• 재활복지공학회논문지
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• 제10권4호
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• pp.305-313
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• 2016

두 발을 번갈아 옮기며 몸을 앞으로 움직이는 단순한 동작의 반복으로 보이는 보행이란 과정은 실제 인체 내의 대부분의 근육 및 인대, 뼈가 연관되어 이루어지는 복잡한 행동이다. 신체 일부가 소실된 하퇴 절단자의 경우 생체조직이 온전히 보전되어 있는 일반인과는 달리 남은 생체 부위와 의지의 공학적인 성능에만 의존해 보행을 해야 한다는 어려운 상황에 직면하게 된다. 따라서 하퇴절단자를 위한 하퇴의지는 우선 환자가 기본적인 보행이 가능케 함과 동시에 최대한 복잡한 지면 상태에 적응할 수 있도록 설계가 되어야 한다. 원활한 보행을 위해서는 배/저굴 방향의 발목의 회전이 매우 중요하고 고르지 못한 지면 상태를 극복하기 위해서는 내/외전 방향의 족부의 회전 기능이 요구된다. 최근 생체역학적인 연구를 접목한 다양한 하퇴의지가 개발되고 있으나, 이러한 고가의 고성능 하퇴의지의 경우 주로 활동성이 높은 하지절단 환자들에 초점이 맞춰져 있다. 본 연구에서는 하퇴의지 착용자의 대다수인 활동성이 낮은 K2 레벨의 환자들을 위한 하퇴의지를 개발했다. 기본적인 보행 능력 향상을 위해서 배/저굴 방향으로의 회전이 가능한 유압식 발목을 개발했고, 이를 통해서 배/저굴 방향으로 각각 $2.5^{\circ}$와 $4^{\circ}$의 회전이 가능함을 확인했다. 또한 수동 조절이 가능한 유압 노즐을 탑재해 환자 개개인에 적합한 발목 회전 저항력을 설정할 수 있도록 설계했다. 내/외전 방향으로의 족부의 회전이 가능하도록 이중고무 방식의 중간재를 삽입해 각각 $3.6^{\circ}$와 $4.1^{\circ}$의 회전이 가능하도록 설계되어 측경사나 작은 장애물들을 극복할 수 있도록 제작했다. 본 연구를 통해 개발된 하퇴의지는 K2 레벨의 하퇴절단자들이 일상생활 중에 겪게 되는 다양한 지면 환경을 극복하는데 도움을 줄 것이다.

• 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.

• 보존과학회지
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• 제38권4호
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• pp.277-288
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• 2022

'Eve 58-1', the subject of this study is a statue made of plaster and its structural stability was evaluated by utilizing the CAE program in order to prevent the risk of damage arising from impact and vibration that are generated during the packaging and transportation process given its material characteristics. CAE is an abbreviation for Computer Applied Engineering for realization by predicting changes at the time of application of virtual physical energy. It is applied by reflecting the physical property conditions and each boundary condition of plaster, and the digital images of the internal and external structure of the work were acquired through 3D scanning and CT analysis for interpretation by executing finite element modeling. When acceleration is applied to the work in the direction of its own weight, the left-right side and the front-rear side, it was possible to confirm a maximum displacement value of 15.24 mm in the head section of the front-rear side direction that has been tilted by approximately 27° from the Y-axis and the largest stress value of 12.46 MPa was at the left ankle section. The corresponding results confirmed that the left ankle section is the most vulnerable area and the section for which precautions need to be exercised and supplemented at the time of transporting the work by means of objective values.

• 대한통합의학회지
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• 제6권3호
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• pp.59-71
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• 2018

Purpose : The purpose of this study was to compare the effects of ankle balance training on unstable and stable surfaces to discover on which surface the proprioception, balance and muscle strength of obese middle aged women improves more. Method : Thirty obese middle-aged women were randomly recruited and divided into two groups (training on an unstable surface, training on a stable surface). The subjects in each group participated in the training for six weeks, three times per week for 30 minutes each session. Proprioception was measured using Dualer IQ digital inclinometer; sway length (SL) and sway area (SA) of center of pressure, and limit of stability (LOS) were measured for balance; muscle strength before and after the training was measured using manual muscle testing. Results : There were significant improvements in the subscales of the proprioception, balance and muscle strength in those who participated in ankle balance training on the unstable surface, and in those who participated on the stable surface. However, before and after the intervention, there were no differences between those who had the balance traning on the unstable surface and those who had the balance traning on the stable surface. Conclusion : Unstable and stable surface ankle balance training are both effective in improving the proprioception, balance and muscle strength of obese middle-aged woman.

