• Physical Therapy Korea
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• v.15 no.2
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• pp.30-37
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• 2008

Anticipatory postural adjustments are pre-planned by the central nervous system (CNS) before the activation of agonist muscles in the limbs, and minimize postural sway. Most previous studies on this topic have focused on upper-limb movement, and little research has been conducted on lower-limb movement. The purpose of this study was to investigate the recruitment order of left and right trunk muscles during limb movement. Fifteen healthy subjects (10 male, 5 female) were enrolled. Electro-myographic signals were recorded on the muscles of: (1) deltoid, lumbar erector spinae, latissimus dorsi and internal oblique during shoulder flexion, (2) rectus femoris, rectus abdominis, external oblique and internal oblique during hip flexion. During right upper limb flexion, the onset of left erector spinae muscle and left internal oblique muscle activity preceded the onset of right deltoid by 8.09 ms and 19.83 ms, respectively. But these differences were not significant (p>.05). A similar sequence of activation occurred with lower limb flexion. The onset of left internal oblique muscle activity preceded the onset of right rectus femoris muscle by 28.29 ms (p<.05). The onset of right internal oblique muscle activity preceded the onset of left rectus femoris muscles by 23.24 ms (p<.05). The internal oblique muscle was the first activated during limb movement. Our study established the recruitment order of trunk muscles during limb movement, and explained the postural control strategy of the trunk muscles in healthy people. We expect that this study will be used to evaluate patients with an asymmetric recruitment order of muscle activation due to impaired CNS.

• The Journal of the Korean bone and joint tumor society
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• v.3 no.1
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• pp.47-55
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• 1997

During the last decade, the use of primary amputation has decreased, and a larger number of patients are being treated with resection and reconstruction with limb preservation. The advantage of chemotherapy, improvements in diagnostic imaging methods and newer techniques for reconstruction have made limb salvage an alternative to amputation for most patients with malignant bone tumor. Clinical results and functional results of the limb salvage operation of bone tumors treated at the Department of Orthopaedic Surgery, Guro Hospital, Korea university was reviewed. Eighteen bone tumors(seven giant cell tumors and eleven malignant bone tumors.) were studied over a period of five years. The limb salvage group included fourteen endoprothesis, two pasteurized autograft, one near total scapulectomy and one rotationplasty. Functional evaluation was performed according to the Enneking's modified system. The results were as followed; 1. At a mean follow-up of thirty two months (15-77 months), fourteen(83%) of the eighteen patients with limb salvage procedures had been continuously disease free. 2. There are no local recurrence but deep infection developed in two patients and three patients with distant metastasis. 3. Thirteen(87%) of the fifteen patients showed above 60% of functional results. 4. Fourteen(93%) of the fifteen patients were satisfied with the limb salvage procedures.

• Journal of Korean Academy of Nursing
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• v.38 no.6
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• pp.874-880
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• 2008

Purpose: The purpose of this study was to identify muscle atrophy in critically ill patients on ventilators. A comparison was made between limb circumferences and muscle areas on the day of admission to an intensive care unit (ICU) and on the 8th day after admission. Methods: The data were collected from 30 critically ill patients using ventilators at S hospital ICU in Seoul during the period from October 2005 to April 2006. Limb circumferences and skinfold thickness were measured on the day of admission and on the 8th day after admission to the ICU. Limb circumferences and skinfold thickness were measured on the right mid-arm, right mid-thigh, and right mid-calf using a measuring tape and a skinfold calipers. Limb muscle areas were calculated by an equation after measuring limb circumferences and skinfold thickness. The data were analyzed by paired t-test and independent t-test. Results: 1) Mid-arm circumference, mid-thigh circumference and mid-calf circumference on the 8th day after admission to the ICU were significantly less than those on the day of admission to the ICU, 2) Mid-arm muscle area, mid-thigh muscle area and mid-calf muscle area on the 8th day after admission to the ICU were significantly less than those on the day of admission to the ICU, 3) Steroid and vecuronium medication didn't affect changes in limb circumferences (mid-arm, mid-thigh, mid-calf) and muscle areas (mid-arm, mid-thigh, mid-calf on the 8th day after admission to the ICU compared to the day of admission. Conclusion: Limb muscle atrophy may occur on the 8th day after admission to the ICU in critically ill patients using ventilator.

• The Korean Journal of Pain
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• v.32 no.4
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• pp.271-279
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• 2019

Background: We utilized diffusion tensor imaging (DTI) to evaluate the cerebral white matter changes that are associated with phantom limb pain in patients with unilateral arm amputation. It was anticipated that this would complement previous research in which we had shown that changes in cerebral blood volume were associated with the cerebral pain network. Methods: Ten patients with phantom limb pain due to unilateral arm amputation and sixteen healthy age-matched controls were enrolled. The intensity of phantom limb pain was measured by the visual analogue scale (VAS) and depressive mood was assessed by the Hamilton depression rating scale. Diffusion tensor-derived parameters, including fractional anisotropy, mean diffusivity, axial diffusivity (AD), and radial diffusivity (RD), were computed from the DTI. Results: Compared with controls, the cases had alterations in the cerebral white matter as a consequence of phantom limb pain, manifesting a higher AD of white matter in both hemispheres symmetrically after adjusting for individual depressive moods. In addition, there were associations between the RD of white matter and VAS scores primarily in the hemispheres related to the missing hand and in the corpus callosum. Conclusions: The phantom limb pain after unilateral arm amputation induced plasticity in the white matter. We conclude that loss of white matter integrity, particularly in the hemisphere connected with the missing hand, is significantly correlated with phantom limb pain.

