• Korea Journal of Hospital Management
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• v.29 no.3
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• pp.1-10
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• 2024

Purposes: When rehabilitation services are provided remotely using information and communication technologies to patients living at home, there is an advantage in providing rehabilitation services to individuals in their everyday social and physical environment, which can improve functional outcomes and satisfaction. The purpose of this study was to analyze the effectiveness of the pilot project by analyzing the outpatient and inpatient medical use and expenses of patients who participated in the rehabilitation patient home-based care pilot project. Methodology: To analyze the effectiveness of the home-based care pilot project for rehabilitation patients, health insurance claims data from the Health Insurance Review and Assessment Service was used. The subjects of analysis were patients who had undergone major lower extremity joint replacement surgery, including hip, knee, and ankle joint replacement surgery, and patients who had lower extremity fracture surgery, which were the targets of the rehabilitation patient home-based care pilot project. To compare medical use and expenses between patients participating in the rehabilitation patient home-based care pilot project and those not participating, chi-square test, t-test, and multiple regression analysis were performed. Findings: As a result of analyzing the number of medical use cases and expenses of patients who participated and those who did not participate in the rehabilitation patient home-based care pilot project, the average outpatient medical use and outpatient medical expenses per person for participating patients were lower than those for patients who did not participate. The average hospitalization cost per person and the average length of stay per person were also lower than those of patients who did not participate. Practical Implications: Home-based care for rehabilitation patients continues to provide medical services at home, not at medical institutions, and can be expected to reduce readmissions and complications by resolving patients' emergency situations at home or on their own, thereby reducing medical use.

• Korean Journal of Applied Biomechanics
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• v.28 no.4
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• pp.227-236
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• 2018

Objective: The purpose of this study was to investigate the effects of a 12-week combined exercise program on gait parameters in elderly women with osteoarthritis. Method: The subjects of this study were 11 elderly women (age: $67.09{\pm}2.47$, height: $157.35{\pm}4.30cm$, weight: $62.49{\pm}6.36kg$) with knee osteoarthritis. The combined exercise program of this study was divided into aerobic exercise and lower extremity strengthening exercises. The exercises were performed for 60 minutes per session, three times a week, for a total of 12 weeks. The maximum joint moments of the hip, knee, and ankle joints with walking were obtained with 8-3D cameras (MX-T20, Vicon, USA) and 2-force plate (AMTI OR6-7-400, AMTI, USA). SPSS Windows version 23.0 was used for statistical analysis. A paired t-test was used for pre-post comparison. An alpha level of .05 was utilized in all tests. Results: The maximum extension moment was significantly higher in the hip joint after P1 on the X axis. The maximum joint moment of P3 in extension was statistically significantly lower after intervention. On the Z axis, the maximum joint moment was significantly lower after the exercise intervention at P3. There was a statistically significant increase in the extension moment of the left and right knee joints in the X axis after exercise intervention. In the right ankle joint, P1 (plantar flexion moment) showed a statistically significant high moment after exercise intervention. Conclusion: These results suggest that combined exercise, including lower limb and aerobic exercise, may have a positive effect on mobility and walking moments in patients with osteoarthritis of the knee.

• Journal of Biomedical Engineering Research
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• v.35 no.3
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• pp.35-41
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• 2014

In this study, joint angles of the lower extremity and inertial sensor data such as accelerations and angular velocities were measured during a ski simulator exercise in order to evaluate the skill of skiers. Twenty experts and twenty unskilled skiers were recruited for the study. All expert skiers held the certificates issued by the Korea Ski Instructors Association. A three-dimensional motion capture system and two inertial sensors were used to acquire joint movements, heel acceleration and heel angular velocity during ski simulator exercises. Pattern variation values were calculated to assess the variations in ski simulator motion of expert and unskilled skiers. Integral ratio of roll angular velocity was calculated to determine the parallel alignment of the two feet. Results showed that ski experts showed greater range of motion of joint angle, peak-to-peak amplitude(PPA) of heel acceleration and PPA of heel angular velocity than unskilled skiers. Ski experts showed smaller pattern variations than unskilled skiers. In addition, the integral ratio of roll angular velocity in ski experts was closer to 1. Inertial sensor data measurements during the ski simulator exercises could be useful to evaluate the skill of the skier.

