• The Journal of Korean Physical Therapy
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• 제33권3호
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• pp.168-177
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• 2021

Purpose: This study applies the ICF to identify the patient's body function, structure, and participation, evaluates the patient's environmental factors and individual factors, and is a high level of movement to return to the society of patients with multiple ligament injury of the knee joint. Methods: Progressive strength training and ROM exercise were performed 30 minutes a day, 5 times a week for 6 weeks. The evaluation was performed by examining the ROM, length, MMT, instability, dynamic balance, pain and depression. Results: The ROM of the knee joint was improved from 110° to 135° after intervention, and the knee flexion length decreased from 69 cm to 45 cm. Knee flexor is Good after intervention from Poor-, and knee extensor is Good+ after intervention from Poor, and the plantar flexor of the ankle joint improved from Poor- before intervention to Good after intervention and dorsi-flexor of the ankle joint improve to Good from Poor. Pain index was moderate before and after the intervention, with a score of 3, 2 after the intervention, and when maintaining the sitting cross-legged, the before intervention score was 7 to 4 after the intervention. Conclusion: The patient's posture of sitting cross-legged was maintained from 30 seconds before intervention to 14 minutes after intervention. These results were able to set the hypothesis design, intervention method and goal that the multifaceted approach of environment and individual factors as well as body function and structure area, activity and participation area using ICF checklists, it is helped the patient to return to daily life.

• 한국운동역학회지
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• 제16권2호
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• pp.1-8
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• 2006

The purpose of this study was to evaluate normalized jerk according to shoes, slope, and velocity during walking. Eleven different test subjects used three different types of shoes (running shoes, mountain climbing boots, and elevated forefoot walking shoes) at various walking speeds(1.19, 1.25, 1.33, 1.56, 1.78, 1.9, 2, 2.11, 2.33m/sec) and gradients(0, 3, 6, 10 degrees) on a treadmill. Since there were concerns about using the elevated forefoot shoes on an incline, these shoes were not used on a gradient. Motion Analysis (Motion Analysis Corp. Santa Rosa, CA USA) was conducted with four Falcon high speed digital motion capture cameras. Utilizing the maximum smoothness theory, it was hypothesized that there would be differences in jerk according to shoe type, velocity, and slope. Furthermore, it was assumed that running shoes would have the lowest values for normalized jerk because subjects were most accustomed to wearing these shoes. The results demonstrated that elevated forefoot walking shoes had lowest value for normalized jerk at heel. In contrast, elevated forefoot walking shoes had greater normalized jerk at the center of mass at most walking speeds. For most gradients and walking speeds, hiking boots had smaller medio-lateral directional normalized jerk at ankle than running shoes. These results alluded to an inverse ratio for jerk at the heel and at the COM for all types of shoes. Furthermore, as velocity increased, medio-lateral jerk was reduced for all gradients in both hiking boots and running shoes. Due to the fragility of the ankle joint, elevated forefoot walking shoes could be recommended for walking on flat surfaces because they minimize instability at the heel. Although the elevated forefoot walking shoes have the highest levels of jerk at the COM, the structure of the pelvis and spine allows for greater compensatory movement than the ankle. This movement at the COM might even have a beneficial effect of activating the muscles in the back and abdomen more than other shoes. On inclines hiking boots would be recommended over running shoes because hiking boots demonstrated more medio-lateral stability on a gradient than running shoes. These results also demonstrate the usefulness of normalized jerk theory in analyzing the relationship between the body and shoes, walking velocity, and movement up a slope.

• 대한인간공학회지
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• 제32권3호
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• pp.245-252
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• 2013

Objective: This paper analyzes the changes on stride parameters, joint angles, and trajectories of the body parts due to high heels during walking and explains the causal relationship between the changes and high heels. Background: This study aims to indicate the comprehensive gait changes by high heels on the whole body for women wearing high heels and researchers interested in high-heeled walking. Method: The experiment was designed in which two different shoe heel heights were used for walking (1cm, 9.8cm), and twelve women participated in the test. In the experiment, 35 points on the body were tracked to extract the stride parameters, joint angles, and trajectories of the body parts. Results: Double support time increased, but stride length decreased in high-heeled walking. The knee inflexed more at stance phase and the spine rotation became more severe. The trajectories of the pelvis, the trunk and the head presented outstanding fluctuations in the vertical direction. Conclusion: The double support time and the spine rotation were changed to compensate instability by high heels. Reduced range of motion of the ankle joint influenced on the stride length, the knee flexion, and fluctuations of the body parts. Application: This study can provide an insight of the gait changes by high heels through the entire body.

