• Title/Summary/Keyword: 근골격 재활

Search Result 79, Processing Time 0.03 seconds

Foot/Ankle Roll-Over Characteristics According to Different Heel Heights of Shoe during Walking (보행 시 신발 굴 높이어 따른 발/발목 복합체의 Roll-Over특성)

  • Kim, Young-Ho;Choi, Hue-Seok
    • Journal of the Korean Society for Nondestructive Testing
    • /
    • v.25 no.4
    • /
    • pp.247-253
    • /
    • 2005
  • This study investigated the effects on foot and ankle roll-over characteristics according to different heel heights during walking. Fifteen female volunteers who have neither musculoskeletal nor foot problems were participated in gait analyses, wearing four different pairs of shoes in different heel heights. To obtain roll-over shape of foot/ankle complex, we used trajectories of knee and ankle joints as well as the renter of pressure between initial contact and opposite initial contact. Results revealed that the entire roll-over shape moved distally as the heel height increased but roll-over characteristics showed uniformly with different heel heights. In addition, we found that nondisablea persons automatically adapted to their foot/ankle complex to varying heel heights within 6cm, by moving the origin of roll-over shape distally to maintain roll-over characteristics. However, since the balance of the gait only by the ankle joint could not be achieved beyond the heel height of 6cm, compensations at the knee and the hip joints occurred simultaneously. Roll-over characteristics in human walking would provide simpler and wider understanding of human walking, and furthermore could be applied to the wide understanding of prosthetics and orthotics of the lower extremity as well as orthopaedic shoes.

Utility of Gait Analysis and Functional Assessment of Prosthetic Reconstruction in Bone Tumor around the Knee (슬관절 주위에 발생한 골종양 환자에서 종양 대치물을 이용한 재건술 후 기능적 평가 및 보행 분석의 유용성)

  • Lee, Jin-Ho;Seol, Young-Jun;Jung, Sung-Taek
    • The Journal of the Korean bone and joint tumor society
    • /
    • v.18 no.2
    • /
    • pp.51-58
    • /
    • 2012
  • Purpose: This study attempts to know functional results and gait analysis usefulness in patients with bone tumor around knee joint tumors who underwent prosthesis knee joint reconstruction. Materials and Methods: Retrospective study was conducted with 7 patients out of 30 patients who underwent prosthesis knee joint reconstruction after wide marginal excision for bone tumor around knee in orthopedics of this hospital from 2001 to 2010. Functional assessment and gait analysis were perforemed. Results: For the SF-36 score, while 'role physical' and 'role emotional' items showed 100% (100 points) high scores individually, general health, physical function, vitality, and social function showed low scores. The mean score of MSTS was 88.1% (23.8 points [17-27]), indicating a relatively high score. For the gait analysis, mean gait velocity was 97.2 m/s, mean cadence was 105.6 step/min, mean stride length was 111.3 m, mean step length was 61.5 cm, swing phase was 39.8%cycle, stance phase was 60.1%cycle, mean single limb support was 37.1%cycle, mean double limb support was 13.0%cycle, and mean push off was 60.7%cycle. Conclusion: It is expected that prosthesis reconstruction after wide marginal excision for bone tumor around knee has relatively good functional results. Gait analysis was considered one of method which showed gait phase and assessed functional ability objectively by quantitative assessment post operative patient condition. It might help treatment and post operative rehabilitation planning with the functional assessment.

The Effect of Shoulder Pain on the Quality of Life of Manual Wheelchair Users With Spinal Cord Injuries (수동휠체어를 사용하는 척수손상자의 어깨통증이 삶의 질에 미치는 영향)

  • Lee, Jung Kyu;Kang, Mo Yeol;Jeon, Eun Mi
    • Therapeutic Science for Rehabilitation
    • /
    • v.12 no.3
    • /
    • pp.33-44
    • /
    • 2023
  • Objective : The purpose of this study was to identify the risk factors for shoulder pain in manual wheelchair users with spinal cord injuries and to explore the correlation between shoulder pain and quality of life. Methods : Out of 182 participants initially included, 168 were selected for analysis. The questionnaire had 41 questions, with 15 on the Wheelchair User's Shoulder Pain Index (WUSPI) and 26 on the World Health Organization Quality of Life-BREF (WHOQOL-BREF). Results : It was found that participants' scored 50.75 in the WUSPI, whereas they scored higher in mobility and overhead activity. In addition, participants' WHOQOL-BREF scored 70.48, with a mean score of 2.71, which was lower than ordinary adults' WHOQOL-BREF (mean: 3.11) and that of older people suffering from chronic musculoskeletal system pain (total score: 77.92). Conclusion : The participants' WUSPI showed negative correlations with all items, including the total scores on the WHOQOL-BREF. This suggests that the participants' shoulder pain had a negative impact on their quality of life. Therefore, clinical experts, including occupational therapists, should provide manual wheelchair users with spinal cord injuries with programs aimed at preventing and managing shoulder pain, thereby contributing to improving their quality of life.

