Malignant peripheral nerve sheath tumor (MPNST) is a very rare type of sarcoma, with an incidence of 0.001%. MPNST has a 5-year survival rate near 80%, so successful reconstruction techniques are important to ensure the patient's quality of life. Sarcoma of the forearm is known for its poor prognosis, which leads to wider excision, making reconstruction even more challenging due to the unique anatomical structure and delicate function of the forearm. A 44-year-old male presented with a large mass that had two aspects, measuring $9{\times}6cm$ and $7{\times}5cm$, on the dorsal aspect of the right forearm. The extensor compartment muscles (EDM, EDC, EIP, EPB, EPL, ECRB, ECRL, APL) and invaded radius were resected with the mass. Tendon transfer of the entire extensor compartment with skin defect coverage using a $24{\times}8cm$ anterolateral thigh (ALT) perforator free flap was performed. The patient was discharged after 18 days without wound complications, and has not complained of discomfort during supination, pronation, or wrist extension/flexion through 3 years of follow-up. To our knowledge, this is the first report of successful reconstruction of the entire forearm extensor compartment with ALT free flap coverage after resection of MPNST.
The purpose of this study was to determine the effects of elbow joint angle on mechanical properties, as represented by ultimate load, failure strain and elastic modulus, of bone-tendon specimens of common extensor tendon of the humeral epicondyle. Eight pairs of specimens were equally divided into two groups of 8 each, which selected arbitrarily from left or right side of each pair, positioned at 45$^{\circ}$ and 90$^{\circ}$ of elbow flexion and subjected to tension to failure in the physiological direction of the common extensor tendon. For comparison of the differences in the failure and elastic modulus between tendon and the bone-junction, data for both were evaluated individually. Significant reduction in ultimate load of bone-tendon specimens was shown to occur at 45$^{\circ}$. The values obtained from the bone-tendon junctions with regard to the failure strain were significant higher than those from tendon in both loading directions, but the largest failure strain at the bone-tendon junction was found at 45$^{\circ}$. The elastic modulus was found to decrease significantly at the bone-tendon junction when the loading direction switched from 90$^{\circ}$ to 45$^{\circ}$. Histological observation, after mechanical tensile tests, in both loading directions showed that failure occurred at the interface between tendon and uncalcified fibrocartilage in the thinnest fibrocartilage zone of the bone-tendon junction. We concluded that differences in measured mechanical properties are a consequence of varying the loading direction of the tendon across the bone-tendon specimen.
Purpose: The purpose of this study was to investigate the effects of a rehabilitation nursing program(RNP) for persons with disabilities. Method: a quasi-experimental pretest and post test study was used to examine the changes of patient's muscle strength, flexibility, self efficacy and health related quality of life at the completion of an 8-week education and physical exercise with a Thera-Band and Exercise Ball course. The subjects consisted of 40 adults who were disabled. Twenty-two experimental and 18 control subjects completed pre and post-test measures. Outcome variables were flexibility, hand grip, elbow flexor and extensor, knee flexor and extensor, self efficacy and quality of life. Independent t-test and ANCOVA were used to examine group differences by using SPSS 12.0 Result: Mean comparisons of the change scores revealed that the experimental group increased significantly in knee extremity flexor(p=0.035), extensor(p=0.039), flexibility(p=0.008), self efficacy(p=0.000), and quality of life(p=0.000). No significant group differences were found in each patient's hand grip, elbow flexor and extensor. Conclusion: RNP can improve lower extremity flexibility, muscle strength, self efficacy and health related quality of life in people with disabilities. The intervention to tailor exercise and education to the unique needs of the disability was suggested for further study.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.9
no.1
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pp.29-38
/
2003
The purpose of this study was to investigate relationship of lumbar extensor muscle power & spinal column curve for old female patients with LDK(Lumbar degenerative kyphosis). Subjects were composed of 37 old female with LDK. The subjects were tested in their spinal segment movement and spinal column curve with Spinal-$Mouse^{\leq}$ in $1^{st}$ loaded test and $2^{nd}$ loaded test and then tested lumbar extensor muscle power with $Medx^{\leq}$ lumbar extension machine. The results of this study, were as follow; There were statistically significant difference $1^{st}$ loaded test and $2^{nd}$ loaded test in upright position increase spinal column forwardly(p<0.01) and decrease lumbar lordosis angle(p<0.01), but no statistically significant difference $1^{st}$ loaded test and $2^{nd}$ loaded test thoracic and hip & sacrum curve angle. Their lumbar extensor muscle poser is very weakness, 61.4% of normal people.
