Purpose: Postoperative exercise for acute Achilles tendon rupture is important for a patient's return to daily life and sports. On the other hand, the protocol requires considerable effort to educate patients and continuous checking. This study evaluated the outcome of a new simple and delayed rehabilitation protocol after Achilles tendon rupture repair. Materials and Methods: From July 2014 to November 2020, one hundred eighty-three patients were operated on by one surgeon. The exercise protocol was classified into two methods. One group (immediate protocol, control group) started immediate full weight bearing with a 20° plantar flexion range of motion from two days postoperatively. Ankle dorsiflexion was restricted to 0°. The other group (delayed protocol, case group) started full weight bearing with a controlled ankle motion boot from two weeks postoperatively. No range of motion exercise was allowed until six weeks postoperatively. Age, sex, body mass index, ankle range of motion, muscle power, time to return to previous physical activity, functional score, and complication rate were evaluated. The results of the two groups were compared using a Mann-Whitney test. Statistical significance was set as p<0.05. Results: The range of motion, double heel rising, and one-leg standing were achieved faster in the control group (p<0.05). However, single-heel rising, repeated single-heel rising, return to previous activity (work, run, and sport), and functional scores showed no statistical difference (p>0.05). Conclusion: Simple and delayed postoperative rehabilitation of acute Achilles tendon rupture without active range of motion exercises showed satisfactory functional results and a low complication rate.
In this study, to explore the working performance of the CFST split spherical node wind power tower, two groups of CFST split spherical joint plane towers with different web wall thicknesses and a set of space systems were analyzed. The tower was subjected to a low-cycle repeated load test, and the hysteresis and skeleton curves were analyzed. ABAQUS finite element simulation was used for verification and comparison, and on this basis parameter expansion analysis was carried out. The results show that the failure mode of the wind power tower was divided into weld tear damage between belly bar, high strength bolt thread damage and belly rod flexion damage. In addition, increasing the wall thickness of the web member could render the hysteresis curve fuller. Finally, the bearing capacity of the separated spherical node wind power tower was high, but its plastic deformation ability was poor. The ultimate bearing capacity and ductility coefficient of the simulated specimens are positively correlated with web diameter ratio and web column stiffness ratio. When the diameter ratio of the web member was greater than 0.13, or the stiffness ratio γ of the web member to the column was greater than 0.022, the increase of the ultimate bearing capacity and ductility coefficient decreased significantly. In order to maximize the overall mechanical performance of the tower and improve its economy, it was suggested that the diameter ratio of the ventral rod be 0.11-0.13, while the stiffness ratio γ should be 0.02-0.022.
Purpose: The purpose of this study is to report a result of the technique that reconstruct posterior cruciate ligament (PCL) and posterolateral corner (PLC) simultaneously using a fresh-frozen Achilles tendon allograft. Materials and Methods: Forty two patients (45 legs) underwent PCL and PLC reconstruction were included. There were 38 males and 4 females. Mean age was 39 years. Used graft was a fresh frozen Achilles tendon allograft, which was divided by two size, larger one (${\emptyset}$ 10 mm) for PCL reconstruction and smaller one (${\emptyset}$ 8 mm) for PLC reconstruction. Arthroscopic reconstruction of the PCL was performed using transtibial, single incision, and single bundle technique with 10mm fresh frozen Achilles allograft tendon first. After PCL reconstruction, reconstruction procedure for posterolateral instability was performed using modified figure of "8" technique using smaller gtaft. For clinical evaluation, range of motion, posterior drawer test, varus stress test, prone external rotation (dial) test, Lysholm score, Tegner activity scale and posterior stress radiograph were used. Mean follow up period was 25 months. Results: Preoperatively posterior drawer test was 5 cases in grade II and 40 cases in grade III posterior instability. At final follow-up 22 cases returned within normal condition, 18 cases grade I and 5 cases grade II posterior instability. Though all patients showed positive result over 10 degrees in dial and varus stress test preoperatively, but only 9 cases showed positive both test at final follow-up. The range of motion deficit over $10^{\circ}$ flexion was 3 cases. Lysholm score was improved from mean 50 preoperatively to mean 83(p<0.05) and Tegner activity scale improved from mean 2.1 preoperatively to mean 4.6(p<0.05). In posterior stress radiographs, posterior displacement was improve from mean 16mm preoperatively to 4.1mm after treatment(p<0.05). All patients had improved compared to their pre-operative status as measured by physical examination such as posterior drawer test, varus stress test, dial test. Conclusion: We had successful results by combined reconstruction of the PCL & PLC with a fresh frozen Achilles tendon allograft in patients with PCL and posterolateral rotatory instability at a time.
