• Title/Summary/Keyword: Hip strategy

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Can Functional Assessment Tools Reflect Balance Abilities at 3 Months after Total hip Arthroplasty?

  • Kim, Min-Woo;Ryu, Young-Uk
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.4
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    • pp.51-58
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    • 2018
  • PURPOSE: This study was conducted to determine if the Harrison hip score (HHS), a tool for assessing hip joint function, and the Burg balance scale (BBS), a general balance assessment tool, actually reflect the balance ability of total hip arthroplasty (THA) patients 3 months after surgery. In addition, this study investigated the initial weight distribution strategy for bilateral lower extremity after THA surgery to understand the balance of THA patients. METHODS: Fourteen 3-month THA patients performed static dual standing and sit-to-stand (STS) tasks. Ground reaction forces on each leg were collected to calculate the weight distribution symmetricity (SWD), and the HHS, functional HHS (f-HHS), and BBS were evaluated. Correlation analyses between SWD and the HHS (also f-HHS) and BBS were then applied to the THA patients. RESULTS: The correlations between functional evaluation tools (HHS, f-HHS, BBS) and SWD were weak strength for the static balance task, but moderate for the dynamic STS task. Among the evaluation tools used in the present study, f-HHS was most useful for evaluation of dynamic balance ability. CONCLUSION: The results suggest that use of HHS, f-HHS, and BBS as functional evaluation tools does not provide meaningful information regarding balance ability, but that they are useful for evaluating dynamic balance ability of THA patients. The dynamic balance ability at 3 months after THA seems to be under development.

Recent updates for biomaterials used in total hip arthroplasty

  • Hu, Chang Yong;Yoon, Taek-Rim
    • Biomaterials Research
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    • v.22 no.4
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    • pp.259-270
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    • 2018
  • Background: Total hip arthroplasty (THA) is probably one of the most successful surgical interventions performed in medicine. Through the revolution of hip arthroplasty by principles of low friction arthroplasty was introduced by Sir John Charnley in 1960s. Thereafter, new bearing materials, fixation methods, and new designs has been improved. The main concern regarding failure of THA has been the biological response to particulate polyethylene debris generated by conventional metal on polyethylene bearing surfaces leading to osteolysis and aseptic loosening of the prosthesis. To resolve these problems, the materials of the modern THA were developed since then. Methods: A literature search strategy was conducted using various search terms in PUBMED. The highest quality articles that met the inclusion criteria and best answered the topics of focus of this review were selected. Key search terms included 'total hip arthroplasty', 'biomaterials', 'stainless steel', 'cobalt-chromium', 'titanium', 'polyethylene', and 'ceramic'. Results: The initial search retrieved 6921 articles. Thirty-two articles were selected and used in the review. Conclusion: This article introduces biomaterials used in THA and discusses various bearing materials in currentclinical use in THA as well as the newer biomaterials which may even further decrease wear and improve THA survivorship.

Management of Severe Bone Defects in Femoral Revision following Total Hip Arthroplasty

  • Yicheng Li;Li Cao
    • Hip & pelvis
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    • v.36 no.2
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    • pp.101-107
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    • 2024
  • Treatment of femoral bone defects continues to be a challenge in revision total hip arthroplasty (THA); therefore, meticulous preoperative evaluation of patients and surgical planning are required. This review provides a concise synopsis of the etiology, classification, treatment strategy, and prosthesis selection in relation to femoral bone loss in revision THA. A search of literature was conducted for identification of research articles related to classification of bone loss, management of femoral revision, and comparison of different types of stems. Findings of a thorough review of the included articles were as follows: (1) the Paprosky classification system is used most often when defining femoral bone loss, (2) a primary-length fully coated monoblock femoral component is recommended for treatment of types I or II bone defects, (3) use of an extensively porous-coated stem and a modular fluted tapered stem is recommended for management of types III or IV bone defects, and (4) use of an impaction grafting technique is another option for improvement of bone stock, and allograft prosthesis composite and proximal femoral replacement can be applied by experienced surgeons, in selected cases, as a final salvage solution. Stems with a tapered design are gradually replacing components with a cylindrical design as the first choice for femoral revision; however, further confirmation regarding the advantages and disadvantages of modular and nonmodular stems will be required through conduct of higher-level comparative studies.

