• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.1
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• pp.6-14
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• 2003

The goal of rehabilitation after ACL reconstruction are return the patient to a reinjury level of activity with stable joint, removing pivot shift phenomenon, preservation of meniscus, restoration of range of motion, and minimize patello-femoral complication. The ACL reconstruction should avoid immediate surgery. The preoperative phase emphasizes two important factors. (1) The patient should have a resolution of knee swelling, a return of full ROM, and a normal gait. (2) The patient should be mentally prepared for the operation and subsequent rehabilitation. The postoperative rehabilitation program emphasizes extension, closed kinetic chain function exercises. The regular follow-up is important.

• Perspectives in Nursing Science
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• v.2 no.1
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• pp.19-36
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• 2005

Muscle atrophy is defined as a decrease in muscle mass, cross-sectional area, and myofibrillar protein content. Causes inducing muscle atrophy may be inactivity, denervation, undernutrition and steroid. Inactivity may decrease protein synthesis and increase protein breakdown of skeletal muscle. The muscle atrophy due to inactivity was induced by bed rest, hindlimb suspension, cast, total hip replacement arthroplasty, anterior cruciate ligament reconstruction. Denervated atrophy may be induced by the loss of innervation from lower motor neuron. The atrophy was apparent in the lower limb of hemiplegic patients following ischemic stroke and in the hindlimb of ischemic stroke rats. Protein breakdown of skeletal muscle in the undernourished state results in muscle atrophy. The atrophy due to undernutrition was evident in cancer and leukemia patients and in the undernourished rats. Steroids have been used to treat allergies, inflammatory diseases, autoimmune diseases and to inhibit immune function following transplantation. Steroids may induce muscle atrophy by protein breakdown of skeletal muscle. Muscle Physiology Laboratoryat College of Nursing, Seoul National University proved that dexamethasone may induce hindlimb muscle atrophy in rats and exercise and DHEA may attenuate hindlimb muscle atrophy induced by the steroid in rats. Nurses working with patients undergoing steroid treatment need to be cognizant of steroid induced muscle atrophy. They need to assess whether muscle atrophy is being occurred during and after the steroid treatment. Moreover, they need to apply exercise and DHEA to the patients undergoing steroid treatment in order to attenuate the steroid induced muscle atrophy.

• Journal of the Korean Arthroscopy Society
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• v.1 no.1
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• pp.123-127
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• 1997

Arthroscopic anterior cruciate ligament reconstructions using bone-patella tendon-bone have been considered the best method by which others are compared. The notchyplasty is one of the important steps of this procedure and it is emphasized recently to prevent retear of the reconstructed ACL caused by impingement. However, until now, there is controversy about adequate amount of notchyplasty. Also, it is hard to examine the adequacy of notchyplasty even in the arthroscopic field, The purpose of this paper is to describe the surgical technique of notchyplasty, using the flexible reamer and preliminary result of its operation. In this study the results of ACL reconstruction with notchyplasty which is made by us were analized from January. 1994 to December, 1995. The results were as follows: 1. The notchyplasty with flexible reamer is the method that can be obtained adequate amount of removal, perfectly smooth notchyplasty. 2. The range of motion of the affected knee joint was normal ROM after post operation 6 month. 3. In the last follow up, 2 cases were positive in anterior drawer test 4 cases were positive in Lachmann's test and 1 knee was positive in Pivot shift test 4. Average Lysholm knee scoring scale was 70 points at preoperative and 92 points at the last follow up.

• Journal of the Korean Arthroscopy Society
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• v.2 no.2
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• pp.107-113
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• 1998

This study is retrospective analysis of 31 patients treated by arthroscopically assisted ACL reconstruction, from September 1995 to September 1996. ACL reconstructions using autogenous bone patellar tendon bone (B-PT-B) were done in 18 patients, and using hamstring tendon were done in 13 patients. We used four-stranded hamstring tendon grafts and fixed the grafts using Endobutton and screw. The mean postoperative Lysholm knee score was 87.2 points in B-PT-B. group, and 89.0 points in hamstring tendon group. There were no clinically significant results between two groups in Telos test, quadriceps atrophy, Lachman test, anterior drawer test and pivot shift test, but the incidences of anterior knee pain were lower in hamstring group. Four-stranded hamstring tendon graft showed enough stability and good functional outcome similar to that of patellar tendon graft, and had an advantage of quicker return of quadriceps function and less donor site morbidity.

