• Tuberculosis and Respiratory Diseases
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• 제40권6호
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• pp.683-693
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• 1993

Background: During movement the major inputs to nervous system come from firstly the muscle and joint to maintain posture and motion and secondly the chemoreceptors and baroreceptors to adjust the cardiovascular and respiratory function. Their complex relationships are generally studied for many years but the direct relation between the joint and respiratory system is not studied thoroughly until now. So this experiment was performed to determine whether the natural movement of knee joint can cause the enhancement of respiratory function by observation of the changes of respiratory rate, phrenic nerve activity and inspiratory neuron activity during the stimulation of knee joint in cat anesthetized with $\alpha$-chloralose. Method: Twenty six male adult cats were used and the extracelluar recording using bipolar platinum electrode and carbon filament electrode was done to record the changes in the activities of phrenic nerve and inspiratory neuron movement of knee joint, injection of chemicals into the joint cavity and electrical stimulation of articular nerve were done. Results: The 60 Hz. could not but 120 Hz. flexion-extension movement of knee joint increased respiratory rate(R.R.), tidal neural activity(TNA) and minute neural activity(MNA). Intra-articular injection of lactate could not increase R.R. but significantly increase TNA and MNA which represented the enhanced respiratory function. Injection of potassium chloride showed similar effects with the case of lactate but the duration of effect was shorter. The electrical stimulation of medial articular nerve with IV strength which could activate only group I and II afferents showed increased TNA and MNA during stimulation but 20 V stimulation which could activate all the afferents increased all the respiratory parameters. The changes of inspiratory neuron activity by knee joint stimulation was similar to that of phrenic nerve. Conclusion: The respiratory center could be directly stimulated by the activation of group I and II articular afferents and it seemed that the magnitude of the respiratory center enhancement is proportional to the amount of sensory information from the knee joint. These facts might suggest that the respiratory function could be enhanced even by the normal movement of knee joint.

• Journal of rehabilitation welfare engineering & assistive technology
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• 제10권3호
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• pp.207-214
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• 2016

The aim of this study was to evaluate Influence on intra-limb coordination in individuals wearing knee brace during walking. Seven healthy male adults ($32.3{\pm}2.7$ years old, $175.2{\pm}3.8cm$, $76.2{\pm}8.7kg$) participated. They wore knee brace or didn't wear any knee brace and were asked to walk along a 10 m long walkway. Spatiotemporal parameters, angles of the lower limbs, and intra-limb continuous relative phase (CRP) were measured and calculated. No differences of spatiotemporal parameters were shown (all p > 0.05). There were no changes in the angle and its range of motion (ROM) in the hip for the subjects as wearing knee brace, while ROM ($65.5{\pm}3.7^{\circ}$ vs. $60.5{\pm}3.5^{\circ}$, p < 0.05) of the angle and maximum flexion angles (stance: $31.9{\pm}4.6$ vs. $25.6{\pm}5.5$, swing: $76.7{\pm}3.1$ vs. $68.9{\pm}3.4$, all p < 0.05) in the knee significantly decreased. No changes in ROM of angle in the ankle were shown, whereas maximum dorsiflexion decreased ($22.4{\pm}2.6$ vs. $19.2{\pm}2.1$, p < 0.05) and maximum plantarflexion increased ($9.5{\pm}3.0$ vs. $15.7{\pm}2.2$, p<0.05). There were no changes in most of CRP between joints. CRP between the hip and knee joints decreased ($93.0{\pm}7.8$ vs, $84.7{\pm}4.9$, p < 0.05). Most of CRP standard deviation increased (between the hip and ankle joint during swing: $25.1{\pm}6.7$ vs. $32.4{\pm}1.9$, between the knee and ankle joint during stance: $46.0{\pm}12.9$ vs. $80.1{\pm}31.1$, between the knee and ankle joint during swing: $34.5{\pm}4.1$ vs. $37.6{\pm}3.1$, all p < 0.05). These results indicated that wearing knee brace affected joint angle and intra-limb coordination, but less affected gait features.

