• 대한정형도수물리치료학회지
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• 제9권1호
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• pp.5-17
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• 2003

경비관절은 문헌적으로나 임상적으로 소홀히 다루는 관절로써 알려져 왔다. 몇몇 연구자들에 의해 생역학적 원리와 병리학적인 무제가 정립되었고, 평가방법 및 정형도수적 치료방법 등이 개발되어 왔다. 무릎과 족관절부의 병변은 항상 경비관절에 문제를 야기시킬 수 있다는 것을 전제로 평가에서 포함하여 다루어져야 한다. 경비관절에서 유발되는 질환은 대개 정형도수적 치료방법이 매루 효과적으로 적용될 수 있다고 사료된다.

• PNF and Movement
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• 제10권1호
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• pp.35-41
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• 2012

Purpose : This study was conducted to identify the effects of high heel shoes on surface electromyography(EMG) activities fo tibialis anterior(TA), soles(S), and gastrocnemius(G) in 12 healthy women. Methods : Subjects were composed of three group(sports shoes, 5cm heel height shoes, and 9cm heel height shoes). The muscle activity of the TA, G, S in the lower leg were measured using a surface EMG. Results : Results of one way repeated measures ANOVA of the after waling 30minutes standing task duration among the sport shoes, 5cm, and 9cm heel height conditions. The comparison of the muscular activities showed significant differences in the G muscles among the high heel shoes. Conclusion : Wearing high heel shoes for hours will bring inappropriate alignment of the lower limbs and cause postural changes or abnormal sensation and several other problems in the body, resulting in exposure to ankle sprain or fall injuries.

• 한국운동역학회지
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• 제26권2호
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• pp.167-174
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• 2016

Objective: The purpose of this study was to determine the interrelationship between ranges of motion of the knee and ankle joints on the sagittal plane and the attenuation magnitude of impact shock at high frequency (9~20 Hz) in the support phase during downhill running. Method: Fifteen male heel-toe runners with no history of lower extremity injuries were recruited for this study (age, $25.07{\pm}5.35years$; height, $175.4{\pm}4.6cm$; mass, $75.8{\pm}.70kg$). Two uniaxial accelerometers were mounted to the tuberosity of tibia and sacrum, respectively, to measure acceleration signals. The participants were asked to run at their preferred running speed on a treadmill set at $0^{\circ}$, $7^{\circ}$, and $15^{\circ}$ downhill. Six optical cameras were placed around the treadmill to capture the coordinates of the joints of the lower extremities. The power spectrum densities of the two acceleration signals were analyzed and used in the transfer function describing the gain and attenuation of impact shock between the tibia and the sacrum. Angles of the knee and ankle joints on the sagittal plane and their angle ranges were calculated. The Pearson correlation coefficient was used to test the relationship between two variables, the magnitude of impact shock, and the range of joint angle under three downhill conditions. The alpha level was set at .05. Results: Close correlations were observed between the knee joint range of motion and the attenuation magnitude of impact shock regardless of running slopes (p<.05), and positive correlations were found between the ranges of motion of the knee and ankle joints and the attenuation magnitude of impact shock in $15^{\circ}$ downhill running (p<.05). Conclusion: In conclusion, increased knee flexion might be required to attenuate impact shock during downhill and level running through change in stride or cadence while maintaining stability, and strong and flexible ankle joints are also needed in steeper downhill running.

• 대한정형외과스포츠의학회지
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• 제1권2호
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• pp.109-114
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• 2002

역사적으로알파인스키부상은스키장비의발달과밀접한관련을가지고변화하여왔다. 근래에일어난스키장비의혁명으로인하여스키부상은또다른양상으로바뀌어가고있는추세이다. 현대적인스키, 스키화, 바인딩의개발로과거에빈발하던경골간부골절이나족관절손상은1970년대말에이르러90$\%$ 가까이감소하였다. 하지만1980년대에들어서전방십자인대손상을포함한심한슬관절손상은 약3배가까이증가하였으며,장비의개발에도불구하고전방십자인대손상을줄이지못하고있다. 최근에는슬관절이하의하지손상및전방삽자인대손상발생율모두변화가중단된상태이다. 최근스키디자인을완전히바꾸어놓은카빙스키는전통스키에비하여상급자에게전방십자인대단독손상의위험성을증가시키는것으로보인다. 대신초급자에게는족관절손상의위험성이높다. 스키로인한하지손상율을더욱낮추기위해서는스키전문점의스키기술자가ASTM (American Society for TestingMaterial)의표준에따라장비를관리하도록유도하여야한다. 현재까지개발된스키장비중전방십자인대손상을줄일수있는것으로검증된것은없다. 효과가입증된유일한방법은,위험한상황을인식하여그것을피하는방법을익히는트레이닝프로그램뿐이다.