• Archives of Plastic Surgery
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• 제46권1호
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• pp.75-78
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• 2019

It is difficult to differentiate acute skin failure (ASF) from pressure ulcer (PU). ASF is defined as unavoidable injury resulting from hypoperfusion caused by severe dysfunction of another organ system. We describe a case of ASF mistaken as PU that resulted in a legal dispute. A 74-year-old male patient was admitted to our intensive care unit with sepsis due to bacterial pneumonia. Despite the use of air cushions and regular position changes, skin ulcerations occurred over his occiput, back, buttock, elbow, and ankle. After improvement in his general condition, he was transferred to the department of plastic and reconstructive surgery. Debridement was performed immediately, followed by conservative treatment (including a vacuum-assisted closure device) for 6 weeks. The buttock and occiput wounds were treated surgically. Despite complete healing, his caregivers sued the hospital for failing to prevent PU formation. ASF is a pressure-related injury resulting from hemodynamic instability due to organ system failure. Unlike PU, ASF may occur despite the implementation of all appropriate preventive measures. Furthermore, misdiagnosis of ASF as PU can lead to litigation. Therefore, it is critical for the proper diagnosis to be made quickly, and for physicians to explain that ASF occurs despite proper preventative treatment.

• Clinical Pain
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• 제20권2호
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• pp.122-126
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• 2021

When a patient represents pain in foot, physician can easily overlook compression neuropathy of peripheral nerve as it is uncommon. Among nerve entrapment syndrome encountered in the foot, selective compression in lateral branch of deep peroneal nerve (DPN) is rare. We report a case of a patient with pain and dysesthesia in dorsolateral foot which turned out as lateral branch of deep peroneal nerve entrapment syndrome caused by talonavicular joint effusion. We would like to share diagnostic work up flow and conservative treatment courses. This case manifests the importance of the deep peroneal nerve and its branches in clinical setting of pain and ankle instability.

• 한국운동역학회지
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• 제25권2호
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• pp.141-147
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• 2015

Objective : This study aimed to understand how increased heart rates at the time of drop landing during a step test would affect biomechanical variables of the lower extremity limbs. Background : Ballet performers do more than 200 landings in a daily training. This training raises the heart rate and the fatigability of the lower extremity limbs. Ballet performance high heart rate can trigger lower extremity limb injury. Method : We instructed eight female ballet dancers with no instability in their ankle joints(mean ${\pm}$ SD: age, $20.7{\pm}0.7yr$; body mass index, $19.5{\pm}1.2kg/m^2$, career duration, $8.7{\pm}2.0yr$) to perform the drop landing under the following conditions: rest, 60% heart rate reserve (HRR) and 80% HRR. Results : First, the study confirmed that the increased heart rates of the female ballet dancers did not affect the working ranges of the knee joints during drop landing but only increased angular speeds, which was considered a negative shock-absorption strategy. Second, 80% HRR, which was increased through the step tests, led to severe fatigue among the female ballet dancers, which made them unable to perform a lower extremity limb-neutral position. Hence, their drop landing was unstable, with increased introversion and extroversion moments. Third, we observed that the increasing 80% HRR failed to help the dancers effectively control ground reaction forces but improved the muscular activities of the rectus femoris and vastus medialis oblique muscles. Fourth, the increasing heart rates were positively related to the muscular activities of the vastus medialis oblique and rectus femoris muscles, and the extroversion and introversion moments. Conclusion/Application : Our results prove that increased HRR during a step test negatively affects the biomechanical variables of the lower extremity limbs at the time of drop landing.

• 한국운동역학회지
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• 제18권1호
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• pp.21-30
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• 2008

이 연구는 60대 남자 노인의 정상인들과 무릎 관절염 환자들 사이에 보행 시 국부적인 안정성을 비교하기 위해 선형기법의 변이 계수와 비선형 시계열 동역학 기법의 Lyapunov지수(LyE) 및 상관차원(correlation dimension, COD) 방법을 적용해 분석했다. 분석 결과 선형 운동인 발목의 수직 변위를 통해 관찰한 국부적 안정성은 선형 기법의 변이 계수를 통해 관찰한 결과 정상인 집단이 무릎관절염 환자 집단보다 불안한 것으로 나타난 반면에 비선형 기법 관찰에서는 두 집단 차이가 없는 것으로 나타났다. 한편 각형 운동인 무릎의 각 변위를 통해 분석된 국부적 안정성은 선형 분석 결과는 두 집단 차이점을 보이지 않았지만, 비선형 기법 결과인 COD 지수는 무릎 관절염 환자가 크게 나타나 결과적으로 보행 시 국부적 불안을 보였다. 이상 본 연구 결과를 종합해 보면 선형 기법의 결과와 비선형 기법의 결과는 일치하지 않았으며, 또한 무릎 관절염 환자의 보행 시 불안정은 발목의 수직 변위인선형에서 보다 무릎 관절 각 변위인 각형에서 뚜렷하게 나타났다.

