• 대한정형외과학회지
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• 제56권2호
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• pp.125-133
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• 2021

목적: 고관절 전치환술 후 발생한 장요건 충돌 환자에서 관절경적 장요건 절단술이 유용한 방법인지 알아보기 위하여 임상 결과에 대하여 조사하였다. 대상 및 방법: 2013년 9월부터 2019년 12월까지 고관절 전치환술 후 지속되는 서혜부 통증 및 굴곡 시 통증을 호소하는 18명(19예 고관절)의 환자를 대상으로 하였다. 평균 연령 60세(범위, 50-69세)의 환자들에서 고관절 전치환술 후 증상발현까지는 평균 4개월(범위, 1-9개월)이 소요되었으며, 18명 환자 중 13명에는 직접전방접근법, 5명에는 측방접근법을 통한 고관절 전치환술이 시행되었다. 병력청취, 신체 검사, 혈액검사, 단순 방사선촬영과 컴퓨터 단층촬영을 이용한 영상 검사, 그리고 국소주사치료를 통하여 장요건 충돌을 진단하였다. 이들 모든 환자는 관절경적 처치를 시행받았고, 역동적 신체 검사를 통하여 술장 내에서 충돌이 이루어짐을 확인하였으며, 근육부위까지 도달하도록 관찰된 건 부위 모두에 대하여 건절단술을 시행하였다. 수술 전, 후, 추시기간의 증상 및 통증 정도에 대하여 조사하여 비교하였다. 결과: Western Ontario and McMaster Universities Osteoarthritis Index 점수는 술 전 평균 58.4점(범위, 40-88점)에서 술 후 평균 35.0점(범위, 15-76점)으로 감소하였다. 시각통증등급도 마찬가지로 술 전 평균 4.0 (범위, 2-6)에서 술 후 평균 1.4 (범위, 0-4)로 감소하였다. 16명(88.9%)에서 통증 경감 및 하지거상 시 통증의 호전을 보였으며, 2명에서는 통증 잔존과 술 후 근력 약화를 보였다. 이후 추시기간에서 근력 약화는 호전되었다. 1명의 경우 소전자부에서 장요건 건절단술을 시행하였으나 증상이 지속되었으며, 관절부에서 한 차례 더 건절단술 시행 후 임상증상의 호전을 보였다. 결론: 고관절 전치환술 후 발생한 장요건 충돌에서 고관절 관절경을 이용한 장요건 건절단술은 양호한 임상 결과를 보였다.

• 한방비만학회지
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• 제7권1호
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• pp.87-96
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• 2007

Objectives : This study was performed to evaluate the effect of oriental medical treatment on aged female obese patient. Methods : We experienced an aged female obese patient. We applied herbal medication(Choweseuncheng-tang), electrolipolysis, auricular acupuncture to her from 26th, March. 2007 to 25th, May. 2007. And we examined the changes of her weight, body composition, body size, skin resistance variability, visual analogue scale of knee pain. Results : 1. Her weight decreased from 73.5kg to 71.1kg and body mass index(BMI) decreased from $29.46kg/m^2$ to $28.11kg/m^2$. 2. Body fat mass(BFM) decreased from 25.7kg to 21.6kg but body muscle mass(BMM) increased from 45.1kg to 46.7kg. 3. Waist-hip ratio(WHR) decreased from 0.96 to 0.92. 4. Basal metabolic rate(BMR) increased from 1,273kcal to 1,314kcal. 5. The circumference of upper extremity decreased 1.03cm and lower extremity decreased 1.30cm but the circumference of the muscle of upper extremity increased 0.41cm and lower extremity increased 0.63cm. 6. The circumference of chest and hip are decreased. In addition to the circumference and fat of abdomen are decreased. 7. The visual analogue scale of knee pain is improved. Conclusions : According to above results, oriental medical treatment could be used safety to aged obese patients without loss of fat free mass. The study is more required to aged obese patient from now on.

