• Archives of Reconstructive Microsurgery
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• 제8권2호
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• pp.130-138
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• 1999

The lower extremity injuries are extremely increasing with the development of industrial & transportational technology. For the lower extremity injuries that result from high-energy forces, particularly those in which soft tissue and large segments of bone have been destroyed and there is some degree of vascular compromise, the problems in reconstruction are major and more complex. In such cases local muscle coverage is probably unsuccessful, because adjacent muscles are destroyed much more than one can initially expect. Reconstruction of the lower extremity has been planned by dividing the lower leg into three parts traditionally The flaps available in each of the three parts are gastrocnemius flap for proximal one third, soleus flap for middle one third and free flap transfer for lower one third. Microvascular surgery can provide the necessary soft tissue coverage from the remote donnor area by free flap transfer into the defect. Correct selection of the appropriate recipient vessels is difficult and remains the most important factor in successful free flap transfer. Vascular anastomosis to recipient vessels distal to the zone of injury has been advocated and retrograde flow flaps are well established in island flaps. Retrograde flow anastomosis could not interrupt the major blood vessels which were essential for survival of the distal limb, the compromise of fracture or wound healing might be prevented. During 5 years, from March 1993 to Feb. 1998, we have done 68 free flap transfers in 61 patients to reconstruct the lower extremity. From analysis of the cases, we concluded that for the reconstruction of the lower extremity, free flap transfer yields a more esthetic and functional results.

• 한국전문물리치료학회지
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• 제15권1호
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• pp.1-11
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• 2008

The purpose of this study was to assess the influence of two shoe size conditions on foot pressure, ground reaction force (GRF), and lower extremity muscle fatigue. Seven healthy men participated. They randomly performed walking and running in two different conditions: proper shoe size and 10 mm greater than proper shoe size. Peak foot pressure, and vertical, anterior and mediolateral force components were recorded with the Parotec system and Kisler force platform. To assess fatigue, the participants performed treadmill running for twenty-five minutes twice, each time wearing a different shoe size. Surface electromyography was used to confirm localized muscle fatigue using power spectral analysis of four muscles (tibialis anterior, gastrocnemius medialis, rectus femoris, and biceps femoris). The results were as follows: 1) In walking conditions, there was a significantly higher peak pressure in the 10 mm greater than proper shoe size insole sensor 1, 2, 14, and 18 (p<.05). 2) In running conditions, there was a significantly higher peak pressure in the 10 mm greater than proper shoe size insole sensor 5, 14, and 15 (p<.05). 3) In walking conditions, there was a significantly higher first maximal vertical GRF in the 10 mm greater than proper shoe size (p<.05). 4) In running conditions, no GRF components were significantly different between each shoe size condition (p>.05). 5) Muscle fatigue indexes of the tibialis anterior and rectus femoris were significantly increased in the 10 mm greater than proper shoe size condition. These results indicate that wearing shoes that are too large could further exacerbate the problems of increased foot pressure, vertical GRF, and muscle fatigue.

• 한국운동역학회지
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• 제19권2호
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• pp.257-264
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• 2009

본 연구의 목적은 파킨슨 환자들에게 일상생활 속에서 빈번히 수행되는 방향전환 동작 중에 작용하는 하지의 운동학 및 근육의 활동을 규명하는데 있다. 호엔야르 $1.5{\sim}4$척도의 60대 파킨슨 환자 7명이 본 실험에 참여하였다. 실험실 바닥에 직선($0^{\circ}$) 및 방향전환($60^{\circ}$, $90^{\circ}$, $120^{\circ}$) 보행로를 만들었다. 보행로에 5cm 넓이의 검은색 접착테이프를 붙여 놓아, 그 경로를 따라 무작위 순서로 지나가도록 하였다. 하지의 운동학적 변인을 측정하기 위해 해당부실에 21개의 마커를 부착하였으며, 근전도 변인을 측정하기 위해 우측 하지의 장내전근, 중둔근, 대둔근, 대퇴이두근, 대퇴직근, 비복근, 전경골근에 전극을 부착하였다. 방향전환 각도별(4수준: $0^{\circ}$, $60^{\circ}$, $90^{\circ}$, $120^{\circ}$)로 얻은 하지의 운동학 및 근전도 변인의 차이를 규명하기 위하여 반복이 있는 일원 변량 분석을 실시하였다. 파킨슨 환자들은 방향전환시 활보장과 보간을 감소시키는 것으로 나타났으며, 하지에 작용하는 근육활동에는 차이가 없는 것으로 나타났다.

