• 대한골관절종양학회지
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• 제2권1호
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• pp.8-17
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• 1996

The purpose of this study is a comparative evaluation of range motion, especially extension deficit between the group of total patellectomy and that of intact patella, after reconstruction of the patellar tendon in the prosthetic replacement of a proximal tibia. Between 1990 and 1994, 15 patients who had a primary malignancy on proximal tibia were operated on. All patients were evaluated clinically and radiographically. Two patients were excluded because one had a deep infection treated with arthrodesis of the knee and the other was a composite allograft. The mean follow-up of the 13 patients was 27 months(15-47), including 10 osteosarcomas, 1 chondrosarcoma, 1 malignant fibrous histiocytoma and 1 malignant giant cell tumor. Eleven patients had a resection of the proximal tibia and 2 had an extracapsular total knee resection with distal femur. Reconstruction of the defect was done in 8 cases with a custom-made Link Endo-Model Total Rotation Knee Joint Prosthesis, and in 5 with How Medica Modular Resection System (HMRS). We used two methods to reconstruct the ligamentum patellae. Fixation of the patellar tendon to the prosthesis only with suturing and/or stapling(group SS) was done in 7. Transposition of gastrocnemius muscle to enhance fixation and to cover the prosthesis(group TG) was done in 6. Regardless of fixation methods, total patellectomy was done in 5 either to lengthen the patellar tendon or to make primary skin closure easier or for both. In 8 cases, patella was left intact or resurfaced with polyethylene prosthesis. Active extension was measured while the patient was in a sitting position. There is no statistically meaningful difference in terms of extension deficit (Wilcoxon rank test, p=0.8800) between patellectomy group and intact patella group, and between group of fixation only with suturing and that of gastrocnemius transposition. Two cases of extension deficit over 30 degree were seen in group SS and in the group of intact patella. Conclusively, total patellectomy could be an option without increasing the risk of extension deficit when primary skin closure is difficult or patellar tendon is a little bit short to be fixed. There is no rating in the Enneking system of functional evaluation that this finding into consideration.

• 한국운동역학회지
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• 제18권4호
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• pp.125-133
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• 2008

본 연구의 목적은 파워보행 시 하지근의 근활성 정도를 비교 분석하고자 근전도 측정을 통해 파워보행과 일반보행 시 하지근비 평균적분 근전도 및 최대적분 근전도를 측정하였다. 피험자는 근골격계에 이상이 없는 남자 대학생 17명으로 선정하였으며, 실험 간 140 beat/min속도로 보행을 실시하였다. 일반보행 동작과 파워보행 동작의 구간별 근전도치를 비교해 본 결과 일반보행 동작 시 보다, 강하고 힘차게 걷는 파워보행 동작 시에서 측정하고자 하는 하지근의 대부분 근육활동이 전체적으로 높게 나타났다. 특히 보행 동작에서 주동근이 되는 대퇴직근 내측광근, 외측광근의 활동이 일반보행 동작보다 파워보행 동작에서 높게 나타났으며, 발이 지면에서 떨어지기 전 지면을 힘껏 밀 때 사용되어지는 내측비복근, 외측비복근에서, 발뒤꿈치가 지면에 닿을 때 사용되어지는 전경골근에서 일반보행동작보다 파워보행 동작에서 전체적으로 통계적으로 높은 유의한 근육활동이 나타났다. 이는 파워보행 동작이 일반 보행 동작보다 더욱 많은 근육활동을 유발시킴으로 하지근의 근육강화 및 에너지 소비에 직접적으로 도움이 되는 유산소 운동으로써 파워보행을 활용 할 수 있을 것이라 판단되어진다. 따라서 본 연구의 결과 파워보행 동작이 건강유지와 다이어트를 원하는 사람들에게 일반보행 보다 더 높은 효과가 있을 것으로 판단된다.

