• Clinics in Shoulder and Elbow
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• 제16권1호
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• pp.33-39
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• 2013

목적: 고령 환자의 상완골 원위부 골절에서 이중 강선 장력대 고정술을 이용한 수술의 임상적 결과를 분석하여 그 유용성을 알아보고자 한다. 대상 및 방법: 상완골 원위부 골절 환자 중 AO 분류상 C형 골절과 골다공증을 가진 65세 이상의 고령 환자에서 이중 강선 장력대 고정술을 이용해 관혈적 정복과 내고정을 시행 받은 10예를 대상으로 하였다. 남자가 1명, 여자가 9명이었으며 평균 연령은 74.6(66~84)세였다. 평균 추시 기간은 39.2(20~74)개월이었다. 골유합 유무, 시기와 주관절의 운동 범위를 측정하였고, Mayo 주관절 수행 점수, Jupiter 등에 의한 평가법을 이용하여 기능 상태를 평가하였다. 결과: 골유합은 10명에서 2차적인 전위 없이 이루어졌고, 평균 골유합 기간은 16.6(13~22)주였다. 최종 추시시 측정한 평균 주관절 운동범위는 굴곡 구축은 8.5 (0~15)도, 후속 굴곡 119(100~140)도, Mayo 주관절 수행 점수는 82(70~90)점으로 각각 우수 2예(20%), 양호 7예(70%), 보통 1예(10%)였다. Jupiter 등에 의한 평가법을 따르면 각각 우수 7예(70%), 양호 1예(10%), 보통 2예(20%)였다. 1예에서 이소성 골화가 있었으나 그에 따른 증상은 동반되지 않아 추시 관찰하기로 하였으며, 1예에서 강선에 대한 피부 자극 증상이 발생하여 장력대 강선 교체 수술을 시행하였다. 결론: 골다공증을 가진 고령 환자의 상완골 원위부 C형 골절의 수술적 치료에서 이중 강선 장력대 고정술은 견고한 고정과 동시에 조기 관절 운동을 가능하게 하여 효과적이며 우수한 치료법으로 사료된다.

• 기본간호학회지
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• 제4권2호
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• pp.267-282
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• 1997

This study was to test the relationship between regular physical exercise and physical fitness in nursing students. These subjects were 54 volunteers who agreed with intention of this study and were composed of 24 active group and 30 non-active group. The selected physical fitness tests were grip strength and back strength for measuring muscular strength, sargent jump and standing broad jump for measuring power, push-up, sit-up, and heart rate for measuring total endurance, reaction time and side step test for measuring agility, stick test and stork stand for measuring balance, and trunk flexion and trunk extension for measuring flexibility. The conclusion acquired was as follows : 1) Grip strength had significant difference between active group of $29.5{\pm}5.9kg$ and non-active group $25.4{\pm}7.2kg$(t=2.283, p=.027), and back strength between active group of $54.1{\pm}13.7kg$ and non-active group of $44.7{\pm}15.7kg$(t=2.310, p=.025), 2) Sargent jump was lower with non-active group($44.9{\pm}8.6cm$) than with active group($45.3{\pm}8.8cm$), however, was not significant(t=.182, p=.856). Standing broad jump was significantly lower with non-active group of $161.3{\pm}28.7cm$ than with active group of $191.4{\pm}27.0cm$(t=3.939, p=.000). 3) Push-up showed significant difference between active group of $25.3{\pm}12.3times$ and non-active group of $11.5{\pm}5.1times$(t=5.572, p=.000), and sit-up between active group of $21.8{\pm}7.4times$ and non-active group of $17.1{\pm}5.8times$(t=2.631, p=.011), and heart rate between actvie group of $110.5{\pm}12.8$beats/min and non-active group of $121.5{\pm}9.5$beats/min(t=-3.648, p=.001). 4) Reaction time was significantly higher with non-active group of $.300{\pm}.051sec$ than with active group of $.341{\pm}.041sec$(t=-3.285, p=.002). Side step test was lower with non-active group($8.8{\pm}1.1times$) than with active group($9.2{\pm}1.2times$), however, was not significant (t=1.309, p=.196). 5) Stick test showed not significant difference between active group of $25.8{\pm}14.8sec$ and non-active group of $30.7{\pm}17.9sec$(t=-1.058, p=.295), and stork stand between active group of $4.5{\pm}3.2sec$ and non-active group of $3.7{\pm}3.5sec$(t=.918, p=.363). 6) Trunk flexion came out not significant difference between active group of $14.2{\pm}5.0cm$ and non-active group of $15.8{\pm}7.3cm$(t=-.927, p=.358), and trunk extension between active group of $67.1{\pm}6.5cm$ and non-active group of $67.3{\pm}6.6cm$(t=-.140, p=.889). 7) Power was shown to be significantly related to total endurance(r=.717, p=.000 ; r-.739, p=.000). 8) Total endurance was shown to be significantly related to agility(r=-.752, p=.000 ; r=.684, p=.000 ; r=-.664, p=.000 ; r=.598, p=.002 ; r=.864, p=.000 ; r=-.536, p=.007). These results suggest that regular physical exercise is effective in promoting and maintaining physical fitness. As the further study, it is necessary to reinvestigate the effect with more refined design.

