• 대한관절경학회지
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• 제1권1호
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• pp.47-51
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• 1997

A torn anterior cruciate ligament(ACL) is the most common serious ligamentous injury to the knee joint. The incidence of ACL tears seems to be increasing, at least partly as a result of the increasing participation of individuals of all ages in high-risk sports. The most commonly used graft source for ACL reconstruction is the autogenous bone-patellar tendon-bone graft unit. Despite a good success record. postoperative complications, such as infection, patellar contracture/patellar baja, patellar fracture, rupture of the patellar tendon, graft failure without reinjury, can occur following ACL surgery. The purpose of this paper is to provide guidelines regarding the key points of the reconstructive procedure in a sequence and how to prevent or minimize the complications that can follow ACL reconstructive surgery. We want this knowledge can help orthopaedic surgeons to understand the reasons for previous and current successes and failures of reconstruction of the ACL, and it can help them to plan the care of patients who have an injury of the ligament.

• The Journal of Korean Physical Therapy
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• 제30권2호
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• pp.73-77
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• 2018

Purpose: The prefrontal lobe, supplementary motor area, cerebellum, and basal ganglia are activated during gait. In addition, gait is controlled by nerves, such as the corticospinal tract (CST) and corticoreticular pathway (CRP). In this study, the presence of an injury to the CST and CRP was identified by diffusion tensor imaging and the characteristics of the gait pattern were investigated according to inferior cerebral artery infarction. Methods: One patient and six control subjects of a similar age participated. A 69-year-old female patient had an injury to the left basal ganglia, insular gyrus, corona radiata, dorsolateral prefrontal cortex, and postcentral gyrus due to an inferior cerebral artery infarction. Diffusion tensor imaging (DTI) data was acquired 4 weeks after the stroke. The kinematic and spatio-temporal parameters of gait were collected using a three-dimensional gait analysis system. Results: On 4 weeks DTI, the CST and CRP in the affected hemisphere did not show injury to the affected and unaffected hemisphere. Gait analysis showed that the cadence of spatio-temporal parameter was decreased significantly in the patient. The angle of the knee joint was decreased significantly in the affected and unaffected sides compared to the control group. Conclusion: The results of diffusion tensor imaging showed that although the patient was evaluated to be capable of an independent gait, the quality and quantity of gait might be reduced. This study could help better understand the gait ability analysis of stroke patients and the abnormal gait pattern of patients with a brain injury.

• 한국융합학회논문지
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• 제8권1호
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• pp.77-87
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• 2017

본 연구는 앞십자인대 재건술 환자를 대상으로 융복합기반 러시안전류와 경피신경전기자극을 적용하였을 때 통증, 근력 및 기능에 미치는 영향을 비교하고자 하였다. 본 연구는 앞십자인대 재건술 환자 40명(러시안전류 적용군 20명, 경피신경전기자극 적용군 20명)을 대상으로 실시하였다. 두 군은 1회 20분, 주5회 4주 동안 각각의 전기중재를 실시하였고, 냉치료와 기기를 사용한 연속수동관절가동운동을 무릎관절주변에 각각 20분간 실시하였다. 치료적 중재의 영향을 알아보기 위하여, 본 연구는 중재 전후에 시각적 상사척도, 무릎 굽힘 및 폄 근력, 무릎상해와 관절염 결과지수, 한국판 다리 기능척도를 측정하였다. 두 군 모두 시각적 상사척도, 무릎 굽힘 및 폄 근력, 무릎상해와 관절염 결과지수, 한국판 다리 기능척도 점수에서 치료적 중재 이후에 통계학적으로 유의한 개선을 보여주었다. 또한, 러시안전류 적용군은 경피신경전기자극 적용군보다 무릎 폄 근력과 한국판 다리 기능척도에서 중재 후 유의한 증가를 보였다. 본 연구의 결과를 바탕으로 앞십자인대 재건술 환자에게 있어 두 중재 방법 모두 효과적인 개선을 보였지만, 러시안전류가 경피신경전기자극보다 무릎근력과 다리기능을 개선하는데 더 효과적이라고 보고하며, 향후 임상에서 앞십자인대 재건술 환자의 재활에 러시안전류의 적용에 긍정적인 이점이 있다고 제언하는 바이다.

• 한국전문물리치료학회지
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• 제12권3호
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• pp.22-30
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• 2005

This study was designed to identify the effect of various decline boards and postures of lower extremities on surface electromyographic (EMG) activity of knee muscles during isometric single-leg decline squat exercises. The subjects were twenty young male adults who had not experienced any knee injury and their Q-angles were within a normal range. They were asked to perform single-leg decline squat exercises in five various conditions. The EMG activities of the gluteus maximus (GM), vastus lateralis (VL), vastus medialis (VMO), tibialis anterior (TA), and gastrocnemius (GCM) muscles were recorded in five various single-leg decline squat exercises by surface electrodes and normalized by maximal voluntary isometric contraction (MVIC) values. The normalized EMG activity levels were compared using one-way ANOVA with repeated measures. The results of this study were as follows: 1) Exercises 2 and 4 produced significantly greater EMG activity of VMO than did exercise 1 ($p_{adj}$<.05/10), 2) The VMO/VL ratio of EMG activity of exercise 4 was the highest, producing a significantly greater ratio than exercise 1 ($p_{adj}$<.05/10). These results show that single-leg lateral oblique decline squat exercise is the best exercise for selective strengthening of VMO, and the posture of the contralateral leg does also affect strengthening of VMO, but we'll need to research patellofemoral joint compression for clinical application of single-leg lateral oblique decline squat exercises.

