• 한국운동역학회지
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• 제21권4호
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• pp.467-477
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• 2011

This study was performed to investigate the effects of tibial rotation while going up stair on muscle activity of vastus medialis oblique and vastus lateralis, and on patellar displacement. The subjects included 30 people (male: 15; female: 15) who were randomly assigned to the tibial internal-rotation, neutral-rotation, and external-rotation groups. The subjects went up the stair while performing the assigned rotations, and the rotation of the hip and the displacement of the patella were measured using a 3D motion analyzer. In addition, the maximum voluntary isometric contraction (MVIC) of the vastus medialis oblique and vastus lateralis were measured using surface electromyogram. On the tibial internal rotation, the hip rotation significantly appeared in the same direction and so did on the tibial neutral and external rotations(p<.001). Although the MVIC of the vastus medialis oblique and vastus lateralis did not significantly differ by tibial rotation during the stair ascent, the MVIC of the vastus medialis oblique was higher than that of the vastus lateralis during the internal and neutral rotations (p<.05). In addition, during the stair ascent, the displacement of the patella was more significant during the tibial external rotation than during the tibial internal and neutral rotations(p<.001). Thus, patients with patellofemoral pain are required to be considered the effects of tibial rotation for their rehabilitation.

• 구강회복응용과학지
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• 제17권4호
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• pp.231-244
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• 2001

This study was conducted to observe the effect on appendage muscle strength according to increase in occlusal vertical dimension. For this study, ten males with a mean age of 21 were selected. The subjects had a complete or almost complete set of natural teeth and reported no subjected symptoms of pain or dysfunction in the masticatory system. The tested occlusal splints were made at the position of increased occlusal vertical dimension of 2mm, 3.5mm, and 5mm from the ICP. Before and after wearing occlusal splints, the appendage muscle strength were tested by CybexII Dynamometer in each subject. The results were as follows : 1. When occlusal vertical dimension was increased, most of mean muscular strength values were increased except for those of supination and pronation of forearm at the position of 5mm increased occlusal vertical dimension. 2. The statistical analyses demonstrated that the increased occlusal vertical dimension position to be significantly stronger than intercuspal position for the muscle strength of the flexion and extension of hip, supination of forearm, external and internal rotation of knee, dorsiflexion and plantarflexion of ankle (p<0.05). 3. At the position of 3.5mm increased vertical dimension displayed the highest mean muscluar strength value than other positions. 4. Statistically demonstrated values, except for supination of forearm, internal rotation of shoulder, were related to lower appendage. Therefore splint was more effective on lower appendage than upper appendage to make muscle strength increased. 5. The mean increased rate of muscular strength tested on knee(57%), ankle(42%), and wrist(20%) were higher than hip(31%), elbow(14%), and shoulder(17%).

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1997년도 춘계학술대회
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• pp.245-248
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• 1997

Excessive stress on the bone-stem interface may cause local micromotion that could produce midthigh pain, interface bone resorption and prevent bony ingrowth. It is important for clinician and prosthetic designer to develop an understanding of the load transfer mechanism, its associated stress pattern and its relationships with the particular mechanical characteristics of the femoral stem designs. Finite element method (FEM) is preeminently suited to provide information in this respect. The authors developed 3-dimensional numerical finite element models implanted with the straight stem which is composed of total 1170 elements of 8 nodes and with the curved stem which is composed of total 885 elements of 8 node, and analysed the relative micromotions between the straight stem and the curved stem in immediate postoperative stage of an uncemented total hip replacement in load simulating the single leg stance. The results showed that the rotational displacement was occupied over 90% of total micromotion in both types of stem and was peak at the proximal medial portion of the stem, but markedly less distally. The curved stem was more stable especially in terms of rotational stability. It is recommended that surgeons do not allow the patient weight bearing until bony ingrowth was achieved. In the future more attention should be drawn to increase initial rotational stability of the two types of femoral stem to prevent loosening from excessive micromotion.