• Archives of Plastic Surgery
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• v.50 no.5
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• pp.501-506
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• 2023

This article portrays the authors' experience with a complex lower limb bone and soft tissue defect, following chronic osteomyelitis and pathological fracture, which was managed by the multidisciplinary orthoplastic team. The decision for functional amputation versus limb salvage was deemed necessary, enhanced by the principles of "spare parts" in reconstructive microsurgery. This case describes the successful use of the osteocutaneous distal tibia turn-up fillet flap that allowed "lowering the level of the amputation" from a through knee to a below-knee amputation (BKA) to preserve the knee joint function. We comprehensibly review reports of turn-up flaps which effectively lower the level of amputation, also applying "spare-parts" surgery principles and explore how these concepts refine complex orthoplastic approaches when limb salvage is not possible to enhance function. The osteocutaneous distal tibia turn-up fillet flap is a robust technique for modified BKA reconstructions that provides sufficient bone length to achieve a tough, sensate stump and functional knee joint.

• Journal of the Korean Society for Precision Engineering
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• v.24 no.11
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• pp.116-125
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• 2007

Human muscle skeletal model was developed for biomechanical study. The human model was consists with 19 bone-skeleton and 122 muscles. Muscle number of upper limb, trunk and lower limb part are 28, 60, 34 respectively. Bone was modeled with 3D beam element and muscle was modeled with spar element. For upper limb muscle modelling, rectus abdominis, trapezius, deltoideus, biceps brachii, triceps brachii muscle and other main muscles were considered. Lower limb muscle was modeled with gastrocenemius, gluteus maximus, gluteus medius and related muscles. The biomechanical stress and strain analysis of human was conducted by proposed finite element analysis model under Kumdo head hitting motion. In this study structural analysis has been performed in order to investigate the human body impact by Kumdo head hitting motion. As the results, the analytical displacement, stress and strain of human body are presented.

• The Journal of Korean Physical Therapy
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• v.16 no.2
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• pp.116-127
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• 2004

The purpose of this study was to determine the effect of shoe lift of the affected limb in subjects with hemiplegia. The subjects of this study were 18 post-stroke hemiplegics. For the study, insole of the paretic side was lifted 10 mm higher, and static weight bearing was measured before and after the lift application. For the measurement of carry-over effect of lift, we got data of those three items prior to and 3 weeks after lift application and 3 days after removal of the lift. Static weight bearing was significantly increased both just after and continuous application of lift for 3 weeks than before. According to this study, lift applied to the shoe of the paretic limb was effective in inducing static weight bearing in the paretic limb. This study suggests that symmetry, induced by shoe lift applied to the paretic limb, could help correct abnormal posture that would be caused in standing and prevent development of abnormal muscle tone in subjects with hemiplegia caused by unilateral stroke.

• Journal of Korean Physical Therapy Science
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• v.5 no.4
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• pp.851-860
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• 1998

The purpose of this study was to quantitatively observe changes in postural stability of double leg support and single limb stance. Thirty-six healthy subjects participated in the study. Postural stability were examined using Dynamic Balance System. Each trial was 25 sec in duration. Each of 6 conditions{double leg support and single limb stance ; eyes open in stable platform, eyes closed in stable platform, eyes open in dynamic platform) evaluated effect of visual, vestibular, proprioceptive system. Center of balance found for displacement to the left along the X axis in double leg support and to the forward on left toe in single limb stance. Sway index was the lowest in double leg support with eyes open in stable platform and the higher in single limb stance with eyes closed in stance platform. We believe that reliable and valid measures should be used to determine the contributing factors of our client's postural problems so that we can design the most effective treatment possible.

• Journal of Electrical Engineering and Technology
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• v.9 no.2
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• pp.733-738
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• 2014

We propose a new approach called as a peak time approach for faster detection of step initiation for the lower limb exoskeleton. As faster detection of step initiation is an important criterion in evaluating the lower limb exoskeleton, many studies have investigated approaches to detect step initiation faster, including using electromyography, the center of pressure, the heel-off time and the toe-off time. In this study, we will utilize vertical ground reaction force events to detect step initiation, and compare our approach with prior approaches. Additionally, we will predict the first step's heel strike time with vertical ground reaction force events from multiple regression equations to support our approach. The lower limb exoskeleton should assist the operator's movement much faster and more reliably with our approach.

• Sleep Medicine and Psychophysiology
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• v.30 no.1
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• pp.3-8
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• 2023

Periodic limb movement disorder (PLMD) is a sleep-related movement disorder characterized by involuntary, rhythmic limb movements during sleep. While PLMD itself is not considered life-threatening, its association with certain underlying health conditions raises concerns about mortality risks. PLMD has been found to be associated with cardiovascular diseases such as hypertension and cardiovascular disease. The fragmented sleep caused by the repetitive limb movements and associated arousals may contribute to sympathetic activation, chronic sleep disruption, sleep deprivation, and subsequent cardiovascular problems, which can increase mortality risks. The comorbidities and health factors commonly associated with PLMD, such as obesity, diabetes, and chronic kidney disease, may also contribute to increased mortality risks. PLMD is often observed alongside other neurological disorders, including restless legs syndrome (RLS) and Parkinson's disease. The presence of PLMD in these conditions may exacerbate the underlying health issues and potentially contribute to higher mortality rates. Further research is needed to elucidate the specific mechanisms linking PLMD to mortality risks and to develop targeted interventions that address these risks.