• Korean Journal of Applied Biomechanics
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• v.23 no.3
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• pp.235-243
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• 2013

The purpose of this study was to analyse scientific according to period of rehabilitation training of ACL patients. ACL patients seven subjects participated in this study. Gait (1.58 m/sec) analysis was performed by using a 3-D Cinematography, a Zebris system and a electromyograph system. The data were analyzed by paired t-test. The joint angles were recorded from the ankle, knee, hip joints. Peak max dorsi-flexion and peak max plantar-flexion identified significant differences (p<0.05). Another angles were no significant difference. Vertical force (Fz) and max pressure variables improved 6 month RTP better than 3 month RTP. EMG were collected from 4 muscles (rectus femoris, biceps femoris, gastrocnemius, tibialis anterior) with surface electrides in gait system. EMG signals were rectified and smoothed data. EMG signas were no significant difference but they also improved 6 month RTP better than 3 month RTP. More research is necessary to determine exactly what constitutes optimal rehabilitation training period for ACL patients.

• Journal of the Korean Arthroscopy Society
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• v.13 no.2
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• pp.87-96
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• 2009

최근 전방십자인대 손상의 치료에 남아있는 인대 다발이 이식건의 생물학적 치유를 도우며 고유 수용감각(proprioception) 기능을 유지할 뿐만 아니라 슬관절의 전방 전위 억제의 생역학적 기능을 가지는 것으로 연구되고 있다. 이러한 이론을 바탕으로 남아있는 전방십자인대를 보존하는 노력들은 다양하게 시도되고 있다. 전방십자인대 손상의 자연 경과는 아직도 논란이 되고 있으나 선택적인 환자에 있어서 보존적 치료는 비교적 좋은 결과를 얻을 수 있으므로 불필요한 재건술을 줄일 수 있다. 최근 시도되고 있는 선택적 다발 재건술 및 남아있는 다발을 보존하는 전방십자인대 재건 수술 수기들은 다양한 방법으로 시도되고 있으며 남아있는 다발을 보존하는 장점이 있으나 협소한 적응증을 가진다. 저자들의 남아있는 다발을 보존하는 전방십자인대 재건술은 자가 슬괵건을 이용한 단일다발 재건술을 시행하면서 잔존하는 이완된 다발에 봉합사를 통과시킨 후 봉합사를 추가적인 터널 없이 bioabsorbable cross pin (RIGIDfix system, Mitek, Johnson & Johnson, USA) 구멍을 통하여 당기고 고정하는 방법이다. 전방십자인대 재건술시 남아있는 다발을 보존하는 방법은 이식건의 생물학적 치유을 촉진하고 또한 경골 부착부에 남아있는 기계수용체를 보존하므로 기능적 회복에 도움이 될 것으로 기대된다. 저자들의 방법은 비교적 광범위한 적응증을 가지며 적은 합병증으로 남아있는 다발을 효과적으로 보존할 수 있는 술식으로 전방십자인대 수술시 좋은 치료 선택의 하나로 사료된다.

• Journal of the Korean Arthroscopy Society
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• v.13 no.2
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• pp.97-104
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• 2009

Optimal treatment of the torn anterior cruciate ligament (ACL) remains controversial. The complexity of surgically reproducing the natural biomechanical and anatomical function of the ACL has led to a diversity of reconstructive procedures. Controversy continues to exist regarding the best reconstructive procedure for the ACL deficient knee, but currently, there is no ideal method. Because of the increased frequency of ACL injury and the functional impairment resulting from that, the role of mechanoreceptors in the ACL recently has attracted considerable attention. Proper reconstruction of the ruptured ACL does not always have good results. Success after operation may depend not only on the mechanical stability but also on the quality of recovery of proprioception. It is well known that most ACL are ruptured in proximal half and most mechanoreceptors have been reported to be located in the subsynovial layer and near the tibial insertion of the ACL. Expected roles of tibial remnant is to enhance the revascularization and cellular proliferation of the graft, to preserve proprioceptive function, and to be able to acquire anatomical placement of the graft without roof impingement. The remnant of the ruptured ACL has been removed to clearly visualize the ACL footprint or decrease the risk of impingement and Cyclops lesion in most current techniques for ACL reconstruction. Therefore it seems reasonable to assume that preserving the tibial remnant as much as possible as a source of reinnervation, if technically possible without causing impingement, would be of potential benefit to the patient. In addition, it will facilitate the vascular ingrowth and ligamentization of the grafted ACL.