Purpose: This study examined the effects of the directions of neck rotation position on the muscle activity and strength of the elbow flexor and extensor muscle. Methods: Forty-one healthy adults participated in this study. The subjects were asked to their elbow 90° flexion in three different neck rotations (neutral, ipsilateral, and contralateral) in the sitting position. The muscle activities of the biceps and triceps brachii muscle were measured using surface electromyography. And the muscle strength of the elbow flexor was measured using dynamometer. One way repeated measures ANOVA was used to compare the muscle activity and strength of the elbow flexor and extensor depending on the different neck turning directions. Results: There were significant differences between contralateral neck rotation and ipsilateral neck rotation, contralateral neck rotation and neutral position. But, there was no significant difference in the triceps brachii muscle activity in comparison with the neck rotation. There were significant differences between contralateral neck rotation and ipsilateral neck rotation, contralateral neck rotation and neutral position. Conclusion: To summarize this study, the elbow flexor and extensor muscle activity and strength was highest in the contralateral neck rotation position. In other words, it was possible to confirm the effect of Asymmetrical Tonic Neck Reflex in healthy adults whose primitive reflexes were inhibition, and head and neck positions should be considered during clinical evaluation and treatment.
Seong-Min Hong;Eun Yoo Lee;Jinho Park;Jiyoun Kim;Sun Yeou Kim
Biomolecules & Therapeutics
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v.31
no.5
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pp.573-582
/
2023
Muscle atrophy is characterized by the loss of muscle function. Many efforts are being made to prevent muscle atrophy, and exercise is an important alternative. Methylglyoxal is a well-known causative agent of metabolic diseases and diabetic complications. This study aimed to evaluate whether methylglyoxal induces muscle atrophy and to evaluate the ameliorative effect of moderate-intensity aerobic exercise in a methylglyoxal-induced muscle atrophy animal model. Each mouse was randomly divided into three groups: control, methylglyoxal-treated, and methylglyoxal-treated within aerobic exercise. In the exercise group, each mouse was trained on a treadmill for 2 weeks. On the last day, all groups were evaluated for several atrophic behaviors and skeletal muscles, including the soleus, plantaris, gastrocnemius, and extensor digitorum longus were analyzed. In the exercise group, muscle mass was restored, causing in attenuation of muscle atrophy. The gastrocnemius and extensor digitorum longus muscles showed improved fiber cross-sectional area and reduced myofibrils. Further, they produced regulated atrophy-related proteins (i.e., muscle atrophy F-box, muscle RING-finger protein-1, and myosin heavy chain), indicating that aerobic exercise stimulated their muscle sensitivity to reverse skeletal muscle atrophy. In conclusion, shortness of the gastrocnemius caused by methylglyoxal may induce the dynamic imbalance of skeletal muscle atrophy, thus methylglyoxal may be a key target for treating skeletal muscle atrophy. To this end, aerobic exercise may be a powerful tool for regulating methylglyoxal-induced skeletal muscle atrophy.
Purpose: This study was conducted to verify the effect of applying a pressure biofeedback unit on walking ability and knee joint function while performing knee joint extensor strengthening exercises using resistance exercise equipment in total knee replacement (TKR) patients. Methods: This study was conducted on twelve patients receiving rehabilitation treatment after being admitted to a rehabilitation hospital post-TKR. Of these, six were allocated to a feedback group with a pressure biofeedback unit, and the other 6 were allocated to a control group without a pressure biofeedback unit. The subjects performed an exercise program for 45 minutes per session, five times a week, for two weeks. Walking ability and knee joint function were evaluated and analyzed before and after exercise. Results: The feedback group showed significantly better improvements in walking speed, gait cycle, step length on the non-operation side, time on the foot on the operation side, K-WOMAC stiffness, and K-WOMAC function than the control group (p<0.05). Conclusion: When strengthening the knee joint extensor muscles using resistance exercise equipment in TKR patients, the provision of a pressure biofeedback unit was found to improve walking ability and knee joint function by inducing concentric-eccentric contraction of the knee joint extensor muscles. Therefore, the study shows that exercise based on the provision of a pressure biofeedback unit should be considered when strengthening knee joint extensor muscles to improve the walking ability and knee joint function of TKR patients in clinical practice.