• 한방재활의학과학회지
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• 제28권1호
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• pp.175-184
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• 2018

The purpose of this study is to report the effectiveness of complex Korean Medicine treatment for anterior cruciate ligament (ACL) injuries with meniscus tear. Four patients were treated with complex Korean Medicine by acupuncture, pharmacopuncture and herbal medication. We evaluated the improvement of knee pain and function by Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC Index), EuroQol-5 Dimension Index (EQ-5D Index). After treatment, we found that knee pain was reduced and joint function was improved by NRS and WOMAC index in all cases. In the evaluation of health-related quality of life through EQ-5D index, there was no significant difference in patients with degenerative knee osteoarthritis and severe meniscal injury. This results show that complex Korean Medicine may be an effective option for ACL injuries with meniscus tear. Further clinical studies are needed to clarify the effect of Korean Medicine therapy on ACL injuries with meniscus tear.

• 대한정형외과스포츠의학회지
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• 제1권1호
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• pp.37-42
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• 2002

목적: 재건술의적응이되지않는전,후방십자인대손상환자에서radiofrequency 방식을이용한열위축술을시행하여술기및단기추시결과를보고하고자한다. 대상및방법 : 재건술의적응이되지않는전방십자인대9예, 후방십자인대5예를대상으로하였으며평균추시기간은6개월이었다. 결과 : 일상생활에서느꼈던불안정성은감소됐으며파행이나통증등이현저하게호전되었다. 다만후방십자인대에서시행한경우시간이지남에따라다시슬관절이완이증가하는소견을관찰할수있었다. 결론 : Radiofrequency를이용한열위축술은많은활동을요하는젊은사람의슬관절십자인대손상에서, 특히경도의부분파열및수술의적응이되지않는이완환자에서증상을보일경우시도해볼수있는술식중의하나로추천할만하다. 그러나본결과는단기추시이므로장기추시와대조군연구가요할것으로사료된다.

• 대한정형외과스포츠의학회지
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• 제7권1호
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• pp.33-36
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• 2008

목적: 축구에 의해 발생한 전방 십자인대 파열 환자에서 손상의 기전을 알아보고자 하였다. 대상 및 방법: 축구 도중에 발생한 전방 십자인대 파열이 된 환자 92명 중 손상 기전을 정확히 기억하는 환자 50명을 대상으로 하였다. 평균 연령은 27세로, 남자 47명, 여자 3명 이였다. 아마추어 및 프로 축구 선수는 15명이었고, 35명은 비선수였다. 수상 기전은 전화나 의무기록으로 조사하였다. 결과: 수상 기전은 접촉성 손상이 17명, 비접촉성 손상이 33명 이었고, 41명의 환자가 손상 당시 발이 지면에 접촉을 하였고, 9명은 지면에 접촉하지 않았다. 접촉성 손상에서 17명 중 9명에서 슬관절에 외반력, 5명에서 내반력이 가해졌고, 11명의 환자가 손상 당시 발이 지면에 접촉을 하였고, 6명은 발이 지면에 접촉하지 않았다. 발이 지면에 접촉된 상태에서 대퇴부의 회전에 의한 손상은 3명이었고, 과신전 손상은 1 명이었고, 감속 손상은 없었다. 비접촉성 손상에서 33명 중 30명의 환자가 손상 당시 발이 지면에 접촉을 하였고, 3명은 발이 지면에 접촉하지 않았다. 30명 중 대퇴부의 회전에 의한 손상은 16명이 있었고, 6명에서 슬관절에 외반력, 5명에서 내반력이 가해졌고, 과신전 손상은 5 명이었고, 감속 손상은 2명 이었다. 발이 지면에 접촉하지 않은 3명의 환자들은 킥을 할 때 손상을 받았다. 결론: 축구 선수에서 전방 십자인대 파열은 대부분(66%) 비접촉성이 원인이며, 발이 지면에 접촉되면서 상체가 회전되면서 발생했다. 접촉성인 경우 대부분(53%) 외측에서의 태클에 의한 외반력이 원인이었다.