• 한국운동역학회지
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• 제25권2호
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• pp.183-190
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• 2015

Objective : Walking with a Material handling is an activity frequently undertaken by agricultural workers in Korea, due to the nature of their work. This study aimed to investigate differences in biomechanical variables according to the mechanical alignment of the lower limbs when walking with a heavy load, and to use this as basic data in the design of various working environments to reduce the skeletomuscular burden on the knee joint. Method : The study subjects comprised of 22 right-foot dominant adult men and women aged between 20 and 23 years. The subjects were divided into a varus or valgus group according to the mechanical alignment of the lower limb by using radiographic findings. The subjects walked without any load and with a load of 10%, 20%, or 30% of their body weight held in front of them. The Kwon3d XP program was used to calculate biomechanical variables. Results : The flexion/extension moment of the knee joint showed a decreasing trend with increased load, irrespective of the mechanical alignment of the lower limb, while the varus group did not show normal compensatory action when supported by one leg at the point of maximum vertical ground reaction force. In addition, in terms of the time taken, subjects showed no difficulties in one-foot support time up to 20%/BW, but at 30%/BW, despite individual differences, there was an increase in single limb. The increased load resulted in a decrease in the ratio of standing phase to ensure physical stability. The valgus group showed a trend of increasing the stability of their center of mass with increasing load, through higher braking power in the early standing phase. Conclusion : In conclusion, although there was no statistical difference in biomechanical variables according to the mechanical alignment of the lower limbs, the varus group showed a more irregular walking pattern with a Material handling than the valgus group, partially proving the association between lower limb alignment and walking with a Material handling.

• 한국운동역학회지
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• 제17권2호
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• pp.11-21
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• 2007

The study was undertaken to present the quantitative materials available in underwater industries, underwater rehabilitation & physical training through comparison & analysis of effects contributing to propulsion of COG by types of fin-kick in underwater activities. For this 3D cinematography was performed for the skilled subjective and conclusions obtained on the basis of analysis of kinematic variables were as follows. In temporal variable the delay in the order of flutter>side>dolphin kick in elapsed time by total & phase resulted in longer sliding phase by larger fin kick of extension & flexion of both leg and thus more contributed in propulsion of COG. than those of the otherwise. In linear variable the contribution ratio to the result of propulsion of COG in both propulsive(mean $35.39{\pm}7.93cm$ in Y axis) and sliding phases(mean $66.36{\pm}11.01cm$ in Y axis)was shown to be order of flutter>dolphin>side fin kick. the maximum velocity of COG in Y direction was showed in both propulsive and sliding phases, and the contribution ratio to the propulsion of COG was in the order of flutter$\geq$dolphin>side fin kick. In angular variable the Significant difference in angle of leg joint by types of fin kick in both leg was showed but no routine order. The Significant difference in angular velocity of leg joint by types of fin kick in both leg was showed in the order of flutter>dolphin$\geq$side fin kick in propulsive but no in sliding phase. The Fluid resistance by tilting angle of trunk in both propulsive and sliding phase was decreased in the order of flutter>dolphin$\geq$side fin kick and tilting angle of trunk of the skilled was smaller than that of the unskilled in difference of maximum mean 7.97degree and minium mean 2.06degree. In summary of the above, It will desirable fin kick type because of more contribution to COG propulsion by the velocity & displacement in Y-axis and less fluid resistance by tilting angle of trunk and larger angular velocity in the case of more delayed in elapsed time of propulsive phase than that of the otherwise.

