• Journal of Korean Physical Therapy Science
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• v.28 no.1
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• pp.76-84
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• 2021

Background: In clinical practice, active knee extension (AKE) test has been widely used to measure hamstring flexibility. During the AKE test, the knee extension is repeated six times. The first five repetitions are considered as warm-up, and the sixth is used as baseline. In order to accurately measure the subject's inherent flexibility, warm-up trials have been proposed as mentioned above; but currently, the evidence is insufficient. Design: Cross-sectional study. Methods: Forty-three healthy adults participated in this study. The AKE was performed slowly after flexing the hip and knee joints by 90° in a supine position. The knee was extended as far as could be done without causing discomfort or pain. When reaching the end range, knee flexion was performed without stopping. As per standard protocol, the subjects performed the knee extension six times. Results: There was no significant difference between the AKE value in the first trial with those in the other five trials. During the repetitions, the average value in the group with higher flexibility tended to decrease and the Intraclass correlation coefficient gradually decreased. Conclusion: Successive repetitions of the AKE test can misrepresent an individual's inherent hamstring flexibility. In order to avoid a decrease in hamstring flexibility, it is strongly recommended that individuals with high initial hamstring flexibility avoid unnecessary repetitions of the AKE test.

• Physical Therapy Korea
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• v.28 no.1
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• pp.13-17
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• 2021

A normal range of motion is essential for performing activities of daily living. The capsular pattern is the proportional motion restriction in range of motion during passive exercises due to tightness of the joint capsule. Although the capsular pattern is widely referred to in clinical practice, there is no scientific evidence to support the concept. In this review, the appropriateness of the capsular pattern for evaluation of joint pathology was assessed. In the Textbook of Orthopaedic Medicine written by Cyriax, the capsular pattern did not specify how much reduction in angular motion is considered motion restriction. As the definition proposed initially was unclear, different methods have been used in previous studies investigating capsular pattern. In addition, the capsular pattern described all the major joints of the human body, but only the hip joint, knee joint, and shoulder joint were studied in experimental studies. Sensitivity and specificity were reported in one study and were meaningful in specific pathologies (loss of extension to loss of flexion). There was no consensus on the reliability and validity. In summary, the capsular pattern suggested by Cyriax or Kaltenborn is not supported or applies only to certain conditions. Various components around a joint complement each other and provide stability to the joint. It is recommended that the therapist perform multiple assessments rather than rely on a single assessment when evaluating joints.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.4
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• pp.1-11
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• 2021

PURPOSE: Lumbosacral orthosis (LSO) is often used to help manage low back pain because it is economical and effective. This study examined the effects of flexible and semirigid LSOs on the lower-limb joint angles in walking in patients with chronic low back pain. METHODS: The effects of the lumbosacral orthosis during gait on the sagittal, frontal, horizontal planes and the change in lower limb angle were examined in fourteen chronic low back pain patients who walked without wearing a LSO, wearing a flexible LSO, and wearing a semirigid LSO in random order for three-dimensional motion analysis. RESULTS: The flexion of the hip and knee joints decreased more significantly during walking with an LSO than without one. The genu valgum angles were reduced in the stance phase more during walking with an LSO than without one. The external rotation of the knee joints in the stance phase increased more during walking with an LSO than without one. CONCLUSION: The angles of the lower-limb joints of patients with chronic low back pain are affected by walking with an LSO, and the effects increased as the LSO stiffened.

• Journal of Korean Physical Therapy Science
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• v.30 no.1
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• pp.31-40
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• 2023

Hamstring flexibility is an important factor that affects muscle performance of the lower extremities and is closely associated with sports injuries. Therefore, evaluation of flexibility is important in clinical practice. Results of evaluation are determined by types of tests and cut-off values used; therefore, accurate and detailed understanding of these is necessary before examination. Although the straight leg raise and sit and reach tests are used to evaluate hamstring extensibility, structures including the nerves, fascia, and other muscles can significantly confound the results of these tests. The knee extension test is performed at 90° of hip flexion to minimize the posterior pelvic tilt that occurs during the straight leg test. The knee extension test is most recommended for selective evaluation of hamstring flexibility. The knee extension test is classified into active and passive tests. The cut-off value is usually set at 20° for the active and at 10° for the passive knee extension test. Although a strong association is observed between the two tests, the active knee extension test is preferred in clinical practice because it can be performed by a single examiner, which serves as an advantage. Age, sex, and warm-up exercise tend to affect flexibility; therefore, results should be interpreted with caution. Detailed understanding of each flexibility test is important for reliable evaluation.

• The Journal of Korea Robotics Society
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• v.18 no.4
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• pp.496-504
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• 2023

This paper recognizes the motion intention of the wearer using a muscle stiffness sensor and proposes a control system for a wearable robot based on this. The proposed system recognizes the onset time of the motion using sensor data, determines the assistance mode, and provides assistive torque to the hip flexion/extension motion of the wearer through the generated reference trajectory according to the determined mode. The onset time of motion was detected using the CUSUM algorithm from the muscle stiffness sensor, and by comparing the detection results of the onset time with the EMG sensor and IMU, it verified its applicability as an input device for recognizing the intention of the wearer before motion. In addition, the stability of the proposed method was confirmed by comparing the results detected according to the walking speed of two subjects (1 male and 1 female). Based on these results, the assistance mode (gait assistance mode and muscle strengthening mode) was determined based on the detection results of onset time, and a reference trajectory was generated through cubic spline interpolation according to the determined assistance mode. And, the practicality of the proposed system was also confirmed by applying it to an actual wearable robot.

