The purpose of this study was to investigate the kinematic characteristics during rising from a chair. Six stroke patients and three healthy subjects participated in the study. Three dimensional kinematic analysis was used to get the duration, center of mass, and lower extremity angle. The stroke patients performed longer duration(0.28sec) than the healthy subjects in rising from a chair. The stroke subjects stayed longer time than the healthy subjects did in phase 2(From the initiation of knee extension to the reversal of trunk flexion to trunk extension)(t=-1.01, p=.04). The healthy subjects showed longer time than the stroke subjects in phase 3(from the reversal of trunk motion to extension to full standing position). The healthy subjects displayed larger value of center of mass in anterioposterior direction than stroke subjects(t=5.79, p=0.05). The center of mass in the mediolateral direction did not change during the completion of movement. However, the center of mass in the anterioposterior direction began to increase throughout the completion of movement. The center of mass in the vertical direction increased extensively in phase 3. The significant difference was not found in the maximum dorsiflexion in ankle, the initiation angle of knee, and the minimum angle of hip between stroke and healthy subjects. Even though statistical results did not show any significant angle difference in the lower extremity, the patterns of the change in the knee and hip angle during rising from a chair were different. The stroke subjects showed smaller angle of knee extension than the healthy subjects in phase 3. The stroke subjects flexed their trunk more than the healthy subjects in phase 2.
Purpose: Ankle fusion that is operated on severe ankle arthritis has its weakness in that normal walking is impossible, even though the result is pretty good. As a alternative choice, total ankle replacement pursues the longer survivorship with material improvement. However, it is not yet known how much range of motion is possible after the replacement, or how it has changed overtime. Therefore, we need an analyzation for that. Materials and Methods: A retrospective review of sixty-seven patients undergoing STAR total ankle replacement at our institution between 1998 and 2002 was conducted. Of those, twenty-six (39%) had complete sets of full dorsiflexion and plantar flexion lateral radiographs both between "immediate" postop and at a minimum of 2-years follow-up and no revision procedure during that time. The mean age of these patients was 63.2 years when the surgery was done; the etiology of arthrosis was 21(81%) post-traumatic/degenerative, 4 rheumatoid and 1 psoriatic. Results: Average "immediate" ankle range of motion was $15.9^{\circ}$, and total foot (non-ankle) motion was $20.6^{\circ}$. At one, two, and three years the average ankle and total foot ranges of motion were $17.4^{\circ}$, $17.6^{\circ}$, $15.6^{\circ}$ and $21.0^{\circ}$, $22.0^{\circ}$, $21.2^{\circ}$ respectively. Statistically there was no significant difference between "immediate" postop motion and one to three years postop (all p>0.05). Conclusion: The range of motion after the STAR total ankle replacement is maintained from the "immediate" postoperative range of motion, but not increased, in the 1-3 year post replacement period.
Journal of Dental Rehabilitation and Applied Science
/
v.17
no.4
/
pp.231-244
/
2001
This study was conducted to observe the effect on appendage muscle strength according to increase in occlusal vertical dimension. For this study, ten males with a mean age of 21 were selected. The subjects had a complete or almost complete set of natural teeth and reported no subjected symptoms of pain or dysfunction in the masticatory system. The tested occlusal splints were made at the position of increased occlusal vertical dimension of 2mm, 3.5mm, and 5mm from the ICP. Before and after wearing occlusal splints, the appendage muscle strength were tested by CybexII Dynamometer in each subject. The results were as follows : 1. When occlusal vertical dimension was increased, most of mean muscular strength values were increased except for those of supination and pronation of forearm at the position of 5mm increased occlusal vertical dimension. 2. The statistical analyses demonstrated that the increased occlusal vertical dimension position to be significantly stronger than intercuspal position for the muscle strength of the flexion and extension of hip, supination of forearm, external and internal rotation of knee, dorsiflexion and plantarflexion of ankle (p<0.05). 3. At the position of 3.5mm increased vertical dimension displayed the highest mean muscluar strength value than other positions. 4. Statistically demonstrated values, except for supination of forearm, internal rotation of shoulder, were related to lower appendage. Therefore splint was more effective on lower appendage than upper appendage to make muscle strength increased. 5. The mean increased rate of muscular strength tested on knee(57%), ankle(42%), and wrist(20%) were higher than hip(31%), elbow(14%), and shoulder(17%).
