• 한국정밀공학회지
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• 제21권11호
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• pp.209-218
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• 2004

The purpose of this paper is to suggest a practical and simple method for the identification of the joint mechanical properties and to apply it to human knee joints. The passive moment at a joint was modeled by three mechanical parts, that is, a gravity term, a linear damper term and a nonlinear spring term. Passive pendulum tests were performed in 5 fat and 5 thin men. The data of pendulum test were used to identify the mechanical properties of joints through sequential quadratic programming (SQP) with random initial values. The identification was successful where the normalized root-mean-squared (RMS) errors between the simulated and experimental joint angle trajectories were less than 10％. The parameter values of mechanical properties obtained in this study agreed with literature. The inertia, gravity and the damping constant were greater at fat men, which indicates more resistance to body movement and more energy consumption fer fat men. The suggested method is noninvasive and requires simple setup and short measurement time. It is expected to be useful in the evaluation of joint pathologies.

• 한국전문물리치료학회지
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• 제28권1호
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• pp.13-17
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• 2021

A normal range of motion is essential for performing activities of daily living. The capsular pattern is the proportional motion restriction in range of motion during passive exercises due to tightness of the joint capsule. Although the capsular pattern is widely referred to in clinical practice, there is no scientific evidence to support the concept. In this review, the appropriateness of the capsular pattern for evaluation of joint pathology was assessed. In the Textbook of Orthopaedic Medicine written by Cyriax, the capsular pattern did not specify how much reduction in angular motion is considered motion restriction. As the definition proposed initially was unclear, different methods have been used in previous studies investigating capsular pattern. In addition, the capsular pattern described all the major joints of the human body, but only the hip joint, knee joint, and shoulder joint were studied in experimental studies. Sensitivity and specificity were reported in one study and were meaningful in specific pathologies (loss of extension to loss of flexion). There was no consensus on the reliability and validity. In summary, the capsular pattern suggested by Cyriax or Kaltenborn is not supported or applies only to certain conditions. Various components around a joint complement each other and provide stability to the joint. It is recommended that the therapist perform multiple assessments rather than rely on a single assessment when evaluating joints.

• Clinical Pain
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• 제20권1호
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• pp.1-6
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• 2021

Ultrasonography (US) of the elbow is an increasingly utilized modality for a variety of diagnoses. In this brief review, US findings for the pathologic conditions of forearm and elbow are described. The most common pathologies discussed here include distal biceps tendon and triceps tendon lesions, medial and lateral epicondylopathies, ulnar collateral ligament tears, ulnar nerve subluxation, joint effusions, and intra-articular bodies.

• Clinics in Shoulder and Elbow
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• 제21권3호
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• pp.127-133
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• 2018

Background: This study was undertaken to evaluate the outcome of the arthroscopic capsular release for adhesive capsulitis of the shoulder. Methods: This study retrospectively investigated thirty shoulders in 29 patients who presented with recalcitrant adhesive capsulitis and underwent arthroscopic treatments. Other than typical findings of adhesive capsulitis, combined pathologies in the glenohumeral joint and subacromial space were evaluated by arthroscopy. Clinical evaluations were performed using the Constant's score and ranges of motion (ROM) at preoperative, 6 months postoperatively and at the final follow-up. Results: Our study included 17 women and 12 men with a mean age of 53.8 years (range, 34-74). Mean follow-up duration was 24 months (range, 12-40 months). Assessment of combined pathologies revealed that partial rotator cuff tear of less than 25% thickness, was most common (overall 83.3%; with bursal 57% and articular 23%). Subacromial synovitis and adhesion were also frequent (53.3%). The Constant score and ranges of motion significantly improved at the final follow-up, compared with preoperative levels. However, clinical results at 6 months postoperatively were found to be significantly inferior to those observed at the final follow-up ($p{\leq}0.001$ for all factors). Functional impairment was the major complaint in 59.3% patients at the 6 months follow-up. Conclusions: Although arthroscopic capsular release yielded favorable outcome at the mean 24 months follow-up, pain and motion limitations at 6-month postoperatively persisted in more than 50% of our patients. While combined pathologies were commonly encountered during arthroscopy, although their effects on surgical outcome in adhesive capsulitis remains unclear in this study.

• 한국전문물리치료학회지
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• 제28권1호
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• pp.27-35
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• 2021

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.

• Hip & pelvis
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• 제34권1호
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• pp.45-55
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• 2022

Purpose: The aim of this study was to evaluate the short-term outcome of physiotherapy in patients with acetabular labral tears and to assess the effectiveness of physiotherapy according to the severity of the labral tear. Materials and Methods: Thirty-five patients who underwent physiotherapy for treatment of symptomatic acetabular labral tears were enrolled. We evaluated the severity of the acetabular labral tears, which were classified based on the Czerny classification system using 3-T MRI. Clinical findings of microinstability and extra-articular pathologies of the hip joint were also examined. The International Hip Outcome Tool 12 (iHOT12) was use for evaluation of outcome scores pre- and post-intervention. Results: The mean iHOT12 score showed significant improvement from 44.0 to 73.6 in 4.7 months. Compared with pre-intervention scores, significantly higher post-intervention iHOT12 scores were observed for Czerny stages I and II tears (all P<0.01). However, no significant difference was observed between pre-intervention and post-intervention iHOT12 scores for stage III tears (P=0.061). In addition, seven patients (20.0%) had positive microinstability findings and 22 patients (62.9%) had findings of extra-articular pathologies. Of the 35 patients, eight patients (22.9%) underwent surgical treatment after failure of conservative management; four of these patients had Czerny stage III tears. Conclusion: The iHOT12 score of patients with acetabular labral tears was significantly improved by physiotherapy in the short-term period. Improvement of the clinical score by physiotherapy may be poor in patients with severe acetabular labral tears. Determining the severity of acetabular labral tears can be useful in determining treatment strategies.