• 한국운동역학회지
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• 제19권2호
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• pp.245-255
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• 2009

본 연구는 낙상을 경험한 여성노인 20명을 각각 10명씩 연령으로 집단을 구분하고 보행 시 하지관절의 협응 능력을 분석하여 운동과학적인 기초자료를 제시하고, 불안정적인 측면의 요소에 효과적으로 대처할 수 있도록 하기 위한 것이다. 이를 위해 보행 시 하지관절의 균형에 대한 기전과 차이를 동작분석과 근전도를 이용하여 비교 분석하여 다음과 같은 결론을 얻었다. 첫째, 보행 시 고관절의 움직임에서 연령증가로 인해 충분하지 못한 지지역할로 보행자세가 저하되어 안정적 이지 못한 패턴을 보였다. 둘째, 무릎관절의 움직임에서 좌우측의 보행패턴이 상이하게 이루어지는 경향을 나타내었다. 셋째, 발목관절의 움직임에서 연령증가와 함께 활보패턴이 비정상적인 경향을 나타내었다. 또한 보행 시 하지 주요근육의 활성정도에 대해 대퇴직근과 대퇴이두근은 무릎의 굴곡을 막기 위해 근수축 활성이 증가되어 전진하는 전기적 특성을 보였고, 전경골근과 내측비복근은 이동 시 높은 전기적 수요를 나타내어 저측굴곡의 비율을 줄여 보행하는 특성을 나타내었다.

• 국제물리치료학회지
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• 제11권2호
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• pp.2021-2027
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• 2020

Background: Previous robot-mediated gait training has been proven several limitations such as pointless repeated motion training, decreased presence, etc. In this research, adult stroke patients were participated in robot-mediated gait training accompanied with or without virtual reality program. Objectives: Exploring whether the results indicated virtual reality system has contribution to muscle strength and balance ability. Design: A case series research, cross-over trial. Methods: Eleven participants (male 4, female 7) with adults diagnosed as stroke from medical doctor ware engaged. The participants received 2 treatment sessions of identical duration, robot-assisted gait training with virtual reality and robot-assisted gait training with screen-off randomly crossed over include 1-day for each person of wash-out period. The parameter was muscle activity, the researchers assessed sEMG (surface electromyography). Results: The result showed less muscle activities during training in robot-assisted gait training with virtual reality circumstances, and these indicated muscles were gluteus medius muscle, vastus medialis muscle, vastus intermedius and vastus lateralis muscle, semimembranosus muscle, gastrocnemius-lateral head, and soleus muscle (P<.05). Conclusion: In this study, we analyzed the outcome of muscle activity for clinical inference of robot-assisted gait training with virtual reality (VR). Less muscle activity was measured in the treatment accompanied by VR, therefore, a more systematic, in-depth and well-founded level of follow-up research is needed.

• 대한물리의학회지
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• 제5권2호
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• pp.223-231
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• 2010

Purpose : The Purpose of this study was to compare muscle activation and foot pressure on baby carrier and sling for baby care. Methods : Thirty one women subjects (mean age 23.2 years) participated in four static conditions : unloaded quite standing, carrying an anterior baby carrier, carrying a posterior baby carrier, and sling. The baby carrier and sling were loaded with baby model that filled 7.6kg loads. Surface electromyography was used to measure activity in the internal oblique, T4, L3, L5 paraspinal muscle, vastus medialis, biceps femoris, tibialis anterior, and gastrocnemius for four conditions. And foot pressure was measured by using MatScan system(Tekscan, USA). Results : The activation of Biceps femoris, T4, L3, and L5 paraspinal muscle were significant differences(p<.05), but other muscles were no significant differences in four conditions(p>.05). Right foot contact area and peak pressure of right mid foot area were significant differences in four conditions(p<.05). Conclusion : The results of this study indicate that the use of baby carrier of sling for baby care were influenced postural responses of young women. Further work is recommended to find out the influences of various assistive devices for baby care.

• 한국정밀공학회지
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• 제33권9호
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• pp.753-760
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• 2016

This study was undertaken to develop a bed-type cycling system of lower limbs for rehabilitation. This system consists of two modes of cycling: active and passive. Different velocity and loads are provided for improving the muscle function recovery and increasing the muscular strength. To analyze the muscle activity pattern, we measured muscular activity of lower limbs in the rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA), medial gastrocnemius (MG), and soleus (SOL), while cycling in the supine position, and based on the pedaling direction. A total of 18 young and 23 elderly, healthy subjects participated in this study. Muscle activity of MG muscles was significantly different in the two age groups. This study could provide the reference data to develop cycling exercises for lower limbs during rehabilitation of the elderly patients.

