• Title/Summary/Keyword: Ankle Joint

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Comparison of Knee Muscle Strength and Ankle Dorsiflexion Range of Motion Between Standing Workers With and Without Patellofemoral Pain Syndrome

  • Weon, Young-soo;Ahn, Sun-hee;Kim, Jun-hee;Gwak, Gyeon-tae;Kwon, Oh-yun
    • Physical Therapy Korea
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    • v.27 no.4
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    • pp.241-249
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    • 2020
  • Background: Prolonged standing during work causes a lower extremity pain and disorders. Patellofemoral pain syndrome (PFPS) is one of the common diagnoses of the knee pain. Although the etiology of PFPS is not completely understood, it is considered to be multifactorial. Objects: The purpose of this study was to investigate difference in strength of knee muscles, quadriceps:hamstring muscles strength ratio (Q:H ratio), asymmetry ratio of knee muscles strength and dorsiflexion range of motion (ROM) between standing workers with and without PFPS. Methods: Twenty-eight standing workers with PFPS and 26 age-, height-, and weight-matched standing workers without PFPS participated in this study. A tension sensor measured knee muscle strength, and motion sensor measured dorsiflexion ROM. The asymmetry ratio of knee muscles was calculated by a specific formula using the knee muscles strength of the dominant side and the sound side. An independent t-test was used to identify significant differences in the strength, ROM, Q:H ratio, and asymmetry ratio between the PFPS and normal groups. Results: The standing worker with PFPS have significantly lower dorsiflexion ROM (p < 0.000) and higher asymmetry ratio of the hamstring muscles strength (p < 0.000) compare to the standing worker without PFPS. No significant differences were seen in the strength of quadriceps muscle and hamstring muscles, Q:H ratio, and asymmetry ratio of quadriceps muscle strength. Conclusion: There was a significant difference in the asymmetry ratio of the isometric hamstring muscle strength. This finding suggests that the asymmetry ratio of isometric hamstring muscle strength may be more important than measuring only the hamstring muscle strength of the PFPS side. Furthermore, the results of this study showed a significant difference in dorsiflexion ROM between the standing industrial workers with and without PFPS. Dorsiflexion ROM and isometric hamstring muscle strength should be considered when evaluating the subjects with PFPS.

The Effect of Knee Strategy on Limits of Stability in Standing Balance (기립균형시 슬관절 전략이 안정성 한계에 미치는 영향)

  • Kwon, Hyuk-Cheol;Jeong, Dong-Hoon
    • Physical Therapy Korea
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    • v.6 no.3
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    • pp.11-21
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    • 1999
  • Human balance is maintained through a complex process involving sensory detection of body motions, integration of sensorimotor information within the central nervous system, and execution of appropriate musculoskeletal responses. The basic task of balance is to position the body center of gravity (COG) over some portion of the support base. When the COG extends beyond the base of support, the person has exceeded the limits of stability (LOS). At this point, a step or stumble is required to prevent a fall. Automatic postural responses operate to keep the COG over the base of support. They are a set of functionally organized, long-loop responses that act to keep the body in a state of equilibrium. There are four commonly identified automatic postural responses, or strategies. These are ankle strategy, hip strategy, suspensory (knee) strategy, and stepping strategy. Thus, the purpose of this study was to evaluate the LOS using various knee strategies. Forty subjects participated in this study. The subjects were comprised of 20 males and 20 females who were without neurologic, orthopaedic or balance performance impairments. The LOS was measured with a Balance Performance Monitor (BPM) Dataprint Software Version 5.3. The results of this study were as follows: 1) Knee joint angle which is to increase stability of standing balance with using knee strategy was at mid-range. 2) There were statistically significant differences in anteroposterior LOSs according to the knee strategy. 3) There were no statistically significant differences in mediolateral LOSs according to the knee strategy. 4) There were statistically significant differences of anteroposterior LOSs with using knee strategy according to gender. 5) There were no statistically significant differences in mediolateral LOSs with using knee strategy according to gender.