• PNF and Movement
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• 제18권2호
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• pp.183-194
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• 2020

Purpose: Functional ankle instability (FAI) causes tension in the joints, ligaments, and tendons, and the impact on visual and vestibular organs leads to imbalance. This study compared the effects of a traditional balance training program to virtual reality training to improve FAI. Methods: Twenty-four participants with FAI (CAIT score < 24) were assigned to a virtual reality training group (n = 13) and a traditional balance training group (n = 11). Both groups pursued their respective training program for four weeks. After a ten-minute warm-up, participants completed a 30-minute training session, three times per week. The traditional balance training group underwent static and dynamic training using a balance board and a stability trainer pad while the virtual reality group underwent balance training using a virtual reality program. Biorescue was used to measure changes in the speed and length of center of pressure (COP) for single-leg stance pre- and post-training. Results: The speed and length of COP improved significantly in both groups after training as compared to before (p < 0.05). However, there were no significant differences in these outcomes between the virtual reality training group and the traditional balance training group (p>0.05). Conclusion: The study findings confirm the effectiveness of both virtual reality training and traditional balance training in reducing ankle instability, with no difference in treatment effects.

• 대한족부족관절학회지
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• 제6권2호
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• pp.201-207
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• 2002

Purpose: To present the clinical analysis of the results obtained in 38 cases of displaced intraarticular calcaneal fractures undergone combined percutaneous axial pin fixation of calcaneal body and minimal internal fixation using extensile lateral approach. Materials and Methods: From March 2000 to February 2002, thirty-eight displaced intraarticular fractures of the calcaneus in 35 patients were fixed with 3.5mm cannulated screws and percutaneous 2.5mm K-wires. The extensile lateral approach was used in all cases. The average follow-up period was 16 months. Clinical evaluation was assessed according to the Ankle-Hind Foot Scale of American Orthopedic Foot and Ankle Society. Results: The clinical results were graded as excellent in 8 cases(21%), good in 22 cases(58%), fair in 6 cases(16%), and poor in 2 cases(5%). Two cases of poor result were type IV of Sanders classification. The postoperative reduction status of the articular surface was analyzed by computed tomography in all cases and was found to be less 2mm of step off in 30 cases and between 2 and 4mm in 8 cases. Unsatisfactory results were correlated with severity of articular comminution and failure to obtain accurate reduction of the articular surface. Using early functional postoperative care, all fractures healed without secondary displacement except 1 case on an average of ten weeks. Two cases had superficial necrosis of the wound margins, however, secondary wound healing was uneventful and skin grafting was not needed. Conclusion: Combined minimal internal fixation and percutaneous pin fixation using extensile lateral approach is useful operative method of intraarticular calcaneal fractures because providing enough stability to permit functional aftercare and allowing excellent anatomical reduction. In addition, this method diminishes the risk of lateral soft tissue problems.

• 한국전문물리치료학회지
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• 제29권1호
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• pp.70-78
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• 2022

Background: Individuals with calf muscle shortening may have decreased dynamic balance. Objects: This study aimed to investigate the effect of mobilization with movement (MWM) and myofascial release (MFR) on kinematic changes in dynamic balance in individuals with calf muscle shortening. Methods: Thirteen participants were randomly assigned to the MWM or the mobilization with movement added myofascial release (MWM-MFR) group. The MWM group received treatment with only MWM, whereas the MWM-MFR group was treated with MWM and MFR. Pre- and post-intervention passive range of motion (PROM), maximum reaching lengths, and modified star excursion balance test (MSEBT) results were compared for all participants. Wilcoxon signed-rank test and Mann-Whitney U test were used for statistical analysis. Results: The results showed significant within-group differences in ankle PROM, but no significant between-group differences. The maximum reaching length in the MWM-MFR group in the posterolateral direction was significantly different before and after the intervention (p = 0.005). This group also showed significantly reduced ankle abduction in MSEBT during the posteromedial direction section 3 (p = 0.007) and posterolateral direction section 5 (p = 0.049) compared with the MWM group. Conclusion: Combined MWM and MFR intervention improves ankle stability in the coronal plane during the posteromedial and posterolateral forward movement in dynamic balance compared with only MWM in individuals with calf shortening.

• 대한족부족관절학회지
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• 제15권2호
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• pp.51-57
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• 2011

Pilon fractures involving distal tibia remain one of the most difficult therapeutic challenges that confront the orthopedic surgeons because of associated soft tissue injury is common. To introduce and describe the diagnosis, current treatment, results and complications of the pilon fractures. In initial assessment, the correct evaluation of the fracture type through radiographic checkup and examination of the soft tissue envelope is needed to decide appropriate treatment planning of pilon fractures. Even though Ruedi and Allgower reported 74% good and excellent results with primary open reduction and internal fixation, recently the second staged treatment of pilon fractures is preferred to orthopedic traumatologist because of the soft tissue problem is common after primary open reduction and internal fixation. The components of the first stage are focused primarily on stabilization of the soft tissue envelope. If fibula is fractured, fibular open reduction and internal fixation is integral part of initial management for reducing the majority of tibial deformities. Ankle-spanning temporary external fixator is used to restore limb alignment and displaced intraarticular fragments through ligamentotaxis and distraction. And the second stage, definitive open reduction and internal fixation of the tibial component, is undertaken when the soft tissue injury has resolved and no infection sign is seen on pin site of external fixator. The goals of definitive internal fixation should include absolute stability and interfragmentary compression of reduced articular segments, stable fixation of the articular segment to the tibial diaphysis, and restoration of coronal, transverse, and sagittal plane alignments. The location, rigidity, and kinds of the implants are based on each individual fractures. The conventional plate fixation has more advantages in anatomical reduction of intraarticular fractures than locking compression plate. But it has more complications as infection, delayed union and nonunion. The locking compression plate fixation provides greater stability and lesser wound problem than conventional implants. But the locking compression plate remains poorly defined for intraarticular fractures of the distal tibia. Active, active assisted, passive range of motion of the ankle is recommended when postoperative rehabilitation is started. Splinting with the foot in neutral is continued until suture is removed at the 2~3 weeks and weight bearing is delayed for approximately 12 weeks. The recognition of the soft tissue injury has evolved as a critical component of the management of pilon fractures. At this point, the second staged treatment of pilon fractures is good treatment option because of it is designed to promote recovery of the soft tissue envelope in first stage operation and get a good result in definitive reduction and stabilization of the articular surface and axial alignment in second stage operation.