• 한국전문물리치료학회지
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• 제14권4호
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• pp.21-27
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• 2007

The purposes of this study were to compare core muscle activities with and without the use of Pilates resistive equipment during bridging exercises and to investigate the efficacy of a Pilates device. Fourteen healthy individuals (6 males, 8 females) between 20 to 26 years of age were examined. They were engaged in a bridging exercise with and without a magic circle. Three consecutive repetitions of each exercise were performed. Surface electromyography (sEMG) was used to measure the electrical activities of the right side internal oblique, the adductor longus, the multifidus, and the gluteus maximus muscles. Normalized EMG activities were compared using a paired t-test and the level of significance was set at =.05. The results showed that the EMG activities of the internal oblique (p=.0078), the adductor longus (p=.0007), and the gluteus maximus (p=.0001) muscles were significantly higher when using the magic circle during the Pilates bridging exercise. Also, statistically significant change existed in the multifidus muscle (p=.0106). The bridging exercise, combined with hip adduction using the magic circle, may enhance core stabilization. Therefore, using a magic circle during hip adduction combined with bridging exercise may be recommended usefully for individuals wanting to strength the core muscles. Further research is needed to access the nature of motor control of the Pilates mat exercises and to deliver exercise intervention for lower back pain patients.

• 한국임상수의학회지
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• 제30권5호
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• pp.366-370
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• 2013

7개월령 암컷 포메라니안견이 오른쪽 후지 파행 증상으로 내원하였다. 내원시 신체 검사에서 오른쪽 대퇴 관절을 신장하였을 때 통증을 호소하였고 일반 방사선 사진에서 오른쪽 대퇴골두에 미약한 방사선 투과성 병변과 오른쪽 대퇴관절 공간의 확장을 확인하였다. 14일 후 일반 방사선 사진에서 오른쪽 대퇴골두 골단의 변위를 확인하였고 컴퓨터단층촬영에서 오른쪽 대퇴골두에 저음영의 병변과 골절선을 확인하였다. 오른쪽 대퇴골두 절제술을 실시하였고 조직학적 검사에서 골두 골간단과 골단의 괴사를 확인하였다. 본 증례는 초기 허혈성 대퇴골두 괴사증이 있는 개의 방사선학적, 컴퓨터단층촬영, 수술적, 조직학적 소견을 기술하였다.

• 한국임상수의학회지
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• 제18권3호
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• pp.243-248
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• 2001

Radiographic findings of degenerative joint disease (DJD) in the coxofemoral joints were studied in 108 dogs referred to Veterinary Medical Teaching Hospital, College of Veterinary Medicine, Seoul National University. Radiographic findings were identified with a extended ventrodorsal projection. Clinical signs such as pain in the affected joint, exercise intolerance, lameness, crepitation on flexion and extension of the joint and decreased range of motion, were shown in 40% and radiographic changes of bilateral coxofemoral joints were identified in 69% of a group of dogs. There are no sex predilections. Thirty-seven dogs were diagnosed as canine hip dysplasia (CHD; 10 cases), avascular necrosis of the femoral head (Legg-Calves-Perthes disease [LCPD]; 12 cases), fracture of the acetabulum (1 case), luxation(10 cases) and subluxation (15 cases), however, luxation and subluxation were identified in 11 dogs affected with CHD and LCPD. Causes of DJD in others (71case) were not identified. Radio-graphic findings identified included osteophyte formation at the attachment of the joint capsule (70%), sclerosis of the subchondral bone of the cranial acetabular edge (47%), remodeling of the femoral head (34%), thickening of the femoral neck(31%), perichondral osteophyte formation (31%), joint laxity (30%) and so on. All of the dogs diagnosed as CHD were large breed such as Retriever, Germain Shepherd, and Weimaraner and their age was under 1 year. This condition occurred bilaterally in 70% of affected animals. Dogs diagnosed as LCPD were young (under 1 year), small breed dogs. The incidence of LCPD is greater in Yorkshire Terrier, Miniature Pinscher and Poodle. This condition occurred unilaterally in 67% of affected animals. Clinical signs of dogs with unknown cause were shown in 15% and this condition occurred bilaterally in 75% of affected animals. Radiographic findings varied with patient's age and breed, however, the most common finding was osteophyte formation at the attachment of the joint capsule.