• 한국운동역학회지
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• 제12권2호
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• pp.215-227
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• 2002

본 연구의 목적은 정상인 휠체어 농구 선수 8명을 대상으로 추진 및 방향전환 동작의 소요시간 측정 및 운동학적 분석을 통하여 포지션별 농구용 휠체어가 추진동작에 미치는 효과를 규명하는데 있다. 포지션별(포드, 센타, 가드) 휠체어의 한 주기(핸드림 접촉에서 다음 핸드림 접촉까지)를 2차원 DLT 방식을 이용하여 구하고자 하는 변인을 산출하였다. 가드용 휠체어는 직선 구간 및 방향전환 구간 모두에서 가장 빠르게 나타났으며, 센타용 휠체어는 방향전환 구간에서 제일 느린 것으로 나타났다. 이동 속도가 가장 빠른 가드용 휠체어는 손이 TDC(Top Dead Center)에 더 가깝게 접촉하며, 더 오랫동안 핸드림에 힘을 가해서 추진하며, 분당 추진빈도는 가장 적은 것으로 나타났다. 반면에 센타용 휠체어는 손이 TDC에서 가장 멀리 접촉하며, 가장 짧은 범위에서 핸드림에 힘을 가해서 추진하는 것으로 나타났다. 가드용 휠체어는 핸드림 접촉시 팔꿈치를 가장 많이 굽히고 몸통을 가장 많이 세우며, 센타용 휠체어는 핸드림 접촉시 팔꿈치를 가장 많이 펴고 몸통을 많이 굽히며 핸드림 이지시 가드용 휠체어에 비해 팔꿈치를 많이 펴는 것으로 나타났다. 휠체어 추진시 좌석의 높이가 가장 낮은 가드용 휠체어는 포드용 및 센타용 휠체어보다 팔꿈치 및 몸통각의 범위가 가장 큰 것으로 나타났다. 몸통 최대 각속도에서 가드용 휠체어는 다른 휠체어와 비교해서 가장 큰 값을 나타냈다.

• 한국콘텐츠학회논문지
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• 제11권4호
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• pp.235-243
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• 2011

본 연구의 목적은 체간근 즉 외(측)복사근(EO), 복횡근(TrA) 및 요부 다열근의 크기를 체간근 지구력 검사 동안 측정하여 요통 경험 유무에 따라 측정 근육의 두께와 근수축의 패턴을 관찰하여 통증유무와 근수축 패턴의 연관성을 알아보고자 하였다. 19세에서 29세사이의 50명의 피험자를 대상으로 측정하였다. 연구 참여자는 요통으로 인하여 일상생활이나 직장생활을 하는 데 제약이 없으며 현재 척추 증상이 없는 자를 대상으로 하였다. 자료분석은 요통 경험 유무에 따라 그룹화하여 실시하였다. 근육의 크기는 드로인 검사, 굴곡근 지구력 검사, 사이드-브릿지 검사에서 실시하고, 측정은 휴식기, 수축기, 수축15초에 하였다. 피험자에 대한 일반적인 데이터는 모든 신체 검사 측정 후 수집하였다. 드로인 검사에서 근수축 시, 오른쪽외(측)복사근 두께가 Group 1에서는 감소하는 반면, Group 2에서는 증가하였으며, 양쪽 복횡근 두께는 그룹에 상관없이 증가함이 관찰되었다. 굴곡근 지구력 검사에서, Group 2에서만 복횡근 두께가 증가되었다. 또한 사이드-브릿지 검사에서는, 오른쪽 복횡근의 두께가 Group 1에서는 수축동안 계속 감소함이, Group 2에서는 수축 시 감소하다가 15초 수축 후에는 층가함이 관찰되었다. 따라서 본 연구 결과는 요통과 연관하여 특정 근육의 기능을 파악하여, 이에 맞춰 구체적인 훈련하는 것이 중요함을 제시할 수 있다.

