High level, major limb amputation above the wrist and ankle joint has some characteristic problems because of the large muscle mass and poor potential for nerve regeneration. As an adjunct method to reduce warm ischemic time prior to bony stabilization, temporary vascular shunting by simple catheterization has been performed, which has not been associated with any significant complication and has improved on success rate in replantation surgery. The authors have experienced 198 cases replantation of amputated limbs and digits from September, 1983 at the Korea medical center, Guro hospital, of which, 13 cases of successful replantation of amputated limbs by avulsion injury above the wrist and ankle joint level, which is generally considered as contraindication, were followed up for average 4.5 years(minimum 1.5 to maximum 8.4 years) on terms of survival rate, function and appearance. The clinical analysis upon these cases is to be presented with review of references.
Objective: The purpose of this study was to examine the effects of increasing running speed on human stability by comparing the Lyapunov Exponent (LyE) and Coefficient of Variation (CV) methods, with the goal of identifying key variables and uncovering new insights. Method: Fourteen adult males (age: 24.7 ± 6.4 yrs, height: 176.9 ± 4.6 cm, weight: 74.7 ± 10.9 kg) participated in this study. Results: In the CV method, significant differences were observed in ankle (flexion-inversion/eversion; p < .05) and hip joint (internal-external rotation; p < .05) movements, while the center of mass (COM) variable in the coronal axis movements showed a significant difference at the p < .001 level. In the LyE method, statistical differences were observed at the p < .05 level in knee (flexion-extension), hip joint (internal-external rotation) movements, and COM across all three directions (sagittal, coronal, and transverse axis). Conclusion: Our results revealed that the stability of the human body is affected at faster running speeds. The movement of the COM and ankle joint were identified as the most critical factors influencing stability. This suggests that LyE, a nonlinear time series analysis, should be actively introduced to better understand human stabilization strategies.
Fractures of the tibial pilon are the severe injuries to the ankle joint resulted from axial compression, shear and/or rotational forces. The pilon fractures have been difficult in management due to the severe comminution of articular surface and frequent soft tissue problem. Among many treatment options, limited internal fixation of the tibia with long screws and multiple pins augmented with external fixation or casting provide adequate stabilization without soft tissue compromise. Among the patients of pilon fracture admitted to our hospital from March 1993 to March 1997 who treated by limited internal fixation and external fixation or casting, 25cases are included who could be follow up for more than 10months. According to Ruedi and Allgower, typeI 3cases, typeII 14cases, typeIII 8cases. The authors analyzed the clinical and radiological results of the tibial pilon fractures according to Magnusson. The results were as follow. 1. 10cases at Ruedi-Allgower typeII were obtained above fair and 5cases at Ruedi-Allgower typeIII were obtained above fair. 2. The postoperative complications were skin problem(3cases) and infection(2cases), which were treated by antibiotics and flap surgery.
Purpose : The purpose of this study was to analyze the coordination of the trunk tilting angle and bilateral lower limbs according to the stirrups length during trot in equestrian. Methods : Participants selected as subject were consisted of adult male(n=7, mean age: $45.00{\pm}3.78yrs$, mean height: $172.50{\pm}2.44cm$, mean body mass: $76.95{\pm}4.40kg$, mean, mean leg length: $97.30{\pm}2.60cm$). They were divided into 3-types of stirrups lengths(67 cm, 72 cm, 77 cm) during trot. The variables analyzed were consisted of the trunk front-rear angle, lower limb joint(Right Left hip, knee, ankle), overall movement index(OMI) of the lower limbs(thigh, shank, foot) and asymmetry index(AI%) during trot. Results : The average angle in hip and knee joint showed more extended posture according to the increase of stirrups lengths and ankle angle showed more plantarflexion posture according to increase of stirrups length during 1 stride in trot. Also, average angle showed more extended posture in right hip and ankle joint than that of left. The angle of knee joint didn't show significant difference statistically between right and left. Also asymmetric index in average angle of hip, knee and ankle joint didn't show significant difference statistically in between lower limbs, but hip joint showed higher asymmetric index in stirrup length of 77 cm and ankle joint showed higher asymmetric index in stirrup length of 67 cm than that of the others respectively. The FR angle in trunk of horse-rider showed relative backward leaning motions at stirrup length of 67 cm and 77 cm than that of stirrup length of 72 cm during stance and swing phase. OMI in thigh, shank, and foot limbs didn't show significant difference statistically according to the stirrups length of right and left lower limbs, but left lower limbs showed higher index than that of right lower limb. Stirrup length of 72 cm in shank and foot limbs showed higher index than that of stirrup length of 67 cm and 77 cm. But stirrup length of 72 cm showed higher asymmetric index than that of stirrups length of 67 cm and 77 cm. Conclusions : When considering the above, 72 cm(ratio of lower limb 74.04%) stirrup lengths could be useful in posture correction and stabilization than 67cm(ratio of lower limb 68.69%) and 77 cm(ratio of lower limb 79.18%) stirrup lengths during trot in horse back riding.
