• Title/Summary/Keyword: Lower Extremity Joint

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A Case of Adult onset Henoch-Sch$\ddot{o}$nlein Purpura with Acute Renal Failure (급성 신부전을 동반한 성인 Henoch-Sch$\ddot{o}$nlein 자반증 1예)

  • Kim, Seok-Min;Chang, Kyung-Ae;Jung, Sun-Young;Park, Chan-Soh;Park, Jong-Won;Do, Jun-Young;Kim, Yong-Jin;Yoon, Kyung-Woo
    • Journal of Yeungnam Medical Science
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    • v.25 no.1
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    • pp.58-63
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    • 2008
  • Henoch-Sch$\ddot{o}$nlein purpura (HSP) is a leukocytoclastic vasculitis of small vessels with deposition of IgA, commonly resulting in skin, joint, gastrointestinal, and kidney involvement. HSP is an uncommon disorder in adults and accounts for 0.6% to 2% of adult nephropathy. We report a case of HSP with acute renal failure successfully treated with corticosteroid. In this case, the patient presented with vasculitic purpuric rash on lower extremity, arthralgia in the wrist, abdominal pain, hematochezia, oliguria and azotemia. Abdominal CT showed wall thickening of the small and large bowels. Skin biopsy revealed leukocytoclastic vasculitis. Percutaneous renal biopsy showed no crescent formation, but mesangial IgA and $C_3$ deposits were observed by immunofluorescence. The patient was treated with corticosteroid (1mg/kg per day) and hemodialysis. After treatment, renal function improved and purpuric lesion, arthralgia and abdominal pain disappeared. Thus, when adults present with purpuric rash and rapidly progressive glomerulonephritis (RPGN), HSP should be a diagnostic consideration.

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Gait Asymmetry in Children with Down Syndrome (다운증후군 아동들의 보행 비대칭성 연구)

  • Lim, Bee-Oh;Han, Dong-Ki;Seo, Jung-Suk;Eun, Seon-Deok;Kwon, Young-Hoo
    • Korean Journal of Applied Biomechanics
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    • v.16 no.2
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    • pp.145-151
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    • 2006
  • A large interindividual variability and some abnormally kinematic patterns at the lower extremity were the main features of the gait in children with Down syndrome. The purposes of this study were to investigate the gait asymmetry and biomechanical difference between dominant leg and non dominant leg in children with Down syndrome. Seven boys with Down Syndrome(age: $120{\pm}0.9yrs$, weight $34.4{\pm}8.4kg$, leg length: $68.7{\pm}5.0cm$) participated in this study. A 10.0 m ${\times}$ 1.3 m walkway with a firm dark surface was built and used for data collection. Three-dimensional motion analyses were performed to obtain the joint angles and range of motions. The vertical ground reaction forces(%BW) and impulses($%BW{\cdot}s$) were measured by two force plates embedded in the walkway. Asymmetry indices between the legs were computed for all variables. After decision the dominant leg and the non dominant leg with max hip abduction angle, paired samples t-test was employed for selected kinematic and ground reaction force variables to analyze the differences between the dominant leg and the non dominant leg. The max hip abduction angle during the swing phase showed most asymmetry, while the knee flexion angle at initial contact showed most symmetry in walking and running. The dominant leg showed more excessive abduction of hip in the swing phase and more flat-footed contact than the non dominant leg. Vertical peak force in running showed more larger than those of in walking, however, vertical impulse showed more small than walking due to decrease of support time. In conclusion, the foot of dominant leg contact more carefully than those of non dominant leg. And also, there are no significant difference between the dominant leg and the non dominant leg in kinematic variables and ground reaction force due to large interindividual variability.

Effect of Active Change of Foot Progression Angle on Lower Extremity Joint During Gait (보행 시 의도적인 발 디딤 각도 변화가 하지 관절 부하에 미치는 영향)