• Clinics in Shoulder and Elbow
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• 제9권2호
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• pp.169-175
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• 2006

Purpose: The purpose of this study was to evaluate the usefullness of polarus nailing in the treatment of proximal humerus fractures including 2 part, 3 part and proximal comminuted fractures. Materials and methods: Fifteen cases of proximal humerus fracture treated with Polarus nailing from March, 2002 to March, 2004 were selected. Man was 3 cases, and woman was 11 cases. There were one case of follow up loss due to decease. Average age was 60 years old (range, 23 to 84), and there were 6 cases of 2 part fracture, 3 cases of proximal segmental fracture, 5 cases of 3 part fracture. We analyzed the outcom results between 2 part fracture and 3 part fracture. The average follow up period after the operation was 1.5(range, 1 to 2) years. Range of motion (ROM), pain and functional outcome were evaluated by visual analogue scale(VAS) and american shoulder and elbow surgery (ASES) activity of daily living (ADL) functional scoring system. Results: All cases showed union on radiologic evaluation, with 2.3 months follow up. In 5 cases of 3 part fracture, average union time was 1.9 months regardless of proximal screw loosening in 4 cases. In 2 part fracture union time was 2.2 months (P>0.05). VAS pain score was 1.3, ROM was $160^{\circ}$ in forward flexion, $40^{\circ}$ in external rotation, L3 level in internal rotation, and ASES, ADL functional score was 21 in 2 part fracture. VAS pain score was 1.25, ROM was $160^{\circ}$, $43^{\circ}$ and L1 level, and ASES, ADL functional score was 21 in 3 part fracture. There were no statistically significant difference between two groups (P>0.05) VAS pain score was 1.6, ROM was $170^{\circ}$, $47^{\circ}$ and L3 level, and ASES, ADL functional score was 23 in proximal comminuted fracture. Conclusion: Polarus nailing could be used as an effective modality in certain cases of proximal humeral fracture including 2 part, proximal segmental and in cases of 3 part fractures with large greater tuberosity fragment.

• 한국콘텐츠학회논문지
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• 제11권12호
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• pp.326-334
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• 2011

본 연구의 목적은 깊은 목굽힘근과 깊은 목폄근의 두께를 목근육 지구력 검사 동안 측정하여 목통증 경험 유무에 따라 깊은 목근육들의 크기에 차이가 있는 지 관찰하였다. 컴퓨터 사용이 많은 대학생 65명이 참여하였으며, 목통증이나 두통으로 인하여 일상생활을 수행하는데 제약이 없고 현재 척추증상이 없는 자를 대상으로 하였다. 근육의 두께는 근지구력검사를 수행하는 중 근이완기, 수축기와 제한시점에서 각각 측정하였다. 목통증과 기능제한에 대한 정보는 설문지를 통하여 수집하였다. 목통증 경험이 없는 대상자들 (그룹1)의 근지구력 시간이 목통증 경험이 있는 대상자들(그룹2)보다 통계적으로 유의하게 길었다 (p<0.01). 그룹1 대상자의 왼쪽 긴목근이 그룹2 대상자보다 근이완기에서 두껍게 관찰되었으며(p=0.02), 오른쪽 긴머리근은 목통증 경험이 없는 대상자들이 근수축에서 제한시점까지의 변화가 목통증 경험이 있는 대상자보다 크게 관찰되었다(p=<0.01). 목통증과 연관하여 특정 근육의 기능파악이 중요하며, 임상 대상자들의 목수축 패턴과 근기능에 대한 연구가 더 필요하다.

