• Title/Summary/Keyword: Lower extremity joint

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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.

Tumor Prosthetic Arthroplasty and Arthroplasty with Bone Cement for the Metastatic Malignant Bone Tumor in the lower Extremity (하지 관절 부위에 발생한 전이성 종양 환자의 종양 대치물 및 골시멘트와 인공관절 삽입술)

  • Yang, Jun-Young;Lee, June-Kyu;Hwang, Deuk-Soo;Shin, Hyun-Dae;Kwak, Sang-Koo;Kim, Kyung-Cheon;Nam, Dae-Cheul
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.12-17
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    • 2003
  • Purpose: In this report we are going to discuss about the functional evaluation and the outcome of treatment of metastatic tumor in the lower extremities treated with tumor prosthetic arthroplasty. Materials and Methods: This report is based on nine patients diagnosed as a metastatic tumor and treated by tumor prosthetic arthroplasty, from June 1998 to December 2001. Age of the patients ranged from 49 to 63 with the average of 56.3. The average follow up period was 23.4 months. Two patients had lung cancer, three had breast cancer, two had renal cancer, one colon cancer, and one had multiple myeloma. All these were primary cancers. The site of metastasis were six in proximal femur, two in distal femur, and one in proximal tibia. Tumor excision was performed after biopsy in following the principle of primary tumor management. Excision with wide surgical margin was tried as possible could. Six cases were treated with tumor prosthesis, and the other three cases were reconstructed with bone cement and arthroplasty. Results: The functional evaluation in the extremities at the last follow up was performed on Enneking evaluation score with 6 categories. The highest scored 26, and the lowest scored 10, with an average of 19.5. A case in which the patient died 15 days after the operation was excluded from the evaluation. Among the categories, emotional acceptance to postoperative function and pain relief were highly scored. At the final follow up, seven patients survived, and one colon cancer patient died 68 days after operation. Conclusion: Metastatic tumor occurring in joints of lower extremities could be treated in accordance to the treatment principle of primary tumor. By insertion of tumor prosthesis, we can get satisfactory results of function in the lower extremity and pain relief especially. So, this aspect of medical favor must be considered in treating patients.

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Synovial Sarcoma (활막 육종)

  • Hahn, Soo-Bong;Shin, Kyoo-Ho;Kim, Jin-Yong;Cho, Nan-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.91-97
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    • 1995
  • Synovial sarcoma is a malignant soft tissue tumor which is the most prevalent in adolescents and young adults between 10 and 40 years of age. It occurs primarily in the para-articular regions, usually in close association with tendon sheath, bursae and joint capsules. Favorable clinical factors are young age of the patients, tumor size smaller than 5cm, and distal rather than proximal location in the extremities. We analysed clinical findings of 13 cases of synovial sarcoma that had been experienced from January 1983 to December 1992. There were 8 females and 5 males, whose age was averaged as 28 years and 10 months ranging from 6 years to 54 years. The mean follow-up was 3 years(range : 9 months- 9 years 1 month). Palpable mass was frequent clinical symptom and lower extremity especially around the knee was the most prevalent site. Treatment modalities were the combination of surgery, radiotherapy and chemotherapy. Distant metastasis occured in 5(38%) cases : 4 cases to lung and 1 case to neck, and 2 cases had local recurrences. At final follow-up 6 cases were continous disease free, 2 alive with disease and 5 died of disease. The Kaplan-Meier's estimated 5 year survival rate of total 13 cases was 66% and satisfactory results were obtained with mass size smaller than 5cm.

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The Effect of Shoe Heel Types and Gait Speeds on Knee Joint Angle in Healthy Young Women - A Preliminary Study