Purpose: The purpose of this study was to evaluate the clinical results of the 4+5th extensor compartmental artery pedicled vascularized bone graft in advanced Lichtman stage III Kienbock's disease. Materials and Methods: Eight patients with advanced Lichtman stage III Kienbock's disease who underwent the 4+5th extensor compartmental artery pedicled vascularized bone graft and followed up more than 1 year were analyzed retrospectively. There were 3 men and 5 women. The mean age was 43.6 years old. Two patients were Lichtman stage IIIA and six patients were IIIB. The clinical outcomes were evaluated with radiocarpal joint pain, range of motion, grip strength, carpal-height ratio, radioscaphoid angle, return to daily living activity and/or work. The mean follow up period was 38.5 months (range from 12 to 86 months). Results: On last follow up, the pain was disappeared in 6 patients, and mild occasional pain was remained in 2 patients. Mean radiocarpal joint flexion and extension were 55 degrees and 60 degrees, 87% and 88% of the normal side, respectively. The carpal-height ratio was maintained or improved in 6 patients and slightly decreased in 2 patients. Radioscaphoid angle were improved or maintained in 7 patients. Mean grip strength was 67 lb, 93% of the normal side. All 8 patients returned to daily living activities and/or their previous works. Conclusion: The 4+5th extensor compartmental artery pedicled vascularized bone graft prevented the progression of disease and provided clinical improvement even in advanced Lichtman stage III Kienbock's disease.
Journal of the Korean Society of Physical Medicine
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v.15
no.1
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pp.95-104
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2020
PURPOSE: A prospective study was conducted to investigate the correlation between the inspiration ability, bone mineral density, lumbar muscle strength, and muscular endurance for the national softball athletes in the national training center. METHODS: The general characteristics of study subjects, inspiration ability, bone mineral density, muscle strength, and muscular endurance data were analyzed using descriptive statistics. In addition, the Pearson product moment correlation was performed to investigate the correlation between the inspiratory capacity, bone mineral density, muscle strength, and muscular endurance. RESULTS: The inspiration, flow rates, and volume were not correlated with the bone mass and bone mineral density. Inspiration and the flow rates and volume were not correlated with the bone mass and bone mineral density. On the other hand, inspiration was correlated with the Extensor muscles (r=.464, p=.006) at an angular velocity of 60°/s and the flexors (r=.463, p=.006) and extensor muscles (r=.615, p<.001) at an angular velocity of 180°/s. The flow rate was also correlated with the extensor muscles (r=.444, p=.009) at an angular velocity of 60°/s and with flexor muscles (r=.432, p=.011) and extensor muscles (r=.589, p<.001) at an angular velocity of 180°/s. Finally, the volume was correlated at the extensor muscles at an angular velocity of 180°/s (r=.534, p=.001). CONCLUSION: The correlation between the inspiratory capacity, bone mineral density, muscle strength, and muscular endurance of softball athletes did not correlate with the bone mass and bone density. On the other hand, the lumbar muscle strength increased with increasing inspiratory capacity.
Lee, June Bok;Lee, Sung Jun;Kim, In Gue;Kim, Sug Won
Archives of Plastic Surgery
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v.32
no.4
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pp.539-542
/
2005
Reconstructions of soft tissue defect of the posterior ankle including Achilles the tendon should take into account not only coverage but functional outcome. Various methods of tendon transfer and tendon graft have been reported as a single-stage procedure. With advances and refinements in microsurgical techniques, several free composite flaps including tendon, fascia, or nerve have been used in single-stage reconstructions of large defects in this area minimizing further damage to the traumatized leg. However, when free flap is not feasible for some reasons, this cannot be accomplished successfully. Here we present a patient with Achilles tendon and circumferential large soft tissue defect. Because of circulatory compromise of the lower extremity, free flap reconstruction could not be applied. Instead, cross-leg composite flap of the dorsalis pedis flap including the extensor hallucis brevis musle and tendon, and tendon strips of the Second, third and fourth extensor digitorum logus were employed, Functional reconstruction of the tendon and resurfacing were obtained at the same time. The flap was detached 3 weeks postoperatively, and the transplanted flap has survived without any complications. By 3 months after surgery, full weight bearing, tip-toe standing and even walking without crutch assistance was possible. When functional reconstruction with the free flap is unattainable in the large defect of the posterior ankle including the Achilles tendon, cross-leg composite island flap of dorsalis pedis flap and tendon strips of the extensor digitorum longus tendon is a viable alternative.
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