• Journal of Korean Academy of Nursing
• /
• v.45 no.6
• /
• pp.823-833
• /
• 2015

Purpose: The purpose of the study was to investigate the effects of the Thera-Band exercise program following total knee arthroplasty. Methods: The research design for this study was a nonequivalent control group non-synchronized design. Participants were 30 patients for the experimental group and 30 patients for the control group. The experimental group participated in the Thera-Band exercise program in addition to conventional CPM (continuous passive motion) exercise. The control group received conventional CPM exercise only. Outcome measures were pain, knee flexion range of motion, CRP, and psychological parameters (self-efficacy and fear of falling). Data were analyzed using ${\chi}^2$-test, Fisher's exact test, t-test, and repeated measure ANOVA with SPSS/PC version 21.0. Results: There were significant improvement in self-efficacy, and decreases in pain, and fear of falling in the experimental group compared to the control group. However, no significant differences were found between the two groups for CRP and knee flexion ROM. Conclusion: The Thera-Band exercise program gave an additional benefit over the conventional CPM exercise for patients following total knee arthroplasty, and is recommended for use as an effective nursing intervention for patients after total knee arthroplasty.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.25 no.1
• /
• pp.37-43
• /
• 2019

Background: This study was conducted to investigate the effects of obstacles gait on balance and fall-efficacy in patients who underwent total knee arthroplasty. Methods: The 24 subjects of this study were recruited from individuals diagnoses with degenerative arthritis who had undergone total knee arthroplasty. The 24 patients were randomly divided into a control groups and experimental groups, obstacles gait exercise was conducted for 4 weeks three exercises. Balance and falls-efficacy were measured to compare the effects of the exercises. Results: The results of the balance ability and falls-efficacy showed that the experimental group showed significantly enhanced results than the control group(p<.05). Conclusions: Based on these results, Obstacles gait exercise effectively improves the recovery of patients with total knee arthroplasty.

• Journal of the Korean Society for Precision Engineering
• /
• v.21 no.9
• /
• pp.188-195
• /
• 2004

Severe osteoarthrosis of the knee joint often requires total knee arthroplasty(TKA) to yield adequate knee function. The knee joint with TKA is expected ideally to restore the characteristics, however, this is not necessarily 1.ue in the clinical cases. In this study the motion of the intact joint and the joint after. TKA were investigated numerically using computer simulation. For active knee extension from 90 degrees of flexion to full extension, the intact knee joint exhibited anterior tibial translation near the full extension and it showed only rotation at other flexion angles. Physiologic external rotation of the tibia near full extension known as screw home movement was also noted in the analytical model. The analysis of the tibial insert of three different shapes (flat, semicurved, and curved types) demonstrated characteristic rotational and sliding motion as well as different contact forces.

• Journal of the Korean Academy of Clinical Electrophysiology
• /
• v.11 no.1
• /
• pp.39-44
• /
• 2013

Purpose : The purpose of present study is to evaluate the joint angles of legs in the standing posture for six patients with unilateral knee osteoarthritis. Methods : The participants underwent unilateral total knee replacement. A motion analysis was used to measure the joint angles of the hip, knee, and ankle. The measurements were taken before the surgery, one week and two weeks after the surgery. Both sides of the legs were evaluated. Results : This result showed that after a certain healing period, both hip joint angles showed a significant difference while there was no significant difference in the knee and ankle joint angles. After surgery, the angle of ankle dorsiflexion was smaller on the operated side than the opposite side compared to the pre-surgery measurements. Conclusion : After surgery, the asymmetry in a standing position left unchanged due to contracture of the knee joint and tightness in the hamstring muscle. Therefore, when physiotherapists plan an initial exercise programs for TKR patients, it is essential to apply adequate exercises which consider the contracture of the leg joints.

