• 생명과학회지
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• 제14권3호
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• pp.484-489
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• 2004

인공관절은 21세기 정형외과 발전의 주요변화들 중의 하나이다. 1997년이래 전 세계적으로 무릎인공관절(Total Knee Arthroplasty: TKA)을 사용하는 사람들이 해마다 약 600,000명씩 증가하고 있는 추세이고 미국에서만 인공관절을 사용하고 있는 사람들이 210,000명에 달하고 있으며 그 시장은 대략 $5 billion을 넘고 있다(7). 무릎인공관절은 일상생활에서 의자에 앉았다 일어날 때 계단을 올라 갈 때 등, 무릎의 근 모멘트가 적당한 활동을 해서 무릎관절 근육에 지레와 같은 작용을 하게 하고, 완전한 무릎으로 정상인의 무릎과 같은 기능을 오랫동안 유지하게 한다. 이러한 목적을 달성하기 위해서는 무릎인공관절 디자인 시 정상적인 무릎 회전축(normal knee's axes of rotation)들의 정확한 위치를 파악하는 것은 중요하다. 인공관절 수술 후 무릎관절의 신전과 굴곡 운동을 하는 동안 하나의 회전축(single-axes)을 가진 하나의 회전 반경(single-radius)을 알아보는 것은 여러 축(multi-axes)으로 움직이게 된다는 다축 회전반경(multi-radius)을 분석하기에 앞서 중요한 연구이다. 따라서 본 연구에 서는 무릎이 신전운동과 굴곡 운동 시 신전과 굴곡 모멘트를 만들어내는 대퇴 사두근(quadriceps muscle)과 무릎 오금근 (hamstring)의 역할을 알아보았고, 또한 모멘트와 대퇴 사두근의 iEMG 형태를 파악하였다. 본 연구를 수행하기 위해 무릎인공관절 수술을 받고 1년과 3년이 지난 정상적인 생활을 하는 피검자(1년2명, 3년2명)를 대상으로 Isometric 테스트를 위한 KIN-COM III을 사용하여 60$^\circ$, 30$^\circ$의 무릎굴곡 측정을 하였고, Isokinetic concentric 테스트를 위해서 무릎굴곡각도의 $10^\circ$-80$^\circ$까지 움직임을 측정하였다 또한 15$^\circ$-75$^\circ$까지의 신전운동(sit-to-stand movement)과 굴곡운동(stand-to-sit movement)을 실시하여 시간의 차이, 내전과 외전의 차이 그리고 iEMG의 차이를 알아보았다. 본 연구의 데이터는 여러 번의 실험을 통하여 가장 일반적인 수치를 사용하였다. 이 때 16-channel BTS TELEMG를 사용하여 대퇴사두근과 무릎오금근의 근육활동모양을 알아보았다. 본 연구결과는 시술 후 3년이 지나면서 TKR (Total Knee Replacement)의 대퇴 사두근 토큐가 약해지는 것으로 나타났고, iEMG 실험에서는 N-TKR (Non-Total Knee Replacement)의 대퇴 사두근이 TKR의 대퇴 사두근 보다 근 수축력이 더 크게 발휘되는 것으로 밝혀졌다. 단축회전반경의 굴곡과 신전의 $10^\circ$-80$^\circ$까지의 각 속도는 굴곡동작이 1.19s, 신전 동작이 1.68s로 나타났다. 굴곡과 신전동작에서 다리의 외전(abduction)의 각도변화는 굴곡 시 5.5$^\circ$, 신전 시 5.2$^\circ$로 나타났고, 내전(adduction)의 각도변화는 굴곡 시 7.2$^\circ$, 신전 시 6.1$^\circ$로 나타났다. 대퇴 사두근의 iEMG변화에서는 15$^\circ$-60$^\circ$까지 vastus medialis (VM), vastus lateralis (VL), rectus femoris (RF) 모두 굴곡동작에서 큰 값으로 나타났고, 61$^\circ$-75$^\circ$사이에서는 신전동작에서 iEMG가 큰 값으로 나타났다. 이와 같은 결과들은 인공관절 수술자들의 다축회전 반경을 분석하기에 앞서 중요한 선행연구가 될 것으로 생각된다.