• Clinics in Shoulder and Elbow
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• 제12권1호
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• pp.53-60
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• 2009

Purpose: Primary osteoarthritis on the elbow is the result of the growth of osteophytes and contracture of the capsule. It often causes disability on joint motion and pain while exercising. As arthroscopy has developed, the arthroscopic diagnosis and treatment of the elbow have recently become more generalized as well. Therefore, we like to report on arthroscopy for treating elbow arthritis and its results. Materials and Methods: This study includes 23 cases of elbow arthritis that were seen between 2005 June to 2007 June and these patients didn't response to conservative treatment. From this we excluded 18 cases that underwent arthroscopic surgery and among these 18 cases, 6 cases underwent ulnar nerve transfer. The average observation time was 21.3 months and the average age was 48.4 years (range: 22-66 years). The pre and post operative pain was evaluated with using the Visual Analogue Scale (VAS) and functional evaluation was done with using the Mayo elbow Performance Score (MEPS) with the range of joint motion. Results: The VAS score at the last follow up was significantly decreased from 3.4 to 1.9 compare to the preoperative score. The range of joint motion was improved by 25 (0-40) to 8.5 (0-20) in extension and 101.7 (80-140) to 125.2 (85-140) in flexion (p<0.05). The MEPS always showed significant improvement by showing an increase from 65.4 (40-85) to 87.9 (55-100). However, 3 cases showed a decreased range of motion after the operation. One case showed ulnar nerve symptoms after surgery. Conclusion: An arthroscopic procedure can treat the pathologic processes associated with arthritis of the elbow and it was safe and effective in this series.

• Clinics in Shoulder and Elbow
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• 제12권2호
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• pp.159-166
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• 2009

Purpose: We wanted to evaluate the surgical results of early mobilization after rigid fixation of small coronoid fracture using the tension band technique Materials and Methods: Eight cases of coronoid fracture were fixed with the tension band technique and using K-wire and wire through the medial approach. All the cases were Regan-Morrey type 2. According to O'Driscoll, they were classified as 5 cases of the tip type (subtype 2) and 3 cases of the anteromedial type (1 case of subtype 2, and 2 case of subtype 3). The associated collateral ligament injuries (6 cases) and radial head/neck fractures (4 cases) were managed simultaneously. After immobilization for 5~7 days, active ROM exercise with a fitted hinge brace started and continued till postoperative 6 weeks. The patients were assessed for pain, ROM and functional disability using the Mayo elbow performance score (MEPS) at an average of 11 months (range: 6~28 months). The ulnar nerve symptoms were also investigated. Results: We observed solid union in all the coronoid fractures without hardware failure. An average of 2.2 wires (range: 2~4) were used. The mean extension was $3^{\circ}$(range: $0^{\circ}\sim25^{\circ}$), the mean flexion was $137^{\circ}$(range: $130^{\circ}\sim140^{\circ}$), the mean pronation was $69^{\circ}$(range: $45^{\circ}\sim90^{\circ}$) and the mean supination was $78^{\circ}$(range: $45^{\circ}\sim90^{\circ}$). The mean MEPS was 96 (range: 65~100). Ulnar nerve symptoms occurred at postoperative one day and persisted in one patient with the terrible triad of taking radial head excision and residual medial instability. Conclusion: The tension band technique uses easily obtained, economic K-wires and the wire was strong enough to permit early elbow ROM exercise and the technique might improve the elbow function. It was especially useful for fixation of multiple small fragments.

• Journal of the Korea Academia-Industrial cooperation Society
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• 제16권9호
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• pp.6099-6111
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• 2015

This study was a systematic review and meta-analysis comparing the effects of aquatic exercise and land-based exercise in the treatment of knee osteoarthritis. 7 studies (n=449) met selection and exclusion criteria out of 287 potential studies obtained from the literature search via Ovid-Medline, Cochrane Library CENTRAL, CINAHL, RISS and KISS. The overall risk of bias of selected studies using SIGN (Scottish Intercollegiate Guidelines Network) checklist for randomized controlled trials (RCT) was regarded as low. As a result of meta analysis, Standardized Mean Difference (SMD) for pain was -0.26(95% CI -0.49, -0.03, p=0.03, $I^2=14%$), which implies that aquatic exercise groups had significant less pain than land-based exercise groups. On the other hand, there was no significant difference between aquatic exercise groups and land based exercise groups for flexion Range of Motion (ROM) (-0.12, 95% CI -0.51, 0.27, p=0.53, $I^2=0%$), extension ROM (-0.04, 95% CI -0.55, 0.48, p=0.89, $I^2=43%$), physical function (-0.12, 95% CI -0.44, 0.19, p=0.44, $I^2=0%$), Quality of Life (QOL) (-0.15, 95% CI -0.54, 0.24, p=0.46, $I^2=0%$). This study has some limitations due to few RCTs comparing aquatic exercise groups and land-based exercise groups in the treatment of knee osteoarthritis. Therefore, further RCTs should be conducted along with long-term outcomes.