• 한국전문물리치료학회지
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• 제16권3호
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• pp.9-15
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• 2009

The purpose of this study was to examine contraction of abdominal muscles on surface electromyographic (EMG) activity of superficial cervical flexors, rib cage elevation and angle of craniocervical flexion during deep cervical flexion exercise in supine position. Fifteen healthy subjects were participated for this study. All subjects performed deer cervical flexion exercise with two methods. The positions of two methods were no volitional contraction of abdominal muscles in hook-lying position with 45 degree hip flexion (method 1) and 90 degrees hip and knee flexion with feet off floor for inducing abdominal muscle contraction (method 2). Surface EMG activities were recorded from five muscles (sternocleidmastoid, anterior scaleneus, recuts abdominis, external oblique, internal oblique). And distance of rib cage elevation and angle of craniocervical flexion were measured using a three dimensional motion analysis system. The EMG activity of each muscle was normalized to the value of reference voluntary contraction (%RVC). The EMG activities, distance of rib cage elevation. and angle of craniocervical were compared using a paired t-test between two methods. The results showed that the EMG activities of sternocleidmastoid and anterior scaleneus during deep cervical flexion exercise in method 2 were significantly decreased compared to method 1 (p<.05). Distance of rib cage elevation and angle of craniocervical flexion were significantly decreased in method 2 (p<.05). The findings of this study indicated that deep cervical flexion exercise with contraction of abdominal muscles could be an effective method to prevent substitute motion for rib cage elevation and contraction of superficial neck flexor muscles.

• 한국운동역학회지
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• 제21권3호
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• pp.383-390
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• 2011

In this study, 26 normal subjects were studied to compare the biomechanical Analysis of Lower Limbs on Speed of Nordic Walking. The biomechanical variables were determined by performing three-dimensional gait analysis, and the measurements items were spatial and temporal parameters; vertical ground reaction force; and moments of the hip, knee, and ankle joints. The purpose of this study based on the speed of Nordic Walking to the vertical ground reaction force and joint moments of each were analyzed. Nordic Walking with poles while being whether this weight is reduced to load, not the improvement of muscle activity by identify Nordic walking is to allow efficient. The results of the analysis were follows. The spatial parameters of step length, stride length significantly increased with increase in velocity(p<0.001). The temporal parameters of step time, stride time, the duration of double support use, and the duration of single support use also significantly decreased with increase in velocity(p<0.001), but cadence significantly increased(p<0.01). Analysis of the changes in ground reaction force revealed that vertical ground reaction force significantly increased at the initial contact and the terminal stance and decreased at the mid stance with increase in velocity(p<0.001). Moments of the hip and knee joints significantly in creased with increase in velocity whereas that of the ankle joint did not. Gait analysis revealed that weight-bearing decreased and moments of the hip and knee joints increased with increase in velocity(p<0.01). The results of this study may help people perform Nordic walking efficiently and Nordic walking can be used in the gait training of people with an abnormal gait.

• 한국전문물리치료학회지
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• 제25권1호
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• pp.22-30
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• 2018

Background: Improvement of lumbo-pelvic stability can reduce the compensatory action of the quadratus lumborum (QL) and selectively strengthen the gluteus medius (GM) during side-lying hip abduction (SHA). There are abdominal draw-in maneuver (ADIM) and abdominal bracing (AB) as active ways, and pelvic compression belt (PCB) as a passive way to increase of lumbo-pelvic stability. It is necessary to compare how these stabilization methods affect the selective strengthening of the GM. Objects: To investigate the effects of ADIM, AB, and PCB during SHA on the electromyography (EMG) activity of the GM, QL, external oblique (EO) and internal oblique (IO), and the GM/QL EMG activity ratio. Methods: A total of 20 healthy male adults participated in the study. The subjects performed three conditions in side-lying in random order: SHA with ADIM (SHA-ADIM), SHA with AB (SHA-AB), and SHA with PCB (SHA-PCB). To compare the differences among the three conditions, the EMG activities of the GM, QL, EO and IO, and GM/QL EMG activity ratio were analyzed using one-way repeated ANOVA. Results: The EMG activity of the QL was significantly higher in SHA-AB than in SHA-ADIM and SHA-PCB. The GM/QL activity ratio was significantly higher in SHA-PCB than in SHA-ADIM and SHA-AB. In addition, the figure for SHA-ADIM was significantly higher than that for SHA-AB. In the case of the EO, the figure for SHA-AB was significantly higher than corresponding values for the other two conditions. The figure for SHA-ADIM was significantly higher than that for SHA-PCB. The EMG activity of the IO was significantly higher in SHA-AH than in SHA-PCB. Conclusion: It can be suggested that wearing the PCB can more selectively strengthen the GM than to perform ADIM and AB during SHA. In addition, the ADIM can be recommended when there is a need to strengthen abdominal muscles during SHA.