Choi, Jong Woo;Kim, Sei Joo;Koh, Seong Beom;Yoon, Joon Shik
Annals of Clinical Neurophysiology
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v.6
no.1
/
pp.35-38
/
2004
Background: The purpose of this study is to evaluate the difference between the hemiplegic patients and controls with the newly developed three demensional electrogoniometer gait analysis program. Methods: The basic kinematic data of hip, knee and ankle joints on the sagittal plane and of temporospatial gait parameters were obtained from 25 hemiplegic patients and 25 healthy adults with three-dimensional electrogoniometer Domotion$^{(R)}$ Results: Significant difference were observed between patients and controls in kinematic parameters. Mean maximal hip flexion of healthy adults and hemiplegic limb of patient was $32.89{\pm}1.8^{\circ}$ and $18.24{\pm}4.8^{\circ}$, maximal knee flexion was $50.32{\pm}2.4^{\circ}$ and $34.98{\pm}10.4^{\circ}$, maximal ankle dorsiflexion was $5.34{\pm}1.2^{\circ}$ and $1.22{\pm}2.8^{\circ}$, and maximal ankle plantar flexion was $15.63{\pm}2.0^{\circ}$ and $8.46{\pm}3.2^{\circ}$(p<0.05). Mean maximal hip flexion of healthy adults and unaffected limb of hemiplegic patient was $32.89{\pm}1.8^{\circ}$ and $28.36{\pm}6.6^{\circ}$, and maximal ankle plantar flexion was $15.63{\pm}2.0^{\circ}$ and $8.62{\pm}3.7^{\circ}$, respectively(p<0.05). Conclusions: The gait parameters of hemiplegic patients showed significant differences as compared with normal gait parameters with the using of three dimensional gait analysis with electrogoniometer.
The purpose of this study was to analyze the kinematic variables of ankle joints and EMG signal of the lower limbs muscle activity for the different walking speed. The subjects were 6 males of twenties. It was classified into three different walking speed-0.75m/s, 1.25m/s, 1.75m/s. The walking performances were filmed by high speed video camera and EMG signal was gained by ME3000P8 Measurement Unit. Tibialis anterior(TA), Gastrocnemius medial head(GM), Gastrocnemius lateral head(GL), Ssoleus(SO) were selected for the dorsiflexion and plantarflexion of the ankle joint. The result of this study were as follows: 1. In the gait cycle, The time parameters for the phases were showed significant difference without the terminal stance phase and terminal swing phase for the different walking speed. 2. The angle of ankle joint was no significant difference for each time point and MDF, MPF but increasing walking speed the angle had the increasing pattern slightly. 3. The angular velocity of ankle joint was showed the significant difference for LHC, RTO, RKC, LHU, MPF and MDF point along the walking speed. 4. TA was showed about 2-3 times muscle activity at the 1.75m/s than 1.25m/s in some phases. And it was showed the similar muscle activity between the 0.75m/s and 1.25m/s but, showed a little much muscle activity in the 0.75m/s. GM was showed about 2-3 times muscle activity in the 1.75m/s than 1.25m/s, and even much muscle activity at the 0.75m/s than 1.25m/s in some phases. GL was showed increasing pattern of muscle activity specially in the initial swing phase as the walking speed increased. SO was showed about 3 times muscle activity in the 1.75m/s than 1.25m/s during the plantarflexion of ankle joint. It was showed the similar muscle activity between the 0.75m/s and 1.25m/s but, showed a little much muscle activity in the 1.25m/s.
The purpose of this study was to examine the effect of step length on the joint moment. The subjects were 4 undergraduate and graduate students in their 20s with normal legs. The subjects were individually tested by the running timer at the walking speed of 0.67m/s, 134m/s, and 2.46m/s. The step length was regulated to -10% of normal, normal and +10% of normal step length using foot print. The walking performances of each subjects were filmed using a high speed video camera. The raw data were analyzed by LabVIEW Graphical Program and these data were analyzed by ANOVAs and Scheffe. The results of this study were as follows: The maximum dorsiflexion moment of the ankle joint increased as the step length increased only at the fast walking speed. Although there wasn't significant difference shown in the plantar flexion moment, regular pattern in the plantar flexion moment which increased as the step length increased was found. The first maximum extension moment of the knee joint increased only at the normal walking speed, but there appeared no significant difference in the maximum flexion and second extension moment. The maximum extension moment of the hip joint increased at the normal and fast walking speed. Although there wasn't significant difference, regular pattern in flexion moment which increased as the step length increased was found.
