• PNF and Movement
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• v.9 no.1
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• pp.39-45
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• 2011

Purpose : The purpose of this article was to review the literature on change of knee position sense after total knee replacement intervention in knee rehabilitation. Methods : This review outlines scientific findings regarding different literature data in knee rehabilitation, and discusses proprioceptive change of knee joints after total knee replacement intervention. Result : Severe pain and diminished joint sensation may precipitate degenerative changes of knees joint, and a strong association between decreased proprioception and function has been identified in elderly patients with knee osteoarthritis. Total knee replacement(TKR) of the knee joint are effective surgical procedures in osteoarthritis patients, resulting in decreased pain, and improved physical function and quality of life in patients. After total knee replacement, joint position sensation is partially recovered, which may improve functional stability of the knee, but aspects of physical functioning are not fully restored to preoperative status. Conclusions : Thus, recovery rate in proprioception after TKR also is considered to be important because it may be a significant risk factor in failure of total knee replacement and knee rehabilitation intervention.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.26 no.1
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• pp.1-8
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• 2020

Background: The aim of this study was to conduct an Otago exercise program with total knee replacement patient (TKR) in a clinical setting and ascertain its effects on balance, walking ability and falls efficacy. Methods: The participating subjects were 30 people who had been diagnosed with TKR. They were assigned to two groups (Exp; Otago exercise and general physical therapy, n=15; Con; balance exercise and general physical therapy, n=15), and the exercises were conducted for three sessions per week for four weeks. The main balance outcomes were evaluated using the timed up and go test (TUG), while walking ability was evaluated using the 10m walk test (10MWT), direction change ability was measured using the figure 8 of walk test (F8WT), and the decrease of fear was evaluated using the modified falls efficacy scale (MFES). Results: In the analysis results, the Exp group showed significant increases in TUG, 10MWT, and F8WT within the both groups. There were significant differences in all variables between the Exp group and the Con group at the post-intervention evaluation, but there was no significant difference between the groups with respect to the TUG. Conclusion: The results of this study demonstrated that Otago exercise would be useful to improve balance and walking for TKR patients who want to improve their abilities and activities of daily living.

• Journal of Korean Physical Therapy Science
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• v.17 no.1_2
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• pp.41-52
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• 2010

Purpose: The purpose of this study was to compare the effects of continuous passive motion(CPM) and continuous active motion(CAM) on proprioception of the knee after total knee replacement(TKR). Methods: Twenty patients with TKR were randomly allocated into two groups, the CPM group(n=10) and the CAM group(n=10). All subjects were evaluated for levels of pain, passive range of motion and angle reproduction of the knee. An angle reproduction test was used to assess the proprioceptive deficit. Two types of angle reproduction test were used: a passive angle reproduction(PAR) test and an active angle reproduction(AAR) test. The relevant examinations were performed before and after intervention(on the 5th day and the 10th day). The statistical significance were calculated using a t-test and a one-way repeated ANOVA. Results: A pre-intervention significant difference was not found between the two groups. Significantly better results were before and after the intervention at 10 days, for the PAR(flexion direction) test; however, only in the CAM group. There were no significant difference, either before or after the intervention, for the AAR test(flexion and extension direction) in both group. Both groups experienced similar levels of pain and passive range of knee motion before and after the intervention. Conclusion: This study revealed that CAM was a better effect to restore position sense of the knee joint after TKR.

• Journal of Biomedical Engineering Research
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• v.27 no.6
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• pp.392-401
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• 2006

Image Guided Surgery (IGS) system which has variously tried in medical engineering fields is able to give a surgeon objective information of operation process like decision making and surgical planning. This information is displayed through 3D images which are acquired from image modalities like CT and MRI for pre-operation. The technique of image registration is necessary to construct IGS system. Image registration means that 3D model and the object operated by a surgeon are matched on the common frame. Major techniques of registration in IGS system have been used by recognizing fiducial markers placed on the object. However, this method has been criticized due to additional trauma, its invasive protocol inserting fiducial markers in patient's bone and generating noise data when 2D slice images are acquired by image modality because many markers are made of metal. Therefore, this paper developed shape-based registration technique to improve the limitation of fiducial marker based IGS system. Iterative Closest Points (ICP) algorithm was used to match corresponding points and quaternion based rotation and translation transformation using closed form solution applied to find the optimized cost function of transformation. we assumed that this algorithm were used in Total Knee replacement (TKR) operation. Accordingly, we have developed region-based 3D registration technique based on anatomical landmarks and this registration algorithm was evaluated in a femur model. It was found that region-based algorithm can improve the accuracy in 3D registration.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.24 no.1
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• pp.77-83
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• 2018

Background: The purpose of this study is to investigate that effect of manual therapy using pelvic compression belt on hip abductor strength and balance ability in total knee replacement (TKR) patients. Methods: The subjects consisted of twenty two post-TKR patients. Participants were randomly assigned to a pelvic belt group (n=11) and a placebo group (n=11). All participants underwent manual therapy including range of motion exercise, soft tissue mobilization around knee joint, strengthening exercise (Quad set, SLR, sidelying hip abduction, standing hamstring curls, sitting knee extension, step-up, wall slide to $45^{\circ}$ knee flexion). Manual therapy was executed five times a week for 2 weeks. Outcome measures included hip abductor strength by using Biodex system 4 pro, anterior to posterior balance, medial to lateral balance, total balance by using Biodex balance system SD. Results: After the completion of the manual therapy, hip abductor strength was showed statistically significant improvements in pelvic belt group (p<.05). Anterior to posterior balance, medial to lateral balance, total balance were showed statistically significant improvements in pelvic belt group and placebo group (p<.05). There was a statistically significant difference between the two groups in hip abductor strength and there was no statistically significant difference in balance. Conclusions: This results suggest that manual therapy using pelvic compression belt has could be used for selective muscle activation of the hip abductor muscle and has useful in hip abductor strength and balance ability in TKR patients.