• 대한인간공학회지
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• 제28권3호
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• pp.125-134
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• 2009

The muscle strengths in various postures are used in our daily life with or without our recognition. Also, many works are still performed with strengths, although mechanization and automation have been fairly accomplished at the industry site. Since the late seventies, various body measurements have been conducted periodically in Korea, however, muscle strengths have not been measured actively. For this reason, the muscle strength data have been hardly accumulated. The aims of this study are to learn more about the physical strength of young-aged Koreans and to provide basic information for designing equipments, tools and facilities in the work site and daily life. The muscle strengths that are related to shoulder and upper limbs joints, which are used frequently, are measured in this study. Eighteen muscle strengths, from seven different movements such as elbow flexion, elbow extension, shoulder abduction(seated), shoulder adduction(seated), shoulder rotation(internal and external), lifting a tray, and turning a key(inward and outward) were measured. For every movement, the muscle strengths for both hands were measured. In each measurement, five seconds averaged value and peak value were collected. Comparing the average value, the strength of shoulder adduction was the strongest for male and female, while strength of turning a key inward with left hand was the weakest for male and female. Strengths of preferred hand in elbow extension, shoulder abduction, shoulder external rotation, lifting a tray, and turning a key were stronger than those of non-preferred hand for both male and female. Rohrer's index considerably had an effect on muscle strength. The results of this study can provide some basic information not only in designing the equipment and facilities in work site or daily life, but also in selection, training and management of workers.

• 한국전문물리치료학회지
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• 제29권4호
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• pp.249-254
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• 2022

Background: The lateral step down (LSD) is a form of stair negotiation used by the elderly because it requires less movement of the lower extremity. Although it is necessary to study the amount of pelvic drop and the strength of a hip abductor during LSD for intervention, limited studies have investigated the relationship between the amount of pelvic drop and strength of a hip abductor during LSD in elderly people. Objects: This study aimed to determine the relationship between the amount of pelvic drop on an unsupported leg and the strength of the hip abductor during LSD in the elderly. Methods: Thirty elderly people (male: 17, female: 13) were recruited. Subjects performed the LSD task, and the evaluator measured and the amount of pelvic drop on an unsupported side. Also, the isometric strength of the hip abductor was measured in a supine position. Results: We found significant relationships between the strength of the hip abductor and the amount of pelvic drop (r = -0.386). The average hip abductor strength normalized by body weight was 1.06 N/kg (max: 1.99, min: 0.52) and the average contralateral pelvic drop (CPD) angle was 4.16° (max: 15.3, min: 0). Conclusion: Our results indicated that the strength of the hip abductor had a moderate correlation with the CPD during a LSD in the elderly. Hip abductor weakness could translate into altered movement of the pelvis.

• 한국전문물리치료학회지
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• 제29권4호
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• pp.262-268
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• 2022

Background: Virtual reality (VR) programs based on motion capture camera are the most convenient and cost-effective approaches for remote rehabilitation. Assessment of physical function is critical for providing optimal VR rehabilitation training; however, direct muscle strength measurement using camera-based kinematic data is impracticable. Therefore, it is necessary to develop a method to indirectly estimate the muscle strength of users from the value obtained using a motion capture camera. Objects: The purpose of this study was to determine whether the pedaling speed converted using the VR engine from the captured foot position data in the VR environment can be used as an indirect way to evaluate knee muscle strength, and to investigate the validity and reliability of a camera-based VR program. Methods: Thirty healthy adults were included in this study. Each subject performed a 15-second maximum pedaling test in the VR and built-in speedometer modes. In the VR speedometer mode, a motion capture camera was used to detect the position of the ankle joints and automatically calculate the pedaling speed. An isokinetic dynamometer was used to assess the isometric and isokinetic peak torques of knee flexion and extension. Results: The pedaling speeds in VR and built-in speedometer modes revealed a significantly high positive correlation (r = 0.922). In addition, the intra-rater reliability of the pedaling speed in the VR speedometer mode was good (ICC [intraclass correlation coefficient] = 0.685). The results of the Pearson correlation analysis revealed a significant moderate positive correlation between the pedaling speed of the VR speedometer and the peak torque of knee isokinetic flexion (r = 0.639) and extension (r = 0.598). Conclusion: This study suggests the potential benefits of measuring the maximum pedaling speed using 3D depth camera in a VR environment as an indirect assessment of muscle strength. However, technological improvements must be followed to obtain more accurate estimation of muscle strength from the VR cycling test.