• 한국전문물리치료학회지
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• 제27권2호
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• pp.133-139
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• 2020

Background: The gastrocnemius (GCM) is one of the lower extremity muscles that tend to tighten easily. GCM tightness results in limited ankle dorsi-flexion (DF), especially when the knee joint is fully extended. Joint flexibility is determined by the morphological and physiological characteristics of joints, muscles, tendons, and ligaments. Impaired joint flexibility can be attributed to increased susceptibility to muscle injury. High-frequency diathermy is clinically used to reduce pain and muscle tightness and to improve limited range of motion. Objects: This study aimed to investigate the immediate effects of high-frequency therapy in subjects with GCM tightness. Methods: The study was designed as a one-group before-after trial. The subjects included 28 volunteers with GCM tightness (an active ankle DF angle of less than 12°) without any known neurological and musculoskeletal pathologies in the ankle and calf areas. WINBACK Transfer Electrode Capacitive and Resistive Therapy equipment was used to apply high-frequency therapy to the subjects' GCMs for 10-15 minutes. The pennation angle and the fascicle length of the GCM were measured using ultrasonography. The flexibility of the ankle joint, peak torque to the passive ankle DF (Biodex), and soft tissue stiffness (MyotonPRO) were also measured. Results: The pennation angle was significantly decreased following the treatment; however, no significant difference in the fascicle length was found (p < 0.05). The flexibility was significantly increased and both the passive peak torque to passive ankle DF and the soft tissue stiffness significantly decreased (p < 0.05). Conclusion: High-frequency therapy is immediately effective for improving the muscle's architectural properties and functional factors in subjects with GCM tightness. Further longitudinal clinical studies are required to investigate the long-term effects of high-frequency therapy on subjects with GCM tightness from various causes.

• 한국운동역학회지
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• 제24권2호
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• pp.173-180
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• 2014

The purpose of this study was to investigate the effect of combined exercise on injury risk factors of lower extremity during landing. Ten sports talented athletes participated in this study. Sports talented athletes participated in a combined exercise (sports talented exercise, coordination) for 16 weeks. A three-dimensional motion analysis was performed using eight infrared cameras (sampling rate of 100 Hz), one force plate, and electromyography system (sampling rate of 1000 Hz) during landing. Kinetic, and kinematics analysis including average impulsive force, angle of lower extremity, vertical stiffness, onset of muscle activation were calculated by Matlab2009a software. Paired t-test was performed at alpha=.05. The average impulsive force in landing phase was not statistically significant (t=-.748, p=.474). The hip joint angle was more decreased in post test compared to pre test (E1: t=2.682, p=.025, E2: t=5.609, p=.000, E3: t=2.538, p=.032). The knee joint (E1: t=-.343, p=.739, E2: t=1.319, p=.220, E3: t=.589, p=.570) and ankle joint (E1: t=.081, p=.937, E2: t=.784, p=.453, E3: t=.392, p=.704) angle were tended to decrease after combined exercise. The vertical stiffness was tended to decrease after combined exercise (t=1.972, p=.080). Onset of quadriceps femoris (t=.698, p=.503) and medial gastocnemius (t=1.858, p=.096) were tended to be faster than biceps femoris (t=-.333, p=.747) after combined exercise. Although thses findings were not statistically significant except on a hip joint angle, risk factors of lower extremity such as joint angle, vertical stiffness and onset of quadriceps femoris, medial gastrocnemius were positively changed after the combined exercise but an additional training for improved onset of biceps femoris would be required in the future.

• 대한관절경학회지
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• 제16권1호
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• pp.34-39
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• 2012

목적: 급성 전방십자인대 손상 환자에서 조기 재건술과 지연 재건술 간의 관절 강직 발생 정도와 임상적 결과를 비교하고자 하였다. 대상 및 방법: 2008년 3월부터 2010년 10월까지 급성 전방십자인대 손상 환자 중 전방십자인대 재건술을 시행한 34예를 대상으로 하였다. 수상 후 1주 이내에 재건술을 시행한 조기 재건군과 수상 후 3주에서 6주 사이에 재건술을 시행한 지연 재건군으로 나누어 수술 전까지 적극적인 관절 운동을 시행하고 술 후에 환자 스스로 운동이 가능하도록 하는 적극적인 재활 치료를 시행한 후 관절 운동 범위, Lachman 검사, pivot shift 검사, Lysholm 점수, International Knee Documentation Committee (IKDC) 점수, Tegner 활동도 점수를 이용하여 평가하였다. 결과: 최종 추시에서 Lysholm 점수는 조기 재건군 91.82점, 지연 재건군 94.83점이었고 IKDC 점수는 전례에서 B (거의 정상) 이상으로 회복되었다(P=0.217, P=0.845). Tegner 활동도 점수는 조기 재건군 6.7점, 지연 재건군 7.1점이었고 (P=0.840) 관절 운동 범위는 양군 간에 차이가 없었으며(P=0.873, P=0.873) 심부 정맥 혈전증이나 감염은 전례에서 발생하지 않았다. Lachman 검사, pivot shift 검사 결과도 양군 간에 유의한 차이는 없었다(P=0.606, P=0.118). 결론: 급성 전방십자인대 손상 환자에서 조기 및 지연 재건군 모두에서 만족할만한 임상적 결과를 얻었다. 따라서 수상 후 1주 이내에 시행하는 조기 재건술도 좋은 치료 방법의 하나로 선택될 수 있을 것이라 생각된다.