• Journal of Korean Physical Therapy Science
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• v.17 no.1_2
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• pp.41-52
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• 2010

Purpose: The purpose of this study was to compare the effects of continuous passive motion(CPM) and continuous active motion(CAM) on proprioception of the knee after total knee replacement(TKR). Methods: Twenty patients with TKR were randomly allocated into two groups, the CPM group(n=10) and the CAM group(n=10). All subjects were evaluated for levels of pain, passive range of motion and angle reproduction of the knee. An angle reproduction test was used to assess the proprioceptive deficit. Two types of angle reproduction test were used: a passive angle reproduction(PAR) test and an active angle reproduction(AAR) test. The relevant examinations were performed before and after intervention(on the 5th day and the 10th day). The statistical significance were calculated using a t-test and a one-way repeated ANOVA. Results: A pre-intervention significant difference was not found between the two groups. Significantly better results were before and after the intervention at 10 days, for the PAR(flexion direction) test; however, only in the CAM group. There were no significant difference, either before or after the intervention, for the AAR test(flexion and extension direction) in both group. Both groups experienced similar levels of pain and passive range of knee motion before and after the intervention. Conclusion: This study revealed that CAM was a better effect to restore position sense of the knee joint after TKR.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.5 no.1
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• pp.39-51
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• 1999

Background and Purpose. Objective measurements of hamstring muscle length are needed to quantify baseline limitations and to document the effectiveness of therapeutic interventions. Several indirect clinical tests for measuring hamstring muscle length are available, but influence of their test procedure is not well documented. The purpose of this study were 1) to describe hamstring muscle length as reflected by use of six tests(active straight leg raising(ASLR), passive straight leg raising(PSLR), passive straight leg raising with the lower back flat(PSLRB), active knee extension(AKE), passive knee extension(PKE), hip joint angle(HJA). 2) to examine the correlation among the tests. Subjects, Sixty subjects(30 men. 30 women) ranging in age from 18 to 25 years(mean 20.2 years) and with no limitation hamstring flexibility and no neurological and orthopedical problems. Methods. All subjects performed six tests. A inclinometer was used to determine the end point of range of motion. HJA was measured using an inclinometer placed over the sacrum. PSLRB were tested PSLR with the low back flat and the opposite thigh slightly flexed and support on pillows. Results, A mean ASLR value of 85.9 degrees, PSLR value of 99.9 degrees, PSLRB value of 109.8 degrees, AKE value of 77.2 degrees PKE value of 83.1 degrees and HJA value of 73.0 degrees were obtained for all subjects. A dependent t-test showed significant difference between the angles of ASLR and PSLR(p<0.001). There was a significant difference between the angles of PSLR and PSLRB(p<0.001). There was a significant difference between the angles of AKE and PKE(p<0.001). The highest correlation was between PSLR and PSLRB(r=0.915, p<0.001). All SLR tests were significants related(p<0.001), as well as AKE and PKE(p<0.001). The lowest correlation was between PKE and HJA(r=0.171. p>0.05). Conclusion and Discussion. The results indicated that the hip flexion angles for ASLR, PSLR and PSLRB were a difference, and the knee extension angles for AKE and PKE were a difference.

• Physical Therapy Korea
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• v.16 no.4
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• pp.1-7
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• 2009

The active-knee-extension (AKE) test has been used to measure hamstring muscle length. The traditional AKE test measures the popliteal angle to the point of resistance with a 90-degree flexion of the hip fixed by straps, while the stabilized AKE test measures the popliteal angle to the point of resistance with a 90-degree flexion of the hip stabilized using a pressure biofeedback unit providing lumbopelvic stabilization. The purpose of this study was to determine test-retest reliability of the traditional AKE test and stabilized AKE test. Twenty healthy adults participated in the study. The popliteal angles were measured with a digital inclinometer during each test. To assess the test-retest reliability between the 2 test sessions, intraclass correlation coefficients (ICCs) were calculated. The intrasubject coefficient of variation ($CV_{intra}$) was also calculated. To compare the traditional and stabilized AKE tests for changes in pressure, paired t-tests were applied. The results of this study were as follows: 1) ICCs(3,1) value for test-retest reliability was .96 in the traditional AKE test, and was .98 in the stabilized AKE test. 2) The maximal $CV_{intra}$ was 33.7% in the traditional AKE test and 15.7% in the stabilized AKE test. 3) Differences of $6.1{\pm}2.1$ mmHg in pressure were measured in the traditional AKE test, and differences of $1.2{\pm}1.0$ mmHg in pressure were measured in the stabilized AKE test. The results show the traditional and stabilized AKE test to be highly reliable, with test-retest reliability. However, the stabilized AKE test represented less variation and more stabilization than the traditional AKE test. Further study is needed to measure the inter-rater reliability of the stabilized AKE test for generalization and clinical application.