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Effects of Yuhyangjeongtong-san on the Carrageenin-induced Acute Inflammation and Adjuvant-induced Arthritis (유향정통산이 Carrageenin 유발 급성 염증과 Adjuvant 유발 관절염에 미치는 영향)

  • Ahn, Hee-Bin;Jeong, Su-Hyeon;Kim, Soon-Joong;Park, Dong-Soo;Seo, Il-Bok
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.3
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    • pp.55-68
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    • 2013
  • Objectives This study was to investigate the effects of Yuhyangjeongtong-san on the carrageenin-induced acute inflammation and adjuvant-induced arthritis in rats. Methods Acute inflammation was induced by injection of 2% carrageenin 0.15 ml into right hind foot of rats. Control group was carrageenin injected and taken distilled water, treated group was carrageenin injected and taken Yuhyangjeongtong-san by orally once. 2 hours after injection, plantar temperature and paw volume were measured. 3 hours after, counts of white blood cell (WBC) were performed. Arthritis was induced by injection of complete freund's adjuvant (CFA) into base of tail. Control group was CFA injected and taken distilled water, treated group was CFA injected and taken Yuhyangjeongtong-san by orally for 10 days. 0,5,10 day, body weight, thickness of ankle joint and paw edema were measured. 10 day, counts of WBC, $interleukin-1{\beta}$ ($IL-1{\beta}$) and tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) level were analysed. Histochemical study of NADPH-d and immunohistochemical study of c-fos were performed. Results In the carrageenin-induced acute inflammation, neutrophils of treated group were significantly decreased compared with control group. In the adjuvant-induced arthritis, paw edema, total counts of WBC and TNF-${\alpha}$ level in paw exudates were significantly decreased compared with control group, and the number of c-fos positive neurons of treated group was significantly decreased compared with control group. Conclusions On the basis of these results, we concluded that Yuhyangjeongtong-san have anti-arthritic and anti-inflammatory effects.

Recurrent macrophage activation syndrome since toddler age in an adolescent boy with HLA B27 positive juvenile ankylosing spondylitis

  • Park, Joon Hyeong;Seo, Yu Mi;Han, Seung Beom;Kim, Ki Hwan;Rhim, Jung Woo;Chung, Nack Gyun;Kim, Myung Shin;Kang, Jin Han;Jeong, Dae Chul
    • Clinical and Experimental Pediatrics
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    • v.59 no.10
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    • pp.421-424
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    • 2016
  • Recurrent macrophage activation syndrome (MAS) is very rare. We present the case of an adolescent boy with human leukocyte antigen (HLA) B27-positive ankylosing spondylitis (AS), who experienced episodes of recurrent MAS since he was a toddler. A 16-year-old boy was admitted because of remittent fever with pancytopenia and splenomegaly after surgical intervention for an intractable perianal abscess. He had been diagnosed with hemophagocytic lymphohistiocytosis (HLH) 4 different times, which was well controlled with intravenous immunoglobulin and steroids since the age of 3. We were unable to identify the cause for the HLH. He remained symptom-free until the development of back pain and right ankle joint pain with swelling at 15 years of age. He was diagnosed with HLA B27-positive AS with bilateral active sacroiliitis. He showed symptom aggravation despite taking naproxen and methotrexate, and the symptoms improved with etanercept. On admission, his laboratory data showed leukopenia with high ferritin and triglyceride levels. Bone marrow biopsy examination showed histiocytic hyperplasia with hemophagocytosis. There was no evidence of infection. He received naproxen alone, and his symptoms and laboratory data improved without any other immunomodulatory medications. Genetic study revealed no primary HLH or inflammasome abnormalities. In this case, underlying autoimmune disease should have been considered as the cause of recurrent MAS in the young patient once primary HLH was excluded.

The Effect of Badminton Shoe Forefoot Flexibility during the Under Clear Quick Lunge from a Jump Smashing (배드민턴화의 굴곡성(Flexibility) 차이가 점프 스매싱 후 언더클리어 동작시 하지에 미치는 영향)

  • Yi, Jae-Hoon;Sohn, Jee-Hoon;Ryue, Jae-Jin;Lee, Ki-Kwang;Lee, Jung-Ho
    • Korean Journal of Applied Biomechanics
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    • v.22 no.1
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    • pp.105-111
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    • 2012
  • The purpose of this study was to investigate the effect that difference in forefoot of shoe flexibility during the quick lunge from a jump smashing on the lower limbs and the plantar pressure distribution. For this 10 elite badminton players with over 10 years experience and right handed participated. Two kinds of badminton shoes were selected and tested mechanical testing for the forefoot flexibility. Motion analysis, ground reaction forces and plantar pressure distribution were recorded. It was required to conduct lunge movement after jumping smashing as possible as high. Photo sensor was located in 3 meter away from standing position and its height was 40 cm. Subjects were conducted to return original position after touching the sensor as under clear movement as possible as fast. Forefoot stiffness had an effect on shoe peak bending degree and peak bending angular velocity in propulsion phase. Forefoot flexibility had an effect on ankle plantar flexion and knee flexion moment. It appears that joint power on lower limb and peak plantar pressure were not influenced by the flexibility of shoes.

