• 제목/요약/키워드: Ligament balance

검색결과 22건 처리시간 0.027초

발목 관절 전치환술에서의 연부조직 재정렬술 (Soft Tissue Balancing on Total Ankle Replacement Surgery)

  • 최성욱;김대환;강현성
    • 대한족부족관절학회지
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    • 제28권1호
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    • pp.1-7
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    • 2024
  • Despite the advances in total ankle replacement (TAR), TAR has emerged as a promising alternative to ankle arthrodesis, particularly in severe ankle arthritis. Restoring ankle stability and alignment is the most important technical consideration and the goal of TAR. Hence, additional procedures, such as soft tissue balancing and osteotomies, are often critical parts of surgical planning. This article reviews the basics of joint balancing, offering suggestions on procedure selection for ligamentous balancing and varus and valgus malalignment in TARs.

Gross motor dysfunction and balance impairments in children and adolescents with Down syndrome: a systematic review

  • Jain, Preyal D.;Nayak, Akshatha;Karnad, Shreekanth D.;Doctor, Kaiorisa N.
    • Clinical and Experimental Pediatrics
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    • 제65권3호
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    • pp.142-149
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    • 2022
  • Background: Individuals with Down syndrome present with several impairments such as hypotonia, ligament laxity, decreased muscle strength, insufficient muscular cocontraction, inadequate postural control, and disturbed proprioception. These factors are responsible for the developmental challenges faced by children with Down syndrome. These individuals also present with balance dysfunctions. Purpose: This systematic review aims to describe the motor dysfunction and balance impairments in children and adolescents with Down syndrome. Methods: We searched the Scopus, ScienceDirect, MEDLINE, Wiley, and EBSCO databases for observational studies evaluating the motor abilities and balance performance in individuals with Down syndrome. The review was registered on PROSPERO. Results: A total of 1,096 articles were retrieved; after careful screening and scrutinizing against the inclusion and exclusion criteria, 10 articles were included in the review. Overall, the children and adolescents with Down syndrome showed delays and dysfunction in performing various activities such as sitting, pulling to stand, standing, and walking. They also presented with compensatory mechanisms to maintain their equilibrium in static and dynamic activities. Conclusion: The motor development of children with Down syndrome is significantly delayed due to structural differences in the brain. These individuals have inefficient compensatory strategies like increasing step width, increasing frequency of mediolateral center of pressure displacement, decreasing anteroposterior displacement, increasing trunk stiffness, and increasing posterior trunk displacement to maintain equilibrium. Down syndrome presents with interindividual variations; therefore, a thorough evaluation is required before a structured intervention is developed to improve motor and balance dysfunction.

Intervention Strategy Applied ICF Checklists for Sitting Cross-Legged in Patient with Multiple Ligament Knee Injury: Single Subject Study

  • Kim, Chan Yang;Kwon, Jung-Won
    • The Journal of Korean Physical Therapy
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    • 제33권3호
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    • pp.168-177
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    • 2021
  • Purpose: This study applies the ICF to identify the patient's body function, structure, and participation, evaluates the patient's environmental factors and individual factors, and is a high level of movement to return to the society of patients with multiple ligament injury of the knee joint. Methods: Progressive strength training and ROM exercise were performed 30 minutes a day, 5 times a week for 6 weeks. The evaluation was performed by examining the ROM, length, MMT, instability, dynamic balance, pain and depression. Results: The ROM of the knee joint was improved from 110° to 135° after intervention, and the knee flexion length decreased from 69 cm to 45 cm. Knee flexor is Good after intervention from Poor-, and knee extensor is Good+ after intervention from Poor, and the plantar flexor of the ankle joint improved from Poor- before intervention to Good after intervention and dorsi-flexor of the ankle joint improve to Good from Poor. Pain index was moderate before and after the intervention, with a score of 3, 2 after the intervention, and when maintaining the sitting cross-legged, the before intervention score was 7 to 4 after the intervention. Conclusion: The patient's posture of sitting cross-legged was maintained from 30 seconds before intervention to 14 minutes after intervention. These results were able to set the hypothesis design, intervention method and goal that the multifaceted approach of environment and individual factors as well as body function and structure area, activity and participation area using ICF checklists, it is helped the patient to return to daily life.