• 한국정밀공학회지
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• 제28권12호
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• pp.1425-1433
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• 2011

We investigated an early rehabilitation training system that increase the intensity of patient rehabilitation training to shorten the time it takes for patients to progress to a secondary rehabilitation training stage by allowing patients incapable of self-ambulation. It consisted of tilting bed, unstable platform using strong springs and training program for lower limb rehabilitation. We performed experimental study on the muscular activities of tibialis anterior(TA), soleus(SO), gastrocnemius(GA) in the lower extremities during training of straight line, circle, quardrangle pattern during tilting angle of $30^{\circ}$, $60^{\circ}$. The muscle activities were higher during tilting angle of $30^{\circ}$ than $60^{\circ}$. In straight line pattern, the muscle activities were higher by SO, GA and TA during medio-lateral direction, however, by TA, SO and GA during anterio-posterior direction. In circle and quardrangle pattern, the muscle activities were higher by TA, SO and GA during clockwise and counterclockwise direction. The results indicate that the early rehabilitation training system could be applied to improve the lower extremity muscular strength for elderly and patients, especially, stroke.

• The Korean Journal of Physiology and Pharmacology
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• 제25권6호
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• pp.585-592
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• 2021

Cisplatin has been reported to cause side effects such as muscle wasting in humans and rodents. The physiological mechanisms involved in preventing muscle wasting, such as the regulation of AKT, PGC1-α, and autophagy-related factor FOXO3a by MuRF 1 and Atrogin-1, remain unclear following different types of exercise and in various skeletal muscle types. Eight-week-old male Wistar rats (n = 34) were assigned to one of four groups: control (CON, n = 6), cisplatin injection (1 mg/kg) without exercise (CC, n = 8), cisplatin (1 mg/kg) + resistance exercise (CRE, n = 9) group, and cisplatin (1 mg/kg) + aerobic exercise (CAE, n = 11). The CRE group performed progressive ladder exercise (starting with 10% of body weight on a 1-m ladder with 2-cm-interval grids, at 85°) for 8 weeks. The CAE group exercised by treadmill running (20 m/min for 60 min daily, 4 times/week) for 8 weeks. Compared with the CC group, the levels of the autophagy-related factors BNIP3, Beclin 1, LC3-II/I ratio, p62, and FOXO3a in the gastrocnemius and soleus muscles were significantly decreased in the CRE and CAE groups. The CRE and CAE groups further showed significantly decreased MuRF 1 and Atrogin-1 levels and increased phosphorylation of AKT, FOXO3a, and PGC1-α. These results suggest that both ladder and aerobic exercise directly affected muscle wasting by modulating the AKT/PGC1-α/FOXO3a signaling pathways regardless of the skeletal muscle type.

• 한국운동역학회지
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• 제29권2호
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• pp.105-112
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• 2019

Objective: The main purpose of this study was to investigate the effects of wearing an ankle weight belt while performing gait in water by focusing on the effect of using ankle weights have on the gait kinematics and the muscle activities for developing optimum training strategies. Method: A total of 10 healthy male university students were recruited for the study. Each participant was instructed to perform 3 gait conditions; normal walking over ground, walking in water chest height, and walking in water chest height while using ankle weights. All walking conditions were set at control speed of $4km/h{\pm}0.05km/h$. The depth of the swimming pool was at 1.3 m, approximately chest height. The motion capture data was recorded using 6 digital cameras and the EMG was recorded using waterproof Mini Wave. From the motion capture data, the following variables were calculated for analysis; double and single support phase (s), swing phase (s), step length (%height), step rate (m/s), ankle, knee, and hip joint angles ($^{\circ}$). From the electromyography the %RVC of the lower limb muscles medial gastrocnemius, rectus femoris, erector spinae, semitendinosus, tibialis anterior, vastus lateralis oblique was calculated. Results: The results show significant differences between the gait time, and step length between the right and left leg. Additionally, the joint angular velocities and gait velocity were significantly affected by the water resistance. As expected, the use of the ankle weights increased all of the lower leg maximum muscle activities except for the lower back muscle. Conclusion: In conclusion, the ankle weights can be shown to stimulate more muscle activity during walking in chest height water and therefore, may be useful for rehabilitation purposes.