승모판막질환에 병발한 동맥색전증의 치험 1례

  • Hur, Y.;Kim, B.Y.;Lee, H.S.;Kim, J.E.;Lee, J.H.;Yu, H.S.
    • Journal of Chest Surgery
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    • v.13 no.1
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    • pp.77-81
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    • 1980
  • We present one case of 26-year-old male having saddle block combined with mitral valvular disease [NYHA Class IV] with auricular fibrillation. The most common cause of emboli is atrial fibrillation. The clinical manifestations of saddle emboli are relatively slow due to development of collateral circulation and large size of lumen of the aorta. The 5month duration of saddle emboli in this case led to severe atrophic changes, coldness, peripheral cyanosis on the both lower extremities, and flexion deformity on the knee and ankle joint of the left lower extremity. We planned staged operation for the saddle block and for mitral stenoinsufficiency and tricuspid insufficiency, because of poor general condition of the patient. The thromboembolectomy of aortic bifurcation was performed through the transabdominal approach without trial of Fogarthy catheter embolectomy, because of expectation of the secondary inflammatory changes of the vessel wall and thrombi which was 3 cm X 1 cm X 0.5 cm in size with irregular surfaced solid in consistency. 1 month later, after thromboembolectomy, mitral valve replacement and tricuspid annuloplasty were performed, with successful early operative result. During operation organized thrombi [1 cm X 0.5 cm] in the left auricle was removed. We wonder if simple management using Fogarthy catheter might be possible to remove the thromboemboli instead of thromboembolectomy by aortotomy in this case.

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Effects of continuous involved weight bearing training on symmetrical weight supporting rate improvement and gait characteristics of patients with Hemiplegia (전자체중계를 이용한 환측 체중부하훈련이 편마비 환자의 제중지지율과 보행에 미치는 효과)

  • Lee, Suk-Min;Shim, Tae-Ho
    • Journal of Korean Physical Therapy Science
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    • v.10 no.1
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    • pp.7-17
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    • 2003
  • The purpose of this study was to investigate the effect of the involved lower limb weight bearing training on symmetrical weight supporting rate improvement and gait characteristics of patients with hemiplegia including their gait velocity, cadence, stride length, step length of the non affected side, step length of the affected side, foot angle of the non affected side, foot angle of the affected side, base of support, and so on. The subject of the study was 28 men and women patients with hemiplegia from 22 to 77 age, among patients who doctor diagnosed as hemiplegia due to stroke or traumatic brain injury, were possible to do independent gait more than 45m without others assistance, the flexion contracture of hip pint was less than $15^{\circ}$, did not have contracture for knee pint and one more than $5^{\circ}$ for ankle joint, did not have contraindication for exercise or gait did not show visual defect due to brain injury. The patients, the subject of the study, were classified into 14 patients of treatment. group applying continuous involved weight bearing with general therapeutic exercise and 14 patients of control group applying general therapeutic exercise, and then analyzed their gait before and after exercise. Temporal distance gait analysis(Boening, 1977) was used to analyze their gait, and ink foot-print was applied as one of measurement methods. However, it was statistically signifiant in the change rate(%) of gait characteristics, and treatment group's patients with hemiplegia had been highly changed in gait characteristics in comparison with control group. From the above-mentioned results, could find that continuous involved weight bearing training for patients with hemiplegia was effective to improve their gait ability and it could increase the ability in comparison with general exercise.

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Muscle Free Flap Transplantation in Chronic Osteomyelitis of the Lower Extremities (하지의 만성 골수염에 시행된 근 유리 판 이식술)