기계적 자극과 interleukin-$1{\beta}$가 치주인대 섬유아세포의 collagenase와 TIMP-1의 발현에 미치는 영향 (Effects of mechanical stress and interleukin-$1{\beta}$ on collagenase and TIMP-1 expression in human periodontal ligament fibroblasts)

  • 김명립;배창
    • 대한치과교정학회지
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    • 제28권1호
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    • pp.165-174
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    • 1998
  • 교정력이 치아에 가해지면 치주인대의 재생과 치조골의 개조가 일어난다. 치주인대 섬유아세포는 collagenase와 TIMP-1을 분비하여 치주조직의 교원질의 분해와 합성을 담당한다. 본 연구에서는 치주인대 섬유아세포예 기계적 자극과 interleukin-$1{\beta}$를 가해 collagenase와 TIMP-1의 발현을 RT-PCR과 면역조직화학 염색을 사용하여 알아보았다. 4명의 10대 남자 교정환자에게서 아무런 병소가 없는 제1소구치를 발치후 치주인대 섬유아세포를 배양하여 4-6세대의 세포를 사용하였다. 대조군, $Petriperm dish^{\circledR}$ 바닥의 표면적을 $5\%$ 증가시킨 기계적 자극을 가한 군, interleukin-$1{\beta}$를 1.0 ng/ml를 가한 군과 기계적 자극과 interleukin-$1{\beta}$를 같이 가한 군으로 나누어 4명의 환자에서 얻은 세포군을 각 군별로 2, 4, 8시간 후 RT-PCR을 시행하여 그 산물을 반정량하여 대조군에 대한 각 실험군의 상대적인 증감을 나타내었고, 24시간후 면역조직화학 염색을 시행하여 다음과 같은 결과를 얻었다. 1. 광학 현미경으로 세포의 형태를 관찰한 결과 대조군에서는 전형적인 별모양과 길쭉한 모양을 함께 보였으나 기계적 자극과 interleukin-$1{\beta}$를 각각 혹은 동시에 준 군들에서는 별모양의 세포가 사라지고 모양이 더욱 길어졌다. 2. collagenase는 대조군에 비해 기계적 자극과 interleukin-$1{\beta}$를 각각 혹은 동시에 준 군들에서 증가하였고, 실험 8시간 후에서는 interleukin-$1{\beta}$를 준 군, 기계적 자극과 interleukin-$1{\beta}$를 동시에 준 군에서 뚜렷한 증가를 보였다. 3. TIMP-1은 세포 자극 2, 4시간 후에는 대조군에 비해 기계적 자극과 interleukin-$1{\beta}$를 각각 혹은 동시에 준 군들에서 감소하였지만, 실험 8시간 후에서는 증가를 보였다. 4. 면역조직화학 염색을 통해 collagenase와 TIMP-1이 대조군에 비해 기계적 자극과 interleukin-$1{\beta}$를 각각 혹은 동시에 준 군들에서 더욱 강한 염색상을 나타내었다. 본 실험의 결과 섬유아세포는 외부 자극이 가해지면 collagenase와 TIMP-1의 발현 조절을 통해 치주인대 재생과 치조골의 개조에 영향을 미쳐 항상성을 유지하려고 함을 알 수 있었다.