• 재활복지공학회논문지
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• 제5권1호
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• pp.1-10
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• 2011

본 연구에서는 공압 액추에이터를 이용하여 보다 안전하고 편리하게 사용자가 원하는 맞춤형 운동 프로그램을 선택할 수 있는 공압용 슬관절 운동시스템을 개발하였고, 재활운동 시 운동효과에 대한 유효성을 검증하고자 한다. 피험자는 평소 운동을 주 1회 이하로 실시하며 슬관절 신전과 굴곡에 이상이 없는 대학생 수준의 20대 남녀 10명을 대상으로 실시하였다. 실험방법은 기존의 유압식 슬관절 운동장비와 개발된 운동시스템을 이용하여 하루 12회씩 3세트의 슬관절 신전 및 굴곡운동을 실시하고, 주 3회 실시하며 실험은 총 4주간 반복되었다. 운동부하 프로그램은 유압식의 수동형 운동부하와 본 연구에서 개발된 시스템의 능동형 운동부하로 나누어 제공하였다. 운동부하 프로그램에 따른 실시간 근육활성 패턴과 운동 전 후 근육활성도를 비교함으로써 재활운동에 대한 운동효과를 검증하였다. 실험결과 수동형 운동부하보다 능동형 운동부하에 보다 높은 근육활성도를 이끌어 냈으며 운동 4주 후 더 큰 근력증진 효과를 나타냈다. 장비 중심의 운동부하 보다 사용자 중심의 운동부하가 더 효과적으로 근력을 증진할 수 있음을 알 수 있었다. 향후 재활환자나 노약자들에게 안전하고 효율적인 재활운동프로그램으로 활용 될 것이며 또한 재활장비에 적용되어 재활치료관련 종사자들에게 보다 쉽고 편리한 재활운동처방이 가능할 것이라 사료된다.

• Clinics in Shoulder and Elbow
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• 제8권2호
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• pp.97-104
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• 2005

Purpose: To report the results of surgical treatment of comminuted fractures of distal humerus and to identify factors that affect the results. Materials and Methods: Thirty-two patients who were treated with open reduction and internal fixation for comminuted fracture of distal humerus were enrolled. According to the AO classification, A2.3 was 1 case, A3.2, 2 cases, A3.3, 8 cases, B1.3, 1 case, B2.3, 1 case, C2.2, 5 cases, C2.3, 4 cases, C3.2, 3 cases and C3.3, 7 cases. As fixation technique, 17 cases were fixed by double plates, 4 cases by only K-wires, 4 cases by only screws, 3 cases by K-wires and screws and 4 cases by one plate and screws. The mean age at the time of the operation was 49 years(range, $19{\sim}77$ years). The mean follow-up period was 16 months(range, $8{\sim}51$ months). Results: At the last follow-up, the mean maximum flexion was $116.4^{\circ}\;(range,\;85{\sim}140^{\circ})$ and the mean loss of terminal extension was $11.8^{\circ}\;(range,\;0{\sim}40^{\circ})$. The average Mayo elbow performance score was $91.4^{\circ}\;(range,\;55{\sim}100^{\circ})$. Overall 29 cases(91%) showed good to excellent results. The mean range of motion of extraarticular and intraarticular fracture group was $105.5^{\circ}\;(range,\;65{\sim}140^{\circ})$ and $104^{\circ}\;(range,\;55{\sim}140^{\circ})$, respectively. The average elbow score of both groups was$93^{\circ}\;(range,\;70{\sim}100^{\circ})$ and $90.7^{\circ}\;(range,\;55{\sim}100^{\circ})$. Over 90% showed more than good results. 30 cases(94%) showed complete bony union but two cases, nonunion. One case of the nonunion cases underwent replating with bone graft as revision surgery and total elbow arthroplasty was performed in the other case. At the last follow-up, 27 patients(84.4%) showed subjective satisfaction. Conclusion: Open reduction and internal fixation with appropriate surgical technique for comminuted fractures of distal humerus showed good results, which were not affected by age at the time of operation, fixation methods and anterior transposition of the ulnar nerve. Transolecranon approach may be considered as good choice for intraarticular comminuted fractures of distal humerus.