• 대한골관절종양학회지
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• 제3권1호
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• pp.18-25
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• 1997

Prosthetic replacement is one of the most common methods of reconstruction after resection of malignant tumor around the knee. Gait analysis provides a relative objective data about the gait function of patients with prosthesis. The purpose of this study was to compare the gait pattern of the patients who underwent limb salvage surgery with prosthesis for distal femur and that of patients with prosthesis for proximal tibia. This study included ten patients (4 males, 6 females, mean age 22.7 years, range 14-36) who underwent a wide resection and Kotz hinged modular reconstruction prosthesis replacement and six normal adult(Control). The site of bone tumor was the distal femur (Group 1) in six patients and proximal tibia (Group 2) in 4 patients. The follow-up period ranged from 15 to 82 months (mean : 33 months). The evaluation consisted of clinical assessment, radiographic assessment, gait analysis using VICON 370 Motion Analysis System. The gait analysis included the linear parameters such as, walking velocity, cadence, step length, stride length, stance time, swing time, single support and double support time and the three-dimensional kinematics (joint rotation angle, velocity of joint rotation) of ankle, knee, hip and pelvis in sagittal, coronal and transverse plane. For the kinetic evaluation, the moment of force (unit: Nm/kg) and power (unit: Watt/kg) of ankle, knee and hip joint in sagittal, coronal and transverse plane. In the linear parameters, cadence, velocity, step time and single support were decreased in both group 1 and group 2 compared with control. Double support decreased in group 2 compared with control significantly(p<.05). In contrast to our hypothesis, there was no significant difference between group 1 and group 2. In Kinematics, we observed significant difference (p<.05) of decreased knee flexion in loading response (G2

• Journal of Nutrition and Health
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• 제38권6호
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• pp.445-454
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• 2005

The purpose of this study was to compare the validity of obese index among body mass index (BMI), waist to hip ratio (WHR), and waist circumference (WC) and to determine which is the best in relation to cardiovascular disease (CVD) risk in Korean elderly more than 65 ages. Data from the 1998 Korean Health and Nutrition Survey were used (n=1017). Anthropometric indices and CVD risk factors were measured, and chi-square test, analysis of variance following duncan's multiple range test, partial correlation analysis, and Receiver Operator Characteristic (ROC) curves were used in the analysis. Anthropometric values were decreased in both male and female when ages were goes up. In female elderly, it specially showed the characteristics of upper body fat and systolic blood pressure risk (p<0.05). Among life style factors the current smokers were prevalent in obese male (p<0.05), but not prevalent in female having obese or upper body fat. Also, person with upper body obesity have more exercise than that of normal group (p<0.01). Mean BMI values of the current smoker was lower than that of normal group in both sexes (p<0.01). Mean BMI value of person with other risk factors were higher than that of normal groups (p<0.05). Among 7 CVD risk factors in partial correlation analysis, WC had the highest correlation coefficient in 5 in male, whereas BMI in 4 in female. In ROC analyses of 12 risk factors and health conditions, the largest area under curve of obese indices for risk factors were WC>WHR>BMI in male and BMI>WHR>WC in female. The optimal cutoff values of each index (BMI : WHR : WC) for one or more risk factors were 19.02 : 0.84 : 71.3 in male and 19.04 : 0.88 : 85.6 in female. In conclusion, Most Korean elderly showed non-obese and abdominal obesity likewise other Asians. Also CVD risk factors were prevalent in Korean elderly within normal limits of obese indices. Therefore the upper body fat indices reflected in the aged whose muscle mass is replaced by fat must be used as an indicator of CVD risk together with BMI. Although WHR was the worst index based on partial correlation analysis and so located between BMI and WC in ROC curve analysis in both sexes, it need to be use with WC to screen the cardiovascular risk group.