Purpose: The purpose of this study was to examine effect of Tai-Chi exercise program on joint flexibility for osteoarthritis patients. To evaluate the effects, quasi-experimental study was used for pre and post test with a nonequivalent control group. Method: Fifty-tow subjects participated in the experiment(twenty-seven for experimental group and twenty-five for control group) and they were from two different senior citizen centers in J city. The experiment period was from April 2002 through August 2002. The experiment group took part in Tai-Chi exercise program for eighteen weeks(three times a week for four weeks and five times a week for fourteen week). The exercise was performed for 50 minutes at every time (15 minutes for warm-up, 30 minutes for Tai-Chi exercise, and 5 minutes for ending). In order to pursue study purpose, the SPSS/WIN 8.0 program was chosen for the statistical analysis; ANCOVA was employed in examining test hypothesis; t-test and $x^2$-test were used to examine homogeneity between experimental and control group. Result: The study results were as follows :Score of vertebral joint flexibility increased significantly after of Tai-Chi exercise program. Score of wrist joint extension increased significantly after of Tai-Chi exercise program. Score of wrist joint flexion increased significantly after of Tai-Chi exercise program. Score of elbow joint extension increased significantly after of Tai-Chi exercise program. Score of elbow joint flexion increased significantly after of Tai-Chi exercise program. There was a slight increase of knee joint extension in the Tai-Chi exercise group compared to control group, but without statistical significance. Score of knee joint flexion increased significantly after of Tai-Chi exercise program. Score of ankle plantar flexion increased significantly after of Tai-Chi exercise program. Score of ankle dorsiflexion increased significantly after of Tai-Chi exercise program. Conclusion: As shown in the results, Tai-Chi exercise program can be effective nursing intervention for osteoarthritis patient to improve joint flexibility.
The purpose of this study was to investigate changes in elastic properties of tendon structure of human ankle dorsiflexor following eccentric exercise. Six male subjects(age: $27.3{\pm}2.0$ years, height: $180.3{\pm}1.4$ cm, weight: $82.6{\pm}5.3$ kg) and three female subjects(age: $26.7{\pm}2.9$ years, height: $170.0{\pm}4.2$ cm, weight: $66.6{\pm}1.4$ kg) performed a single bout eccentric exercise consisting of 120 repetitions of maximum eccentric contractions. Prior to and following the eccentric exercise, isometric ankle dorsiflexion strength along with longitudinal ultrasound image of the tibialis anterior(TA) were collected. Muscle strength decreased about 30% after eccentric exercise. From the muscle strength vs. aponeurosis elongation curve, we obtained an index of stiffness. Stiffness of deep aponeurosis of the TA was assessed and found to be decreased from $87.4{\pm}33.56$ N/mm to $73.1{\pm}23.52$ N/mm. The results of this study suggest that decrease in stiffness of the TA aponeurosis following eccentric exercise might have significant implications to functions of the muscle-tendon complex and the involved joint motion and provide better understanding of eccentric exercise in the fields of training and rehabilitation.
The Journal of the Korean bone and joint tumor society
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v.10
no.1
/
pp.22-28
/
2004
We retrospectively reviewed the cases of peroneal nerve palsy in seven patients after musculoskeletal tumor resection. Their mean age was 38 years. Three had osteosarcoma in proximal fibula, 2 had chondrosarcoma in proximal fibula and calf and 2 had malignant fibrous histio cytoma in calf. Four of 7 patients had been managed using active dorsiflexion brace. Three patients who underwent tibialis posterior transfer and could walk without brace were able to discontinue the use of the orthosis. Peroneal nerve palsy after wide excision of tumor including peroneal nerve can not resolve spontaneously and results in severe functional disability. To improve the gait function, active surgical treatment should be considered.
Purpose: We assessed the clinical results of modified Brostrom procedure as a revision method after failure of a primary reconstruction. Materials and Methods: This is a retrospective study of seven patients treated with Modified Brostrom procedure after failed lateral ankle ligament reconstruction between 1996 and 2002. Instability symptom developed average 4.7 month after the initial reconstruction surgery at other clinics. All patients had significant functional impairment before surgery and not responded to conservative protocols. Modified Brostrom procedure was applied to all patients. Results: The average follow up was 51 months (18 to 84). Seven of eight patients had clinical stability following revision reconstruction, six patients (75%) returned to their previous functional level. American Orthopaedic Foot and Ankle Society ankle-hindfoot scores averaged 87.5. There is no difference in active or passive range of motion of plantar flexion or dorsiflexion when compared to the contralateral ankle. However, three patients were noted to have lost some degree of inversion when compated to contralateral ankle. Two patients had osteochondral lesion and multiple spurs and had pain around the ankle that prevented their full recovery. One patient complained of persistent pain which was considered complex regional pain syndrome. Conclusion: Though the outcome of the Modified Brostrom procedure as a method of revision surgery was less satisfactory compared to the results of primary ankle reconstruction, it would be an appropriate option when concomitant abnormalities were not accompanying.
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