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Posterior and Multidirectional Instability

  • Kim, Seung-Ho
    • 대한견주관절학회:학술대회논문집
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    • 대한견주관절학회 2005년도 제3차 연수강좌
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    • pp.78-93
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    • 2005
  • The posterior and multidirectional instability of the shoulder is a complex problem in terms of diagnosis and treatment. Increased joint volume by redundant capsular ligament has been regarded as a major pathogenesis of the posterior and multidirectional instability. Distinct from multidirectional hyperlaxity, multidirectional instability has symptoms related with increased translations in more than one direction. Recent report that shoulder symptom originates from labral lesion which was created by excessive rim-loading of the humeral head on the posteroinferior glenoid labrum during repetitive subluxation helps us to understand the pathogenesis of such instability. Painful jerk and Kim tests indicate labral lesion in the multidirectionally loose shoulder, suggesting multidirectional instability. Also, painful jerk test is a prognostic sign of failure of nonoperative treatment. The labral lesion can be an incomplete tear or a concealed lesion which often has been underestimated. Operative treatment is indicated when nonoperative treatment has failed. Arthroscopic capsulolabroplasty is a reliable procedure, which not only provides capsular balance, but also restores the labral height.

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착지 시 외부 무게 부하에 따른 남성과 여성의 하지 관절 각속도, 모멘트, 에너지 흡수에 미치는 영향 (Effect of Added Mass between Male and Female on The Lower Extremity Joints Angular Velocity, Moment, Absorb Energy During Drop Landing)

  • 권문석
    • 한국운동역학회지
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    • 제22권3호
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    • pp.325-332
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    • 2012
  • This study aimed to analyze the effects of external load between male and female on angular velocity, moment, and absorbed energy of the lower-extremity joints during drop landing. The study subjects were 9 male($mass=70.82{\pm}4.64kg$, $height=1.71{\pm}0.04m$, $age=24.5{\pm}1.84years$), 9 female($mass=50.14{\pm}4.09kg$, $height=1.61{\pm}0.03m$, $age=23.6{\pm}2.62years$), without any serious musculoskeletal, coordination, balance, or joint/ligament problems for 1 year before the study. The angular velocity, flexion/extension and abduction/adduction moments, and absorbed energy of the lower-extremity joints were compared between the men and women during drop landing under 4 different conditions of external load(0%, 8%, 16%, and 24%) by using two-way repeated ANOVA(p < .05). The women landed with a greater peak angular velocity of the ankle joint, greater peak inversion moment, and lower peak hip-extension moment than the men did, under all 4 conditions. Additionally, the landing characteristics of the women were distinct from those of the men; the women showed a greater peak knee-adduction moment and greater absorbed energy of the knee joint. These differences indicate that anterior cruciate ligament(ACL) strain was greater in the women than in the men and therefore, women may be at a higher potential risk for noncontact injuries of the ACL with an increase in external load.

Throwing athletes에서 어깨 관절의 손상 (Shoulder Injuries in Throwing Athletes)

  • 이광원
    • 대한정형외과스포츠의학회지
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    • 제2권2호
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    • pp.119-126
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    • 2003
  • Overhead athletes에서 특히 자주 볼 수 있는 불안정성 SLAP 병변, Internal impingement, 회전근 개 병변 등의 질환은 개별적으로 나타나는 것이 아니라 여러 질환이 동반되어 나타나므로 진단이나 치료에 어려움이 많다. 어깨 관절 손상의 성공적인 치료 및 운동으로의 복귀를 위하여는 각각의 운동의 생역학적인 측면과 개개의 질환의 증상 및 정확한 진단, 병리기전에 대한 확실한 이해가 선행되어야한다.

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보행 시 신발의 아웃솔 형태가 하지 관절 운동과 발의 압력에 미치는 영향 (The Effect of Form and Hardness of Outsoles on the Motion of the Lower Extremity Joints and on Foot Pressure during Gait)

  • 김의환;김성섭;권문석;위웅량;임정;정재욱
    • 한국운동역학회지
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    • 제21권2호
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    • pp.223-230
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    • 2011
  • The purpose of this study was to analysis the effect of form and hardness of outsoles on the motion of the lower extremity joints and on foot pressure during gait. The subjects were 15 women(mean age, $48.5{\pm}2.4$ years), who had no serious musculoskeletal, coordination, balance or joint/ligament problems within 1 year prior to the study. The pelvic tilt, joint angles at the lower extremities and the vertical ground reaction force(GRF) were compared during gait with 3 types of shoes (A, B, C) by using one-way repeated ANOVA(p<.05). During gait, the peak tilt angle and the range of motion(ROM) of the ankle and knee joints were found to be significantly different among the 3 types of shoes. The type C shoes showed a significantly lower mean second maximum vertical GRF than types A and B. The curved outsoles of type C shoes, which had a form and hardness different from those of A and B, was designed strategically for walking shoes to provide stability to the Additionally, type C induced the dispersion of eccentric pressure and made the center of pressure roll over to the center line of the foot.