The purpose of the study was to examine the thickness of the trunk muscles ie. external obliques (EO), transversus abdominis (TrA), and multifidus and the trunk endurance strength in order to determine any relationship between the presence or absence of low back pain (LBP) and the size of trunk muscles. Data were obtained from 50 subjects, aged between 19-29 years. Participants had no experience of spinal problems that had resulted in a restriction of normal activity or time-off work and no current spinal symptoms. Measurements of muscle thickness of the trunk muscles were collected at rest, contraction and 15 seconds of post contraction during endurance strength tests. Background information was obtained followed all physical measures. Subjects were divided into two groups based on their experience of LBP. In draw-in maneuver, increasing the thickness of TrA was observed in all participants while EO was decreased at contraction in group 1 and increase in group 2. Only subjects in the group 2 had TrA increased during the flexion endurance test. In the side-bridge endurance test, the thickness of the right TrA was also observed differently between groups. Therefore, the results of the study may suggest that a function of specific muscle should be addressed for training persons with LBP.
The aim of the study was to investigate the thickness of deep neck muscles during neck endurance tests using ultrasonography images to assess muscle sizes in persons with or without neck pain experience. Sixty-five university students volunteered for the study. The thicknesses of longus colli, longus capitis, semispinalis and cervical multifidus were assessed bilaterally using diagnostic ultrasound equipment during each endurance test. Participants were divided into two groups based on their Neck Pain(NP) experience; 45 subjects of those had no experience of NP (Group1) whereas 20 subjects of those reported NP experience sometime in their lives (Group2). Endurance time of both neck flexion and extension tests in Group1 showed significantly longer than Group's (p<0.01). The thicknesses of deep neck flexors and extensors were observed smallest at the terminal of endurance tests in general. Only left longus colli was found to be significantly smaller at rest in subjects of Group2 than Group 1's (P=0.02). The size difference between at contraction and the terminal of right longus capitis was observed bigger in subjects of group1 than subjects in group2. Future studies are needed to conduct with clinical subjects to assess contraction patterns of neck muscles.
The effect of the developed symmetric upper extremity motion trainer on the cortical activation pattern was investigated in three chronic hemiparetic patients using both fMRI and Fugl-Meyer test. The training program was performed at 1 hr/day, 5 days/week during 6 weeks. Fugl-Meyer tests were performed every two weeks during the training. fMRI was performed at 3T scanner with wrist flexion-extension in two different tasks before and after the training program: the only unaffected hand movement (Task 1) and passive movements of affected hand by the active movement of unaffected hand (Task 2). fMRI studies in Task 1 showed that cortical activations decreased in ipsilateral SMC but increased in contralateral SMC. Task 2 showed cortical reorganizations in bilateral SMC, PMA and SMA. Therefore, it seems that the cortical reorganization in chronic hemiparetic patients can be induced by the training with the developed symmetric upper extremity motion trainer.
The purpose of this study was to examine the effect of kinesio taping on muscle strength and changes of muscle fatigue and damage. 10 male subjects participated in 1-RM and isometric cybex muscle strength tests with and without taping application. Muscle strength (bench press, leg press) and extension (knee, shoulder) strength were significantly increased after taping, but there was no significant difference in flexion (knee, shoulder) strength. The concentration of fatigue factors (ammonia, phosphorous), muscle damage index substances (CK, LDH), IGF-I and creatinine were reduced after taping, but there were no significant differences.
The purpose of this study was to compare the effect of wearing roller shoes and jogging shoes on kinematic characteristics in lower extremity during walking. Eight male middle school students(age: $15.0{\pm}0.0^{\circ}$ yrs, height $175.9{\pm}6.6cm$, weight: $616.3{\pm}84.9$ N) who have no musculoskeletal disorder were recruited as the subjects. Temporal parameters, step length, stride length, center of mass, velocity of CM, angle of segment, angular velocity and range of motion were determined for each trial. For each dependent variable, paired t-test was performed to test if significant difference existed between shoe conditions(p < .05). The results showed that stride length and velocity of CM in wearing roller shoes were significantly less than those found in wearing jogging shoes. These indicated that walking patterns may be changed by different shoe conditions and unstable braking condition because of wheel. Angle of ankle joint at LHC1 and LHC2 in wearing roller shoes was greater than the corresponding value for wearing jogging shoes. It seems that the ankle joints are locked in an awkward fashion at the heel contact to compensate for imbalance. Otherwise, dorsi flexion was not produced at the heel contact point in wearing roller shoes.