• Korean Journal of Applied Biomechanics
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• v.25 no.1
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• pp.49-56
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• 2015

Objectives : The purpose of this study was to present quantitative data and basic references to decrease the accident risk of soccer instructors. Methods : To obtain data, we conducted an investigation on how H/Q ratio affects the dynamic stability of the lower extremity at the time of drop landing. The study targeted 13 soccer players from C University who have not had any injuries or wounds in the lower extremity joints and in any other parts of their bodies over the last 6 months. By using CMIS (USA), the players were divided into two groups according to H/Q ratios higher and lower than 69%, respectively. The subjects in each group were instructed to perform a drop landing. Results : The H/Q ratio did not affect the maximal flexion angle of the knee joints at the time of drop landing. In addition the dominant group with a relatively high H/Q ratio was observed to have increased time to reduce shock and to efficiently absorb the ground reaction force during drop landing. Also, the dominant group with a relatively high H/Q ratio utilized the strong performances of the antagonistic muscles around the hamstrings and the controlled rotatory powers of the thighs that were applied to the tibias supported by the ground. Finally, H/Q ratio, load factors, and mean and maximum EMG were significantly negatively related, whereas GRFx showed a positive relationship. In fact, these factors all affected the impact of the load from the H/Q ratio to the knee joints. Conclusion : From these findings it can be concluded that unbalanced H/Q ratio can be considered as a predictor of knee joint injury at the time of drop landing.

• PNF and Movement
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• v.17 no.3
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• pp.463-469
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• 2019

Purpose: This study investigated the effect of plantar-flexor muscle fatigue on the force sense and joint reposition sense of ankle joints in the healthy adults. Methods: Fifteen healthy subjects (male: 9, female: 6) participated in this study. A digital dynamometer was used to measure the force sense error while a wireless motion capture device was used to measure the joint reposition sense error. To induce plantar-flexor muscle fatigue for a dominant lower extremity, the subjects were asked to perform plantar flexion until exhaustion while barefoot. The differences in force sense error and joint reposition sense error for the ankle joint were measured immediately. The Wilcoxon test was used to compare these values before and after inducing plantar-flexor muscle fatigue. Results: The force sense error and joint reposition sense error of ankle joints after inducing plantar-flexor muscle fatigue increased significantly compared to the values before inducing muscle fatigue. Conclusion: This study suggests that plantar-flexor muscle fatigue could degrade the force sense and joint reposition sense in ankle joints. In addition, it could deteriorate ankle proprioception.

• Journal of Fisheries and Marine Sciences Education
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• v.26 no.3
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• pp.535-542
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• 2014

The purpose of this study was to analyze the movements of the lower extremity joints during a taekwondo kick motion called 'Juchumseogi hu Apkkoaseogi yeopchagi', which was administered to players to improve their balance, stability, and range of motion for the prevention of injuries. Eight professional players and amateur players were recruited as the subjects. Kinematic data were collected by four real-time infrared cameras. The hip joint, knee joint, and ankle joint angles were measured using instruments. During the 'Juchumseogi hu Apkkoaseogi yeopchagi' kick motion, there were small and inconsistent effects on each joint. This study processed the data using the Windows SPSS Ver. 18.0 to get an independent t-test, with the setting, p< .05. Results indicated that hip joint, knee joint, and ankle joint angles were almost significantly different between professional and amateur player during 'Juchumseogi hu apgeule Apkkoaseogi' kick motion.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.11 no.1
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• pp.39-44
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• 2013

Purpose : The purpose of present study is to evaluate the joint angles of legs in the standing posture for six patients with unilateral knee osteoarthritis. Methods : The participants underwent unilateral total knee replacement. A motion analysis was used to measure the joint angles of the hip, knee, and ankle. The measurements were taken before the surgery, one week and two weeks after the surgery. Both sides of the legs were evaluated. Results : This result showed that after a certain healing period, both hip joint angles showed a significant difference while there was no significant difference in the knee and ankle joint angles. After surgery, the angle of ankle dorsiflexion was smaller on the operated side than the opposite side compared to the pre-surgery measurements. Conclusion : After surgery, the asymmetry in a standing position left unchanged due to contracture of the knee joint and tightness in the hamstring muscle. Therefore, when physiotherapists plan an initial exercise programs for TKR patients, it is essential to apply adequate exercises which consider the contracture of the leg joints.