EMG를 이용한 경사면에서의 근피로도 분석 (EMG assessment of Muscle Fatigue on Sloping Ground When Lifting)

  • 서승록;김종석
    • 한국산업정보학회논문지
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    • 제5권2호
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    • pp.1-8
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    • 2000
  • 인력물자취급(MMH)작업은 작업현장에서 육체적 상해와 요통(LBP)을 발생시키는 주요 원인 중에 하나이며 이러한 산업재해는 점점 증가하고 있는 실정이다. 특히 좋지 않은 작업환경 즉, 비탈진 경사면에 위치한 농장이나 과수원, 항만부두의 하역작업, 경사진 벌목장 작업, 광산의 막장에서의 작업은 많은 재해의 위험성을 초래하며, 신체균형의 상실은 근골격계(musculoskeletal System)의 부상을 초래하게 된다. 본 연구는 경사면에서의 들기작업시 작업자의 근육의 force information과 근피로도를 측정하기 위해 EMG 시스템을 이용하였다. 측정결과 AEMG의 경우 모든 조건에서 일반적으로 multifidus 근육에 걸리는 부하가 다른 근육에서보다 많은 것으로 나타났고, 15$^{\circ}$, 20$^{\circ}$인 경우 neck extensors의 사용이 많은 것으로 나타났다. MPF천이 결과 공통적으로 multifidus부위 근육의 천이정도가 가장 많은 것으로 나타났다. 근육별 부하(%)에 대한 결과는 deep spinal 근육인 multifidus, erectorspinae부위가 상대적으로 많은 것으로 나타났고 neck extensor부위는 근육분담이 적은 것으로 나타났다.

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생강 약침의 임상적 활용을 위한 고찰 (A Study of Ginger Herbal Pharmacopuncture for Practical Application)

  • 이채우;이병훈;윤현민
    • 대한약침학회지
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    • 제12권1호
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    • pp.43-51
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    • 2009
  • Objective : The purpose of this study is to present the standard for practical application of ginger herbal pharmacopuncture Material and Methods : We refer to ancient literatures and the recent papers for ginger. Conclusions : The following results have been obtained 1. The effect of ginger(Zingiber officinale Roscoe) is to "release exterior", "balance nutrient & defensive qi", "resolve phlegm", "arrest coughing", "warm the lungs". So ginger herbal pharmacopuncture can be applied to treating fever, chilling sign, headchae, snuffle and gasping cough due to cold affection and treating the symptoms like sputum and asthma that be revealed by pulmonary disease. 2. The effect of ginger is to "warm spleen and stomach", "arrest vomiting" "promote normal flow of water". So ginger herbal pharmacopuncture can be applied to treating nausea, vomiting, abdominal distension and diarrhea due to phlegm & dampness and treating edema. 3. The effect of ginger is to eliminate blood stasis. So ginger herbal pharmacopuncture can be applied to treating contusion, blood stasis, sprain and gynecologic disease. 4. Ginger can treat myalgia and pain due to wind-damp and have anti-inflammatory effect in pharmacology. So ginger herbal pharmacopuncture can be applied to treating disease of joint, ligament and muscle. 5. Ginger can resolve phlegm and resuscitate. So ginger herbal pharmacopuncture can be applied to treating unconsciousness. But, treating incipient cardiovascular accident, it needs to call your special attention to the danger of blood pressure increase. 6. In pharmacology, ginger is effective for antitumor, antioxidant effects and activating immunocyte. So ginger herbal pharmacopuncture can be applied to treating broadly varieties of tumor and allergic disease.