• 제목/요약/키워드: Lateral Flexion

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CT기반 3차원 모델을 이용한 고관절 운동범위 예측 (Hip Range of Motion Estimation using CT-derived 3D Models)

  • 이연수
    • 한국방사선학회논문지
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    • 제12권1호
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    • pp.115-122
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    • 2018
  • 본 연구에서는 CT영상기반 3차원 고관절모델을 이용한 컴퓨터시뮬레이션을 통해서 고관절의 운동범위(Range of Motion)를 측정하는 방법을 제시하였다. 본 연구에서는 그 측정방법에 대한 기술적인 사항을 제시하고, 그 기술이 재현성 있게 실현할 수 있도록 대퇴골두 중심점의 결절, 대퇴골 외전(Abduction)/내전(adduction)회전축, 굽힙(flexion)/신전(extension) 회전축을 정의하고 측정하는 명확한 방법을 제시하였다. 외전각은 해부학적인 시상면(Sagittal plane)상의 Anterior-Posterior축에 대해 아래쪽(Inferior)면으로부터 Lateral 쪽으로의 회전각으로 정의된다. 최대외전각은 대퇴골두가 엉덩이뼈(Pelvis)의 절구(Acetabulum)의 테두리와 겹치지 않고 Anterior-Posterior축을 중심으로 회전할 수 있는 최대 외전각으로 결정된다. 굴곡각은 해부학적인 관상면(Coronal plane)상의 Medial-Lateral축에 대해 아래쪽(Inferior)면으로부터 회전각으로 정의된다. 최대굴곡각은 대퇴골이 Medial-Lateral축을 중심으로 엉덩이뼈(Pelvis)의 절구(Acetabulum)의 테두리와 겹치지 않고 회전할 수 있는 최대 굴곡각으로 결정된다. 정상고관절에 비해 인공고관절술을 받은 해당 환자의 경우, 외전에서는 60도 정도, 굽힘에서는 4도 정도 운동범위가 줄어들 수 있다는 예측이 나왔다. 본 연구에서 행한 시뮬레이션을 해보고 외전의 경우 운동범위의 감소가 예측되므로, 대퇴골두를 조금 큰 것을 고르거나 대퇴골목부의 길이 (femoral neck offset)를 길게 시술해야 할 필요가 있음을 의미한다.

체간 굴곡과 신전 시에 요부 신근과 고관절 신근의 동원패턴 (Recruitment Patterns of Lumbar Extensor and Hip Extensors in Trunk Flexion and Extension)

  • 이현옥;구봉오
    • The Journal of Korean Physical Therapy
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    • 제21권1호
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    • pp.57-63
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    • 2009
  • Purpose: We determined the recruitment pattern of lumbar elector spinalis, gluteus maxims, inner and outer hamstring muscle during trunk flexion and extension. Methods: Thirty healthy subjects(male; 15, female; 15) without low back pain and other problems in lower extremities participated in this study. To measure the recruitment pattern, the onset times of electromyographic activity of the muscles were recorded during trunk flexion and return(extension) to standing position. Results: The medial and lateral hamstring muscle was activated first, next elector spinalis, the last, gluteus maximus in trunk flexion. In trunk extension to standing position, the order of recruitment was similar to trunk flexion although the frequency is different. There were different between male and female in flexion and extension movement. Conclusion: The recruitment order of lumbar extensor and hip extensors in trunk flexion and extension will provide database in evaluation and intervention of lower back pain and lumbo.pelvic rhythm disorder.

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후외상성 주관절 강직에서의 변연 관절 성형술 (Debridement Arthroplasty for Post-Traumatic Stiff Elbow)