• 재활복지
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• 제21권3호
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• pp.147-163
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• 2017

본 연구의 목적은 승마기구운동이 뇌졸중환자의 하지 골격근 두께에 미치는 영향을 알아보기 위해서 시행되었다. 연구대상자는 G 광역시에 위치한 A병원에 입원중인 뇌졸중환자 30명을 대상으로 선정하였다. 본 연구의 대상자들은 두 그룹으로 승마기구운동군 15명, 대조군 15명으로 무작위 배치되었다. 승마기구운동군은 실험 기간 총 6주 동안 주 3회, 회당 20분 운동을 실시하였다. 넙다리곧은근, 앞정강근, 안쪽 장딴지근, 중간볼기근의 두께 변화를 측정하기 위해서 초음파 영상촬영 장치를 사용하였다. 30명의 연구대상자들에 대한 측정은 운동 전, 운동 6주 후에 수행되었다. 데이터의 분석은 통계적 유의수준을 결정하기 위해서 독립 t-검정과 대응표본 t-검정을 이용하였다. 각 그룹 간 중재 전 후 차이값에 대한 근 두께의 비교에서는 네 근육 모두 유의한 차이가 나타났다. 승마 운동군은 근육 두께에 대한 운동 전과 후의 비교에서 네 근육 모두 유의한 증가를 보였다. 대조군은 운동 전과 후의 비교에서 RF, GM, TA에서 유의한 증가가 있었다. 결과적으로 승마기구운동은 무릎의 안정화와 하지 폄근의 활성으로 인해 하지 근두께의 향상이 나타났다.

• 한국운동역학회지
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• 제32권1호
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• pp.17-23
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• 2022

Objective: The aim of this study was to investigate the effect Tiger-step walking on the movement of the lower extremities during walking. Method: Twenty healthy male adults who had no experience of musculoskeletal injuries on lower extremities in the last six months (age: 26.85 ± 3.28 yrs, height: 174.6 ± 3.72 cm, weight: 73.65 ± 7.48 kg) participated in this study. In this study, 7-segments whole-body model (pelvis, both side of thigh, shank and foot) was used and 29 reflective markers and cluster were attached to the body to identify the segments during the gait. A 3-dimensional motion analysis with 8 infrared cameras and 7 channeled EMG was performed to find the effect of tigerstep on uphill walking. To verify the tigerstep effect, a one-way ANOVA with a repeated measure was used and the statistical significance level was set at α=.05. Results: Firstly, Both Tiger-steps showed a significant increase in stance time and stride length compared with normal walking (p<.05), while both Tiger-steps shown significantly reduced cadence compared to normal walking (p<.05). Secondly, both Tiger-steps revealed significantly increased in hip and ankle joint range of motion compared with normal walking at all planes (p<.05). On the other hand, both Tiger-steps showed significantly increased knee joint range of motion compared with normal walking at the frontal and transverse planes (p<.05). Lastly, Gluteus maximus, biceps femoris, medial gastrocnemius, tibialis anterior of both tiger-step revealed significantly increased muscle activation compared with normal walking in gait cycle and stance phase (p<.05). On the other hand, in swing phase, the muscle activity of the vastus medialis, biceps femoris, tibialis anterior of both tiger-step significantly increased compared with those of normal walking (p <.05). Conclusion: As a result of this study, Tiger step revealed increased in 3d range of motion of lower extremity joints as well as the muscle activities associated with range of motion. These findings were evaluated as an increase in stride length, which is essential for efficient walking. Therefore, the finding of this study prove the effectiveness of the tiger step when walking uphill, and it is thought that it will help develop a more efficient tiger step in the future, which has not been scientifically proven.

• 한국전문물리치료학회지
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• 제9권1호
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• pp.17-42
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• 2002

