• 대한골관절종양학회지
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• 제2권1호
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• pp.8-17
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• 1996

The purpose of this study is a comparative evaluation of range motion, especially extension deficit between the group of total patellectomy and that of intact patella, after reconstruction of the patellar tendon in the prosthetic replacement of a proximal tibia. Between 1990 and 1994, 15 patients who had a primary malignancy on proximal tibia were operated on. All patients were evaluated clinically and radiographically. Two patients were excluded because one had a deep infection treated with arthrodesis of the knee and the other was a composite allograft. The mean follow-up of the 13 patients was 27 months(15-47), including 10 osteosarcomas, 1 chondrosarcoma, 1 malignant fibrous histiocytoma and 1 malignant giant cell tumor. Eleven patients had a resection of the proximal tibia and 2 had an extracapsular total knee resection with distal femur. Reconstruction of the defect was done in 8 cases with a custom-made Link Endo-Model Total Rotation Knee Joint Prosthesis, and in 5 with How Medica Modular Resection System (HMRS). We used two methods to reconstruct the ligamentum patellae. Fixation of the patellar tendon to the prosthesis only with suturing and/or stapling(group SS) was done in 7. Transposition of gastrocnemius muscle to enhance fixation and to cover the prosthesis(group TG) was done in 6. Regardless of fixation methods, total patellectomy was done in 5 either to lengthen the patellar tendon or to make primary skin closure easier or for both. In 8 cases, patella was left intact or resurfaced with polyethylene prosthesis. Active extension was measured while the patient was in a sitting position. There is no statistically meaningful difference in terms of extension deficit (Wilcoxon rank test, p=0.8800) between patellectomy group and intact patella group, and between group of fixation only with suturing and that of gastrocnemius transposition. Two cases of extension deficit over 30 degree were seen in group SS and in the group of intact patella. Conclusively, total patellectomy could be an option without increasing the risk of extension deficit when primary skin closure is difficult or patellar tendon is a little bit short to be fixed. There is no rating in the Enneking system of functional evaluation that this finding into consideration.

• 한국정밀공학회지
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• 제23권7호
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• pp.152-158
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• 2006

The objective of this work is to develop the knee joint model for representing various pendulum motions and quantifying the spasticity. Knee joint model included the extension and flexion muscles. The joint moment consists of both the active moment from the stretch reflex and the passive moment from the viscoelastic joint properties. The stretch reflex was modeled as nonlinear feedback of muscle length and the muscle lengthening velocity, which is Physiologically-feasible. Moreover, we modeled the spastic reflex as having dynamic threshold to account far the various pendulum trajectories of spastic patients. We determined the model parameters of three patients who showed different pendulum trajectories through minimization of error between experimental and simulated trajectories. The simulated joint trajectories closely matched with the experimental ones, which show the proposed model can predict pendulum motions of patients with different spastic severities. The predicted muscle force from spastic reflex appeared more frequently in the severe spastic patient, which indicates the dynamic threshold relaxes slowly in this patient as is manifested by the variation coefficient of dynamic threshold. The proposed method provides prediction of muscle force and intuitive and objective evaluation of spasticity and it is expected to be useful in quantitative assessment of spasticity.

• 대한관절경학회지
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• 제1권1호
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• pp.132-138
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• 1997

The purpose of this study is to compare the results between conventional and accelerated rehabilitation program following ACL reconstruction using bone-patellar tendon-bone. Conventional rehabilitation focused on protecting the new ligament by blocking terminal extension and avoiding active quadriceps function in the terminal degrees of extension. But there is current trend toward early postoperative mobilization and intensive. so called 'accelerated', rehabilitation stressing hyperextension of the knee. The results of intraarticular ACL reconstruction with conventional and accelerated rehabilitation were prospectively compared for one year postoperatively in a series of 27 patients. Range of motion and thigh circumference were checked preoperatively, and weekly up to 8 weeks, 3 months. 6 months, and 1 year postoperatively. Stress radiologic test, KT-1000 arthrometer. Cybex II dynamometer were checked in preoperatively, and 3 months, 6 months, and 1 year postoperatively. There were no differences of objective stability and restoration of muscle power. But the accelerated group had a low incidence of extension loss. excellent range of motion, and less difference of thigh circumference. We concluded that accelerated rehabilitation program is recommendable due to superiority in terms of range of motion, especially less extension loss without increasing laxity of knee joint.