• PNF and Movement
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• v.20 no.2
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• pp.295-306
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• 2022

Purpose: This study aimed to investigate the effect of robot-assisted gait training on the active ranges of motion, gait abilities, and biomechanical characteristics of gait in patients who underwent lower extremity surgery, and to verify the effectiveness and clinical usefulness of robot-assisted gait training. Methods: This study was conducted on 14 subjects who underwent lower extremity surgery. The subjects participated in robot-assisted gait training for 2 weeks. The active ranges of motion of the lower extremities were evaluated, and gait abilities were assessed using 10-m and 2-min walk tests. An STT Systems Inertial Measurement Unit was used to collect data on biomechanical characteristics during gait. Spatiotemporal parameters were used to measure cadence, step length, and velocity, and kinematic parameters were used to measure hip and knee joint movement during gait. Results: Significant improvements in the active ranges of motion of the hip and knee joints (flexion, extension, abduction, and adduction) and in the 10-m and 2-min walk test results were observed after robot-assisted gait training (p < 0.05). In addition, biomechanical characteristics of gait, spatiotemporal factors (cadence, step length, and velocity), and kinematic factors (gait hip flexion-extension, internal rotation-external rotation angle, and knee joint flexion-extension) were also significantly improved (p < 0.05). Conclusion: The results of this study are of clinical importance as they demonstrate that robot-assisted gait training can be used as an effective intervention method for patients who have undergone lower extremity surgery. Furthermore, the findings of this study are clinically meaningful as they expand the scope of robot-assisted gait training, which is currently mainly applied to patients with central nervous system conditions.

• Proceedings of the KIEE Conference
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• 2005.10b
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• pp.376-378
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• 2005

In this study, we have evaluated and classified arthritic pathology using the acoustical analysis of knee joint sounds. Six normal subjects and 11 patients with knee problems were enrolled. Patients were divided into the 1st patient group which required an orthopeadic surgery and the 2nd patient group of osteoarthritis. During sitting and standing periods, subjects' active knee flexion and extension were monitored. Fundamental frequency, mean amplitude of pitch, jitter and shimmer were analyzed according to the position and the joint angle. The result showed that the fundamental frequency of the 2nd patient group and standing position was higher than the others, and that the pitch of sounds changed unstably.

• Physical Therapy Rehabilitation Science
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• v.11 no.2
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• pp.259-268
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• 2022

Objective: The purpose of this study was to measure the immediate effect of hip hinge exercise stretching on hamstring flexibility, pelvic tilting angle, proprioception, and dynamic balance in individual with tightness of the hamstring. Design: A randomized controlled trial. Methods: A total of 35 healthy young adults (27 males, 8 females) volunteered for this study and randomly divided into three groups (Hip hinge exercise stretching group, passive stretching group, and PNF stretching group). The hamstring flexibility, pelvic tilting angle, knee joint proprioception, dynamic balance was conducted for 3 times. In order to evaluate the hamstring flexibility, the active knee extension test was performed. Forward bending test was performed to examine pelvic tilting angle.The proprioception was tested by the joint position sense test and dynamic balance was evaluated by Y balance test. Results: The hamstring flexibility, pelvic tilting angle and dynamic balance were significantly improved between three groups before and after intervention (p<0.05). Dynamic balance was significantly difference between the three groups in the posterolateral direction (p<0.05). Conclusions: This study result showed that hip hinge exercise stretching was the most effective method for increasing hamstring flexibility, pelvic tilting angle and dynamic balance. In addition, it is necessary to study whether hamstring stretching is effective in low back pain patient with hamstrings tightness.

• Physical Therapy Korea
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• v.27 no.3
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• pp.171-177
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• 2020