The purpose of this study was to investigate the treatment effect of three interventions on the disuse atrophy of rat hindlimb after two weeks suspension. Forty-eight 11~12 weeks old female Sprague-Dawley white rats were divided into four intervention groups: 1) suspension only (S; n=10), 2) intensive weight bearing treadmill (IWBT; n=10), 3) electrical stimulation (ES; n=9), 4) 2)+3) (ES/IWBT; n=9). Another 10 rats received no intervention or hindlimb suspension and served as controls (C). After the interventions, 1) the cross-sectional area (CSA), 2) the ratio of white muscle fiber composition (WMFC), 3) isometric tetanic tension (ITT), and 4) muscle weights (MWs) were measured from the four calf muscle specimens. The results were as follows: 1. In all intervention groups, the CSAs of medial and lateral gastrocnemius (MG LG), soleus (SOL), and flexor digitorum superficialis (FDS) decreased when compared to the control (C) group (p<.05). The CSA increased in FDS and LG for the IWBT group, in SOL for the ES/IWBT group compared to the S only group (p<.05). 2. The ratios of WMFC in MG, LG, SOL, and FDS increased compared to the C group for all interventions (p<.05). The ratios of WMFC decreased in SOL and LG for the IWBT group, in SOL for the ES/IWBT group compared to the S only group, and decreased in SOL for the ES/IWBT group compared to the IWBT group (p<.05). 3. The ITT in the MG, LG, SOL, and FDS decreased compared to the C group for all interventions (p<.05). The ITT increased in MG LG/FDS, SOL, and the whole calf muscles (WCMs) in the IWBT, ES and ES/IWBT groups compared to the S only group (p<.05). 4. The MWs in MG LG/FDS, SOL, WCMs decreased compared to the C group for all interventions (p<.05). The MWs increased in MG LG/FDS and WCMs for the IWBT group, in SOL for the ES group, and in SOL for the ES/IWBT group compared to the S only group (p<.05). 5. In atrophied muscles, the IWBT group showed the best recovery and the ES/IWBT and ES groups followed in decreasing order. The most susceptible muscle to disuse atrophy was the SOL. But conversely, it showed the best recovery in the ES/IWBT group. After two weeks of hindlimb suspension, the calf muscles of rats atrophied and their isometric tension decreased. These changes were best reversed by hindlimb-focused treadmill activity. The next best results were achieved by electrical stimulation combined with the treadmill followed by only electrical stimulation. These findings indicate that full weight bearing treadmill activity alone or in combination with electrical stimulation are effective treatments for non-weight bearing induced muscle atrophy. Further study of the effect of different intensities of electrical stimulation and variations in the duration period of full weight bearing treadmill activity on disuse atrophy is recommended.

• 재활복지공학회논문지
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• 제6권2호
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• pp.43-48
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• 2012

본 논문에서는 Electromyogram(EMG) 신호와 허벅지 각도 측정 장치, 발바닥 저항 센서를 이용하여 보행의 단계를 판단하는 방법을 제시한다. 신호의 측정을 위하여 건강한 성인 남성 5명을 대상으로 실험을 실시하였고 정상 보행에서의 EMG, 허벅지 각도, 발바닥 저항 센서를 통한 변화를 측정 하였다. EMG 신호의 획득을 위하여 실험자의 대퇴 사두근, 대퇴 이두근, 전경골근, 장딴지근에 Ag/AgCl 표면 전극을 부착하였으며, 양측 발뒤꿈치와 앞꿈치에 저항센서를 부착 하였다. 허벅지 각도 측정 장치는 굴곡 25도, 신전 20도 까지 범위를 가지며 이를 통하여 허벅지의 각도를 측정 하였다. 실험 결과 보행 시 입각기와 유각기를 명확히 판단 할 수 있었으며 세부적으로 8단계의 보행 상태를 판단 할 수 있었다.

• 한국운동역학회지
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• 제25권1호
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• pp.103-111
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• 2015

Objective : The purpose of this study was to evaluate the effect for running shoes with resilience of midsole on biomechanical properties. Methods : 10 healthy males who had no history of injury in the lower extremity with an average age of 26.5 year(SD=1.84), height of 172.22 cm(SD=4.44) and weight of 67.51 kg(SD=6.17) participated in this study. All subjects ran on the treadmill wearing three different running shoes. Foot pressure data was collected using Pedar-X system(Novel Gmbh, Germany) operating at 100 Hz. Surface EMG signals for biceps femoris, rectus femoris, vastus lateralis, medial lateralis, tibialis anterior, medial gastrocnemius, soleus and peroneus longus were acquired at 1000 Hz using Bignoli 8 System(Delsys Inc., USA). To normalize the difference of the magnitude of muscle contractions, it was expressed as a percentage relative to the maximum voluntary contraction (MVC). The impact resilience of the midsole data was collected using Fastcam SA5 system(Photron Inc., USA). Collected data was analyzed using One-way ANOVA in order to investigate the effects of each running shoes. Results : TPU midsole was significantly wider in contact area than EVA, TPE midsole in midfoot and higher in EMG activity than EVA midsole at biceps femoris. TPE midsole was significantly wider in contact area than EVA midsole in rearfoot and higher in peak pressure than EVA midsole in forefoot. EVA midsole was significantly higher in EMG activity than TPU midsole at tibia anterior. In medial resilience of midsoles, TPE midsole was significantly higher than EVA, TPU midsole. Conclusion : TPU midsole can reduce the load on the midfoot effectively and activate tibialis anterior, biceps femoris to give help to running.

