• Journal of Korean Neurosurgical Society
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• v.53 no.6
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• pp.331-336
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• 2013

Objective : The offset connector can allow medial and lateral variability and facilitate intralaminar screw incorporation into the construct. The aim of this study was to compare the biomechanical characteristics of C7 intralaminar screw constructs with and without offset connector using a three dimensional finite element model of a C6-7 cervical spine segment. Methods : Finite element models representing C7 intralaminar screw constructs with and without the offset connector were developed. Range of motion (ROM) and maximum von Mises stresses in the vertebra for the two techniques were compared under pure moments in flexion, extension, lateral bending and axial rotation. Results : ROM for intralaminar screw construct with offset connector was less than the construct without the offset connector in the three principal directions. The maximum von Misses stress was observed in the C7 vertebra around the pedicle in both constructs. Maximum von Mises stress in the construct without offset connector was found to be 12-30% higher than the corresponding stresses in the construct with offset connector in the three principal directions. Conclusion : This study demonstrated that the intralaminar screw fixation with offset connector is better than the construct without offset connector in terms of biomechanical stability. Construct with the offset connector reduces the ROM of C6-7 segment more significantly compared to the construct without the offset connector and causes lower stresses around the C7 pedicle-vertebral body complex.

• Journal of Korean Physical Therapy Science
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• v.28 no.1
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• pp.11-22
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• 2021

Background: This study was to investigate the effects of active stretching and stability exercise on piriformis muscle thickness and low back pain of male patients with chronic low back pain. Design: Randomized Controlled Trial. Methods: 45 male patients participated in this study. All subjects were randomly assigned. Subjects divided into 15 who underwent contract relaxation (CR) of the proprioceptive neuromuscular facilitation (PNF) to their hip joints, 15 who underwent a combination of isotonic (CI) of the PNF, and the rest 15 who underwent the two techniques (CR+CI). Real-time diagnostic ultrasound was used to measure thickness of the piriformis muscles. The visual analogue scale (VAS) was used to measure degrees of low back pain. A two-way repeated measures ANOVA was used to compare the average values. The SPSS 24.0 was used as the statistical program, and the significance level was set at .05. Results: The CR and the CR+CI groups had more decreased thickness of piriformis muscle when compared to the CI group. The CR+CI group had more decreased pain when compared to the CR and the CI groups. Conclusion: These results suggest that combination of stretching and stability exercise was effective on male patients with chronic low back pain showing limited hip medial rotation.

• Journal of the Korean Orthopaedic Association
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• v.56 no.2
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• pp.134-141
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• 2021

Purpose: Patellar dislocations have a range of causes. This study examined the results of treatment aimed at balancing soft tissues around the patella. Materials and Methods: Thirty-two patellar dislocations in 28 patients (21 females and seven males) were examined. The mean patient age at the time of surgery was 11.5 years, and the mean follow-up period was 4.6 years. Dislocations were 19 chronic, six habitual, six congenital, and one acute. Soft tissue balancing surgery included lateral capsular release, medial capsular plication, and inferolateral transfer of the vastus medialis obliquus. Medial transfer of the patellar tendon, partial strip of the rectus femoris and patella tendon, and distal femoral osteotomy were also performed selectively. The preoperative Q angle, femoral anteversion angle, tibial external rotation angle, tibial tubercle-trochlear groove distance (TT-TG distance), mechanical femoral-tibial angle, and femoral trochlear dysplasia according to Dejour were measured, and the pre- and postoperative Lysholm-Tegner scores were used to analyze the clinical results. Results: The mean preoperative Q angle, TT-TG distance, femoral anteversion angle, tibial external rotation angle, mechanical femoraltibia angle, and Lysholm-Tegner score were 9.3°, 15.5 mm, 25.6°, 30.4°, 3.0°, and 75.8, respectively. Eleven patients had systemic ligament laxity with a Beighton score of five or more. Twenty-two patients had femoral trochlear dysplasia: four type A (3 patients), 16 type B (15 patients), one type C (1 patient), and four type D (3 patients). Of the 32 cases, 28 were corrected successfully by the first operation. Of four cases of postoperative subluxation, three were corrected by the second operation, and one of them was corrected after a third operation. The last patient is currently being followed-up. The mean Lysholm-Tegner score improved to 85.6 after the operation. Conclusion: Correcting all the causes of patella dislocation simultaneously is difficult. Nevertheless, satisfactory outcomes were obtained with soft tissue balancing surgery around the patella and a corrective osteotomy for an abnormal mechanical axis of the femur-tibia and torsion.