• 한국전문물리치료학회지
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• 제27권3호
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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.

• 대한정형도수물리치료학회지
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• 제15권1호
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• pp.64-71
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• 2009

Purpose: to purpose prevent to dysfunction and decrease to pain level use to active therapeutic movement and sling manual, stability exercise in shortening hamstring chronic back patient. Methods: The patient's complain was Buttock and Lower Back Pain due to dysfunction posture work. The subject's initial Pain Scale was 60 of 100(VAS). The Subject Treatment to Sling Mobility exercise, Home exercise, ATM, Sling Stability exercise, sensory motor training During 8weeks for 18 times. Results: The result was Visual Analog Scale(VAS)was decreased 10 of 100 after treatment. Conclusion: Visual Analog Scale(VAS)was decreased 10 of 100 after treatment. Functional Leg Length Was recover to same level. Trunk Flexibility was increase to 18cm. Active Knee Extension ankle was decrease to $15^{\circ}$ limit range of motion due to Lt. Hamstring Shortening limit range of motion $30^{\circ}$. GPS(Gobal Postural System)test was recover to same level. This case study need to sufficient data and times.

• PNF and Movement
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• 제21권3호
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• pp.319-326
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• 2023

Purpose: The purpose of this study was to investigate the effects of modified ankle movement patterns on participants' active dorsiflexion range of motion and leg muscle activity. Methods: This study recruited twenty-five participants, all of whom were healthy individuals with no abnormalities in the ankle or knee joints. The research methodology involved measuring the active dorsiflexion range of motion and muscle activity in each person's legs based on the presence or absence of toe extension while the subjects were in a comfortable, supine position. A statistical analysis was conducted using SPSS 25.0, and a paired samples t-test was employed. The significance level was set at 0.05. Results: When the participants demonstrated the modified ankle movement pattern with a controlled toe grip, there was an increase in their active dorsiflexion angle. However, during the proprioceptive neuromuscular facilitation technique without a controlled toe grip, a higher level of activity was observed in the leg muscles. Conclusion: The results of this study could be used as foundational data for establishing a rehabilitation exercise program designed to enhance range of motion and muscle activation in the ankle joint.

• 대한물리치료과학회지
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• 제27권1호
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• pp.9-17
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• 2020

Background: This study aimed to examine the repeatability of hamstring strength during maximal voluntary contractions (MVCs) and to examine the sex difference. Design: Quasi-experiment design. Methods: The study recruited 23 healthy young individuals as participants. Hamstring flexibility was measured before and after MVCs by active knee extension test. Five trials of MVCs were performed, and hip extension forces were measured using a strain gauge during MVCs. Repeatability was confirmed by intraclass correlation coefficient (ICC) and coefficient of variation, and the difference between male and female participants was confirmed by independent samples t-test. Results: The forces measured during MVCs were significantly different between men and women over five trials. We observed the minimum and maximum force production at the first and fifth trial of MVCs in both men and women. Excellent to moderate reliability of the hamstring strength during MVCs was found in men (ICC range, 0.70-0.98) and women (ICC range, 0.66-0.90). There was no significant difference in hamstring flexibility between men and women. Conclusion: In clinical settings, we recommend excluding the first trial of MVCs in both men and women. Additionally, performing at least three trials of MVCs would be useful to improve the reliability of the baseline measures in women.

