• Title/Summary/Keyword: Anterior pelvic tilt

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Kinematic Analysis of Lower Extremities during Stairs and Ramp Climbing with Older Adults (노인의 계단과 경사로 오르기 동안 하지의 운동학적 분석)

  • Han, Jin-Tae;HwangBo, Gak
    • Korean Journal of Applied Biomechanics
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    • v.19 no.3
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    • pp.435-448
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    • 2009
  • The purpose of this study was to investigate the kinemaitc gait parameter of lower extremities with different gait conditions(level walking, stairs, ramp) in old adults. Fourteen healthy older adults participated in this study and kinematic data were measured using 3D motion analysis system(Vicon, Oxford Metrics, England). Statistical analysis was used one-way ANOVA to know the difference of lower extremities angle at each gait phase with a different gait conditions. In sagittal plane, pelvic anterior tilt increased in stairs and ramp climbing and hip and knee flexion increased in stairs climbing but ankle dorsiflexion increased in ramp climbing. In frontal plane, pelvic was up in stairs and hip abduction and adduction more changed in stairs climbing than level walking. Knee varus and ankle inversion increased in stair climbing. In horizontal plane, pelvic internal rotation increased in stairs and ramp climbing and knee internal rotation increased in stairs climbing but ankle external rotation increased in stairs climbing. This results was shown that the stairs and ramp climbing changed the kinematic gait parameters of lower extremities in healthy old adults.

Understanding and Exercise of Gluteus Medius Weakness: A Systematic Review

  • Baik, Seung-min;Cynn, Heon-seock;Kim, Seok-hyun
    • Physical Therapy Korea
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    • v.28 no.1
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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.

Relationship between Bony Alignment of Foot and Scoliosis in Children and Adolescent (소아 청소년기에서의 족부 지표와 척추측만증과의 관계)

  • Jae Hwang Song;Woo Jin Shin;Sung Jun Moon;Jin Woong Yi;Tae Gyun Kim
    • Journal of Korean Foot and Ankle Society
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    • v.28 no.2
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    • pp.48-54
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    • 2024
  • Purpose: Foot alignment affects the overall balance and alignment of the body. This study examined the relationship between the foot parameters and scoliosis in children and adolescents through simple radiographs. Materials and Methods: Two hundred and forty-one outpatients under 15 years old from 2013 to 2022 were evaluated. Patients with an abnormal leg length discrepancy or pelvic tilt were screened. The patients included were divided into four groups. Each group was tested to determine if they had scoliosis. The foot anterior-posterior/lateral X-rays were selected for the foot parameters, and the EOS system was used for the spline and pelvis parameters. Results: A t-test of all groups showed no statistically significant difference as the p-value exceeded 0.05. An analysis of variance (ANOVA) comparing the Cobb's angle and foot parameters did not show a significant correlation. On the other hand, female and older patients had a higher Cobb's angle. Conclusion: No direct relationship was noted between scoliosis and the foot parameters that could be measured radiographically among children and adolescents. In addition, no correction between the Cobb's angle and foot parameters was found.

Three-Dimensional Video Analysis of the Gate Patterns in Normal Children and Hemiplegic Children with Cerebral Palsy (정상아와 편마비 뇌성마비아의 삼차원 보행분석)

  • Lee Jin-Hee;Bae Sung-Soo;Kim Chung-Sun
    • The Journal of Korean Physical Therapy
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    • v.9 no.1
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    • pp.127-145
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    • 1997
  • The purpose of this study wa9 to analyse the gait patterns of two female children with hemiplegic cerebral palsy by using the three-dimensional video motion analysis technique. Case 1 has mild spastic hemiplegia on the right side while Case 3 has moderate spastic hemiplegia on the left side. A group of 10, normal female children of the same age(7-8 years old) were selected as the control group for comparison. Time and distance variables as well as the Center of Mass displacement, and the pelvic and joint motions in three anatomical planes were analysed for this purpose. The following observations were made through the analysis : Case 1 revealed an asymmetrical gait pattern in which the step length of the unaffected side was shorter than that of the affected side, which wan a result of the effort to minimize loading on the affected leg by shortening the swing phase of the unaffected leg. Case 1 scored similar phase ratios, cadence and walking velocity to the normal group. A slight posterior tilt of the pelvis was observed throughout the gait cycle. Less hip and knee flexion than the normal group was observed, and demonstrated hyperextension of the knee in the terminal stance phase. The main problem in case 1 originated from the insufficient dorsiflexion of the affected foot during the swing phase. Therefore, Case 1 has difficulty with foot clearance in the swing phase. Usually, this is compensated for by using exessive hip abduction and medial rotation in conjuction with trunk elevation as well as increased vortical displacement of the center of mass. Case 1 revealed a foot-flat initial contact pattern. Case 2 was characterized by a consistent retraction ef the affected aide of the body througout the gait cycle, As a result, an asymmetrical gait pattern with increased stance phase ratios of the unaffected side was observed. In spite of this the step lengths of both sieds were similar. Case 2 scored lower cadence and walking speed than the normal group with lower gait stability. The main problem in Case 2 originated from an excessive plantaflexion of the affected foot which, in turn, rebutted in high hip and knee flexion. Hyperextension of the knee was observed at mid-stance, and execessive anterior tilt of the pelvis throughout the gait cycle was noticed. A gait pattern with high hip abduction and medial circumduction was maintained for the stability in the stance phase and foot clearance in the swing phase. Case 2 revealed a forefoot-contact initial contact pattern.