• 한국방사선학회논문지
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• 제16권3호
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• pp.281-288
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• 2022

본 연구에서는 고관절에 금속삽입물(Metal implant)이 삽입되어 있는 환자를 대상으로 일반적인 CT검사(Before MAR) 영상과 MAR을 사용하여 얻어진(After MAR) 영상을 4개의 알고리즘(Soft, Standard, Detail, Bone)에 적용하여 Noise, SNR, CNR을 비교 분석하여 정량적 평가로 최적의 알고리즘을 알아보고자 하였다. 분석방법으로는 4개의 알고리즘으로 재구성한 영상에 이미지 분석과 영역 및 픽셀값을 계산할 수 있는 Image J 프로그램을 사용하였다. Noise, SNR, CNR을 구하기 위해 측정부위를 영상에서 금속삽입물이 가장 인접해 있는 Bone(궁둥뼈, ischium)을 지정하여 HU mean값과 HU SD값을 구하고 배경잡음(Background)은 주위 근육으로 하였다. 관심영역(region of interest, ROI)은 뼈의 크기를 감안하여 동일하게 15×15 mm로 지정하였으며 SNR과 CNR의 값은 주어진 식에 의거하여 산출하였다. 결과적으로 노이즈는 After MAR, Soft 알고리즘에서 노이즈가 가장 낮게 나타났으며, SNR, CNR은 Before MAR, Soft 알고리즘이 가장 높게 나타났다. 따라서 Soft 알고리즘이 고관절 금속삽입술 CT에 가장 적절한 알고리즘으로 판단된다.

• 한국운동역학회지
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• 제25권2호
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• pp.175-182
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• 2015

Objective : The purpose of this study was to investigate difference in fascicle behavior of the medial gastrocnemius during the locomotion with varying intensities, such as gait and one-legged and two-legged vertical jumping. Methods : Six subjects (3 males and 3 females; age: $27.2{\pm}1.6yrs.$, body mass: $62.8{\pm}9.8kg$, height: $169.6{\pm}8.5cm$) performed normal gait (G) at preferred speed and maximum vertical jumping with one (OJ) and two (TJ) legs. While subjects were performing the given tasks, the hip, knee and ankle joint motion and ground reaction force was monitored using a 8-infrared camera motion analysis system with two forceplates. Simultaneously, electromyography of the triceps surae muscles, and the fascicle length of the medial gastrocnemius were recorded using a real-time ultrasound imaging machine. Results : Comparing to gait, the kinematic and kinetic parameters of TJ and OJ were found to be significantly different. Along with those parameters, change in the medial gastrocnemius (MG) muscle-tendon complex (MTC) length ($50.57{\pm}6.20mm$ for TJ and $44.14{\pm}5.39mm$ for OJ) and changes in the fascicle length of the MG ($18.97{\pm}3.58mm$ for TJ and $20.31{\pm}4.59mm$ for OJ) were observed. Although the total excursion of the MTC and the MG fascicle length during the two types of jump were not significantly different, however the pattern of length changes were found to be different. For TJ, the fascicle length maintained isometric longer during the propulsive phase than OJ. Conclusion : One-legged and two-legged vertical jumping use different muscle-tendon interaction strategies.

• 대한통합의학회지
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• 제8권2호
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• pp.199-209
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• 2020

Purpose : This study used a sarcopenia diagnostic algorithm proposed by the Asia working group in adults over 50 to diagnose sarcopenia and analyze body function. The purpose of this study is to prepare basic data for the management and prevention of sarcopenia. Methods : We performed a diagnostic evaluation of sarcopenia in 97 adults over the age of 50 years with the cooperation of the Seongnam senior experience complex in Seongnam-si, Gyeonggi-do. As a result of the diagnostic process, 24 subjects were placed into the sarcopenia group, while 73 subjects were placed into the normal group. We measured each subject's body, performed the timed up and go test to evaluate functional mobility, and conducted a questionnaire on the pre-symptom of locomotive syndrome and locomotive syndrome. Results : There were statistically significant differences in height, weight, and skeletal muscle mass between the two groups. There was also a statistically significant difference in the timed up and go test, which confirmed the difference in functional mobility between the two groups. In addition, there was a statistically significant difference between the two groups in the proportion and the mean score of subjects with pre-symptom of locomotive syndrome and locomotive syndrome. In the correlation analysis, grip strength was statistically significantly correlated with height, weight, skeletal muscle mass, waist circumference, timed up and go test, pre-symptom of locomotive syndrome and locomotive syndrome. Gait speed was significantly correlated with the timed up and go test and locomotive syndrome. Appendicular skeletal muscle index was significantly correlated with height, weight, waist circumference, hip circumference, and the pre-symptom of locomotive syndrome. Conclusion : In conclusion, sarcopenia is closely related to height, weight, skeletal muscle mass and functional mobility, as well as the pre-symptom of locomotive syndrome and, locomotive syndrome. In consideration of this, the prevention and management of sarcopenia should be made accordingly.