• Physical Therapy Rehabilitation Science
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• v.8 no.1
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• pp.8-14
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• 2019

Objective: Degenerative knee arthritis is the most common disease that occurs in older people. Constriction-induced movement therapy (CIMT) has been reported to be as an effective treatment for the impairments, such as asymmetric weight-bearing and reduced balance that occurs after receiving a total knee replacement (TKR). Game-based rehabilitation training for persons with TKR is interesting and provides a variety of feedback. Design: Randomized controlled trial. Methods: Thirty-six subjects with TKR were randomly assigned to either the CIMT game training (n=12), general game training (n=12), or the control (n=12) group. Each group underwent twelve sessions (30 min/d, 3 d/wk for 4 weeks). In the CIMT game training group, the application of CIMT adjusted the weight of the pressure delivered from the two boards used in Wii games. In the general game training group, the game was played without adjusting the weight of pressure. The game training used the Wii Fit's Ski Slalom application. Subjects were assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Activities-specific Balance Confidence (ABC) Scale. Results: All three groups showed significant improvements in pain, stiffness and physical function, total WOMAC scores, and ABC scores after the intervention (p<0.05). Significant differences were observed in physical function, total WOMAC scores, and ABC scores of the CIMT game training group compared with the other groups (p<0.05). Conclusions: The CIMT game training and general game training exhibited improvements on stiffness, but the CIMT game training exhibited a larger effect on lower extremity function and balance confidence levels.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.2
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• pp.55-67
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• 2021

Background: This study aimed to use the muscle energy technique (MET) with total knee replacement (TKR) during the chronic phase in a clinical setting and confirm its effects on the knee extensor strength and ROM, balance, and walking ability. Methods: A total of 20 female patients who underwent TKR 1~4 years ago were assigned to two groups (Control: Q setting exercise+general physical therapy, n=10; Exp: MET+general physical therapy, n=10). Interventions were performed three times a week for 4 weeks. The strength of the knee extensor was evaluated using an aneroid sphygmomanometer, and ROM was evaluated using degrees at the end range on active knee flexion. The main balance outcomes were evaluated using two standard scale (TSS) and timed up and go (TUG) test, whereas the walking ability was evaluated using the 10 meter walk test (10MWT). Results: Analysis showed that both groups had significant increases in strength, ROM, TSS, TUG, and 10MWT. Differences in all variables were significant between the control and Exp groups at the post-intervention evaluation (p<.05). However, no significant difference was observed in strength and TUG. Conclusion: Results of this study demonstrated that MET would help improve the strength, ROM, balance, and walking ability of patients with chronic TKR who want to enhance their abilities and performance in activities of daily living.

• Land and Housing Review
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• v.6 no.2
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• pp.61-66
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• 2015

This study is the realization of natural gas as ways to advance the South and the continental railway linking basic research was conducted on railway transport. Summary data on the Status of North Korean railway which was to have reviewed the case of LNG railway transportation in Japan and China is becoming an LNG tank containers by rail transportation is done. In the case of Korea, the stability of railway transportation through the development of LNG tank containers and rail transportation pilot project was tested. It was set up and the basic directions of freight trains transport routes and methods for rail transport 7.5 million tons of natural gas per year. TKR ~ TSR between the LNG transportation business is an existing railway south. North. Russia gas pipeline (PNG) instead of a separate project to replace the business SRX (Silk Road Express) is a symbolic project for the early realization of the Eurasian railway linking policy. This study may give greater meaning to secure the iconic railway transport route for continental transport of containers and bulk cargo (coal, ores, etc.).

• Proceedings of the KSR Conference
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• 2001.10a
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• pp.35.2-48
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• 2001

남북한의 경제협력은 한반도 통합과정과 통일 한반도에 있어서 매우 중요한 의미를 지니게 될 것이다. 남북한 통합이 아직 속단할 단계는 아니므로 중장기적 전망이 타당하겠지만 러시아의 시베리아지역은 아ㆍ태지역과 유럽(중동과 서남아시아와 중앙아시아 포함)을 이어주는 교량의 위치에 놓여 있는 중요한 지역이므로 이지역을 둘러싼 국제적인 경쟁과 다양한 형태의 국가간 및 지역간 협력의 시대가 불원간에 도래할 것임을 전망할 수 있다.(중략)

• Journal of Distribution Science
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• v.14 no.1
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• pp.17-28
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• 2016

Purpose - Given the increasing interest in the Eurasian Initiative, government-wide studies for the construction of the Silk Road Express are currently being conducted. However, the Korean Government has no experience in operating international freight railroads and has not encountered problems in train service plans, international conventions, and customs clearance, which will arise when TKR is connected to TSR, TCR, and TMGR. Research design, data and methodology - Given these conditions, the cases of direct services in international freight railroads between China and Europe are investigated to identify the possible problems in the connection between TKR and continental railroads. This study also identifies the plans for activating Eurasian railroad logistics. Results - For the service of international freight trains, Korea needs to join international conventions, such as OJSD, as a regular member. Furthermore, any relevant international conference after the conclusion of such an agreement is needed for the agreement on train service schedules, fees, and procedures for passing border stations. Conclusions - Customs clearance and relevant documents must be standardized to address the differences in clearance systems between nations.