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Effect of uneffected side insole on Gait Pattern in Hemiplegia Patients (편마비 환자의 비손상측 안창 착용이 보행에 미치는 영향)

  • You, Jae-Eung;Jung, Seok
    • Journal of Korean Physical Therapy Science
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    • v.10 no.2
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    • pp.37-41
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    • 2003
  • The aim of this study is to present the basic reference data Effect of uneffected side insole on Gait Pattern in Hemiplegia Patients. The basic gait parameters were extracted from 10 Adult Hemiplegia Patients, 5 left Hemiplegia Patients and 5 right Hemiplegia Patients, 50 to 60 years of age using VICON 512 Motion Analyzer. The results were as follows; 1) The mean Cadence of the shoes to the 1cm insole in shoes were $70.58{\pm}12.67\;steps/min$, to $77.28{\pm}14.58\;steps/min$.(p>0.05) 2) The mean Walking Speed of the shoes to the 1cm insole in shoes were $0.40{\pm}0.17\;m/s$, to $0.49{\pm}0.18\;m/s$.(p>0.05) 3) The mean Stride Length of the shoes to the 1cm insole in shoes were $0.67{\pm}0.20\;m$, to $0.75{\pm}0.19m$.(p>0.05) 4) The mean anterior angles of pint on the pelvic tilt for different the shoes to the 1cm insole in shoes were $13.22{\pm}7.25^{\circ}$, to $11.68{\pm}4.02^{\circ}$.(p>0.06) 5) The mean maximal angles of pint on the hip flexion motion for different the shoes to the 1cm insole in shoes were $24.62{\pm}8.35^{\circ}$, to $24.74{\pm}9.12^{\circ}$.(p>0.05) 6) The mean maximal angles of joint on the knee flexion motion for different the shoes to the 1cm insole in shoes were $34.27{\pm}16.71^{\circ}$, to $35.93{\pm}18.22^{\circ}$.(p>0.05) insole in shoes were $15.97{\pm}7.72^{\circ}$, to $18.77{\pm}11.03^{\circ}$.(p>0.05) 7) The mean maximal angles of joint on the ankle dorsiflexion motion for different the shoes to the 1cm. 8) The mean maximal angles of joint on the ankle plantarflexion motion for different the shoes to the 1cm insole in shoes were $-4.24{\pm}10.66^{\circ}$, to $-7.04{\pm}11.00^{\circ}$.(p<0.05)

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Evaluation of the Degenerative Changes of the Distal Intervertebral Discs after Internal Fixation Surgery in Adolescent Idiopathic Scoliosis

  • Dehnokhalaji, Morteza;Golbakhsh, Mohammad Reza;Siavashi, Babak;Talebian, Parham;Javidmehr, Sina;Bozorgmanesh, Mohammadreza
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.1060-1068
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    • 2018
  • Study Design: Retrospective study. Purpose: Lumbar intervertebral disc degeneration is an important cause of low back pain. Overview of Literature: Spinal fusion is often reported to have a good course for adolescent idiopathic scoliosis (AIS). However, many studies have reported that adjacent segment degeneration is accelerated after lumbar spinal fusion. Radiography is a simple method used to evaluate the orientation of the vertebral column. magnetic resonance imaging (MRI) is the method most often used to specifically evaluate intervertebral disc degeneration. The Pfirrmann classification is a well-known method used to evaluate degenerative lumbar disease. After spinal fusion, an increase in stress, excess mobility, increased intra-disc pressure, and posterior displacement of the axis of motion have been observed in the adjacent segments. Methods: we retrospectively secured and analyzed the data of 15 patients (four boys and 11 girls) with AIS who underwent a spinal fusion surgery. We studied the full-length view of the spine (anterior-posterior and lateral) from the X-ray and MRI obtained from all patients before surgery. Postoperatively, another full-length spine X-ray and lumbosacral MRI were obtained from all participants. Then, pelvic tilt, sacral slope, curve correction, and fused and free segments before and after surgery were calculated based on X-ray studies. MRI images were used to estimate the degree to which intervertebral discs were degenerated using Pfirrmann grading system. Pfirrmann grade before and after surgery were compared with Wilcoxon signed rank test. While analyzing the contribution of potential risk factors for the post-spinal fusion Pfirrmann grade of disc degeneration, we used generalized linear models with robust standard error estimates to account for intraclass correlation that may have been present between discs of the same patient. Results: The mean age of the participant was 14 years, and the mean curvature before and after surgery were 67.8 and 23.8, respectively (p<0.05). During the median follow-up of 5 years, the mean degree of the disc degeneration significantly increased in all patients after surgery (p<0.05) with a Pfirrmann grade of 1 and 2.8 in the L2-L3 before and after surgery, respectively. The corresponding figures at L3-L4, L4-L5, and L5-S1 levels were 1.28 and 2.43, 1.07 and 2.35, and 1 and 2.33, respectively. The lower was the number of free discs below the fusion level, the higher was the Pfirrmann grade of degeneration (p<0.001). Conversely, the higher was the number of the discs fused together, the higher was the Pfirrmann grade. Conclusions: we observed that the disc degeneration aggravated after spinal fusion for scoliosis. While the degree of degeneration as measured by Pfirrmann grade was directly correlated by the number of fused segments, it was negatively correlated with the number of discs that remained free below the lowermost level of the fusion.