• Physical Therapy Rehabilitation Science
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• 제3권2호
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• pp.101-106
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• 2014

Objective: To investigate the appropriate position for abdominal drawing-in maneuver (ADIM) exercise by rehabilitative ultrasound image. Design: Cross-sectional study. Methods: Twenty-eight young adults with no history of low back pain participated in the study. Three positions compared were crook lying position with hip $60^{\circ}$ flexion, standing position with the feet hip width apart and knees straight, and saddle standing positionunsupported with the knees $20^{\circ}$ flexed. Once in the appropriate position, the subjects were verbally cued to draw in their abdominal wall, with the intention of pulling their navel inward toward their lower back. The thickness of each transversus abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles were measured via ultrasound and recorded at the end of inspiration. Results: When compared to the TrA thickness of rest, the TrA thickness was significantly increased in all three positions (crook lying, standing, and saddle standing) during the ADIM (p<0.05). IO thickness was significantly greater in standing and saddle standing than in crook lying (p<0.05). EO thickness was constant in all the three positions. Conclusions: The present study suggests that standing and saddle standing positions could be recommended for the ADIM to maximize recruitment of the TrA and IO activation. Specifically, the saddle standing position with knees flexed to $20^{\circ}$ was observed to increase the TrA activation more than the standing position. These findings should be considered when core stability exercises such as the ADIM are conducted.

• 한국전문물리치료학회지
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• 제30권2호
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• pp.110-119
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• 2023

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.

• 대한정형외과학회지
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• 제55권6호
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• pp.503-510
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• 2020

목적: 고령의 환자에게 발생한 대퇴골 전자간 불안정성 골절에 대하여 관혈적 정복 및 내고정 이외의 다른 대안으로 고관절 반치환술이 선택적으로 사용되고 있다. 최근 의료 시스템과 기술의 발달로 대퇴골 전자간 골절 후 생존율이 높아지면서 중장기 이상의 기간을 고려한 대퇴 스템의 선택이 필요하다. 이에 저자들은 이중으로 가늘어 지는 직각 단면의 대퇴 스템(C2 stem)을 이용하여 불안정성 전자간 골절에 고관절 반치환술을 시행하고 5년 이상 추시한 환자에 대하여 그 임상적 방사선적 결과를 알아보고자 하였다. 대상 및 방법: 2004년 1월부터 2013년 12월까지 대퇴골 전자간 불안정성 골절에 대하여 C2 스템으로 고관절 반치환술을 시행한 43명의 환자(43 고관절)를 대상으로 하였다. 평균 연령은 78.6세(70-84세), 평균 추시 기간은 85.4개월(60-96개월)이었다. 추시 기간 동안 임상적으로는 통증, 보행 능력, 고관절 기능의 변화를 알아보았고, 방사선적으로는 피질골의 골다공증과 골 흡수 등 근위 대퇴골의 변화를 알아보았으며, 탈구와 인공 관절 주변 골절 등 추시 기간 중 발생한 합병증에 대하여 알아보았다. 결과: 통증은 수술 후 유의하게 감소하였는데, 수술 후 4년부터 증가하였고 수술 후 60개월에 보행 능력 평가에서 9예의 환자가 두 단계 보행 능력이 감소하였으며 Harris 고관절 점수는 수술 후 2년부터 3년 사이에 유의하게 감소하였다. 방사선적으로 피질골 골다공증은 14예 발생하였는데, 이 중 5예의 환자가 피질골 흡수 현상으로 진행하였다. 피질골 흡수 현상을 보인 5예 중 4예는 전자부 골절편이 불유합 된 경우였고, 3예는 역사상 골절인 경우였다. 결론: 골다공증을 동반한 고령의 환자에게 발생한 불안정성 전자간 골절에 3C 형태의 무시멘트 스템을 이용하여 고관절 반치환술을 일차로 시행하는 경우 환자의 건강 상태와 잔여 수명을 고려하여 주의 깊은 선택이 필요할 것으로 생각된다.