• Clinics in Shoulder and Elbow
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• 제27권2호
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• pp.247-253
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• 2024

Acromioclavicular (AC) joint dislocations frequently co-occur with intra-articular glenohumeral pathologies. Few comprehensive studies have focused on labral tears specifically associated with AC joint trauma. This systematic review will address this gap. A comprehensive electronic search was conducted across PubMed, Cochrane Library, and Google Scholar (pages 1-20) spanning from 1976 to May 19, 2023. Seven studies met the inclusion criteria for this systematic review, consisting of three retrospective studies and four case series. These studies collectively involved 1,044 patients, of whom 282 had concomitant labral lesions. The pooled prevalence of intra-articular labral injuries associated with acute AC joint dislocation was 27%. The prevalence of these labral lesions varied significantly between studies, ranging from 13.9% to 84.0% of patients, depending on the study and the grade of AC joint dislocation. Various types of labral tears were reported, with superior labrum anterior to posterior (SLAP) lesions being the most common. The prevalence of SLAP lesions ranged from 7.2% to 77.4%, with higher grades of AC joint dislocations often associated with a higher prevalence of SLAP tears. Moreover, grade V dislocations exhibited a complete correlation with SLAP tears. The studies yielded contradictory findings regarding older age and higher grades of AC joint dislocation as risk factors for concurrent labral lesions. This review underscores the frequent association between labral lesions and AC joint dislocations, particularly in cases of lower-grade injuries. Notably, SLAP lesions emerged as the predominant type of labral tear.

• 대한인간공학회지
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• 제28권3호
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• pp.1-6
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• 2009

Recently, importance of the rehabilitation of hand pathologies as well as the development of high-technology hand robot has been increased. The biomechanical model of hand is indispensable due to the difficulty of direct measurement of muscle forces and joint forces in hands. In this study, a three-dimensional biomechanical model of four fingers including three joints and ten muscles in each finger was developed and a mathematical relationship between neural commands and finger forces which represents the enslaving effect and the force deficit effect was proposed. When pressing a plate under the flexed posture, the muscle forces and the joint forces were predicted by the optimization technique. The results showed that the major activated muscles were flexion muscles (flexor digitorum profundus, radial interosseous, and ulnar interosseous). In addition, it was found that the antagonistic muscles were also activated rather than the previous models, which is more realistic phenomenon. The present model has considered the interaction among fingers, thus can be more powerful while developing a robot hand that can totally control the multiple fingers like human.

• 감성과학
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• 제7권4호
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• pp.19-24
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• 2004

본 연구의 목적은 관절계 댐핑특성을 상용 에르고미터(BIODEX)의 등속운동을 이용하여 파악할 수 있는지를 평가하는 것이다. 제안된 방법은 등속운동을 유지하기 위해 인가한 외부토크와 하퇴의 관성토크의 차로부터 슬관절의 댐핑토크를 계산하는 것이다. 댐핑토크는 여러 가지 관절각속도에서 산출되었고, 이로부터 댐핑특성을 유도하였다. 실험장치는 BIODEX 시스템과 별도의 힘센서 및 Labview 시스템으로 구성되었다. 댐핑특성의 해석에는 Matlab을 사용하였다. 실험결과로부터 등속운동의 기동 및 종료를 위한 크랭크 암의 가속 및 감속으로 인한 미세한 각속도의 변화가 댐핑토크의 영향보다 큰 관성토크를 유발하는 것을 알 수 있었다. 따라서, 현재의 등속운동장비로는 댐핑특성을 추정하기가 어렵다고 보여진다.

• Clinics in Shoulder and Elbow
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• 제7권2호
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• pp.65-69
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• 2004

Purpose: The purpose of this study is to evaluate the short-term clinical outcome of the capsulolabral repair using absorbable suture anchor in traumatic anterior instability of shoulder. Materials and Methods: From June 2000 to September 2001, 15 shoulders with recurrent anterior instability were operated with arthroscopic Bankart repair using absorbable suture-anchor 'PANALOK' (Mitek, westwood, MA), and were followed up over 1 year (average; 13 months). The mean age was 23-years. There were fourteen males and one female. The mean duration from the initial symptoms to the operation was 24 months. Associated pathologies were Hill-Sachs defect in 12 cases, SLAP in 6 cases, and partial rotator cuff tear in 2 cases. The results were evaluated by patien's satisfaction, Modified Rowe Score in regard to joint stability, mobility, pain and function in comparison with the preoperative ones, and other complications. Results: At the last follow-up, the total Rowe Score increased from 38 points to 92 points. There were no recurrence and 14 patients among 15 patients gained pre-operative level of sports activity and no other complications. Conclusion: Effective capsulolabral repair could be obtained by the absorbable anchoring without any untoward complications. This procedure is simple and safe one and this system can be a good substitute for the metallic anchor.