• 한국응용과학기술학회지
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• 제37권3호
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• pp.509-515
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• 2020

본 연구의 목적은 딥 스쿼트 동작 시 발목 관절 유연성이 무릎 관절의 운동역학적 요인들간의 관련성을 분석하는데 있었다. 본 연구는 최근 1년간 하지 근골격계 병력이 없는 성인 남성 19명과 여성 8명이 연구대상자로 참여하였다. 딥 스쿼드 시 발목 관절 유연성과 하지 관절의 운동역학적 요인들과 상관관계를 검증하기 위해 pearson의 적률상관계수(pearson's correlation coefficient)를 이용하였고(SPSS 24.0, Armonk, NY, USA), 통계적으로 유의미한 상관성을 나타낸 변인들은 단순회기분석(simple regression analysis)을 실시하였으며, 유의 수준은 .05로 설정하였다. 본 연구를 통해 발목 관절 유연성과 무릎 관절의 압력을 결정하는 최대 관절모멘트와 관절반발력 요인들 간의 관련성을 확인할 수 있었다. 그러므로 근력 트레이닝 시 딥 스쿼트와 같은 무릎 관절에 많은 부하를 발생시킬 수 있는 운동을 적용할 때 개인에 신체적 특성 중 발목 관절의 유연성의 정도를 확인하는 것은 신체의 안정성과 무릎 관절의 상해 위험성을 감소시킬 수 있는 운동 강도를 설정하는데 도움이 될 수 있을 것으로 기대한다.

• 한국운동역학회지
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• 제15권2호
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• pp.11-20
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• 2005

This study has a purpose on contributing to apprehend safe and right way to stop to the inline skate beginners and to the instructors who teaches line skating on the basis for the result of the kinematical analysis on Heel brake stop movement of the inline skate, focusing on the displacement on COG, angle displacement of ankle joint, angle displacement of knee joint, angle displacement of hip joint, using a 3D image method by DLT. To achieve this goal, we analysed the kinematical factor of the 3 well-trained inline skating instructors and obtained the following results. 1. During the movement of heel-brake stop, when strong power was given to a stable and balanced stop and the lower limbs, if the physical centroid is lowered the stability increases, and if it is placed high from the base surface, as the stability decreases compared to the case of low physical centroid, we should make a stop by placing a physical centroid in the base surface and lowering the hight of physical centroid. 2. To make a stable and balanced stop and to provide a strong power to the lower limbs, it is advisable to make a stop by decreasing an angle displacement of ankle joint during a "down" movement. In case of the left ankle joint, in all events and phases the dorsiflexion angle showed a decrease. Nevertheless, in the case of the right ankle joint, the dorsiflexion angle shows an increase after a slight decrease. The dorsiflexion angle displacement of ankle joint can be diminished because of the brake pad of the rear axis frame of the right side inline skate by raising a toe, but cannot be more decreased if certain degree of an angle is made by a brake pad touching a ground surface. To provide a power to a brake pad, it is recommended to place a power by lowering a posture making the dorsiflexion angle of the left ankle joint relatively smaller than that of the right ankle. 3. To make a stable and balanced stop and to add a power to a brake pad, the power must be given to the lower limbs in lowering the hight of physical centroid. For this, it is recommended to make a down movement by decreasing the flexion angle of a knee joint and it is necessary to make a down movement by a regular decrease of the angle displacement of knee joint rather than a swift down movement in every event and phase. 4. The right angle displacement of hip joint is made by lowering vertically the hight of physical centroid as leaning slightly forward. If too narrow angle displacement of hip joint is made by leaning forward too much, the balance is lost during the stop by placing the center in front. To make a stable and balance stop and to place a strong power to the lower limbs, it is recommendable to make a narrow angle by lower the hip joint angle. However, excessive leaning of the upper body to make the angle too narrow, can cause an instable stop and loss of physical centroid. After this study, it is considered to assist the kinematical understanding during the heel brake stop movement of the inline skate, and, to present basic data in learning a method of stable and balanced stop for the inline skating beginners or for the inline skate instructors in the present situation of the complete absence of the study in inline skating.