  • 이용걸;김희선;전영수;조영린
    • Clinics in Shoulder and Elbow
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    • 제1권2호
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    • pp.242-249
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    • 1998
  • Stiffness of the elbow joint is relatively common after trauma, ectopic ossification, bum, postoperative scar, and etc. Mild flexion deformity can be reduced by use of active or passive motion exercise, dynamic sling, hinged distractor device, or turnbuckle orthosis. But these methods have disadvantages of difficulty in gaining acceptable range of motion only with stretching exercise, re-contracture after conservative managements and poor results that flexion contracture remained. The common described operative exposures for treatment of the stiff elbow are anterior, lateral, posterior, and medial approach. Through Anterior, lateral and medial approach each has not access to all compartments of the elbow. But, posterior approach has benefits that access to posterior, medial and lateral aspects of the elbow and as needed, fenestration to the olecranon fossa that produces a communication between the anterior and posterior compartments of the elbow are possible. From June 1991 through April 1997, 11 patients who had posttraumatic stiff elbow, were treated with debridement arthroplasty through the posterior approach. The purpose of this study are to introduce technique of the debridement arthroplasty and to evaluate final outcomes. With regarding to preoperative pain degree, mild degree matches to 3 cases, moderate to 3 cases, and severe to 2 cases. In preoperative motion, flexion was average 85° and extension was 30°. Postoperatively nine patients had got the complete relief of pain and two patients continued to have mild pain intermittentely. Postoperative flexion improved to 127° and extension to 2°, so that elbow flexion had improved by an average of 42° and elbow extension by 28°. On the objective scale all patients had good or excellent results and they all felt that they were improved by operation. Debridement arthroplasty is one of excellent procedures for the intractable stiff elbow if it is not unstable or it has not incongrous. But it need a meticulous operative technique and a well-programmed rehabilitation.

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카이로프랙틱 요법과 요통 운동 요법이 요추 자세 및 통증 변화에 미치는 영향 비교 - 통학버스 이용 대학생을 대상으로 - (The Effects of Chiropractic Therapy and Low Back Exercise of University Students in Commuter)

  • 정한석;함주현;최서연;정문영
    • 한국학교ㆍ지역보건교육학회지
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    • 제15권1호
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    • pp.77-87
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    • 2014
  • Objectives: The Purpose of this study was to investigate the effects of chiropractic treatment and low back exercise on lumbar lordosis angle, gravity line, range of motion, and pain degree of university students who are taking a commuter bus at least 4 hours of round trip. Methods: A group of 15 participants received chiropractic treatment around the lumbar spine region twice per week for 8 weeks. Another group of 15 participants were treated with low back exercise three times per week for 8 weeks. Results: In the present results, both chiropractic treatment and low back exercise did not affect the change of lumbar lordosis. However, chiropractic treatment also significantly improved the range of the lumbar motion, including Flexion, Extension, Right Lateral Flexion and Left Lateral Flexion(p<0.05), and consequently decreased the pain degree. Low back exercise significantly moved the lumbar gravity line to almost normal scale, and improved the range of the lumbar motion, including Flexion, and Right Lateral Flexion (p<0.05), resulting in the reduction of pain degree, although both chiropractic treatment and exercise treatment did not change the lumbar lordosis angle at the statistically significant. Conclusions: From these results, it can be inferred that chiropractic treatment might be beneficial to alleviating the low back pain of the university students using a commuter bus by improving the range of lumbar motion or stabilizing the lumbar gravity line.

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In vivo 3-dimensional Kinematics of Cubitus Valgus after Non-united Lateral Humeral Condyle Fracture

  • Kim, Eugene;Park, Se-Jin;Lee, Ho-Seok;Park, Jai-Hyung;Park, Jong Kuen;Ha, Sang Hoon;Murase, Tsuyoshi;Sugamoto, Kazuomi
    • Clinics in Shoulder and Elbow
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    • 제21권3호
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    • pp.151-157
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    • 2018
  • Background: Nonunion of lateral humeral condyle fracture causes cubitus valgus deformity. Although corrective osteotomy or osteosynthesis can be considered, there are controversies regarding its treatment. To evaluate elbow joint biomechanics in non-united lateral humeral condyle fractures, we analyzed the motion of elbow joint and pseudo-joint via in vivo three-dimensional (3D) kinematics, using 3D images obtained by computed tomography (CT) scan. Methods: Eight non-united lateral humeral condyle fractures with cubitus valgus and 8 normal elbows were evaluated in this study. CT scan was performed at 3 different elbow positions (full flexion, $90^{\circ}$ flexion and full extension). With bone surface model, 3D elbow motion was reconstructed. We calculated the axis of rotation in both the normal and non-united joints, as well as the rotational movement of the ulno-humeral joint and pseudo-joint of non-united lateral condyle in 3D space from full extension to full flexion. Results: Ulno-humeral joint moved to the varus on the coronal plane during flexion, $25.45^{\circ}$ in the non-united cubitus valgus group and $-2.03^{\circ}$ in normal group, with statistically significant difference. Moreover, it moved to rotate externally on the axial plane $-26.75^{\circ}$ in the non-united cubitus valgus group and $-3.09^{\circ}$ in the normal group, with statistical significance. Movement of the pseudo-joint of fragment of lateral condyle showed irregular pattern. Conclusions: The non-united cubitus valgus group moved to the varus with external rotation during elbow flexion. The pseudo-joint showed a diverse and irregular motion. In vivo 3D motion analysis for the non-united cubitus valgus could be helpful to evaluate its kinematics.