• Journal of the Korean Orthopaedic Association
• /
• v.54 no.1
• /
• pp.37-44
• /
• 2019

Purpose: Tumor infiltration around the knee joint or skip metastasis, repeated infection sequelae after tumor prosthesis implantation, regional recurrence, and mechanical failure of the megaprosthesis might require combined distal femur and proximal tibia replacement (CFTR). Among the aforementioned situations, there are few reports on the indication, complications, and implant survival of CFTR in temporarily arthrodesed patients who had a massive bony defect on either side of the knee joint to control infection. Materials and Methods: Thirty-four CFTR patients were reviewed retrospectively and 13 temporary arthrodesed cases switched to CFTR were extracted. All 13 cases had undergone a massive bony resection on either side of the knee joint and temporary arthrodesis state to control the repeated infection. This paper describes the diagnosis, tumor location, number of operations until CFTR, duration from the index operation to CFTR, survival of CFTR, complications, and Musculoskeletal Tumor Society (MSTS) score. Results: According to Kaplan-Meier plot, the 5- and 10-year survival of CFTR was 69.0%±12.8%, 46.0%±20.7%, respectively. Six (46.2%) of the 13 cases had major complications. Three cases underwent removal of the prosthesis and were converted to arthrodesis due to infection. Two cases underwent partial change of the implant due to loosening and periprosthetic fracture. The remaining case with a deep infection was resolved after extensive debridement. At the final follow-up, the average MSTS score of 10 cases with CFTR was 24.6 (21-27). In contrast, the MSTS score of 3 arthrodesis cases with failed CFTR was 12.3 (12-13). The average range of motion of the 10 CFTR cases was 67° (0°-100°). The mean extension lag of 10 cases was 48° (20°-80°). Conclusion: Although the complication rates is substantial, conversion of an arthrodesed knee to a mobile joint using CFTR in a patient who had a massive bony defect on either side of the knee joint to control infection should be considered. The patient's functional outcome was different from the arthrodesed one. For successful conversion to a mobile joint, thorough the eradication of scar tissue and creating sufficient space for the tumor prosthesis to flex the knee joint up to 60° to 70° without soft tissue tension.

• Journal of The Korean Society of Integrative Medicine
• /
• v.8 no.1
• /
• pp.1-14
• /
• 2020

Purpose : The purpose of this study was to investigate the effect of an exercise program with patella mobilization on range of motion, muscle strength, and gait in patients with total knee arthroplasty. Methods : Thirty patients under the age of 65 who visited the T hospital in Daegu Metropolitan City and underwent total knee arthroplasty surgery were selected for this study. Fifteen patients were randomly assigned to the experimental group and took part in an exercise program with patella mobilization, and fifteen patients were randomly assigned to the control group and took part in just the exercise program. Each group took part in their intervention three times a week for four weeks. The measurement tools used included a goniometer, handheld dynamometer, and 10-meter walking test. In the statistical analysis results, to compare the about pre and post test differences within each group, a paried t-test was used, and to compare the differences between each group, an independent t-test was used. Results : There was a significant difference (p<.05) in the range of motion, muscle strength of the quadriceps femoris and, hamstrings, and 10-meter walking test within each individual group and between the two groups before and after the intervention (p<.05). Conclusion : All the results for the experimental group were significant. Therefore, it is expected that an exercise program with patella mobilization will be helpful for the recovery of the knee joint in patients who have undergone total knee arthroplasty.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.27 no.1
• /
• pp.51-62
• /
• 2021