  • Go, Eun-Ae;Hong, Su-Yeon;Lee, Ki-Kang;An, Keun-Ok
    • Korean Journal of Applied Biomechanics
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    • v.23 no.1
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    • pp.85-90
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    • 2013
  • Efficient gait is compensate for a lack of exercise, but the wrong walking can cause disease that joints, muscles, brain and body structure(Scott & Winter, 1990). Also many researchers has been studied gait of positive mechanism using analytical methods kinetic, kinematic. This study is to identify nature of knee adduction moment, depending on different foot progression angle and the movement of rotation of pelvis and body. Health study subject conducted intended walking with three different angles. The subjects of this study classified three types of walking; walk erect, pigeon-toed walk and an out-toed gait. Ten university students of K without previous operation and disease record selected for this study. For accuracy of this study, three types of walking carried out five times with 3D image analysis and using analysis of ground reaction force to analyze nature of knee adduction moment and the movement of rotation of pelvis and body. Firstly, the HC(heel contact) section value of intended walk erect, pigeon-toed walk and an out-toed gait was not shown statistically significant difference but TO(toe off) section value was shown that the pigeon-toed walk statistically significant. The value of pigeon-toed walk was smallest knee adduction moment(p< 0.005). Secondly, X axis was the change of rotation movement body and pelvis when walk erect, pigeon-toed walk and an out-toed gait. Shown statistically Y axis was not shown statistically significant but Z axis statistically significant(p<0.05). These result show the significant differences on TO section when walking moment reaches HC, it decides the walking types and rotates the foot.

The effects of strengthening exercise, stretching and meditation on electromyography onset timing of the rectus femoris and gastrocnemius during vertical jump performance in healthy adults

  • Eum, Ji Young;Kim, Yeoung Kyun;Park, Eun Ji;Lee, Ju Hee;Lee, Ji Eun;Lim, Jin Ju;Choi, Man Ho;Kim, Hyun Hee
    • Physical Therapy Rehabilitation Science
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    • v.4 no.1
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    • pp.22-27
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    • 2015
  • Objective: Jump training helps increase the muscle power by improving the muscle strength and reaction time of the muscle in operation. The purpose of this study was to identify the effects of strengthening, stretching exercise and meditation on electromyographic (EMG) onset timing of rectus femoris and gastrocnemius muscle during vertical jump performance. Design: Cross-sectional study. Methods: Ten healthy adults (5 male and 5 female) who were familiar with the vertical jumping task and had no lower extremity injuries or any bone or joint disorders, were recruited for this study. Muscle onset timing was measured by surface EMG. After EMG onset timing were measured during performing three baseline vertical jump trials, strengthening and stretching exercises of the rectus femoris and gastrocnemius, and meditation were performed in random order. EMG onset timing was measured during vertical jump after intervention, respectively. EMG value was averaged for the three trials and analyzed using one-way repeated ANOVA. Results: During vertical jump, EMG onset timing of gastrocnemius was a significant difference after intervention (p<0.05), and then there was significantly faster in strengthening exercise than meditation (p<0.05). Conclusions: These results indicate the potential positive effect of performing strengthening exercise of the gastrocnemius before a jumping event. Future research is required to identify the effects of intervention over a long period.

Human Postural Dynamics in Response to the Horizontal Vibration

  • Shin Young-Kyun;Fard Mohammad A.;Inooka Hikaru;Kim Il-Hwan
    • International Journal of Control, Automation, and Systems
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    • v.4 no.3
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    • pp.325-332
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    • 2006
  • The dynamic responses of human standing postural control were investigated when subjects were exposed to long-term horizontal vibration. It was hypothesized that the motion of standing posture complexity mainly occurs in the mid-sagittal plane. The motor-driven support platform was designed as a source of vibration. The AC Servo-controlled motors produced anterior/posterior (AP) motion. The platform acceleration and the trunk angular velocity were used as the input and the output of the system, respectively. A method was proposed to identify the complexity of the standing posture dynamics. That is, during AP platform motion, the subject's knee, hip and neck were tightly constrained by fixing assembly, so the lower extremity, trunk and head of the subject's body were individually immovable. Through this method, it was assumed that the ankle joint rotation mainly contributed to maintaining their body balance. Four subjects took part in this study. During the experiment, the random vibration was generated at a magnitude of $0.44m/s^2$, and the duration of each trial was 40 seconds. Measured data were estimated by the coherence function and the frequency response function for analyzing the dynamic behavior of standing control over a frequency range from 0.2 to 3 Hz. Significant coherence values were found above 0.5 Hz. The estimation of frequency response function revealed the dominant resonance frequencies between 0.60 Hz and 0.68 Hz. On the basis of our results illustrated here, the linear model of standing postural control was further concluded.