Park, Ji-Hyun;An, Soon-Sun;Choi, Yong-Hun;Hong, Seo-Young;Heo, Dong-Seok;Yoon, Il-Ji
Journal of Korean Medicine Rehabilitation
/
v.18
no.4
/
pp.147-159
/
2008
Objectives : In order to investigate the relation of body composition analysis and isokinetic trunk muscle strength for the screening test of low back pain. Methods : This study was carried out with the data from comprehensive medical testing. 75 subject aged 20-59 performed the segmental bioelectrical impedance analysis, isokinetic trunk muscle strength test and questionnaire. Then we analyzed the relationship of data. Results : Low back pain(LBP) prevalence in high obesity index(Body mass index(BMI), Percentage of Body Fat(PBF), Waist Hip Ratio(WHR)) group was higher than LBP prevalence in normal obesity index group(p<0.001). In LBP group, Extension Peak Torque(Ext.PT), Extension Peak Torque per Body Weight(Ext.PT/BW) were significantly lower than Non-LBP group(p<0.001). And 90% of LBP group indicated abnormal Extension-Flexion Ratio(E/F ratio)(1.0 < Normal E/F ratio <1.6). When it comes to analyze relation between obesity index and muscle strength, Ext.PT/BW was significantly decreased according to PBF, WHR score. And correlation coefficient in Flex.PT, Flex.PT/BW, Ext.PT, Ext.PT/BW and PBF showed decreasing function. Conclusions : Results from this investigation showed positive correlation between obesity and LBP prevalence. Decreased muscle strength and inbalanced E/F ratio were shown in LBP. Trunk muscle strength was changed according to body mass composition parameters. This results are expected to contribute to prevent and diagnose LBP by application the clinical index of body composition analysis.
The purpose of this study was to investigate the effect of close kinetic chain(CKC) and open kinetic chain(OKC) posion on proprioceptive neuromuscular facilitation applied to the unilateral upper extremity on the muscle activation of lower extremity. All subjects were randomly assigned to two groups: open kinetic chain group(n=5),closed kinetic chain group(n=5). All participants were PNF patterns applied on the unilateral upper extremity in all subjects were the kinetic chain(CKC) and open kinetic chain(OKC) posion on flexion/abduction/external rotation. The hold and approximation techniques for the irradiation were applied to end range. All measurements for each subject took the following tests: pre-test, post - test in 4weeks, post-testin 8weeks. EMG data was collected from the vastus medialis, tibialis anterior, biceps femoris, and gastrocnemius muscle of both lower extreamity using surface EMG system, Each EMG value in individual muscle was normalized for maximal voluntary contraction. The data were analyzed using Two-way analysis of variance(ANOVA) with repeated measures to determine the statistical significances. The results of this study are summarized as follows. First, during for close kinetic chain(CKC) and open kinetic chain(OKC) posion on PNF pattern application, all of the %MVIC values of close kinetic chain and open kinetic chain posion increased sign ificantly compared(p<0.05). Second, The close kinetic chain(CKC) and open kinetic chain(OKC) posion on PNF pattern application was significantly increased with in the intervention period(p<.05). Third, there was a no significant open kinetic chain posion on PNF pattern application of sing muscle group with in the intervention period.(p<0.05) there was a significant close kinetic chain posion on PNF pattern application of sing muscle group with with in the intervention period(p<0.05). Forth, interaction of the exercise position and muscle was also significant. Post-hoc tests revealed that the activation levels of vastus medialis muscle and tibialis anterior muscle was higher in the closed kinetic chain position(p<.05). that the activation levels of vastus medialis and gastrocnemius muscle was higher in the open kinetic chain position(p<.05). In conclusion, it was found that the application of PNF patterns to the unilateral upper extremity effect on the muscle activation of lower extremity and both open kinetic chain exercise and closed kinetic chain exercise was significantly increased muscle activity. Further studies are needed to analyzed long term effects and subjects resulting from these changed.
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