• The Journal of Korean Physical Therapy
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• v.36 no.1
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• pp.33-38
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• 2024

Purpose: This study investigated the effect of proprioceptive neuromuscular facilitation (PNF) on gait speed in a stroke patient with genu recurvatum. Methods: The subject was a 52-year-old female diagnosed with stroke. Information on health was collected through client Interview based on the International Classification of Functioning, Disability and Health (ICF). The ICF was used to identify connections between functional problems, and for diagnosis, and functional problems were described using ICF terms. For prognostic purposes, comprehensive goals for functional activity and participation level are presented as long- and short-term goals. Intervention was performed using an exercise program composed of techniques and principles based on PNF concepts for 50 minutes a day, 3 times a week, for 6 weeks. Gait speed and lower limb strength before to after intervention differences were used as study outcomes. Results: Clinical advantages were observed in body function (3.6kg increase in knee extension strength, 1.4kg increase in knee flexion strength, 0.9kg increase in hip abduction). Gait speed, which was the patient's primary limitation, was improved by 0.2m/sec. Conclusion: Based on the results of this study, application of the PNF concept would appear to improve gait speed and genu recurvatum in stroke patients.

• Journal of Community Nutrition
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• v.1 no.2
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• pp.98-107
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• 1999

The purpose of this study was to investigate Bone Mineral Density(BMD) and affecting factors on BMD of college women in Seoul. The subjects were 47 healthy college women aged 18-25 years. Antrophometric and body fat measurements were performed by Bioelectrical Impedance Fatness Analyzer(Tanita TVF 202). Blood pressure and pulse frequency were measured. Dietary intakes and general living habits were examined through questionnaires and nutrient intakes were analyzed by Computer Aided Nutritional Analysis(CAN) program for professional. Serum total cholesterol, TG(triglyceride), HDL-cholesterol, total protein, albumin, GOT, calcium were measured by Spotchem(SP-4410). Serum osteocalcin and alkaline phosphatase(ALP) were measured to monitor bone formation. BMD of lumbar spine(L2-L4), right hip(neck, ward's triangle, trochanter) and right forearm were measured by Dual Energy X-ray Absorptiometry(DEXA). Muscle strength was measured by examining leg flexion strength(right and left), leg extension power(right and left), handgrip power(right and left) and back strength. All data were statistically analyzed by the SAS PC package program. BMD of college women was normal(by WHO, 1994). Their muscle strength was bad(by national fitness guidebook, 1995). Only a mall number of them exercised (32.6% of subjects). There was no significant difference among BMD, muscle strength and % body fat(p<0.05). There were significant differences between BMD and total cholesterol as well as TG and VLDL-cholesterol(p<0.05). Total cholesterol was associated with decreasing BMD of the right forearm(p<0.05). TG and VLDL-cholesterol are associated with increasing BMD of right hip ward's triangle(p<0.05). There were significant differences among BMD, ALP and serum total protein. ALP was associated with decreasing BMD of the right forearm(p<0.05). There were significant differences between BMD and Ca as well as between Na and K intakes (p<0.05). Intakes of Na and K were associated with decreasing BMD of the right forearm (UD)(p<0.05). There were significant differences between in BMD and pulse frequently and serum albumin (p<0.05). Serum albumin is associated with increasing BMD of L3-L4(p<0.05), right hip neck(p<0.05). %Body fat, TG, VLDL-C, Ca intake, pulse frequency and serum albumin were associated with increasing BMD(p<0.05). Intakes of Na and K, ALP, total cholesterol, total cholesterol, total protein and height are associated with decreasing BMD(p<0.05). Overall results indicate that Ca intake but to be moderate in protein and Na intakes in order to increase BMD. Body exercise was recommended to increase BMD as well.

• Journal of Korean Physical Therapy Science
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• v.10 no.2
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• pp.37-41
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• 2003