Recent Interventional Procedures for Spinal Discogenic Pain for Life Care : Technical and Ethical Issues (라이프케어를 위한 추간판성 통증 치료의 최신중재기법 기술적 윤리적 문제들에 관하여)

  • Hong, Young-Ki
    • Journal of Korea Entertainment Industry Association
    • /
    • v.13 no.4
    • /
    • pp.311-320
    • /
    • 2019
  • Discogenic pain which develops during the degenerative process of intervertebral disc is an intractable disease of musculoskeletal system. Unlike other diseases in modern medical science, it is not clinically confirmed through objective imaging and clinicopathologic index. Moreover, current technology has been facing difficulties finding fundamental treatment. This study examined through reviewing literature whether the therapeutic rationales of interventional procedures for the discogenic pain, such as nerve block, intradiscal electrothermal therapy and nucleoplasty, are valid and whether safety reviews such as preclinical tests are carried out faithfully during the technology development process. As a result, it is presumed that there is not yet an interventional treatment for discogenic pain, whose therapeutic rationale has been objectively verified. And there are some cases of interventional treatment that have not been adequately equipped with the preclinical test steps necessary to review the safety of the procedure during the technology development process. In conclusion, since there is still no interventional treatment for discogenic pain which has clear therapeutic rationale, it is necessary to recognize that a more careful approach is needed to judge whether the procedure is performed in clinical settings. And medical ethical issues may arise for some interventional treatment that are deemed to have been carried out without a thorough review of safety.

The Effect of Upper Thoracic Mobility on the Forward Head Posture, Disability, and Quality of Life in Patients with Chronic Neck Disability by Forward Head Posture (상부등 가동성이 만성 목 통증 환자들의 목 기능장애와 삶의 질에 미치는 효과)

  • Lee, Eun-Sang
    • Journal of Korea Entertainment Industry Association
    • /
    • v.13 no.6
    • /
    • pp.257-264
    • /
    • 2019
  • The purpose of this study was to investigate effective intervention(upper thoracic mobilization and upper cervical mobilization) methods for forward head posture. 32 subjects were divided into two groups: upper thoracic mobilization(UTM) and upper cervical mobilization(UCM) on three times a week for a total of four weeks. In both groups significant difference in forward head posture pre and post test(p <.01), significant difference between the two groups (p <.05, 95% CI: .157-.341). In both groups significant difference in neck disability index pre and post test(p <.01), significant difference between the two groups (p <.01, 95% CI: 1.273-8.728). In both groups significant difference in quality of life pre and post test(p<.05), significant difference between the two groups (p <.01, 95% CI: 4.234-18.391). The results of this study showed that the UTM was more effective than that of the forward head posture. It would be possible to provide more effective interventions for patients with forward head posture and also to prevent secondary musculoskeletal disorders due to forward head posture.

Effects of Nordic Walking Exercise on muscular strength, Flexibility, Balance and Pain in Older Woman with Knee Osteoarthritis (노르딕 워킹이 퇴행성 무릎 관절염 노인여성의 근력과 유연성, 균형 및 통증에 미치는 영향)

  • Oh, Yoo-Sung;Kim, Ji-sun;Jang, Woo-Seong
    • Journal of the Korean Applied Science and Technology
    • /
    • v.36 no.4
    • /
    • pp.1312-1326
    • /
    • 2019
  • The purpose of this study is to examine whether the 12-week Nordic walking can improve the physical function and arthritis pain of elderly women with osteoarthritis This study were divided into randomly assigned Nordic Walking Exercise Group (n=9) and Control Group (n=7) for 16 Elderly women diagnosed with Osteoarthritis (age: 73±3.79 year, height: 154.3±4.09 cm). The exercise group used Nordic sticks to carry out 30 minutes of Nordic walking exercise three times a week for 12 weeks, and the kinetic intensity was set at 40-60% of HRR. The control group maintained daily life for the same period. Body composition (weight, percentage body fat, skeletal muscle mass), muscular strength, Flexibility (muscular strength of upper and lower limbs, flexibility of upper and lower limbs), balance ability (static balance, dynamic balance) and pain level were measured as subordinate variables. These indicators were measured twice before and after the exercise program. The study shows that percentage body fat and skeletal muscle mass in the body composition function over 12 weeks of Nordic walking exercise have significant effects after the exercise than before (p=004)(p=.003), and it also shows significant interaction effects between the groups and timings(p=.018)(p=.005). In muscular strength, Flexibility factors, there were significant effects between the groups and timings in the upper limb muscular strength and the lower limb flexibility (p=.009)(p=.036), and a significant difference between the exercise group and the control group(p=.006) in the lower limb muscular strength. In addition, in the upper limb flexibility, there was a more significant difference after the exercise than before(p=.020). There were improvement effects after the exercise than before in the balance ability and the static balance(p=.016), but no difference in the dynamic balance(p>.05). In pain, there was a significant improvement after the exercise than before(p=.022), and a significant difference between the exercise group and the control group(p=.013). In conclusion, the 12-week Nordic walking exercise has positive effects on the body composition functions of the elderly women with Osteoarthritis, and has a positive effect on the improvement of upper limb muscular strength and lower limb flexibility in the health fitness factors. These effects are believed to have contributed effectively to the improvement of the level of pain by contributing to the improvement of physical and motor functions of the elderly women with Osteoarthritis. Therefore, it is considered that Nordic walking exercise, which enhances stability and balance of the patients with Osteoarthritis by using poles, is an effective exercise method for the improvement of the body and motor functions by lowering the pain of the joints and reducing the muscular strength and percentage body fat.