Effect of Gender Difference on the Functional Asymmetry during Preferred Walking Speed

  • Hyun, Seunghyun;Ryew, Checheong
    • International journal of advanced smart convergence
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    • v.9 no.2
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    • pp.49-57
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    • 2020
  • We have not identified on what gender difference during gait at a pace of one's preferred velocity effects on the function of bilateral lower limb. This study was undertaken to investigate a difference of gait strategy by gender during gait at a one's preferred velocity of participants of adult male and female (n=20). Cinematographic data for motion analysis, ground reaction force (GRF) variables, and muscle volume of lower limb were analyzed. Significant difference of variables on movement of center of mass whole body, joint angle and moment of lower limb, and ground reaction force were tested by 2-way ANOVA analysis (P<0.05). Male group showed more muscle volume than female, and both showed more volume in dominant leg than non-dominant. Main effect by bilateral leg during gait showed higher difference in right than left leg in change of vertical position of center of mass (maximal, minimal). Main effect by gender in vertical change of position and velocity of center of mass showed higher difference in male than female (maximal, minimal). Hip joint showed more flexed and extended angle in male than female, and also dorsiflexion of ankle and flexion moment of knee and hip joint showed higher in male than female group. Therefore, this result was assumed that dominant showed furthermore more contribution for propulsive function than non-dominant leg. Gender difference showed in strategy controlling of biomechanical characteristics, and perhaps influenced by muscle volume.

Effect of a PNF Intervention Strategy with the ICF Tool Applied to a Patient with Bilateral Total Hip Replacement Walking a Crosswalk (양측 엉덩관절 전치환술 환자의 횡단보도 걷기 개선을 위해 ICF Tool을 적용한 PNF 중재전략: 사례보고 )

  • Jin-cheol Kim;Jae-heon Lim
    • Journal of the Korean Society of Physical Medicine
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    • v.19 no.1
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    • pp.95-105
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    • 2024
  • PURPOSE: This study aimed to utilize the International Classification of Functioning, Disability, and Health (ICF) tool to identify a problem list and explore intervention effects using proprioceptive neuromuscular facilitation (PNF) for improving the crosswalk performance of patients who have undergone a bilateral hip arthroplasty. METHODS: The subject of this study was a 43-year-old male who had undergone a bilateral hip arthroplasty. To address the subject's functional status, a clinical decision-making process was carried out in the order of examination, evaluation, diagnosis, prognosis, intervention, and outcome. Patient information during the examination was collected using the ICF core set. The evaluation involved listing the items of each problem using the ICF assessment sheet and identifying the interaction between activity limitations and the impairment level. The diagnosis explicitly described the causal relationships derived from the evaluation using ICF terminology. The prognosis presented activity goals, body function, and structured goals in terms of the activity and participation levels that needed to be achieved for an individual's functional status. The intervention approached problems through the four components of the PNF philosophy, namely basic principles and procedures, techniques, and patterns, in an indirect-direct-task sequence. Results were compared before and after the intervention using the ICF evaluation display. RESULTS: The results of the study showed that the primary activity limitation, which was the walking time across the crosswalk, showed improvement, and the trunk's counter rotation and the weight-bearing capacity of both the lower limbs, which were impairment level indicators, were enhanced. CONCLUSION: This study suggests that PNF intervention strategies will serve as a positive approach for improving crosswalk walking in patients with bilateral hip arthroplasty.

Plantar Hypoesthesia Alters Gait Kinematics Pattern in Individuals with and without Chronic Ankle Instability (만성 발목 불안정성 환자군과 정상인 군의 발바닥 감각기능 저하에 따른 운동학적 보행 패턴의 변화)

  • Kang, Tae Kyu;Lee, Sae Yong;Lee, Inje;Kim, Byong Hun;Jeong, Hee Seong;Kim, Chang Young
    • Korean Journal of Applied Biomechanics
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    • v.31 no.2
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    • pp.79-86
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    • 2021
  • Objective: The purpose of this study was to identify the effect of reduced plantar cutaneous sensation on gait kinematics during walking with and without CAI. Method: A total of 20 subjects involved in this study and ten healthy subjects and 10 CAI subjects participated underwent ice-immersion of the plantar aspect of the feet before walking test in this study. The gait kinematics were measured before and after ice-immersion. Results: We observed a before ice-immersion on plantar cutaneous sensation, CAI subject were found to reduced ankle dorsiflexion, knee external rotation, hip adduction, and internal rotation compared to control subject. After ice-immersion, CAI subjects were found to reduce knee external rotation, hip adduction. However, no significant ankle joint kinematics. Conclusion: While walking, gait pattern differences were perceived between groups with and without plantar cutaneous sensation. The results of the study may explain the abductions in the hip angle movements in CAI patients at initial contact compared to healthy subjects in the control group when plantar cutaneous sensation was reduced. A change in proximal joint kinematics may be a conservative strategy to promote normal gait patterns in CAI patients.