  • Lee, Jun-Mo;Song, Kwang-Hun;Park, Jong-Hyuk
    • Archives of Reconstructive Microsurgery
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    • v.18 no.2
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    • pp.49-54
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    • 2009
  • Purpose: To evaluate the result of muscle free flap transplantation in chronic osteomyelitis of the tibia and calcaneus occurred from open fractures and exposed bones and internal fixatives. Materials and Methods: The free muscle flap were transferred in the tibia and calcaneus and followed up average 7.3 years at the department of orthopedic surgery from March 1997 to September 2009. Six patients were male and 1 case female averaged 50.3 years of age. Two latissimus dorsi myocutaneous free flaps were transplanted to the exposed 2/3 of the tibia with soft tissue defect, one rectus abdominis muscle free flap to the mid 1/3 of the tibia and four gracilis muscle free flaps to the distal 1/3 of the tibia and calcaneus. Results: At average 7.2 years follow-up, all of the 7 cases obtained solid bone union in the X-ray and kept sound soft tissues without pus discharges. The overall result of bone union, healed soft tissues defect and normal knee and ankle joint range of motion were excellent. Conclusion: The free muscle flap transferred to the chronic osteomyelitis of the tibia and calcaneus showed excellent results in bone union and eradication of the pus forming bacteria by its abundant blood flow.

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Shock Attenuation Mechanism in Drop Landing According to the Backpack Weight Changes (드롭랜딩 시 backpack 중량 변화에 따른 충격 흡수 기전)

  • Choi, Chi-Sun;Nam, Ki-Jeong;Shin, In-Sik;Seo, Jung-Suk;Eun, Seon-Deok;Kim, Suk-Bum
    • Korean Journal of Applied Biomechanics
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    • v.16 no.2
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    • pp.25-35
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    • 2006
  • The purpose of this study was to investigate the shock attenuation mechanisms while varying the loads in a backpack during drop landing. Ten subjects (age: $22.8{\pm}3.6$, height: $173.5{\pm}4.3$, weight: $70.4{\pm}5.2$) performed drop landing under five varying loads (0, 5kg. 10kg. 20kg. 30kg). By employing two cameras (Sony VX2100) the following kinematic variables (phase time, joint rotational angle and velocity of ankle, knee and hip) were calculated by applying 2D motion analysis. Additional data, i.e. max vertical ground force (VGRF) and acceleration, was acquired by using two AMTI Force plates and a Noraxon Inline Accelerometer Sensor. Through analysing the power spectrum density (PSD), drop landing patterns were classified into four groups and each group was discovered to have a different shock attenuation mechanism. The first pattern that appeared at landing was that the right leg absorbed most of the shock attenuation. The second pattern to appear was that subject quickly transferred the load from the right leg to the left leg as quickly as possible. Thus, this illustrated that two shock attenuation mechanisms occurred during drop landing under varying load conditions.

The Effect of Rehabilitation Training Programs on the Kinetic and Kinematic Parameters During Sit-To-Stand in Chronic Stroke Patients (만성편마비 환자의 재활 운동 유형이 일어서기 동작의 운동학 및 운동역학적 변인에 미치는 영향)

  • Yu, Yeon-Joo;Yoon, Te-Jin;Eun, Seon-Deok
    • Korean Journal of Applied Biomechanics
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    • v.16 no.2
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    • pp.121-134
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    • 2006
  • The purpose of this study was to analyze the effect of different types of rehabilitation training program on the kinetic and kinematic parameters during sit-to-stand movement(STS) in chronic stroke patients. Two groups of hemiparetic patients, experimental and control, participated in the study. The experimental group participated in a 10-week training program (three sessions/wk, $1{\sim}1.5\;hr/session$) consisting of a warm-up, aerobic exercises, lower extremity strengthening. and a cool-down. The control group participated in an aerobic exercise. Three dimensional kinematic analysis and force platform; were used to analyze the duration of STS, lower extremity angle, and weight bearing ability. The experimental group which had more strength of lower extremity displayed decrease in duration of STS. However, the control group showed increases in duration during sit-to-stand movement. The control group flexed their trunk more than the group did Therefore, it took more time to extend their trunk during STS. The duration in sit-to-stand was affected by the strength of lower extremity and the angle of trunk movement. The angles of ankle and knee joint had an influenced on duration of STS. The post experimental group performed with their feet near the front leg of the chair during sit-to-stand, therefore the duration was decreased. The repetitive sit-to-stand movements as a resistance exercise was effective to hemiparetic patients in learning mechanism of sit-to-stand. The control group showed decreased differences in the vertical ground reaction forces between paretic and non-paretic limbs. Their training program included strengthening exercise that may help improving weight bearing ability. The control group showed increases in the center of pressure in the anteroposterior and mediolateral displacement. This means that the stability of movement was low in the control group. Their training program which combined aerobic and strengthening exercises that are more effective to improve the stability of movement.