• 한국산학기술학회논문지
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• 제12권9호
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• pp.3834-3842
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• 2011

본 연구에서는 선천적으로 관절 느슨함과 낮은 근 장력을 갖고 있는 다운증후군아동 보행의 운동학적 특성을 알아보고자 한다. 특히 자료수집의 편리성과 재현성이 높고, 유용한 보행훈련도구로서 그 사용이 증가되는 추세인 트레드밀에서 보행을 실시하였다. 다른 중복장애가 없는 다운증후군 남자아동 10명을 대상으로 적외선카메라로 3차원 보행 자료를 수집하여 시공간적 변인과 운동학적 변인을 산출하여 이들의 보행특성을 분석하였다. 그 결과, 다운증후군아동들은 선천적인 근골격계 특성으로 인한 보행불안정성을 극복하기 위해 엉덩, 무릎, 발목관절 모두를 구부리고 걷는 구부정 걸음(crouch gait)형태를 보였으며, 모든 다리관절의 신전을 작게 하여 결과적으로 추진력이 자제하였다. 이는 더 크게 신체를 추진할수록 발뒤꿈치 착지 시에 체중수용의 부담이 증가하기 때문인 것으로 판단된다. 이 연구 결과는 다운증후군의 관절불안정성을 개선하기 위해 효과적인 근 골격계 강화훈련 프로그램을 마련하는데 유용한 자료를 제공할 것으로 기대되며, 다운증후군뿐만 아니라 선천적 또는 후천적 근골격계 장애를 개선하거나 극복할 수 있는 운동프로그램 개발에도 참고 자료가 될 것으로 예상된다.

• 한국전문물리치료학회지
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• 제28권1호
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• pp.27-35
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• 2021

A weak or dysfunctional gluteus medius (Gmed) is related to several pathologies, and individuals with hip abductor weakness have Gmed weakness. This study aimed to systematically review the literature associated with the anatomy and function of the Gmed, and the prevalence, pathology, and exercise of Gmed weakness. Papers published between 2010 and 2020 were retrieved from MEDLINE, Google Academic Search, and Research Information Sharing Service. The database search used the following terms: (glut* OR medius OR hip abduct*) AND weak*. The Gmed plays an important role in several functional activities as a primary hip abductor by providing pelvic stabilization and controlling hip adduction and internal rotation. Weakness of the Gmed is associated with many disorders including balance deficit, gait and running disorders, femoroacetabular impingement, snapping hip, gluteal tendinopathy, patellofemoral pain syndrome, osteoarthritis, iliotibial band syndrome, anterior cruciate ligament injury, ankle joint injuries, low back pain, stroke, and nocturia. Overuse of the tensor fasciae latae (TFL) as a hip abductor due to Gmed weakness can also cause several pathologies such as pain in the lower back and hip and degenerative hip joint pathology, which are associated with dominant TFL. Similarly, lateral instability and impaired movements such as lumbar spine lateral flexion or lateral tilt of the pelvis can occur due to compensatory activation of the quadratus lumborum for a weakened Gmed while exercising. Therefore, the related activation of synergistic muscles or compensatory movement should be considered when prescribing Gmed strengthening exercises.

• 대한정형외과스포츠의학회지
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• 제5권2호
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• pp.129-134
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• 2006

목적: 국내 프로 축구팀에서 시즌 전 체력검사를 시행하여 포지션에 따른 자료를 분석하고 표준화하고자 했다. 대상 및 방법: 34명으로 구성된 한 개의 축구팀을 대상으로 시행하였으며 평균 나이 24.9세였다. 설문지를 통한과거 병력 조사, 이학적 검사를 통한 근 골격계 검사, 등속성 근력기기를 이용한 근력 검사, 생리적 검사, 기능적 검사를 시행하고 포지션에 따른 차이를 분석하였다. 결과: 과거력 상 슬관절 손상이 23예 중 11 예(47%)로 가장 빈번했고, 이학적 검사 결과 총 40예 중 족관절 손상이 14예 (46%)로 슬관절 손상 11예 (24%)보다 많은 손상이 있었다. 위치 별로 공격수는 장무지 굴곡 건염, 미드필드는 만성 족관절 불안정성 수비수는 아킬레스 건염이 많았고 근력 검사상 우세 $60^{\circ}$ 신전/굴곡 체중당 최대 염력비 평균이 55.1%였다. 생리학적 검사상 미드필드 체 지방율이 17.8% (표준편차 2.9)로 높게 측정되었고 기능적 검사 결과 배근력 125.5N (표준편차 28.3), 서전트 점프 59.6cm, 반응시간 208 5초, 유연성 19.2 m/s, 사이드 스텝 39.9 cm였다. 결론: 시즌 전 체력검사를 통하여 선수들의 체력을 평가하고 이를 기초로 하여 재 손상에 대한 예방적 수단을 강구 할 수 있다.