수중에서 고유수용성신경근촉진법 하지 패턴이 근력 및 유연성에 미치는 영향 (The Effects of Proprioceptive Neuromuscular Facilitation Lower Extremity Pattern on Muscular Strength and Flexibility in an Aquatic Environment)

  • 이동규;김용남
    • The Journal of Korean Physical Therapy
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    • 제25권2호
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    • pp.49-55
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    • 2013
  • Purpose: This study was conducted in order to analyze the effect of proprioceptive neuromuscular facilitation lower extremity pattern on muscular strength and flexibility in an aquatic environment. Methods: Ten members of the experimental group and 10 members of the control group were randomly selected from 20 college students who are in their 20s. Bilateral symmetry pattern among proprioceptive neuromuscular facilitation lower extremity patterns was applied in an aquatic environment in the experimental group three times per week for a period of six weeks, and a set consisted of 10 times, which was repeated 10 times. On the other hand, subjects in the control group did not receive any treatment while maintaining daily life. Muscular strength was measured using a dynamometer and electromyogram system for maximum voluntary isometric contraction of hip flexor, hip extensor, knee flexor, and knee extensor. Cervical flexibility was measured using cervical range of motion instrument for cervical flexion, rotation, and lateral flexion. Lumbar flexibility was measured using back range of motion instrument II for lumbar flexion. Results: For the experimental group, significance was observed for hip flexor, extensor, knee flexor, extensor, cervical flexion, rotation, lateral flexion, and lumbar flexion. For the control group, no significance was observed for any other variables except for cervical flexion. As a result of observation of difference between the two groups, relatively high significance was observed in the experimental group, compared with the control group. Conclusion: In conclusion, proprioceptive neuromuscular facilitation lower extremity pattern had a positive effect on muscular strength and flexibility in an aquatic environment.

혀의 자세가 경추의 관절가동범위에 미치는 영향 (The Effects of Tongue Positions on the Cervical Range of Motion)

  • 한동욱;박민희;정연희
    • 한국임상보건과학회지
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    • 제1권1호
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    • pp.29-34
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    • 2013
  • Purpose : This study was to investigate that tongue positions have effect on the cervical range of motion (ROM). Methods : 18 subjects, 20 to 25 years of age, were participated in this study. The tongue positions were neutral position, anterior protrusion, posterior protrusion, superior protrusion, inferior protrusion, left side protrusion and right side protrusion. The neck movements were right side flexion, left side flexion, right rotation and left rotation. The cervical range of motion measured by cervical range of motion instrument (CROM, C9266-49, USA). The changes were analyzed using the paired t-test. SPSSWIN (ver. 20.0) was used for data analysis and the significance level was chosen as ${\alpha}$=0.05. Results : In the lateral flexion, the angle of left lateral flexion increased in anterior protrusion(p<0.05) and right side protrusion(p<0.05) significantly. In the rotation, the angle of right rotation increased in anterior protrusion(p<0.05), posterior protrusion (p<0.05), superior protrusion(p<0.05), inferior protrusion(p<0.05), and left side protrusion (p<0.05) significantly. Conclusions : In conclusion, we found that the tongue positions affected some cervical movements.