• Journal of the Korean Orthopaedic Association
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• 제55권2호
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• pp.169-177
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• 2020

Purpose: To assess the effectiveness of mixed grafts in lumbar posterolateral fusion (PLF) by comparing the bone union rates of an autobone with a bone substitute mixed graft. Materials and Methods: The patients were followed-up for at least two years after PLF and divided into four groups according to the mixed graft retrospectively. Group I was 48 cases using a femoral head allobone. Group II was 38 cases using β-tricalcium phosphate. Group III was 92 cases using biphasic calcium phosphate. Group IV was 38 cases using biphasic calcium phosphate and autologous bone marrow. Union was evaluated by the work up simple radiographs after two years from PLF. Union was defined if the radiographs demonstrated a bilateral continuity in the fusion mass between the cephalad and caudal transverse processes with less than 2° of angular motion and no translation between the vertebrae at the level of fusion on the lateral flexion-extension radiographs. Results: According to simple radiographs after two years from PLF, the rate of union was highest in Group IV using local autobone, biphasic calcium phosphate and autologous bone marrow mixed graft. Conclusion: Biphasic calcium phosphate is an osteoconductive bone substitute that increases the bio-absorbability and mechanical strength. Autologous bone marrow has osteoinductive and osteogenic properties. These features can increase the rate of bone union. Therefore, a local autobone, biphasic calcium phosphate and autologous bone marrow mixed graft can be considered an effective bone graft substitute for lumbar PLF instead of an autobone graft.

• Journal of the Korean Orthopaedic Association
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• 제54권3호
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• pp.244-253
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• 2019

Purpose: Total hip arthroplasty was performed using a direct anterior approach (DAA) on an ordinary operation table and a short femoral stem. The clinical radiographic results were evaluated by a comparison with those performed using the modified hardinge (anterolateral approach, ALA) method. Materials and Methods: From January 2013 to November 2015, 102 patients who underwent total hip arthroplasty using DAA (DAA group) and the same number of patients using ALA (ALA group), both performed by a single surgeon, were compared and analyzed retrospectively. The operation time and amounts of bleeding were compared, and the improvement in post-operative pain, ambulatory capacity and functional recovery of the hip joint were checked. The location of insertion of the acetabular cup and femoral stem were evaluated radiologically, and the complications that occurred in the two groups were investigated. Results: The amount of bleeding was significantly smaller in the DAA group (p=0.018). Up to 3 weeks postoperatively, recovery of hip muscle strength was significantly higher in the DAA group (flexion/extension strength p=0.023, abduction strength p=0.031). The Harris hip score was significantly better in the DAA group for up to 3 months (p<0.001) and the Koval score showed significantly better results in the DAA group up to 6 weeks (p≤0.001). The visual analogue scale score improvement was significantly higher in the DAA group by day 7 (p=0.035). The inclination angle (p<0.001) and anteversion angle (p<0.001) of the acetabular cup were located in the safe zone of the DAA group more than in the ALA group, and there was no statistically significant difference in the position of the femur stem and leg length difference. During surgery, two cases of greater trochanter fracture occurred in the DAA group (p=0.155). Conclusion: The DAA performed in the ordinary operation table using a short femoral stem showed post-operative early functional recovery. Because a simple to use fluoroscope was used during surgery with an anatomical position familiar to the surgeon, it is considered to be useful for the insertion of implants into the desired position and for an approach that is useful for the prevention of leg length differences.

• 한국노년학
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• 제30권3호
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• pp.831-842
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• 2010

BACKGROUND: Sarcopenic obesity(SO), a condition of the reduction in muscle mass paired with an increased fat mass has been paid attention because of its association with disability in later life. A few evidence, however, has reported the association with these factors. PURPOSE: To explore the association among SO, physical function and fitness in older women. METHOD: 257 older women(age of 74) were recruited from Y city and 7 physical functions and 4 fitness tests were measured. Participants were classified into one of four groups based on their body fat and muscle mass: Normal group (GR-A), high fat(GR-B), sarcopenia(GR-C), and sarcopenic obese(GR-D). GLMand LSD-test were conducted with SPSS 12.0. RESULTS: Chair stand, arm-curl, back-scratch, 2-min steps of GR-A was higher than GR-C and GR-D(p<.05). One-leg stand of GR-A was higher than GR-D(p<.01) and of GR-C was higher than GR-D(p<.01).8ft-TUG of GR-D was lower than GR-A(p<.01). Grip strength, knee extension of GR-A was higher than that of GR-C and GR-D(p<.01) and knee flexion of GR-A was also higher than that of GR-C and GR-D(p<.01). CONCLUSION: Based on our findings, we conclude that SO is significantly associated with lower physical function and fitness in older Korean women, which alarm the risk of frailty induced by SO.