power spectrum density (PSD), drop landing patterns were classified into four groups and each group was discovered to have a different shock attenuation mechanism. The first pattern that appeared at landing was that the right leg absorbed most of the shock attenuation. The second pattern to appear was that subject quickly transferred the load from the right leg to the left leg as quickly as possible. Thus, this illustrated that two shock attenuation mechanisms occurred during drop landing under varying load conditions.

압박성 신경병증에 의한 족하수(足下垂) 환자(患者) 1례(例)에 대한 임상적(臨床的) 고찰(考察) (A Clinical Case Study of Common Peroneal Nerve Palsy(Foot Drop) Following Entrapment Neuropathy)

  • 신정철;이동현;위통순;김선종;최원확;류충열;윤여충;조명래;채우석;나건호
    • Journal of Acupuncture Research
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    • 제22권4호
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    • pp.1-12
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    • 2005
  • Objectives : The Purpose of this study is to report in patient with common peroneal nerve palsy, who improved by oriental medical treatament. Methods : We Checked the temperature of a leg by Digital Infrared Thermal Imaging(DITI) at intervals of 10 days, angle of active dorsiflexion and range of active motion for estimating the improvement of symptoms. We used the Visual Analogue Scale(VAS) for estimating the degree of pain, too. Results : After 4 weeks treatment, the movement and power of ankle joint improved to nearly normal range. The degree of active dorsiflexion of the ankle increased from $-40^{\circ}\;to\;15^{\circ}$ and range of active motion increased from Gr III to Gr I. The difference of temperature between the both legs decreased remarkably. Conclusion : In this case we experienced improvement of symptoms by conservative oriental medical therapy, e.g acupuncture stimulation, herbal medication, physical therapy. It should be needed further investigation on common peroneal nerve palsy and its symptoms in order to set up a reasonable standard about a surgical operation.

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계단 하강 시 성별차이와 중량 변화가 하지역학에 미치는 영향 (Effect of gender difference and change of load on lower extremity kinetics in step descent)

  • 현승현
    • 한국인터넷방송통신학회논문지
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    • 제23권1호
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    • pp.109-116
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    • 2023
  • 이 연구의 목적은 계단 내리기 시 성별과 중량차이가 하지역학에 미치는 영향을 분석하는 것이다. 건강한 남성 10 명과 여성 10 명이 참여하였다. 계단 내리기 동작은 중량 변화(체중의 0%, 10%, 20%, 30%)에 따라 영상분석법과 지면반력 시스템을 이용해 분석하였다. 골반의 최대 합성속도에서 성별(남성>여성)과 중량변화(30%, 20%, 10%> 0%)에 따라 서로 차이가 있는 것으로 나타났으며, 성별과 중량 간 상호작용이 나타났다(중량>성별). 계단 내리기 동안 성별의 주효과는 초기 접촉 단계에서 남성보다 여성이 더 감소된 다리길이를 보였다. 또한, 남성보다 여성에게서 더 굴곡된 엉덩, 무릎관절 각도와 발목관절 각도의 저측 굴곡형태가 나타났다. 운동역학 변인에서, 계단 내리기 시 성별의 주효과는 남성보다 여성이 더 증가된 좌우 지면반력과 다리강성을 보였다. 결론적으로 여성들이 계단 내리기 동안 엉덩 관절의 운동 범위와 함께 합성이동속도를 감소시켜 중량을 성공적으로 수용한다는 것을 발견하였다. 반면 남성들은 중량수용과 운동량을 제어하기 위해 좌우 및 수직지면반력, 그리고 다리강성을 더 증가시킨다.

주니어 역도 선수 인상 종목의 Dead-lift 동작 시 스탠스유형에 따른 운동학적 변인 비교분석 (The Comparative Analysis on the Kinematic Variables according to the Types of Stance in the Dead-lift of Snatch Events of Junior Weight Lifters)

  • 정남주;김재필
    • 한국운동역학회지
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    • 제18권4호
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    • pp.99-107
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    • 2008
  • 본 연구는 주니어 역도 선수 인상 종목의 주요 국면인 Deadlift 동작 시 스탠스 유형에 따른 운동학적 변인을 비교 분석하여 선수들의 경기력 향상과 훈련 시 기초자료를 제공하기 위하여 실시하였다. 본 연구에서 8자형은 11자형에 비해 바벨과 신체의 발란스에 적합한 소요시간을 보였고 바벨을 끌어올리는데 요구되는 인체중심의 전 후, 좌 우이동범위를 작게하여 인체의 안정성을 유도하였다. 또한 8자형의 인체중심속도와 바벨의 속도는 E3(바가 고관절에 도달할 때)를 지나면서 상방향으로 바를 끌어올리는데 유리한 조건의 큰 속도를 발휘하는 것으로 나타났다. 그리고 몸통과 고관절 무릎, 발목 및 스탠스 각도에서 8자형은 11자형에 비해 인체의 안정성을 유지하면서 순간적인 힘을 발휘하는데 유리한 조건을 갖추고 있는 것으로 나타났다.