• 대한물리의학회지
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• 제9권4호
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• pp.455-463
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• 2014

PURPOSE: The purpose of this study was to compare the effects of Graston and self-myofascial release (SMR) techniques on knee joint flexibility, hamstring, and quadriceps strength. METHODS: Twenty subjects with hamstring shortness participated in this study. The subjects were assigned randomly to one of two groups: The Graston technique (GT) group received intervention using a Graston instrument for one minute, and the SMR group performed self-exercises using a foam roll for one minute. The range of motion (ROM) of the knee joint was measured by active knee extension test, and a handheld dynamometer was utilized to collect the hamstring and quadriceps muscle strength. This experiment was performed by two physical therapists. The significant level was set at ${\alpha}$=0.05. RESULTS: The results were as follows: 1) The ROM of the knee joint and quadriceps muscle strength were significantly increased in both groups. 2) Hamstring muscle strength was significantly reduced in both groups. 3) There were no significant differences between the GT group and SMR group for any variable. CONCLUSION: The results of this study suggest that SMR is an effective and easy technique for restoring proper muscle length and strength in subjects with hamstring shortness. We recommend that SMR technique be used for treat hamstring shortness in clinical setting and home-program.

• 대한물리의학회지
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• 제15권4호
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• pp.111-119
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• 2020

PURPOSE: In adults with hamstring tightness, stretching is considered a therapeutic exercise that improves flexibility. However, previous studies have reported efficacy of numerous methods, and are inconclusive in determining the most effective stretching techniques. This study aims to compare the outcomes of Evjenth-Hamberg stretching (E-HS), proprioceptive neuromuscular facilitation stretching (PNFS), and static stretching (SS), on muscle tone and flexibility. METHODS: A total of 30 subjects were assigned to each of the three stretching groups:; E-HS (n₁ = 10), PNFS (n₂ = 10), and SS (n₃ = 10). Muscle tone of the hamstring muscle, active knee extension (AKE), and passive knee extension (PKE) were assessed by range of motion. RESULTS: After the intervention, statistically significant differences were obtained between groups for muscle tone (p < .05). The post hoc test, showed statistically significant differences in muscle tone between the E-HS and PNFS groups (p < .05), and PNFS and SS groups (p < .05). Post hoc test after intervention, also revealed statistically significant differences in flexibility (p < .05) between the E-HS and PNFS groups (p < .05), E-HS and SS groups (p < .05), and PNFS and SS groups (p < .05). Moreover, a statistically significant difference was observed in PKE scores between the E-HS and SS groups (p < .05), and PNFS and SS groups (p < .05). CONCLUSION: This study indicates that E-HS may be the most effective stretching technique for muscle tone and flexibility, in adults with hamstring tightness.

• 대한임상전기생리학회지
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• 제5권2호
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• pp.35-45
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• 2007

The purpose of this study was to examine spiral way movement of a trunk exerts on the movement ability. The details established to achieve for this article. This examination confirmed the weight, weight/height2 index, ratio of lumbar to pelvic, musculoskeletal quantity, push up for 2 minute, pitch a ball and voluntary isometric contraction with flexion and extension of knee joint of the subjects with spiral direct movement. Healthy eighteen subjects who understand fully the significance of procedure, consented to a plan, without neuromuscular disease were participated in two groups of experiment. The group were a spiral movement(9), rectilinear movement(9). Trunk movement tested 2 sessions of a spiral movement and rectilinear movement with a push up for 2 minute, 5days per a week, for the 4 weeks. This experiment tested 3 times with a sufficient rest for fatigue limitation. An analysis of the results used a paired samples t-test for difference from before and after experiment. The following results were obtained; At an internal change of the body, the musculoskeletal quantity was increased significantly to spiral movement group, but the weight was increased significantly, the musculoskeletal quantity was not significant to rectilinear movement. The movement ability evaluation for a external change was increased significantly in a push up for 2 minute, pitch a ball, isometric contraction with extension of knee joint of a spiral movement group, but a push up for 2 minute was increased significantly in a push up for 2 minute on the abdominal muscle training of a rectilinear movement group. As compared with a rectilinear movement, a spiral movement was more effect by cooperation with nerve and musculoskeletal system and an increase in movement ability was caused by learning acknowledgment, muscular reeducation. These results lead us to the conclusion that a spiral movement of trunk was more effect than a rectilinear movement, the coordination of nerve and musculoskeletal system was of importance of Multi-direction movement. Therefore, A further studies concerning the therapeutic exercise intervention and active-dynamic analysis could enhance the development of the most effect on the trunk.