Changes in the Biomechanical Properties of Ankle Plantarflexors Following 8-week Resistance Training with or without Whole-Body Vibration in Older Women (8주간의 체중을 이용한 저항운동 시 전신진동 유·무에 따른 노인 여성하지의 발바닥쪽굽힘근의 생체역학적 특성 변화)

  • Han, Bo-Ram;Lee, Dae-Yeon;Jeong, Si-Woo;Lee, Hae-Dong
    • Korean Journal of Applied Biomechanics
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    • v.24 no.4
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    • pp.399-415
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    • 2014
  • The aim of this study was to investigate the effect of resistance training with and without whole-body vibration(WBV) on the biomechanical properties of the plantarflexor in the elderly women (>60 yrs., n=35). Thirty-five volunteers were randomly assigned to a resistance training with WBV group (RVT, n=14), a resistance training without WBV (RT, n=11), and a non-training control group (CON, n=10). The RVT and the RT groups participated in the training sessions three times a week for 8 weeks, followed by a 4-week detraining period. The CON group was instructed to refrain from any type of resistance training. To assess strength and activation of the plantarflexor muscles, maximum isometric ankle plantarflexion torque and muscle activation of the triceps surae muscles were measured using dynamometry, twitch interpolation technique and electromyography at four different ankle joint angles. Also, the lower extremity function was assessed by vertical jumping. The measurements were performed prior to, 2 and 8 weeks after the training and after a 4-week detraining period. Following the 8-week training sessions, an increase in the isometric plantarflexion strength was found to be greater for the RVT compared with the RT group (p<.05). Muscle inhibition was significantly decreased after training than before training only for the RVT (p<.05). Following the detraining period, a decrease in isometric plantarflexors strength and a increases in muscle inhibition were significantly less in the RVT compared with the RT group. In conclusion, the exercise with WBV is a feasible training modality for the elderly and seems to have a boosting effect when used with conventional resistance training.

Effects of the Short Foot Exercise With Neuromuscular Electrical Stimulation on Navicular Height in Flexible Flatfoot in Thailand: A Randomized Controlled Trial

  • Namsawang, Juntip;Eungpinichpong, Wichai;Vichiansiri, Ratana;Rattanathongkom, Somchai
    • Journal of Preventive Medicine and Public Health
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    • v.52 no.4
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    • pp.250-257
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    • 2019
  • Objectives: Flatfoot, or low medial longitudinal arch, contributes to back and lower extremity injuries and is caused by weak abductor hallucis (AbdH) muscles. The purpose of this study was to investigate the effects of short foot exercise (SFE) alone or with neuromuscular electrical stimulation (NMES) on navicular height, the cross-sectional area (CSA) of the AbdH muscle, and AbdH muscle activity in flexible flatfoot. Methods: Thirty-six otherwise healthy people with flexible flatfoot were randomly assigned to a group that received SFE with placebo NMES treatment (the control group) or a group that received both SFE and NMES treatment (the experimental group). Each group received 4 weeks of treatment (SFE alone or SFE with NMES). Navicular height, the CSA of the AbdH muscle, and AbdH muscle activity were assessed before and after the intervention. Results: No significant differences were found in navicular height or the CSA of the AbdH muscle between the control and experimental groups, while AbdH muscle activity showed a statistically significant difference between the groups ($SFE=73.9{\pm}11.0%$ of maximal voluntary isometric contraction [MVIC]; SFE with $NMES=81.4{\pm}8.3%$ of MVIC; p<0.05). Moreover, the CSA of the AbdH muscle showed a statistically significant increase after treatment in the SFE with NMES group ($pre-treatment=218.6{\pm}53.2mm^2$ ; $post-treatment=256.9{\pm}70.5mm^2$ ; p<0.05). Conclusions: SFE with NMES was more effective than SFE alone in increasing AbdH muscle activity. Therefore, SFE with NMES should be recommended to correct or prevent abnormalities in people with flexible flatfoot by a physiotherapist or medical care team.