• 대한정형외과스포츠의학회지
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• 제3권1호
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• pp.87-91
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• 2004

목적: 인라인 스케이트를 타던 중 발생한 골절상을 분석하여 골절의 분포 및 경향을 파악 하고자 한다. 대상 및 방법: 2002년 9월부터 2003년 8월까지 1년간 인라인 스케이트를 타다가 골절이 발생하여 입원 가료 하였던 35명의 환자 중 최소 1년 이상 추시가 가능하였던 20명, 20례를 대상으로 환자의 성별, 연령분포, 부위별 빈도, 동반손상, 숙련도별 손상, 손상 유형 등을 후향적으로 분석하였다. 남자가 18명(90$\%$), 여자가 2명(10$\%$)이었고, 연령대별로는 활동성이 강한 연령층인 21$\~$30세 (6명 30$\%$), 31$\~$40세 (6명 30$\%$)의 순이었다. 결과: 상지골절이 12명(60$\%$)로 하지골절 8명(40$\%$)보다 많았다. 손상 부위별 빈도는 족관절부가 7례(35$\%$)로 가장 많았고, 전완부 4례(20$\%$), 수근부 4례(20$\%$), 주관절 3례(15$\%$), 대퇴부 1례(5%$\%$)의 순이었다. 족관절 골절 손상은 Lauge-Hansen 분류 상, 회외 -외회전 형이 4례로 가장 많았으며, 회외-외전 형이 2례, 회내-외회전 형이 1례였고, 전완부 골절손상과 수근부 골절 손상의 경우에는 요골 원위부 골절 3례, 요골-척골 골절 1례, 주상골 골절 2례, 중수골 골절 2례로 넘어질 때 손으로 짚으면서 발생한 골절의 양상이 많았다. 주관절 골절은 2례에서 과상부 골절이었고 1례에서는 외과 골절 이었다. 성장판 손상이 동반된 소아 골절 3례는 모두 Salt-Harris type II 였으며, 보존적 치료를 시행 하였다. 전체 골절 중 6례는 관절 내 골절 이었다. 동반 손상으로는 타박상이 8명 (42.11$\%$)으로 가장 많았고, 숙련도 별로는 인라인 스케이트를 시작한지 3개월 이내의 초보자들이 8명(40$\%$)으로 가장 많았고, 수상 형태로는 넘어짐과 같은 비접촉성 수상이 14명(70$\%$)으로 접촉성 수상(6명 30$\%$)보다 많았다. 11례 (55$\%$)가 수술적 치료를 받았으며, 9례(45$\%$)는 보존적 치료를 받았고, 추시 중에 특별한 합병증은 발생되지 않았다. 결론: 20$\~$30대의 젊은층의 초보자들에서 족관절부의 골절 손상이 가장 많았으므로, 이에 대한 주의가 필요할 것으로 사료된다

• 대한족부족관절학회지
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• 제8권1호
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• pp.92-96
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• 2004

Purpose: To analyze the clinical and radiological results of the operative treatment in the avulsion fracture on the base of the fifth metatarsal. Materials and Methods: We studied retrospectively, 11 patients of avulsion fracture on the base of the fifth metatarsal operated and followed over 1 year, from February 2000 to May 2002. There were eight men and three women and the average age was 39 years old. The mean follow up period was 14 months. Ten cases were slip-down and one case was fall from a height injuries. We used the modified Foot Score by Wiener for the clinical evaluation, and analyzed the time of union and state of reduction radiologically. Results: In clinical results, we had ten excellent and one good cases by the modified Foot Score at last follow-up. In radiologic results, the complete bony union was achieved in all cases and the duration of the bony union was 37 days in average. Conclusion: We had good result for the avulsion fractures on the base of the fifth metatarsal treated by the operation. This study shows the operation was recommended for the moderate and severe displacement of the avulsion fractures on the base of the fifth metatarsal.

• Archives of Plastic Surgery
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• 제41권6호
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• pp.709-715
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• 2014