  • Chhoeum, Vantha;Wang, Changwon;Jang, Seungwan;Min, Se Dong;Kim, Young;Choi, Min-Hyung
    • Journal of Internet Computing and Services
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    • v.21 no.6
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    • pp.41-50
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    • 2020
  • The consequences of wearing high heels can be different according to the heel height, gait speed, shoe design, heel base area, and shoe size. This study aimed to focus on the knee extension and flexion range of motion (ROM) during gait, which were challenged by wearing five different shoe heel types and two different self-selected gait speeds (comfortable and fast) as experimental conditions. Measurement standards of knee extension and flexion ROM were individually calibrated at the time of heel strike, mid-stance, toe-off, and stance phase based on the 2-minute video recordings of each gait condition. Seven healthy young women (20.7 ± 0.8 years) participated and they were asked to walk on a treadmill wearing the five given shoes at a self-selected comfortable speed (average of 2.4 ± 0.3 km/h) and a fast speed (average of 5.1 ± 0.2 km/h) in a random order. All of the shoes were in size 23.5 cm. Three of the given shoes were 9.0 cm in height, the other two were flat shoes and sneakers. A motion capture software (Kinovea 0.8.27) was used to measure the kinematic data; changes in the knee angles during each gait. During fast speed gait, the knee extension angles at heel strike and mid-stance were significantly decreased in all of the 3 high heels (p<0.05). The results revealed that fast gait speed causes knee flexion angle to significantly increase at toe-off in all five types of shoes. However, there was a significant difference in both the knee flexion and extension angles when the gait in stiletto heels and flat shoes were compared in fast gait condition (p<0.05). This showed that walking fast in high heels leads to abnormal knee ROM and thus can cause damages to the knee joints. The findings in this preliminary study can be a basis for future studies on the kinematic changes in the lower extremity during gait and for the analysis of causes and preventive methods for musculoskeletal injuries related to wearing high heels.

The Kinetic Analysis of Arabesque Turn Motion in Modern Dance by Upper Extremity Usage (상지이용유무에 따른 현대무용 아라베스크 턴 동작의 운동역학적 분석)

  • Park, Yang-Sun;Kim, Ji-Hye
    • Korean Journal of Applied Biomechanics
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    • v.19 no.3
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    • pp.457-466
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    • 2009
  • This study puts the purpose in providing the scientific basis of dance motion as an artistic expression by analyzing the kinematic variable and the distribution factor of power affecting the motion, which is connected to the turn, right after the arabesque motion according to the existence and non existence of using the arm in the arabesque motion of modern dance. As a result of this study, arabesque turn motion, not using the upper limbs, used more turning force of head and body than the arabesque turn motion, using the upper limbs, and arabesque turn using the upper limbs obtained the turning force, using the right shoulder. The range of the hip joint on the left and the position change of left tiptoe in the Arabesque turn motion using the upper limbs is largely ascended to the vertical axis, while, the position of tiptoe in the Arabesque turn motion, not using the upper limbs is dropped to the lower part of each event. In the replacement of body center, Arabesque turn motion using the upper limbs is moved more to the turning axis than arabesque turn motion not using the upper limbs. As a result of maximum vertical ground reaction force, Arabesque turn motion using the upper limbs appeared to be a lower value than the Arabesque turn motion not using the upper limbs.

The Cross-Leg Gastrocnemius Muscle Flap for Leg Reconstruction of the Difficult and Unfavorable Conditions (비복근을 이용한 교차하지 근육 피판술)

  • Kim, Ji Ye;Yang, Eun Jung;Hwang, Eun A;Kim, Sug Won
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.583-590
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    • 2009
  • Purpose: In the cases of a vascular compromised condition in an injured lower extremity, soft tissue coverage with free tissue transfer presents a challenging problem to the reconstructive surgeon. For this reason, cross - leg flaps are still used in unusual circumstances. Advances in surgical technique has made the cross - leg free flap possible although it may require long operation time along with significant donor site morbidity. Therefore, a pedicled cross - leg muscle flap may be an alternative treatment modality when local flap or free flap is not possible. Methods: Twelve patients(9 males and 3 females) underwent the operation between October of 2001 and December of 2008. The patients' age ranged from 6 to 82 years. The unusual defects included the regions such as the knee, popliteal fossa, distal third of the tibia, dorsal foot, and the heel. Indications for the cross - leg gastrocnemius flap are inadequate recipient vessels for free flap(in eight cases), extensive soft tissue injuries(in three cases) and free flap failure(in one case). The muscle flap was elevated from contralateral leg and transferred to the soft tissue defect on the lower leg while both legs were immobilized with two connected external fixator systems. Delay procedure was performed 2 weeks postoperatively, and detachment was done after the establishment of the adequate circulation. The average period from the initial flap surgery to detachment was 32 days (3 to 6 weeks). Mean follow - up period was 4 years. Results: Stable coverage was achieved in all twelve patients without any flap complications. Donor site had minimal scarring without any functional and cosmetic problems. No severe complications such as deep vein thrombosis or flap necrosis were noted although mild to moderate contracture of the knee and ankle joint developed due to external fixation requiring 3 to 4 weeks of physical treatment. All patients were able to walk without crutches 3 months postoperatively. Conclusion: Although pedicled cross - leg flaps may not substitute free flap surgery, it may be an alternative method of treatment when free flap is not feasible. Using this modification of the gastrocnemius flap we managed to close successfully soft tissue defects in twelve patients without using free tissue transfers.