• The Journal of the Korean bone and joint tumor society
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• v.7 no.4
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• pp.139-143
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• 2001

Purpose : Limb salvage for osteosarcoma of proximal tibia is challenging problem due to difficulties in mobilizing or retracting the main neurovascular structure, inadequate soft tissue coverage, and unsolved problem of patellar tendon reattachment to endoprosthesis. The authors analyzed the functional result of limb salvage using tumor prosthesis with medial gastrocnemius rotation plasty for osteosarcama of the proximal tibia. Materials and Methods : Eleven patients with histologically proven osteosarcoma of the proximal tibia, treated with adjuvant and neoadjuvant chemotherapy and limb salvage operation with tumor prosthesis between January 1992 and December 1998 at our Medical Center, were selected. There were 6 male and 5 female. Age ranged from 15 years to 23.7 years with an average of 23.7 years. Follow-up period ranged from 1 year to 4.5 years with an average of 2.5 years. The final functional result was evaluated using the method by ISOLS, 1993. The factors include pain, functional activities, emotional acceptance, use of external supports, walking ability and gait. Each of the factors has been scored from 0 to 5 depending on the appropriate description or data. The rating score is determined by dividing the individual factor scores into the total score and indicates percentage of normal function. Results : The overall functional result ranged from 53,3% to 86.7% with an average of 68.3% of normal function. In details, the averages were 82.5% for pain, 62.5% for functional activities, 67.5% for emotional acceptance, 77.5% for use of external supports, 62.5% for walking ability, and 57.5% for gait. The average range of motion of the knee joint was $5^{\circ}$ extension and $85^{\circ}$ flexion. Five patients have extension lag ranged from $5^{\circ}$ to $15^{\circ}$ with an average of $10^{\circ}$. Two patients suffered postoperative infection. One was treated with antibiotics injection only, but the other needed removal of the prosthesis and knee fusion. Both of them showed unsatisfactory result. C o n c l u s i o n : The overall functional result after limb salvage using tumor prosthesis with medial gastrocnemius rotational flap for osteosarcoma of the proximal tibia was relatively satisfactory in case of no postoperative infection. The patients were less satisfactory in functional activities, emotional acceptance and gait than pain, use of external supports due to limitation of motion and extension lag. More aggressive postoperative physical therapy and protection with brace for 6~9 months as well as surgical technique is mandatory for more satisfactory result.

• Development and Reproduction
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• v.15 no.2
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• pp.143-150
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• 2011

The objective of this study was to determine the effect of exercise on a hemiparkinsonian rat model. Nigrostriatal dopamine cell lesions were produced by injecting 6-hydroxydopamine at the left medial forebrain bundle of rats. In this study, the rats were divided into the following 4 groups: the control group without any exercise, experimental group I with aqua-exercise (Exp I), experimental group II with balance exercise (Exp II) and experimental group III with complex exercise (aqua-exercise+balance exercise; (Exp III)). Exercises were applied to all the experimental groups after the operation. In order to observe the dopaminergic cell loss, we assessed the level of tyrosine hydroxylase (TH) expression in the midbrain of rats, and performed the apomorphine-induced rotation test at postoperative days (PDs) 7, 14, and 21. Experimental groups had significantly higher TH-immunoreactivity and behavioral performance than the control group. However, there was no difference in TH-immunoreactivity and behavioral performance across the experimental groups. These results suggest that the application of aqua-exercise and balance exercise could suppress dopaminergic cell loss in the substantia nigra of rat brains and could increase behavioral recovery in hemiparkinsonian rats.

• The Korean Journal of Physiology and Pharmacology
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• v.5 no.2
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• pp.123-131
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• 2001

To investigate the effects of electrical stimulation on vestibular compensation, which is the recovery of vestibular symptoms following unilateral labyrinthectomy (UL), intermittent electrical stimulation was applied to the injured vestibular portion in Sprague-Dawley rats. Vestibuloocular and vestibulospinal reflexes, electrical activity and expression of c-Fos protein in medial vestibular nuclei (MVN) were measured with time following UL. Spontaneous nystagmus occurred with frequency of $2.9{\pm}0.2$ beats/sec at 2 hours after UL and disappeared after 72 hours. Electrical stimulation decreased the frequency of nystagmus significantly till 24 hours after UL. Roll head deviation was $107{\pm}9.7^{\circ}$ at 2 hours after UL and the deviation was maintained till 72 hours, but electrical stimulation decreased the deviation significantly 6 hours after UL. Resting activity of type I neurons in ipsilateral MVN to the injured vestibular side decreased significantly compared with control at 6 and 24 hours after UL, but the activity of type I neurons was recovered to control level by electrical stimulation at 24 hours after UL. Gain of type I neurons induced by sinusoidal rotation of 0.1 Hz decreased significantly till 24 hours after UL, but electrical stimulation restored the activity at 24 hours. The gain of type II neurons decreased significantly at 6 hours after UL, but electrical stimulation restored the activity. Expression of c-Fos protein was asymmetric between bilateral MVN till 24 hours after UL, but the asymmetry disappeared by electrical stimulation 6 hours after UL. These results suggest that electrical stimulation to the injured vestibular portion facilitates vestibular compensation following UL by restoration of symmetry of neuronal activity between bilateral vestibular nuclei resulting from increased activity in ipsilateral vestibular nuclei to the injured side.

• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.1
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• pp.37-43
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• 2003

Purpose: This study is to analyse the injury patterns of knee ligament and the factors influencing ligament injuries of knee, and to evaluate the changes of knee function and activity after ski injury. Materials and Methods: Thirty cases of ligament injuries of knee were studied with a questionaire, stress radiographs, magnetic resolution imaging, and physical examination. Mean age was 28.6 years old and mean follow up was 29.6 months. Clinical evaluation of Lysholm knee scoring scale was used for knee function and Tegner activity score was used for activity change after ski injury. Results: The anterior cruciate ligament (ACL) injury accompanied with medial collateral ligament(MCL) injury was most in 11 cases and isolated MCL injury was the next in 9 cases. The common types of injury mechanism were Phantom foot phenomenon (13 cases, 43$\%$) and valgus external rotation injury (12 cases, 40$\%$), which constitute 83$\%$ of all case. At the last follow up, the mean Lysholm score was 93.4 and mean Tegner activity score was 4.2. The reduced Tegner activity score after injury was 1.9. Among several injury groups, the evaluation of knee function and activity was best in the isolated MCL injury group and worst in the ACL injury accompanied with MCL injury group. The factors to influence ski injury were participation to ski class, release of binding, and skiing long time more than 2 hours. Conclusions: Lysholm score at last follow up revealed good grading, but sports activity after ski injury was reduced when compared with pre-injury state. It seems to need a active, systemic sports rehabilitation program after sports injury.

• Physical Therapy Korea
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• v.11 no.2
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• pp.35-45
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• 2004

The purpose of this study was to investigate the correlation and characteristics between electromyographic (EMG) activities of lower leg muscles and the posturographic assessment of static balance control in normal adults. Twenty-four young, healthy adults(12 males, 12 females) participated in the study. Center of pressure (COP) parameters were obtained using force platform as total path distance, total sway area, X mean frequency and Y mean frequency for 20 seconds in the following conditions: (1) comfortable standing with eyes opened or closed, (2) uncomfortable standing (feet together) with eyes opened or closed, (3) virtual moving surround delivered using Head mount display (HMD) with four different moving patterns. The virtual moving patterns consisted of close-far, superior-inferior tilting (pitch), right-left tilting (roll), and horizontal rotation (yaw) movements. Surface electromyographic activites were recorded on the tibialis anterior, peroneus longus, medial and lateral heads of gastrocnemius muscles under each condition. Correlation between the posturographic measures and EMG activities were evaluated. Total path distance and total sway area of COP were significantly increased during uncomfortable standing. EMG activity of tibialis anterior was significantly more during uncomfortable standing and virtual moving surround stimulation than during comfortable standing. Total path distance and sway area of COP during comfortable standing with closed eyes showed significant positive correlation with the EMG activities of the lateral head of gastrocnemius muscle. Total path distances and total sway area of COP during muscle. Total path distances and total sway area of COP during presentation of virtual moving surround also had significant positive correlations with EMG activities of the lateral head of gastrocnemius muscle under close-far movement.

• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.220-225
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• 2003

The meniscal cyst of knee joint is a rare disease, and the discoid meniscal cyst has not been reported in Korea. We report 3 cases of the discoid meniscal cyst confirmed by MRI and arthroscopy. In physical examination, all cases have tenderness of the knee joint. One has palpable mass of knee joint and the other one has limitation of knee motion with knee flexion contracture of 10 degrees and positive McMurray test at external rotation of the knee. All cases are complete discoid meniscus, which are, one medial discoid meniscus and two lateral discoid meniscus through MRI. We confirmed horizontal tear of meniscus in all cases and the location of meniscal cysts are anterior hem of meniscus in one and body of meniscus in two. We could get excellent results in all 3 cases that return to normal knee range of motion.

• Proceedings of the Korean Society for Emotion and Sensibility Conference
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• 2002.11a
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• pp.233-244
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• 2002

The purpose of this study is to assess the ability of balance control in moving surround using head mount device and force platform and to examine the clinical usefulness of COP parameters. Fifteen patients with stroke and healthy persons were participated. COP parameters were obtained as total path distance, frequency of anterior-posterior and medial-lateral component by FFT analysis, weight-spectrum analysis in the two different conditions; (1) in comfortable standing with opened or closed eyes, (2) in virtual moving surround delivered using HMD to four different moving pattern. In virtual moving surround setting, moving pattern was composed of close-far, superior-inferior tilting(pitch), right-left tilting(roll) and horizontal rotation(yaw) movement. In all parameters, the reliebility of COP analysis system was significantly high. Also, the construct validity compared between fifteen patients with stroke and normal persons was excellent in virtual moving surround condition(p