Background: The flexion-relaxation phenomenon (FRP) refers to a sudden onset of activity in the erector spinae muscles that recedes or fades during full forward flexion of the trunk. Lumbar spine and hip flexion are associated with many daily physical activities that also impact trunk flexion. Shorter hamstring muscles result in a reduction of pelvic mobility that eventually culminates in low back pain (LBP). Many studies have explored the FRP in relation to LBP. However, few studies have investigated the influence of hamstring muscle length on the FRP in relation to the erector spinae muscles during trunk flexion. Objects: This study aimed to investigate the influence of hamstring muscle length on the FRP in relation to the erector spinae muscles during trunk flexion. Methods: Thirty subjects were divided into three groups according to hamstring length measured through an active knee extension test. The 30 participants consisted of 10 subjects who had a popliteal angle of 20° or less (Group 1), 10 subjects who had a popliteal angle of 21°-39° (Group 2), and 10 subjects who had a popliteal angle of 40° or more (Group 3). A one-way analysis of variance was used to compare the difference in muscle activity of the erector spinae muscles during trunk flexion. Results: The subjects with a shorter hamstring length had significantly higher muscle activity in their erector spinae muscles during trunk flexion and full trunk flexion (p < 0.05). The subjects with a shorter hamstring length also had a significantly higher flexion-relaxation ratio (p < 0.05). Conclusion: The results of this study demonstrate that differences in hamstring muscle length can influence the FRP in relation to the erector spinae muscles. This finding suggests that the shortening of the hamstring might be associated with LBP.

• Physical Therapy Korea
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• v.19 no.3
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• pp.98-104
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• 2012

The aim of this study was to examine the effects of repeated passive movement (RPM) of different velocities on the improvement of knee joint position sense (JPS) in post-stroke patients with hemiplegia, thereby investigate the possibility of clinical application in the initial stage of rehabilitation for patients with post-stroke hemiplegia. Thirteen hemiplegic patients participated in this study. For the subjects' knee JPS tests, a passive angle reproduction test and an active angle reproduction test were performed prior to and after the intervention, which involved 30 repetitions of passive full-range-of-motion flexion and extension exercise of the knee joints at randomized degrees of $0^{\circ}/s$, $45^{\circ}/s$, and $90^{\circ}/s$. Paired t-test analysis was done in order to compare changes in the pre- and post-intervention knee JPS. One-way repeated analysis of variance was used in order to compare changes in JPS after intervention at three different movement velocities. The level of significance was set at .05. The result was that the subjects' post-intervention knee JPS significantly improved after the RPM exercise at a $45^{\circ}/s$ and a $90^{\circ}/s$ relative to the RPM exercise $0^{\circ}/s$ (p<.05). JPS changes with RPM intervention at the rapid velocity of $90^{\circ}/s$ were most increased, suggesting the most effective enhancement in knee JPS is with intervention at the velocity (p<.05). Therefore, RPM intervention at a half or higher velocity improved stroke patients' knee JPS. During the initial stage of rehabilitation for patients with post-stroke hemiplegia, the efficient application of the RPM exercise at a half or higher velocity will be possible.

• Proceedings of the KIEE Conference
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• 2005.05a
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• pp.51-53
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• 2005

Considerable noise is sometimes associated with degeneration of the hee joint surface. Such noise may indicate roughness or softening of the cartilage surfaces, and may be a useful index for early disease. In this study, we have evaluated arthritic pathology using the acoustical analysis of knee joint sounds. During sitting and standing periods, subjects' active knee flexion and extension were monitored. Fundamental frequency, mean amplitude of pitch, jitter and shimmer were analyzed according to the position and the joint angle. The result showed that the fundamental frequency of the 2nd patient group and standing position was higher than the others, and that the pitch of sounds changed unstably. These results suggest that an analysis of knee joint sound might assist non-invasive diagnosis of an articular pathology.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.4
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• pp.1-9
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• 2020

PURPOSE: The current generation has shortened hamstrings due to a sedentary lifestyle, resulting in reduced flexibility of the hamstring and dysfunction. This study was undertaken to compare effects of three different release exercises on hamstring flexibility, in participants with short hamstrings. METHODS: Totally, 20 subjects having short hamstrings were involved in this study. The inclusion criterion for study participation was active knee extension test (AKET) less than 60°. All participants were subjected to 3 methods: hamstring foam roller release (HFRR), sitting self myofascial release (sitting SMR), and standing self myofascial release (Standing SMR). All participants randomly performed all three methods to avoid bias caused by learning or fatigue. Passive knee extension test (PKET), AKET, finger to floor distance test (FTFT), and pelvic tilting angle test (PTAT) were measured pre- and post-exercises. RESULTS: The PKET, AKET and FTFT were significantly increased after HFRR, sitting SMR, and standing SMR exercise (p < .05). However, PTAT was not significantly increased after the three exercises (p > .05). Furthermore, no significant differences were observed between PKET, AKET, FTFT and PTAT subsequent to HFRR, sitting SMR, and standing SMR (p > .05). CONCLUSION: Our results indicate that HFRR, sitting SMR and standing SMR were immediately effective in improving hamstring flexibility in participants with short hamstrings.