• 대한통합의학회지
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• 제10권3호
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• pp.63-72
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• 2022

Purpose : Several studies have investigated the effects of dynamic stretching (DS) and self-mobilization (SM), however, studies comparing the two interventions are rare. Therefore, the purpose of this study was to compare the effects of DS and SM on ankle strength, dorsiflexion range of motion (DFROM), and balance to determine which is superior. Methods : Thirty-two healthy young adults participated in this study. Participants were randomly assigned to two groups (SM and DS). DS was performed for the purpose of stretching the medial gastrocnemius muscle. For the SM group, ankle joint SM was performed in three ways. For all participants, the following measurements were performed as pre- and post-tests: isometric strength of dorsiflexor and plantar flexor, weight-bearing lunge test (WBLT) to evaluate DFROM, Tetrax system to evaluate static balance, and y balance test (YBT) to evaluate dynamic balance. Differences before and after the intervention within each group were compared using paired t-test. Also, the variable's variation was compared between groups using an independent t-test. Results : Significant differences were found in ankle dorsiflexor strength, WBLT, YBT, weight distribution index (WDI) (pillow and opened eyes; PO), and stability index (ST) (normal and closed eyes; NC) before and after intervention in the SM group (p<.05). In the DS group, significant differences were found in ankle dorsiflexor and plantar flexor strength, WBLT, YBT anterior, WDI (normal and opened eyes; NO, PO), and ST (NO, NC, PO, pillow and closed eyes) before and after the intervention (p<.05). Ankle plantar flexor strength and WDI (PO) were significantly different between groups. Conclusion : Based on the results of this study, DS or SM can be considered as a possibility for selective use according to variables for improving ankle joint function (DFROM, muscle strength, balance).

• 한국전문물리치료학회지
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• 제31권2호
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• pp.151-158
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• 2024

Background: In Taekwondo athletes, ankle sprain is the most common risk factor for injury. Repeated ankle injuries lead to weakness and imbalance of the ankle muscles, resulting in chronic ankle instability (CAI). Both the ankle and toe muscles contribute to the inversion and eversion of the foot at the subtalar joint. Therefore, it is necessary to consider the ankle and toe joint positions when measuring ankle invertor and evertor strength. Objects: This study aimed to compare the muscle strength and ratio differences of the ankle invertor and evertor muscles in both the toe and ankle positions between the CAI and uninjured sides in Taekwondo athletes. Methods: Fifteen Taekwondo athletes participated in this study. The isometric strengths of both the ankle invertor and evertor were determined in different ankle and toe positions (dorsiflexion with toe extension, dorsiflexion with toe flexion, plantarflexion with toe extension, and plantarflexion with toe flexion). Paired t-tests were used to determine the differences between the ankle invertor and evertor in strength and ratio according to toe and ankle positions between the ankle CAI side and the uninjured side. Results: The results demonstrated that ankle evertor strength significantly decreased in all ankle and toe positions on the CAI side (p < 0.05). In addition, significant differences were observed in the ratios of the ankle invertor and evertor strengths in the dorsiflexion with toe flexion, plantarflexion with toe extension, and plantarflexion with toe flexion positions (p < 0.05). Conclusion: The findings of this study suggest that athletes, trainers, and clinicians should consider ankle and toe positions when measuring invertor and evertor strength and develop ankle rehabilitation protocols for Taekwondo athletes with CAI.

• 한국전문물리치료학회지
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• 제31권2호
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• pp.142-150
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• 2024

Background: Scapular dyskinesis (SD) is closely related to imbalance of the rotator cuff (RC) muscles. However, previous studies have only focused on isometric strength. To our knowledge, there has been no study examining potential differences in concentric and eccentric strength and functional strength ratio (FSR) of the RC muscles based on functional parameters related to throwing in with or without SD. Objects: This study aimed to determine whether there was a difference in the RC muscle strength and FSR between the dominant shoulder with SD and the non-dominant shoulder without SD in adolescent baseball players. Methods: Forty adolescent baseball players participated and classified types of SD based on movement patterns using the SD test by two examiners. The isokinetic concentric and eccentric peak torque of the internal rotation (IR) and external rotation (ER) were measured and quantified as peak torque to body weight (PT/BW). Also, the FSR was obtained by calculating the strength ratios of eccentric IR to concentric ER (IRecc/ERcon) and eccentric ER to concentric IR (ERecc/IRcon), respectively. Results: There was a significant decrease in the IR and ER PT/BW in the dominant shoulder with SD compared to the non-dominant shoulder without SD (p < 0.05), regardless of contraction types. However, no significant difference was observed in the FSR in both IRecc/ERcon and ERecc/IRcon ratios. Conclusion: The findings indicate that the isokinetic concentric and eccentric PT/BW of the IR and ER muscles were significantly lower in the dominant shoulder with SD than in the nonthrowing shoulder without SD. Therefore, when establishing a strategy for addressing RC muscle weakness in adolescent baseball players with SD, it is essential to consider an approach that accounts for scapular kinematic recovery.