• Physical Therapy Korea
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• v.28 no.4
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• pp.273-279
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• 2021

Background: Lunge exercises are lower extremity rehabilitation and strengthening exercises for patients and athletes. Most studies have shown the effectiveness of the forward and backward lunge exercises for treating patellofemoral pain and anterior cruciate ligament injuries (by increasing lower extremity muscle activity) and improving kinematics. Objects: However, it is not known how the two different lunge movements affect trunk muscle activities in healthy individuals. The purpose of this study was to investigate the electromyographic activity of the rectus abdominis and erector spinae muscles during forward and backward lunge exercises in healthy participants. Methods: Twelve healthy participants were recruited. Electromyographic activity of the rectus abdominis and erector spinae was recorded using surface electrodes during forward and backward lunges, and subsequently normalized to the respective reference voluntary isometric contractions of each muscle. Results: Activity of the erector spinae was significantly higher than that of the rectus abdominis during all stages of the backward lunge (p < 0.05). The activity of the erector spinae was significantly greater during the backward than forward lunge at all stages (p < 0.05). Conclusion: Backward lunging is better able to enhance trunk motor control and activate the erector spinae muscles.

• Physical Therapy Rehabilitation Science
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• v.10 no.4
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• pp.406-413
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• 2021

Objective: The purpose of this study was to investigate effects of taping technique applied to knee instability. Design: Cross sectional study. Methods: Twenty-six participants with knee instabilityparticipated in this study. They were randomly assigned to the Kinesio taping (KT) group (n=13) and the dynamic taping (DT) group (n=13). Both groups applied knee stabilization taping techniques. In order to compare the effects of each taping technique, the change in the landing error scoring system (LESS) and lower extremity joint angle wasrecorded before and after the intervention. Results: Both groups significantly decreased in the change before and after the LESS (p<0.05). At the joint angle of the lower extremities, KT group significantly reduced the valgus angle at the max knee flexion (p<0.05). In DT group knee joint flexion and hip joint flexion angles were significantly increased at foot contact (p<0.05). In max knee flexion, the knee joint flexion angle was significantly increased (p<0.05). In foot contact, max knee flexion, the knee joint valgus angle was significantly increased (p<0.05). DT group showed more significant changes in knee joint flexion angle at foot contact and hip joint flexion angle at max knee flexion. Conclusions: Dynamic taping is a clinically applicable intervention method for lowering the risk of non-contact injury in participants with knee instability and for knee stability during rehabilitation exercises.

• Physical Therapy Rehabilitation Science
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• v.11 no.3
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• pp.279-284
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• 2022

Objective: This study was conducted to confirm the effect of physiotherapy on the balance and walking in dog with sciatic nerve injury and degenerative arthritis of stifle joints. Design: Single case study Methods: The dog walked abnormally for six months and was administrated in S animal hospital. The dog's right hindlimb was operated for cranial cruciate ligament repair and the dog had been taking a nonsteroidal anti-inflammatory analgesic before being refered. There was severe degenerated osteoarthritis in the right hindlimb. During stance and walking, the right hindlimb was often shown partial weight bearing. The dog's left hindlimb was shown plantigrade stance and walking. The radiograph was shown an intact calcaneal tendon in the left hindlimb. In the neurologic examination, sciatic nerve injury in the left hindlimb was confirmed. The dog was treated using muscle strengthening, proprioceptive exercise, underwater treadmill and Laser therapy two, or three times a week for 3 months. At the 10th and 17th treatment, it was evaluated through stance and gait analyzer system to measure dog's balance and walking. Results: 3 months following physiotherapy, the dog's balance was improved in center of pressure(COP). And peak vertical force(PVF), vertical impulse(VI) was increased in right hindlimb and double stance was decreased. Conclusions: Physiotherapy may have improved the prognosis in this dog with severe osteoarthritis and sciatic nerve injury. This study suggested that animal physiotherapy is a valuable way to improve balance and walking.