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PNF 목 패턴이 전방머리자세를 가진 성인의 목 움직임 및 목 장애 지수에 미치는 영향 (Effect of PNF Neck Patterns on Neck Movement and NDI in Adults with Forward Head Posture)

  • 오현주;송귀빈
    • PNF and Movement
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    • 제14권3호
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    • pp.177-183
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    • 2016
  • Purpose: The purpose of this study was to investigate the effects of neck patterns in proprioceptive neuromuscular facilitation (PNF) for neck movement and the neck disability index (NDI) among adults with forward head posture. Methods: Thirty-nine subjects were randomly assigned into two groups. Subjects in the proprioceptive neuromuscular facilitation exercise group (PNFG, n = 20) received 20 minutes of PNF neck pattern (flexion-Rt. lateral flexion-Rt. rotation followed by extension-Lt. lateral flexion-Lt. rotation) 3 times weekly for 4 weeks. Outcomes were measured using absolute rotation angle (ARA), anterior weight bearing (AWB), range of flexion and extension motions (RFEM), and neck disability index (NDI) methods before and after the 4-week intervention period. Results: There were significant effects for the PNFG, pre- and post-intervention, in ARA, AWB, RFEM, and NDI. There were significant differences in ARA, AWB, RFEM, and NDI compared with CG. Conclusion: The results of this study suggest the PNF neck pattern could be beneficial for adults with forward head posture.

The Effects of Kinesiotaping Applied onto Erector Spinae and Sacroiliac Joint on Lumbar Flexibility

  • Shin, Do-Yun;Heo, Ju-Young
    • The Journal of Korean Physical Therapy
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    • 제29권6호
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    • pp.307-315
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    • 2017
  • Purpose: The purpose of this study was to investigate the effects of kinesio taping on lumbar flexibility onto erector spinae and sacroiliac joint. Methods: Sixty healthy adults (male=36, female=24) participated in this study and were randomly assigned to the experimental group that received kinesio taping onto erector spinae and sacroiliac joint (n=30) or the control group that received X-letter placebo taping onto them (n=30). Lumbar flexibility (flexion, extension, lateral flexion, and rotation) was measured using back range-of-motion instrument (BROM) II before and after taping. Results: In the change of lumbar flexibility after taping in the experimental group, there were statistically significant difference in flexion, lateral flexion, and rotation (p<0.05), but there was no significant difference in extension. There was no significant difference in the change of lumbar flexibility after taping in the control group. Conclusion: In conclusion, kinesio taping onto erector spinae and sacroiliac joint improved the joint function. Kinesio taping may reduce the muscle tension and facilitate the circulation of tissue fluid. In light of these results, it is thought that the application of kinesio taping had influence on an increase in lumbar flexibility. Therefore, kinesio taping will be able to be used as the method of the prevention of pain and the treatment in the lumbar region.

수지 화상 후 굴곡성 구축 치료 시 족질부 이식 (Great Toe Pulp Graft for the Reconstruction of the Postburn Flexion Contracture in the Fingers)

  • 서제원;권호;임영민;정성노
    • Archives of Plastic Surgery
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    • 제34권5호
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    • pp.587-592
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    • 2007
  • Purpose: In case of postburn flexion contracture of the fingers, skin graft, geometrical relaxation techniques, local flap, and free flap have been used. Among these procedures, full-thickness skin grafts from the inguinal area are widely used to reconstruct a postburn flexion contracture in the fingers. But there are many esthetic and functional problems in this procedure. Especially, hyperpigmentation of the skin-grafted fingers poses a troublesome problem, particularly in the patients who have dark colored skin. To solve the problem, we have used pulp graft which was harvested from the lateral aspect of great toe. In the present study, we report pulp graft, with which we have obtained a good result in the treatment of postburn flexion contracture of the fingers. Methods: Between September of 2004 and August of 2006, great toe pulp graft was performed to 20 sites of 15 patients. After release of the postburn flexion contracture using Z-plasty, the composite tissue (pulp) harvested from the lateral aspect of great toe was grafted on the raw surface. Moisture dressing with ointment and foam dressing material was performed. Stratum corneum of the graft got stripped off in two to four weeks after pulp graft. The color of the pulp graft was slightly reddish, then it became similar to the adjacent tissue. Results: There was complete take in all the patients who were treated with pulp graft. Great toe pulp graft provided similar color and texture to the adjacent skin, high rate of graft take, and left only a minimal scar at donor site. Conclusion: Thick keratin layer and inelastic nature of the pulp make this type of the graft much easier and simpler, and ensure a better take. Pulp graft is useful method for the reconstruction of the postburn flexion contracture in fingers.