• 대한골관절종양학회지
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• 제9권1호
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• pp.115-123
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• 2003

연구계획: 골반골의 악성골종양의 재건술에서 체외열처리를 이용한 재활용 자가골 이식술 및 인공 관절 치환술을 시행한 3례의 후향적 연구 연구목적: 골반골의 악성골종양의 재건술에서 체외열처리를 이용한 재활용 자가골 이식술 및 인공 관절 치환술이 골반골의 재건에 있어 그 유용성을 알아보고자 하였다. 증례: 증 례 1~20세 여자 환자로 3개월 전부터 시작된 우측 고관절부와 대퇴부 동통을 주소로 외부 병원에서 우측 장골에 소파술 및 골 시멘트 충전술 시행 후 악성 골종양으로 진단하에 술 후 방사선 치료 6회 시행 후 전원되어 우측 장골 광범위 절제술 및 섭씨 132도에서 2분간 열처리 후 자가골 재삽입술 시행하고 우측 고관절의 인공 관절 치환술 (ABG$^{(R)}$)을 병행하였다. 수술 당시 전이의 증거는 없었으며 술후 조직 병리 검사상 고분화 골육종 진단되었으며 술전 또는 술후 화학 요법은 시행하지 않았다. 증 례2~56세 여자 환자로 약 3개월 전부터 시작된 우측 대퇴부 동통으로 방사선 검사상 이상 발견되어 전원 후 절개 생검 시행하였다. 결과상 골육종 진단되어 우측 골반골 광범위 절제술 후 섭씨 6 5도 하에서 3 0분간 저온 열처리 후 자가골 삽입 고정술 시행하고 우측 고관절에 대하여 인공 관절 치환술 (ABG$^{(R)}$)을 병행하였다. 수술 당시 전이의 증거는 없었으며 술 후 조직 병리 검사상 고등급 섬유모세포형의 골육종이 진단되었다. 술후 화학 요법은 HDMTX, ADR, CDDP으로 시행하였다. 증 례 3~46세 여자 환자로 우연히 발견된 좌측 장골의 종괴로 연골육종 의심 하에 좌측 골반골 광범위 절제술 후 섭씨 65도 하에서 30분간 저온 열처리 후 자가골 삽입 고정술 시행하고 좌측 고관절에 대하여 인공 관절 치환술 (Protek$^{(R)}$)을 병행하였다. 수술 당시 전이의 증거는 없었으며 술후 조직 병리 검사상 II/III 등급의 연골육종이 진단되었다. 결과: 최종 추시상 각 증례의 종양학적 및 기능적 결과는 증례 1은 7년 추시상 국소적 재발이 없는 상태였으며 Ennecking 등에 따른 기능적 평가 지수에서 53%로 평가되었다. 방사선 추시상 약 1년에서 1년 6개월 사이에 골유합이 관찰되었으며 최종 추시시 장골의 재건 금속판의 파괴 소견이 보였으나 환자의 증상과 연관되지는 않았다. 증례 2는 3년 6개월 추시상 국소적 및 원격 재발이 없는 상태였으며 기능적 평가 지수는 60%로 평가되었다. 증례 3은 7개월 추시상 국소적 및 원격 재발이 없는 상태였으며 기능적 평가 지수는 63%로 평가되었다. 결론: 체외 열처리를 이용한 재활용 자가골 이식술 및 인공 관절 치환술을 시행한 3례에서 비교적 만족할만한 종양학적 및 기능적 결과를 보였으며 한국에서 동종 골 이식술이 어려운 점을 감안할 때 이 방법은 골반골을 재건하는데 한 방법이 될 수 있을 것이라 사료된다.