A Study of Motor Expertise about Kinematic and Kinetic Characteristics of Lower Extremity in the Seokmun Ilwol Martial Art Yin-yang Bo Gait Pattern (석문일월무예 음양보법의 숙련성에 따른 보행 패턴의 하지 운동학 및 운동역학적 특성)

  • Park, Bok-Hee;Kim, Ky-Hyoung
    • Korean Journal of Applied Biomechanics
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    • v.24 no.3
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    • pp.239-248
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    • 2014
  • The purpose of this study was to quantify kinematic and kinetic characteristics of Yin-yang Bo gait according to their motor expertise, one of the Seokmun Ilwol martial art gait patterns. Yin-yang Bo gait pattern shows initial forefoot contact instead of heel contact, and increased time of stance phase time, internal-external rotation of ankle-knee-hip joints and pelvic. It aims to produce and store the more energy through continuous homeostasis of center of gravity (COG) and performance of stretch-shortening cycle. Some of these characteristics also were similar to the gait modification strategies for reducing knee adduction moment such as toe-out progression, medial thrust, internal rotation of hip joint. To identify the characteristics, four factors of expert Yin-yang Bo gait performance group were compared to that of none expert group; 1) angles of COG displacement and rotation 2) distal joint pre-rotation in internal-external rotation of ankle-knee-hip joints and pelvic, 3) invariability pelvic potential and pelvic segment total energy 4) knee abduction moment. Six healthy(three male) subjects participated in the experiment to perform Yin-yang gait pattern. Three-dimensional and force plate data were collected. Kinematic and kinetic data were compared between two groups using t-tests. Results showed that 1) the peak point of COG internal rotation angle was reduced in expert group, 2) kneeexternal and hip joint -internal and pelvic rotation angle peak frames were more near points in expert group.

A Study of 3D Virtual Fitting Model of Men's Lower Bodies in Forties by Morphing Technique. (모핑 기법을 활용한 40대 남성 하반신 가상모델 생성에 관한 연구)

  • Park, Sun-Mi;Nam, Yun-Ja;Choi, Kueng-Mi
    • Journal of the Korean Society of Clothing and Textiles
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    • v.31 no.3 s.162
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    • pp.463-474
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    • 2007
  • With rapid expansion in e-retailing of apparel business, personalized fitting model service shows the possibility as the differentiated marketing strategy in cyber shopping. According as necessity of personalized fitting model construction rises, it is tried personalized fitting model creation in several fields such as computer engineering, mechanical engineering, information engineering. But, because existent study was concentrated only on human body modeling, it does not reflect average morphological characteristics of human body properly. In this study, we wish to examine if morphing is fit for expressing characteristic of average human body shape and suggest desirable morphing. We used 3-D scan data of 254 Korean middle aged men collected by Size Korea 2004. The result of this study are as follows: Lower body types were categorized by height hip girth and lower drop(hip girth-navel girth) which were main factors of lower body shape. Then each factor was divided into 3 groups respectively, 30% in the middle, over 30%, under 30%. In 27 groups, the group which belonged to 30% in the middle of height, 30% in the middle of hip girth, 30% in the middle of lower drop was selected as a representative group. We tested geometrical figure by differ volume, tilt, position of point. And we created a representative type of men's lower bodies by morphing the representative group and analyzed it's horizontal, vertical sections. A representative type which was created by morphing reflected a real body and changed realistically at the part of hip, crotch, calf muscle and so on. A cross sections of a representative type were similar to average cross sections of the representative group in size and shape. So it was proved that morphing was successful.

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

  • Kwon, Hyuk-Cheol;Jeong, Dong-Hoon
    • Physical Therapy Korea
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    • v.6 no.3
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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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A Strategy of the Home Visiting Physical Therapy (가정 방문 물리치료의 전략)

  • Bae Sung-soo
    • The Journal of Korean Physical Therapy
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    • v.15 no.4
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    • pp.180-189
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    • 2003
  • The purpose of this study was to emphasize the strategy of the home visiting physical therapy for elderly patients who have joint and musculoskeletal problems, disabled person who staying in home and early discharged person who staying in home with replacement of artificial hip joint and central nerve system problems with CP, CVA, SCI etc. Home visiting physical therapist can provide evaluation and diagnosis, treatment with their special knowledge and techniques, treatment council and education for the patients and family member and refer the patients to other specialist. Home visiting physical therapy can expects that patients will have better treatment with emotionally, economically and for long term care patients.

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