• 대한인간공학회지
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• 제33권6호
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• pp.553-563
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• 2014

Objective: The purpose of this study was to evaluate the effect of gender (male, female) and grip spans (45, 50, 60, 70, 80mm) on total grip strength, resultant force, finger force and subjective discomfort rating. Background: In order to prevent musculoskeletal disorders, studies of hand tools need to be preceded based on grip strength, finger force, and subjective discomfort rating. However, experimental apparatus using tools such as pliers that reflect the actual work place was almost non-existent. Method: Fifty-Two (26 males and 26 females) participants were recruited from the student population. In this study, a pair of revised pliers, which can change grip span from 45 to 80mm was applied to estimate total grip strength, resultant force and individual finger forces. All participants were asked to exert a maximum grip force with three repetitions, and to report the subjective discomfort rating for five grip spans of pliers (45, 50, 60, 70, 80mm). Results: There were significant differences of total grip strength, resultant force, individual finger forces and subjective discomfort rating according to grip span. The lowest total grip strength was obtained from the grip span of 80mm for both genders. For resultant force, the highest resultant force was exerted at grip spans of 50, 60 and 70mm for females and 50 and 60mm for males. The lowest subjective discomfort rating was observed in the 50mm for both genders. Conclusion: Based on the result, 50mm and 60mm grip spans which provide the highest force and lowest discomfort rating might be recommendable for the male and female pliers users. Application: The findings of this study can provide guidelines on designing a hand tool to help to reduce hand-related musculoskeletal disorders and obtain better performance.

• 한국전문물리치료학회지
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• 제30권3호
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• pp.245-252
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• 2023

Background: Various functional tests such as upper quarter Y-balance test (UQYBT) are used to evaluate shoulder stability and mobility in clinical or sports fields. Previous studies have been conducted to determine the correlation between the scapular or trunk muscle and UQYBT. However, the correlation between UQYBT and hip flexor, which can be considered as a core muscle, has not been confirmed. Objects: To verify the relationship between the UQYBT and scapular muscle (scapular protractor and lower trapezius [LT]), trunk muscle, and hip flexor strengths in healthy male participants. Methods: A total of 37 healthy male participants were recruited and underwent UQYBT in the push-up posture. The isometric strength of the scapular protractor, LT, trunk flexor and extensor, and hip flexors were measured using a smart KEMA strength sensor (KOREATECH Inc.). Results: The superolateral direction of the UQYBT was moderately to strongly related to trunk extensor (r = 0.443, p < 0.01), scapular protractor (r = 0.412, p < 0.05), LT (r = 0.436, p < 0.01), and both sides of the hip flexors (supporting-side: r = 0.669, p < 0.01; non-supporting-side: r = 0.641, p < 0.01). The inferolateral direction of the UQYBT was moderately related to the scapular protractor (r = 0.429, p < 0.01), LT (r = 0.511, p < 0.01), and both sides of hip flexors (supporting-side: r = 0.481, p < 0.01; non-supporting-side: r = 0.521, p < 0.01). The medial direction of the UQYBT was moderately to strongly related with the scapular protractor (r = 0.522, p < 0.01), LT (r = 0.541, p < 0.01), and both sides of hip flexors (supporting-side: r = 0.605, p < 0.01; non-supporting-side: r = 0.561, p < 0.01). Conclusion: This study showed that the strength of the scapular muscles, trunk muscles, and hip flexor muscles correlated to the UQYBT. Therefore, the strength of not only the scapular and trunk muscles but also the hip flexor muscles should be considered to improve the UQYBT.

• 한국운동역학회지
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• 제24권1호
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• pp.35-42
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• 2014

Tendon elasticity is an important factor affecting muscle function and thus human movements. It has been reported that the mechanical properties of tendon are adaptable to external loading condition. Based on the adaptability of muscle and tendon to external loading conditions, one can assume that there might be an optimum ratio between muscle strength and tendon stiffness. The present study aimed to investigate whether there is correlation between plantar flexor muscle strength and stiffness of the achilles tendon (AT). Twenty two male subjects (age: $23.2{\pm}1.5yrs$, height: $175.5{\pm}6.2cm$, weight: $75.4{\pm}9.8kg$) performed maximum voluntary isometric plantarflexion on a custom-built dynamometer and muscle-tendon junction of the medial gastrocnemius muscle was simultaneously monitored using a real-time ultrasound imaging machine. The averages of muscle force and tendon stiffness were $366.38{\pm}79.37N$, $35.34{\pm}10.42N/mm$, respectively. Significant positive correlation was observed between muscle strength and tendon stiffness (r=0.8507), indicating that the muscle force is proportional to tendon stiffness. The results might have been used in computational modeling and criterion of training progress level in the fields of training and rehabilitation.