The aim of this study is to present the basic reference data Effect of uneffected side insole on Gait Pattern in Hemiplegia Patients. The basic gait parameters were extracted from 10 Adult Hemiplegia Patients, 5 left Hemiplegia Patients and 5 right Hemiplegia Patients, 50 to 60 years of age using VICON 512 Motion Analyzer. The results were as follows; 1) The mean Cadence of the shoes to the 1cm insole in shoes were $70.58{\pm}12.67\;steps/min$, to $77.28{\pm}14.58\;steps/min$.(p>0.05) 2) The mean Walking Speed of the shoes to the 1cm insole in shoes were $0.40{\pm}0.17\;m/s$, to $0.49{\pm}0.18\;m/s$.(p>0.05) 3) The mean Stride Length of the shoes to the 1cm insole in shoes were $0.67{\pm}0.20\;m$, to $0.75{\pm}0.19m$.(p>0.05) 4) The mean anterior angles of pint on the pelvic tilt for different the shoes to the 1cm insole in shoes were $13.22{\pm}7.25^{\circ}$, to $11.68{\pm}4.02^{\circ}$.(p>0.06) 5) The mean maximal angles of pint on the hip flexion motion for different the shoes to the 1cm insole in shoes were $24.62{\pm}8.35^{\circ}$, to $24.74{\pm}9.12^{\circ}$.(p>0.05) 6) The mean maximal angles of joint on the knee flexion motion for different the shoes to the 1cm insole in shoes were $34.27{\pm}16.71^{\circ}$, to $35.93{\pm}18.22^{\circ}$.(p>0.05) insole in shoes were $15.97{\pm}7.72^{\circ}$, to $18.77{\pm}11.03^{\circ}$.(p>0.05) 7) The mean maximal angles of joint on the ankle dorsiflexion motion for different the shoes to the 1cm. 8) The mean maximal angles of joint on the ankle plantarflexion motion for different the shoes to the 1cm insole in shoes were $-4.24{\pm}10.66^{\circ}$, to $-7.04{\pm}11.00^{\circ}$.(p<0.05)

• Korean Journal of Human Ecology
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• v.7 no.3
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• pp.35-48
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• 2004

In this study, by determining lower limb movements which cause significant changes in body surface lines, body parts with the greatest maximum expansion and contraction rate respectively were illustrated in descending order. Using unmarried female university students aged 18 - 24 as subjects, a total of 32 body surface categories (15 body surface lines and 17 body surface segment lines) were measured in one static and 9 movement poses. In particular, expansion and contraction levels and rates were measured and used in the analysis. The analysis first involved the calculation of the average measurement per body part in body surface line in static pose as well as of the average expansion and contraction levels and rates in 9 lower limb movements. Two-way MANOVA and multiple comparison analysis (Tukey) were conducted on movements and individual somatotypes regarding measurement per body part and expansion and contraction rates. Movements which cause measurements of body surface lines differed significantly in body surface line in static pose versus in movement were then identified. Among average expansion and contraction rates in such movements, maximum average expansion and contraction levels, maximum average expansion and contraction rate, and classes of expansion and contraction rate were determined per body part. The results of this study are as follows. First, 5 lower limb movements; F2, F5, F6, F7, F8, which caused significant changes in body surface lines were determined and illustrated in table 4. Second, the levels, rates, and classes of expansion and contraction rate per body part are illustrated in Tables 5 and 6. Body parts with the greatest maximum expansion rate were, in descending order: upper segment of center back leg line, upper segment of inner leg line, middle segment of center front leg line, posterior crotch length, anterior knee girth, anterior thigh girth, center back leg line, girth at crotch height, anterior midway thigh girth, hip girth, anterior crotch length, knee girth, waist girth, inner leg line, thigh girth, and crotch length. Those with the greatest maximum contraction rate were, in descending order: anterior crotch length, upper segment of center front leg line, lower segment of center back leg line, center front leg line, and posterior thigh girth. The maximum expansion rates and maximum contraction rates, which ranged from 2.05 to $35.95\%$ and from -0.20 to $-30.16\%$ respectively, were classified per body part into 4 ABCD classes. The body part with maximum expansion was the upper segment of the center back leg line at vertical body surface line, expanding by $35.95\%$ or 16.03cm in F5 flexion movement. In contrast, the body part with maximum contraction was the anterior crotch length at vertical body surface line, contracting by $-30.16\%$ or -10.54cm in F5 flexion movement. Both, however, were the body parts to expand or contract the most among all horizontal and vertical body surface lines.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.12
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• pp.5766-5772
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• 2011

This study was to investigate the change of gait temporal parameter and ankle joint moment between patients with achilles tendinitis and healthy people. Thus, the purpose of this study is to clarify biomechanical change of gait in patients with achilles tendinitis and to find risk factor for prevention of achilles tendinitis. We recruited 20 patients with an achilles tendinitis and 20 healthy people. While subjects shuttled 5 times on 13 m distance with comfortable pace, we examined gait function marker with three-dimensional gait analysis system. All subject outstepped center of forceplate during gait and calculated ankle joint moment using software. Obtained data was analyzed using SPSS 12.0 software. In results, we confirmed that patients with achilles tendinitis showed reduction of extension moment in early initial phase and reduction of flexion moment in mid-stance on hip joint. and reduction of flexion moment in early initial phase and reduction of extension moment in late phase on knee joint. And we identified that patients with achilles tendinitis showed reduction of dorsiflexion moment in early stance phase, maximal plantarflexion moment in mid stance phase, and dorsiflexion moment in late stance phase. Thus, there are biomechanical changes on gait in patients with achilles tendinitis compared to healthy people. And, in clinical settings, they should focus on changes of gait in patients with achilles tendinitis. Further study will be undertaken for the biomechanical changes of patietns with achilles tendinitis.