A Study of Postural Control Characteristics in Schoolchild with Intellectual Disability (초등학교 지적장애아동의 자세조절 특성)

  • Lee, Hyoung Soo
    • 재활복지
    • /
    • v.14 no.3
    • /
    • pp.225-256
    • /
    • 2010
  • This study aims to provide the basic data of the rehabilitation program for the schoolchild with intellectual disability by designing new framework of the features of postural control for the schoolchild with intellectual disability. For this, the study investigated what sensations the schoolchild are using to maintain posture by selectively or synthetically applying vision, vestibular sensation and somato-sensation, and how the coordinative sensory system of the schoolchild is responding to any sway referenced sensory stimulus. The study intended to prove the limitation of motor system in estimating the postural stability by providing the cognitive motor task, and provided the features of postural control of the schoolchild with intellectual disability by measuring the onset times and orders of muscle contraction of neuron-muscle when there is a postural control taking place due to the exterior disturbance. Furthermore, by comparatively analyzing the difference between the normal schoolchild and the intellectually disabled schoolchild, this study provided an optimal direction for treatment planning when the rehabilitation program is applied in the postural control ability training program for the schoolchild with intellectual disability. Taking gender and age into consideration, 52 schoolchild including 26 normal schoolchild and 26 intellectually disabled schoolchild were selected. To measure the features of postural control, CTSIB test, and postural control strategy test were conducted. The result of experiment is as followed. First, the schoolchild with intellectual disability showed different feature in using sensory system to control posture. The normal schoolchild tended to depend on somato-sensory or vision, and showed a stable postural control toward a sway referenced stimulus on somato-sensory system. The schoolchild with intellectual disability tended to use somato-sensory or vision, and showed a very instable postural control toward a sway referenced vision or a sway referenced stimulus on somato-sensory system. In sensory analysis, the schoolchild with intellectual disability showed lower level of proficiency in somato-sensation percentile, vision percentile and vestibular sensation percentile compare to the normal schoolchild. Second, as for the onset times and orders of muscle contraction for strategies of postural control when there is an exterior physical stimulus, the schoolchild with intellectual disability showed a relatively delayed onset time of muscle control, and it was specially greater when the perturbation is from backward. As for the onset orders of muscle contraction, it started from muscles near coax then moved to the muscles near ankle joint, and the numbers and kinds of muscles involved were greater than the normal schoolchild. The normal schoolchild showed a fast muscle contracting reaction from every direction after the perturbation stimulus, and the contraction started from the muscles near the ankle joint and expanded to the muscles near coax. From the results of the experiments, the special feature of the postural control of the schoolchild with intellectual disability is that they have a higher dependence on vision in sensory system, and there was no appropriate integration of swayed sensation observed in upper level of central nerve system. In the motor system, the onset time of muscle contraction for postural control was delayed, and it proceeded in reversed order of the normal schoolchild. Therefore, when use the clinical physical therapy to improve the postural control ability, various sensations should be provided and should train the schoolchild to efficiently use the provided sensations and use the sensory experience recorded in upper level of central nerve system to improve postural control ability. At the same time, a treatment program that can improve the processing ability of central nerve system through meaningful activities with organizing and planning adapting reaction should be provided. Also, a proprioceptive motor control training program that can induce faster muscle contraction reaction and more efficient onset orders from muscularskeletal system is need to be provided as well.