• The Journal of the Korean bone and joint tumor society
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• v.1 no.1
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• pp.45-51
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• 1995

The incidence of metastatic bony lesion has been increased recently, with the advanced therapeutic modalities of malignant tumors. The purpose of this study was to evaluate the effectiveness of surgical treatment in impending or established pathologic fractures due to metastasis in extremity. From 1981 to 1992, thirty two patients who had established or impending pathologic fractures in extremity had been treated surgically. The locations of metastasis, were lower extremity in 24 cases(femsral head and neck;5, intertrochanteric;7, subtrochanteric;8, femoral shaft;4) and upper extremity in 8 cases(proximal humerus;2, humoral shaft;6). The method of surgery was excision of tumor mass and rigid internal fixation to allow immediate mobilization, except 2 cases of amputation. The results were analysed by two criteria. The first was the grade of performance status that was made by modification of Functional Classification of New York Heart Association. The second was the degree of pain relief. The performance status was improved at least one grade in all patients and the mean improvement was 1.7 grades. The satisfactory pain relief was achieved in 81% of patients. Postoperatively, most of the patients had only slight to moderate limitation of physical activities and they became comfortable at rest and ordinary activities. The solitary metastatic lesions showed better pain relief(92%) than multiple metastasis(75%). The curative surgery was done in 3 cases, and they showed more than 24 months of disease-free survival.

• Korean Journal of Applied Biomechanics
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• v.16 no.4
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• pp.31-38
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• 2006

The purpose of this study was to investigate the effect of changing the steps height on the joint moment of lower extremity in stair-descent activity of elderly persons. Data were collected by 3-D cinematography and force platform. 9 male elderly subjects in the 60s and 70s participated in this study. All subjects performed a stair-descent in four different heights of stairs (10, 14, 18, 22cm) having 5 step staircase. The results were as follows. 1. For the step height of 22cm the maximum. plantarflexion moment was the smallest and the largest for the step height of 14cm. 2. There was not a statistical difference shown for the extension moment of the knee joint for the different height of steps. 3. There was not a statistical difference shown for the flexion moment of the hip joint for the varying height of steps but on average for the 18cm step this increased rapidly. 4. The smallest maximum. value for inversion moment was revealed for the step height of 10cm and this increased significantly for the step height of 22cm. 5. The smallest maximum. value for abduction moment of the hip joint was revealed for the step height of 10cm and this increased significantly for the step height of 22cm. 6. There was no significant difference shown for the maximum. abduction moment for the hip joint. The main conclusion is that there is a huge difference in the moment of the lower extremities for the elderly while walking down a stairs with a step height above 18 cm and that this moment increased or decreased rapidly under a condition of step height being 22cm. With the results from this research and related research of elderly walking upstairs it can be shown that the step height has a large role in the safety for the elderly.

• Korean Journal of Applied Biomechanics
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• v.16 no.3
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• pp.105-115
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• 2006

The purpose of this study is to elucidate the mechanical characteristics of lower extremity joint movements at different walking speeds in obese people and suggest the very suitable exercise for obese person's own body weight and basic data for clinical application leading to medical treatment of obesity. This experimental subjects are all males between the ages of 20 and 30, who are classified into two groups according to Body Mass Index(BMI): one group is 15 people with normal body weight and the other 15 obese people. Walking speed is analysed at 3 different speeds ($1.5^m/s$, $1.8^m/s$, $2.1^m/s$) which is increased by $0.3^m/s$ from the standard speed of $1.5^m/s$. We calculated joint moments of lower extremity during stance phase through video recording and platform force measurement.Two-way ANOVA(Analysis of Variance, Mix) is applied to get the difference of moments according to walking speeds between normal and obese groups. Pearson's Correlation Analysis is applied to look into correlation between walking speeds and joint moments in both groups. Significance level of each experiment is set as ${\alpha}=.05$. As walking speed increases maximum ankle plantar flexion moment in the stance phase is smaller in obese group than in normal group, which is suggestive of weak toe push-off during terminal stance in obese group, and the highest maximum ankle plantar flexion moment in obese group during the middle speed walking($1.8^m/s.$). Maximum ankle dorsal flexion moment in obese group is relatively higher than in normal group and this is regarded as a kind of compensatory mechanism to decrease the impact on ankle when heel contacts the floor. Maximum knee flexion and extension moments are both higher in normal group with an increase tendency proportional to walking speed and maximum hip flexion and extension moments higher in obese group. In summary, maximum ankle plantar flexion moment between groups(p<.025), maximum knee moment not in flexion but in extension(p<.001) within each group according to increasing walking speed, and maximum hip flexion and extension moment(p<.001 and p<.004, respectively according to increasing walking speed are statistically significant but knee and hip moments between groups are not. Pearson correlation are different: high correlation coefficients in maximum knee flexion and extension moments, in maximum hip extension moment but not hip flexion, and in maximum ankle dorsal flexion moment but not ankle plantar flexion, in each group. We suspect that equilibrium imbalance develops when the subject increases walking speed and the time is around which he takes his foot off the floor.