Lumbar Juxtafacet Cyst Treated with Direct Needle Aspiration Under the Guidance of Image Intensifier (영상증폭기하에서 직접적 바늘 흡인술로 치료한 요추 후관절 주위 낭종)

  • Hong, Sung-Ha;Suh, Seung-Pyo;Hwang, Seok-Ha;Kim, Yun-Seong
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.261-265
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    • 2020
  • A lumbar juxtafacet cyst is a rare disease that causes low back pain, radiculopathy and neurological claudication by compressing the nerve roots. A 34-year-old male complained of severe low back pain and radicular pain in the right lower extremity. Magnetic resonance images revealed a cyst at the lateral recess of the spinal canal between the L3-4 disc and posterior facet joint that extended to the L4 body level. Under the guidance of an image intensifier, needle aspiration of the cyst was performed, which extracted 1.5 ml of serous, yellowish colored fluid. After the aspiration, the symptoms subsided dramatically. The follow-up magnetic resonance images showed no recurrence of the cyst. To the best of the author's knowledge, there are no reports of lumbar juxtafacet cyst treated with needle aspiration in Korea. This case is reported with a review of the relevant literature.

Effects of Limited Dorsiflexion Range of Motion on Movement Strategies during Landing (발등굽힘 관절가동범위 제한이 착지 시 움직임 전략에 미치는 영향)

  • Inje Lee;Donggun Kim;Hyeondeukje Kim;Hyunsol Shin;Jiwon Lee;Yujin Jang;Myeongwoo Pi
    • Korean Journal of Applied Biomechanics
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    • v.33 no.4
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    • pp.147-154
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    • 2023
  • Objective: This study aimed 1) to compare the Landing Error Scoring System (LESS) score and movement patterns during landing of the lesser dorsiflexion range of motion (LDFROM) group to that with the greater dorsiflexion range of motion group, and 2) to identify the correlation between the weight-bearing dorsiflexion range of motion (WBDF ROM), LESS score, and movement patterns during landing. Method: Fifty health adults participated in this study. WBDF ROM was measured using the weight bearing lunge test while movement patterns during landing was assessed using the LESS. The joint angles of the ankle, knee and hip joints during landing were analyzed using the 2D video analysis. After mean value of WBDF ROM was calculated, participants were divided into two groups (GDFROM and LDFROM) based on the mean value. The Mann-Whiteny 𝒰 test was used to identify differences in movement strategies during landing between two groups and the Pearson's correlation analysis was performed to determine relationships between WBDF ROM and movement strategies. Results: The LDFROM group showed the poorer LESS score and stiffer landing kinematics during landing compared to the GDFROM group (p<0.05). In addition, DFROM was significantly related to the LESS score and landing kinematics (p<0.05) except for total hip excursion (p=0.228). Conclusion: Our main findings showed that the LDFROM group had poorer landing quality and stiffer landing movements compared to the GDFROM group. In addition, increase of WBDF ROM significantly improved landing quality and soft-landing movements. To reduce shock during landing such as ground reaction forces, individuals need to better utilize WBDF ROM and lower extremity movements based on our findings. Therefore, intervention programs for safer landings should include exercises that increase WBDF ROM and utilize eccentric contraction.

Difference of muscle activity and muscle contraction onset time of the trunk and lower extremity according to object weights and leg length discrepancy during lifting tasks (물건 들기 시 다리길이 차이 유무와 물건 무게에 따른 몸통과 다리의 근활성도와 근수축 개시시간 차이)

  • Hyeon Nam Ryu;Sung Jun Han;Jin Tae Han
    • Journal of Korean Physical Therapy Science
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    • v.31 no.2
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    • pp.30-40
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    • 2024
  • Background: The purpose of this study is to identify the difference in muscle activity and muscle contraction onset time according to a LLD and object weight When subjects performed a lifting task. Design: Repeated measure design Methods: 15 male adults participated in this study. When subjects performed a lifting task, we measured a difference of muscle activity and muscle contraction onset time in the rectus abdominis(RA), the erector spinae(ES), and the rectus femoris(RF) between both legs using the surface electromyogram (Telemyo DTS, Noraxon Inc., USA). When subjects performed a lifting task, the weight of the object was set to 0% kg, 10% kg, and 20% kg of the subject's body weight, excluding the weight of the box. Results: The difference in muscle activity in the RA, the ES, and the RF between both legs when lifting an object was larger in LLD condition than in non-LLD condition(p<0.05). In all of muscles, the difference of contraction onset time was generally increased as the object's weight increased. Specially, the difference in muscle contraction onset time in the RA, the ES between both legs was larger in the LLD condition than in the non-LLD condition(p<0.05). Conclusion: This study suggests that LLD affects the muscle activity and muscle contraction onset time during lifting objects. It can be used as data to prevent joint damage and muscle due to the LLD during work and movements of daily living.