Background: Osteoarthritis is a common condition with an increasing prevalence and is a common cause of disability. Osteoarthritic pain decreases the quality of life, and simple gait training is used to alleviate it. Knee osteoarthritis limits joint motion in the sagittal and lateral directions. Although many recent studies have activated orthotic research to increase knee joint stabilization, no study has used patellar tendon straps to treat knee osteoarthritis. Objects: This study aimed to determine the effects of patellar tendon straps on kinematic, mechanical, and electromyographic activation in patients with knee osteoarthritis. Methods: Patients with knee osteoarthritis were selected. After creating the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), leg length difference, Q-angle, and thumb side flexion angle of the foot were measured. Kinematic, kinetic, and muscle activation data during walking before and after wearing the orthosis were viewed. Results: After wearing the patellar tendon straps, hip adduction from the terminal stance phase, knee flexion from the terminal swing phase, and ankle plantar flexion angle increased during the pre-swing and initial swing phases. The cadence of spatiotemporal parameters and velocity increased, and step time, stride time, and foot force duration decreased. Conclusion: Based on the results of this study, the increase in plantar flexion after strap wearing is inferred by an increase due to neurological mechanisms, and adduction at the hip joint is inferred by an increase in adduction due to increased velocity. The increase in cadence and velocity and the decrease in gait speed and foot pressure duration may be due to joint stabilization. It can be inferred that joint stabilization is increased by wearing knee straps. Thus, wearing a patellar tendon strap during gait in patients with knee osteoarthritis influences kinematic changes in the sagittal plane of the joint.
The purpose of this study was to investigate the effect of stability on one leg standing posture in yoga practice. Thirteen women college student who have never done yoga participated in this study. In order to collect data before and after yoga practicing for two years, we were used 3D motion capture system and electromyography. The results were as follows. First, ranges of motions for Y axis of left knee joint and X axis of right ankle joint were significantly different in dancer posture(p<.05), and then X axis of right ankle and Y axis of left ankle joint were significantly different in tree posture of pre and post training. Second, the planar alignment angle of trunk-pelvis was not significant difference in dancer and tree posture. Third, CoM-distances of Y, Z directions were significant difference in the tree posture(p<.05). Fourth, Muscle activities of both rectus abdominis, erector spinae and left quadriceps were significant difference in tree posture(p<.05). These findings suggested that yoga training played important roles in stable postures as results of decreasing rotation ankle joint and movement of CoM and enforcing core muscles. This study provides evidence for effectiveness of the stability on standing posture and can get a great effect on posture correction by means of yoga training. Hereafter, study on alignment angle, which is a measurement of postural stabilization will be needed by future yoga training.
Purpose: The purpose of this study was to analyze the gait patterns of adults with intellectual disability and healthy adults based on collected kinematic data on the lower extremities and to investigate the gait patterns of intellectually disabled people by comparing the differences between the two groups. Methods: The participants were divided into in one group of healthy adults (n = 9) and one group with mild intellectual disabilities (n = 9). 3D motion analysis (Myomotion) was used to collect kinematic data from each group while the participants walked 3 times over 10 m. As a statistical method, each group's kinematic data during walking was analyzed and compared using an independent sample t-test. Results: Comparing the kinematic data of the lower extremities during walking between the group with mild intellectual disability and the healthy group, there were significant differences between the two groups in the hip and ankle joints in the stance and swing phases. Conclusion: The analysis suggests that people with intellectual disabilities have kinematic differences compared with healthy people. Based on the results of this study, it is necessary to conduct further research on rehabilitation programs for joint stabilization, exercise for increasing joint range of motion, muscle strengthening exercise, and proprioception training for people with intellectual disabilities with insufficient physical function.