• Advances in materials Research
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• 제3권4호
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• pp.183-197
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• 2014

Copolymers of gelatin and poly (vinyl alcohol), (PVA) grafted by acrylic acid (AAc) with excellent water absorption and retention abilities under neutral conditions were successfully synthesized using $^{60}Co$ gamma radiations in presence of ammonium persulphate (APS), as water soluble initiator and sodium bicarbonate ($NaHCO_3$) as foaming agent. The optimum synthesis conditions pertaining to maximum swelling percentage were evaluated as a function of gelatin/PVA ratio, amount of water, concentration of APS, $NaHCO_3$, monomer concentration and total irradiation dose. Maximum percent swelling (1694.59%) of the copolymer, gelatin-co-PVA, was obtained at optimum $[APS]=2.92{\times}10^{-1}mol/L$, $[NaHCO_3]=7.94{\times}10^{-2}mol/L$ and 1.5 mL of water at total dose of 31.104 kGy while in case of grafted copolymer, (gelatin-co-PVA)-g-poly(AAc), maximum percent swelling (560.86%) was obtained using $8.014{\times}10^{-1}mol/L$ of AAc in 9 mL water with 31.104 kGy preirradiation dose. The pristine and grafted copolymers were characterized by Fourier Transform Infrared Spectroscopy (FTIR), Scanning electron Microscopy (SEM), Thermal gravimetric analysis (TGA) and X-Ray Diffraction (XRD) methods. The copolymers loaded with an antiseptic, Povidone, were used as wound dressing materials for wounded gastrocnemius muscle of mice and the results exhibit that (gelatin-co-PVA)-g-poly (AAc) copolymer is a potent wound dressing material as compared to the copolymer.

• 대한기계학회논문집B
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• 제41권3호
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• pp.153-160
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• 2017

보행 분석은 다양한 지형에서 수행되고 있으나 지형이 변화되는 시점에서의 보행 분석 연구는 보고된 바 없다. 본 연구의 목적은 삼각경사 보행 시 지형이 변화되는 시점에서 발목 및 무릎 관절의 운동학과 운동역학을 평지 보행과 비교 분석하는 것이다. 3차원 동작분석 시스템과 지면 반력기를 사용하여 성인 남성 18명의 하지 운동학 및 운동역학 자료를 획득하였다. 삼각경사 보행에서 최대 발목 배측굴곡각 및 모멘트와 최대 무릎 신전 모멘트가 평지보행과 비교하였을 때 증가하였다(p<0.05). 삼각경사의 상승경사 보행 시 $50^{\circ}$가 넘는 무릎 굽힘각과 그 시기에 발생하는 큰 무릎 신전 모멘트는 슬개대퇴증후군의 위험을 높일 수 있을 것으로 보인다. 또한 삼각경사의 하강경사 보행에서 증가된 발목 배측굴곡 운동범위는 비복근과 아킬레스건 부상 위험을 높일 수 있을 것으로 보인다.

• 대한물리의학회지
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• 제5권3호
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• pp.487-498
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• 2010

Purpose : To investigate the immediate effects of transcutaneous electrical nerve stimulation(TENS) on the spasticity and the balance in the stroke patients. Methods : 26 subjects with spasticity over lower limbs were allocated randomly into two groups : (1) TENS group, (2) placebo-TENS group. TENS was applied on the both gastrocnemius for 60 minutes(100 Hz, 0.25 ms, 2 times sensory threshold). The modified Ashworth Scale(MAS) and Manual Muscle Tester were used to assess the spasticity of the ankle plantar flexors. Static balance under three conditions was measured by force-plate; in (1) the condition of standing with eyes opened, (2) with eyes closed and (3) the condition of standing on unstable surface with eyes opened. Results : When compared with the pre and post TENS application, TENS showed significant reduction of ankle spasticity in MAS and MMT measurement. Also, Application of high-frequency TENS improved the balance under three conditions. Conclusion : A single session of TENS to stroke patients could reduce spasticity and improve the balance.