Recurrence Analysis of Giant Cell Tumor after Curettage and Cementation (거대 세포종에서 골 소파술 및 시멘트 충전술 후의 재발 분석)

  • Hahn, Soo-Bong;Lee, Won-Jun;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
    • /
    • v.10 no.2
    • /
    • pp.71-78
    • /
    • 2004
  • Purpose: The purpose of this study is to investigate the characteristic of recurred giant cell tumor after bony curettage and cementation, and to review a way to prevent the recurrence. Materials and Methods : Thirty seven cases were analyzed, which were pathologically diagnosed giant cell tumor after diagnostic biopsy or surgical excision, followed by curative curettage, burring and cementation. Location, character, and time interval to recurrence were reviewed. Results: Thirteen out of thirty seven analyzed cases(35%) showed recurrence after primary curettage and cementation. The mean interval to recurrence was sixteen months(5 months to 43 months). Most of recurrence happened within the first two years except two cases. Among the recurred cases, eleven showed recurrence in the vicinity of window area. Two cases recurred in the depth of bone marrow, where cementation was made. The advantage of curettage and cementation is the immediate stability of the operation site, early rehabilitation, and early detection of recurrence. Furthermore, cementation is beneficial in that the cement-producing heat can eradicate the residual tumor burden. In this study, 85% of cases with insufficient curettage (for example, in cases where too small surgical window was made, or where there were anatomical difficulty in approaching the target tumor burden) showed recurrence. Conclusion: Bony curettage, burring and cementation is widely used as the primary curative modality for giant cell tumor. A few other modalities such as chemical cautery using phenol and $H_2O_2$; cryotherapy; and anhydroalcohol have also been introduced, but the benefit of these are still questionable. For some cases that relatively small surgical window was made due to anatomically complicated structures (such as ligament insertion or origin site) over the target tumor burden, unsatisfactory curettage and burring was made. This study showed high chance of recurrence after unsatisfactory curettage, and 85% of recurrence developed in the vicinity of the small window area. Most of the recurrence occurred within the first two years. It is concluded that sufficient window opening, extensive curettage and eradicative burring are key factors to prevent recurrence. Also, it should be reminded that careful and close observation should be made for at least the first two years after initial treatment for early detection of recurrence.

  • PDF

Functional Result of Limb Salvage Surgery with Tumor Prosthesis for Osteosarcoma of Proximal Tibia (근위 경골 골육종의 종양대치물을 이용한 사지 구제술 후의 기능 평가)

  • Bahk, Won-Jong;Sohn, Jong-Min;Chung, Yang-Guk;Kang, Yong-Koo
    • The Journal of the Korean bone and joint tumor society
    • /
    • v.7 no.4
    • /
    • pp.139-143
    • /
    • 2001
  • Purpose : Limb salvage for osteosarcoma of proximal tibia is challenging problem due to difficulties in mobilizing or retracting the main neurovascular structure, inadequate soft tissue coverage, and unsolved problem of patellar tendon reattachment to endoprosthesis. The authors analyzed the functional result of limb salvage using tumor prosthesis with medial gastrocnemius rotation plasty for osteosarcama of the proximal tibia. Materials and Methods : Eleven patients with histologically proven osteosarcoma of the proximal tibia, treated with adjuvant and neoadjuvant chemotherapy and limb salvage operation with tumor prosthesis between January 1992 and December 1998 at our Medical Center, were selected. There were 6 male and 5 female. Age ranged from 15 years to 23.7 years with an average of 23.7 years. Follow-up period ranged from 1 year to 4.5 years with an average of 2.5 years. The final functional result was evaluated using the method by ISOLS, 1993. The factors include pain, functional activities, emotional acceptance, use of external supports, walking ability and gait. Each of the factors has been scored from 0 to 5 depending on the appropriate description or data. The rating score is determined by dividing the individual factor scores into the total score and indicates percentage of normal function. Results : The overall functional result ranged from 53,3% to 86.7% with an average of 68.3% of normal function. In details, the averages were 82.5% for pain, 62.5% for functional activities, 67.5% for emotional acceptance, 77.5% for use of external supports, 62.5% for walking ability, and 57.5% for gait. The average range of motion of the knee joint was $5^{\circ}$ extension and $85^{\circ}$ flexion. Five patients have extension lag ranged from $5^{\circ}$ to $15^{\circ}$ with an average of $10^{\circ}$. Two patients suffered postoperative infection. One was treated with antibiotics injection only, but the other needed removal of the prosthesis and knee fusion. Both of them showed unsatisfactory result. C o n c l u s i o n : The overall functional result after limb salvage using tumor prosthesis with medial gastrocnemius rotational flap for osteosarcoma of the proximal tibia was relatively satisfactory in case of no postoperative infection. The patients were less satisfactory in functional activities, emotional acceptance and gait than pain, use of external supports due to limitation of motion and extension lag. More aggressive postoperative physical therapy and protection with brace for 6~9 months as well as surgical technique is mandatory for more satisfactory result.

  • PDF