Objective : The purpose of this study was to investigate biomechanical changes of the lower limb including dynamic stability with changes in illumination (300Lx, 150Lx, and 5Lx) and slope (level and $15^{\circ}$ downhill) as risk factors for elderly falls. Method : Fifteen elderly females were selected for this study. Seven infrared cameras (Proreflex MCU 240: Qualisys, Sweden) and an instrumented treadmill (Bertec, USA) surrounded by illumination regulators and lights to change the levels of illumination were used to collect the data. A One-Way ANOVA with repeated measures using SPSS 12.0 was used to analyze statistical differences by the changes in illumination and slope. Statistical significance was set at ${\alpha}=.05$. Results : No differences in the joint movement of the lower limbs were found with changes in illumination (p>.05). The maximum plantar flexion movement of the ankle joints appeared to be greater at 5Lx compared to 300Lx during slope gait (p<.05). Additionally, maximum extension movement of the hip joints appeared to be greater at 5Lx and 150Lx compared to 300Lx during slope gait (p<.05). The maximum COM-COP angular velocity (direction to medial side of the body) of dynamic stability appeared to be smaller at 150Lx and 300Lx compared to 5Lx during level gait (p<.05). The minimum COM-COP angular velocity (direction to lateral side to the body) of dynamic stability appeared smaller at 150Lx compared to 5Lx during level gait (p<.05). Conclusion : In conclusion, elderly people use a stabilization strategy that reduces walk speed and dynamic stability as darkness increases. Therefore, the changes in illumination during gait induce the changes in gait mechanics which may increase the levels of biomechanical risk in elderly falls.
A weak or dysfunctional gluteus medius (Gmed) is related to several pathologies, and individuals with hip abductor weakness have Gmed weakness. This study aimed to systematically review the literature associated with the anatomy and function of the Gmed, and the prevalence, pathology, and exercise of Gmed weakness. Papers published between 2010 and 2020 were retrieved from MEDLINE, Google Academic Search, and Research Information Sharing Service. The database search used the following terms: (glut* OR medius OR hip abduct*) AND weak*. The Gmed plays an important role in several functional activities as a primary hip abductor by providing pelvic stabilization and controlling hip adduction and internal rotation. Weakness of the Gmed is associated with many disorders including balance deficit, gait and running disorders, femoroacetabular impingement, snapping hip, gluteal tendinopathy, patellofemoral pain syndrome, osteoarthritis, iliotibial band syndrome, anterior cruciate ligament injury, ankle joint injuries, low back pain, stroke, and nocturia. Overuse of the tensor fasciae latae (TFL) as a hip abductor due to Gmed weakness can also cause several pathologies such as pain in the lower back and hip and degenerative hip joint pathology, which are associated with dominant TFL. Similarly, lateral instability and impaired movements such as lumbar spine lateral flexion or lateral tilt of the pelvis can occur due to compensatory activation of the quadratus lumborum for a weakened Gmed while exercising. Therefore, the related activation of synergistic muscles or compensatory movement should be considered when prescribing Gmed strengthening exercises.
This study is historical research on the relationship between the Changes of the Form of costume and the recognition of the beauty of the body from prehistorical period to Ch'ing Dynasty in Chinese female costume. In figure painting a significant point was to describe the spirit of the figure so Chinese painters were less interested in ideal body pro-portion or body shape than Westerns. But idealized beauty of the female body existed and changed keeping abreast with the form of costume in each period. In the prehistorical period Wemen fasten waist belt so enabled to distinguish upper part of the body from lower one. "Locust-forehead moth-eyebrows(蝗首蛾毛)" recorded in "the Book of odes(詩經)" was the canon of beaty and Wemen tried to make their forehead broad and square from Zhou Dynasty to the Wei Jin periods. From the age of Civil War to han Dynasty Slender waist was loved so waist was tightly fastened and hemline became broader. in the course of that time Plump body in big cloth with broad sleeve emerged but that was less significant than Tang Dynasty. During Wei Jin and the Southern/Northern Dynasty undergo disruption and division they admired Taoist images. Loose fitting style with handkerchief hemline and broad sash belt was prevailed while miserable life was reflected gaunt face and lean body. Suk Dynasty also preferred a slim and long body silhouette. The style was presented extremely high waist line long and narrow sleeve slim and long skirt which expressed dynamic and straight image. The culture of Tang Dynasty was open and diverse and that character enabled blod decolletate revealing body line by tight fitting and special make-up-Social background of uion and stabilization made female body extremely plump full face. full breast and hips with most erotic image. The period of Kaiyuan Tianbao fashioned mannish disguise presented androgynous image. Five Dynasty and Song Dynasty restored standard body type so upper garments concealed neck and bust high waist line lowered which represented refined and simple outfit. But another eroticism emerged as foot-binding in Song Dynasty. For the sake of covering up deformed top of the feet and ankle gaiters and arrow shaped shoes were devised. During Ming Ch'ing Dynasties body shape became more slim weak and young causing to escort instinct that reflects 'Lust' or 'Mundanity'.
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