Background The distally based sural artery flap is a reliable, local reconstructive option for small soft tissue defects of the distal third of the leg. The purpose of this study is to describe an adipofascial flap based on a single sural nerve branch without sacrificing the entire sural nerve, thereby preserving sensibility of the lateral foot. Methods The posterior aspect of the lower limb was dissected in 15 cadaveric limbs. Four patients with soft tissue defects over the tendo-achilles and ankle underwent reconstruction using the adipofascial flap, which incorporated the distal peroneal perforator, short saphenous vein, and a single branch of the sural nerve. Results From the anatomical study, the distal peroneal perforator was situated at an average of 6.2 cm (2.5-12 cm) from the distal tip of the lateral malleolus. The medial and lateral sural nerve branches ran subfascially and pierced the muscle fascia 16 cm (14-19 cm) proximal to the lateral malleolus to enter the subcutaneous plane. They merged 1-2 cm distal to the subcutaneous entry point to form the common sural nerve at a mean distance of 14.5 cm (11.5-18 cm) proximal to the lateral malleolus. This merging point determined the pivot point of the flap. In the clinical cases, all patients reported near complete recovery of sensation over the lateral foot six months after surgery. All donor sites healed well with a full range of motion over the foot and ankle. Conclusions The distally based sural artery adipofascial flap allowed for minimal sensory loss, a good range of motion, an aesthetically acceptable outcome and can be performed by a single surgeon in under 2 hours.

• 산업공학
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• 제18권3호
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• pp.288-296
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• 2005

Many jobs and activities in our daily lives require squatting postures. The fore part includes housekeepers, farmers, and welders and the latter includes a wide variety of activities such as housekeeping; planting, cultivating and harvesting various agricultural products; grinding, welding, etc. It is speculated that prolonged squatting postures without any supporting stool would gradually cause musculoskeletal injuries to workers. This study is conducted to examine the proper height of stools according to the position of the working materials and to develop wearable stools for workers with squatting posture. Forty male and female subjects participated in the experiment to find the proper height of stools according to the position of the working materials. Subjects were asked to squat and work with 3 different working positions: floor level; ankle level; shank level of 3 different stool height conditions: 10cm height; 15cm height; and 20cm height. After 5 minutes of maintaining a squatting work posture while sitting on the different height stools, Likert summated rating method as well as pairwise ranking test was applied to evaluate the user preferences for provided stools under the conditions of different working positions. The results of statistical analysis show that the subjects preferred 10cm height stool for floor level, 15cm height stool for ankle level, 20cm height stool for knee level. We thus strongly recommend to use appropriate height stools in accordance with the different working positions. Moreover, a prototype wearable stool was designed such that workers with squatting posture do not need to move the stool while they are moving about. The purpose of developing wearable stool was to decrease the physical stress and hence promote worker's health who work with squatting posture.

• 융합정보논문지
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• 제10권4호
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• pp.160-167
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• 2020

본 연구는 달리기 시 속도와 경사변화가 하지관절의 생체역학적 요인에 미치는 영향을 보고자 한다. 이를 위해 20대 성인남성 15명이 트레드밀에서 2.7, 3.3 m/s와 -9°, -6°, 0°, 6°, 9°로 달리기를 실시하였고, 속도와 경사 변화에 따른 주행특성(보장, 보빈도), 생체역학적 변인(발목, 무릎, 엉덩관절의 가동범위, 모멘트, 관절파워), 지면반력(수직지면반력, 부하율, 제동력, 추진력)을 측정하였다. 연구결과, 주행특성은 오르막 달리기(UR)가 내리막 달리기(DR)에 비해 크게 나타났다(p<.05). 하지관절의 가동범위와 수직지면반력은 UR에서 크게 나타났고(p<.05), 하지관절의 모멘트와 제동력, 추진력, 부하율은 DR에서 크게 나타났다(p<.05). 관절파워는 발목관절은 DR에서 크고, 엉덩관절에서는 UR이 크게 나타났다(p<.05). 이러한 결과로부터 3.3m/s의 속도로 DR을 달리는 경우에서 발목관절 부상의 영향이 클 것으로 예상된다.

• 대한족부족관절학회지
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• 제7권2호
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• pp.250-257
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• 2003

Purpose: Pilon fracture is caused by high energy and axial compression forces, and it is often associated with severe comminution and soft tissue injury. Recently, limited internal fixation of this fracture may avoid the soft tissue complications associated with formal open reduction and internal fixation and avoid incongruity of joint margin associated with conservative treatment. We have treated Ovadia and Beals type II or III pilon fracture with limited internal fixation and the results were satisfactory. Materials and Methods: We analyzed 15 cases of Ovadia and Beals type II or III fractures who were treated by limited internal fixation(K-wire or screw fixation) from January 1995 to December 2000. The average follow up period was 20 months(range, 12 to 38 months). According to the Ovadia and Beals classification, seven cases were type II, and eight cases were type III. Radiographic results were assessed by Ovadia and Beals criteria. We also assessed the functional results by Mast and Teipner criteria. Results: Radiographic results showed good in 67% and fair in 33% of cases. Clinical results showed good in 73% and fair in 27% of cases. There were no complications such as wound infection and skin necrosis, but traumatic arthritis were 2 cases. Conclusion: Pilon fractures are high energy injuries with significantly associated soft tissue damage and traumatic arthritis. Limited internal fixation offers good solution to Ovadia and Beals type II or III fracture.