Background: The purpose of this study was conducted to investigate the effects of the ankle mobilization with movement (MWM) technique on ankle dorsiflexion range of motion (ROM), balance, and gait in patients who underwent total knee replacement (TKR). Methods: Thirty patients with knee osteoarthritis were recruited and randomly divided into two groups: the experimental group (EG; n=15) and the control group (CG; n=15). For five days a week for 3 weeks, participants in the EG were treated with the ankle MWM technique and traditional total knee replacement (TKR) exercise, and those in the CG only performed traditional TKR exercises. The dorsiflexion ROM, balance, and gait of the patients were before and after exercise. Results: Balance system SD was used compare changes in dynamic balance. Patients in the EG group showed statistically significant differences after the intervention (p<.05). In addition, there was a statistically significant difference in dynamic balance between the EG and CG groups after the intervention (p<.05). STT-IBS was used to compare changes in velocity, step length, stride length, and ankle dorsiflexion ROM. Patients in the EG group showed statistically significant differences after the intervention (p<.05). In addition, there was a statistically significant difference in the velocity, step length, stride length, and ankle dorsiflexion ROM between the EC and CG groups after the intervention (p<.05). Conclusion: Our results showed that applying the ankle MWM technique with traditional TKR exercises improved ankle dorsiflexion ROM, dynamic balance, and gait in patients.

• The Journal of Korean Physical Therapy
• /
• v.25 no.2
• /
• pp.81-87
• /
• 2013

Purpose: The purpose of the current study was to examine the effects of electromyography (EMG)-biofeedback training on lower extremity muscle activity and balance of patients with total knee replacement (TKR). Methods: Subjects were randomly allocated to two groups: experimental and control group. Subjects in the experimental group (n=10) were provided with quadriceps setting exercise by EMG-biofeedback (QSE+BF) and those in the control group were provided with QSE. Subjects in both groups were provided with the respective training programs for 20 minutes per session, five times per week, for a period of six weeks. To test significance, data analysis was performed using repeated-ANOVAs. Results: Statistically significant differences in muscle activity of the rectus femoris muscle and the vastus lateralis, and dynamic balance ability were observed in the experimental group, compared with the control group. In comparison of the muscle activity of the rectus femoris muscle and the vastus lateralis, and dynamic balance ability between different training periods within the groups, both groups showed statistically significant differences. Conclusion: EMG-biofeedback training is effective in improving lower extremity muscle activity and balance ability of patients with TKR, and should be effective in patients with other diseases.

• Journal of the Korean Academy of Clinical Electrophysiology
• /
• v.10 no.2
• /
• pp.31-35
• /
• 2012

Purpose : The purpose of this study was to investigate the effect of kinematic variables by analysis of a gait in older. Methods : This study selected nine in older adults with osteoarthritis. The Kinematic variables during walk were compared analyzed using motion analysis. Results : The findings of this study are as follows. Stance time showed significant difference within-subject groups and interaction within-subjects and time. The swing and stride time showed a no significant interaction within-subjects and time. Swing time showed a no significant difference according to time and within-subjects. Stride time showed a significant difference according to time. But, stride time showed a no significant difference according to within-subjects. Conclusion : These findings of this study indicate that when the patients with total knee arthroplasty decreased stability. Therefore, stance and stride time showed increase when walking, because to decrease the weight bearing that is delivered to knee. And swing time showed decrease.

• Journal of the Korean Academy of Clinical Electrophysiology
• /
• v.11 no.1
• /
• pp.21-29
• /
• 2013

Purpose : The purpose of this study was to determine the changes in ultrasound imaging of the lower limbs in patients with degenerative osteoarthritis who received a total knee replacement (TKR). Methods : The participants for the study were ten patients who were to receive a total knee replacement. Measurements were taken a total of three times: before receiving a total knee replacement, and one week and two weeks after receiving a total knee replacement. The vastus medialis, rectus femoris muscle, tibialis anterior and gastrocnemius muscle were measured using ultrasound imaging. Results : Muscle thickness of the vastus medialis, rectus femoris muscle, tibialis anterior and gastrocnemius muscle had no significant interaction over time whether surgery was performed or not. White area index (WAI) and density of vastus medialis, rectus femoris muscle, tibialis anterior and gastrocnemius muscle had no significant interaction over time whether surgery was performed or not. Conclusion : In conclusion, lower quality muscles were due to a decrease in muscle fiber and an increase in fat fiber. Therefore, initial physical therapy after total knee replacement should consider this point and be designed appropriately as a therapeutic approach for total knee replacement patients.