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Evaluation of Knee Joint after Double-Bundle ACL Reconstruction with Three-Dimensional Isotropic MRI

  • Jung, Min ju;Jeong, Yu Mi;Lee, Beom Goo;Sim, Jae Ang;Choi, Hye-Young;Kim, Jeong Ho;Lee, Sheen-Woo
    • Investigative Magnetic Resonance Imaging
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    • v.20 no.2
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    • pp.95-104
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    • 2016
  • Purpose: To evaluate the knee joint after double-bundle anterior cruciate ligament (ACL) reconstruction with three-dimensional (3D) isotropic magnetic resonance (MR) image, and to directly compare the ACL graft findings on 3D MR with the clinical results. Materials and Methods: From January 2009 to December 2014, we retrospectively reviewed MRIs of 39 patients who had reconstructed ACL with double bundle technique. The subjects were examined using 3D isotropic proton-density sequence and routine two-dimensional (2D) sequence on 3.0T scanner. The MR images were qualitatively evaluated for the intraarticular curvature, graft tear, bony impingement, intraosseous tunnel cyst, and synovitis of anteromedial and posterolateral bundles (AMB, PLB). In addition anterior tibial translation, PCL angle, PCL ratio were quantitatively measured. KT arthrometric values were reviewed for anterior tibial translation as positive or negative. The second look arthroscopy results including tear and laxity were reviewed. Results: Significant correlations were found between an AMB tear on 3D-isotropic proton density MR images and arthroscopic proven AMB tear or laxity (P < 0.05). Also, a significant correlation was observed between increased PCL ratio on 3D isotropic MRI and the arthroscopic findings such as tear, laxities of grafts (P < 0.05). KT arthrometric results were found to be significantly correlated with AMB tears (P < 0.05) and tibial tunnel cysts (P < 0.05). Conclusion: An AMB tear on 3D-isotropic MRI was correlated with arthroscopic results qualitatively and quantitatively. 3D isotropic MRI findings can aid the evaluation of ACL grafts after double bundle reconstruction.

Effects of Increased Saddle Height on Length and Activity Pattern of Vastus Lateralis and Biceps Femor is Muscle (사이클 안장 높이 증가가 대퇴 외측광근과 대퇴이두근의 길이 및 활성화 패턴에 미치는 영향)

  • Choi, Jin-Seung;Kang, Dong-Won;Seo, Jeong-Woo;Bae, Jae-Hyuk;Tack, Gye-Rae
    • Korean Journal of Applied Biomechanics
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    • v.22 no.4
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    • pp.413-419
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    • 2012
  • The purpose of this study was to investigate the effects of increased saddle height on the length and activity pattern of vastus lateralis (VL) and biceps femoris (BF) muscle. To compare the effects of increased saddle height, Preferred (self-selected height of subject) and High saddle height (approximately 5% higher saddle height than self-selected) were used. Seven elite cyclists (career: $16.1{\pm}8.5years$) participated in 3 min. sub-maximal pedaling tests under the same cadence (90 RPM) and pedaling power (150 W). Hip and knee joint angles, and the length and activity of VL and BF were compared by measuring 3D motion and electromyography (EMG) data. Results showed that there were significant differences in peak extension timing of the hip joint angle and the range of motion of the hip and knee joint between different saddle heights. Although there were significant differences in muscle length of both muscles with increasing saddle height, the timing and amount of muscle activity differed only at the BF. These findings suggest that the timing and amount of bi-articular muscle activity (i.e. BF) can be altered by changing the saddle height. For practically applying these results, further study is necessary to evaluate the effects of various cadence and the pedaling power with various saddle heights.

Effects of Hamstring HR Technique on Knee Joint Angle Increase (넙다리뒤근육의 유지-이완기법이 무릎관절 각도 증가에 미치는 효과)

  • Jeong, Eun-ho;Kim, Chi-hyok
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.24 no.2
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    • pp.75-81
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    • 2018
  • Background: The purpose of this study was to investigate the effect of various relaxation techniques on various dysfunction problems caused by shortening of the sagittal muscles. Method: The subjects were 44(18 males, 26 females). The subjects were composed of 3 groups. The experimental group consisted of 14 patients with proprioceptive neuromuscular facilitation stretching (PNF) technique, control group A 15 patients with self myofacial release (SMR) ball exercise, and control group B with 15 patients with Sling exercise. After 3 weeks of relaxation on the hamstring muscle, the length of the hamstring muscle before and after the intervention was compared. Results: The results of relaxation exercise of the snake muscles applied to passive PNF group, SMR ball group, and Sling relaxation group are as follows. 1. In the passive PNF group, the muscle length of the hamstring muscle was significantly increased after the intervention. 2. The muscle length of the hamstring muscle was significantly increased after the intervention in the SMR ball group. 3. Sling relaxation group significantly increased the muscle length of the hamstring muscle after sling exercise intervention. 4. Passive PNF group showed the greatest change in muscle length before and after intervention than SMR ball group and Sling relaxation group. Conclusion: Passive PNF relaxation therapy, SMR ball relaxation therapy, and Sling relaxation therapy applied to the hamstring muscle were effective in increasing muscle length of the hamstring muscle. PNF relaxation therapy showed the most significant effect after 3 weeks intervention.

The Mechanism Study of Gait on a Load and Gender Difference

  • Ryew, Checheong;Hyun, Seunghyun
    • International Journal of Internet, Broadcasting and Communication
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    • v.13 no.1
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    • pp.47-53
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    • 2021
  • Gait kinematics and kinetics have a similar tendency between men and women, yet it remains unclear how walking while carrying a load affects the gait mechanism. Twenty adults walked with preferred velocity on level ground of 20 m relative to change of a load carriage (no load, 15%, 30% of the body weights) aimed to observe gait mechanism. We measured gait posture using the three-dimensional image analysis and ground reaction force system during stance phase on left foot. In main effect of gender difference, men showed increased displacement of center of gravity (COG) compared to women, and it showed more extended joint angle of hip and knee in sagittal plane. In main effect of a load difference, knee joint showed more flexed postuel relative to increase of load carriage. In main effect of load difference on the kinetic variables, medial-lateral force, anterior-posterior force (1st breaking, 2nd propulsive), vertical force, center of pressure (COP) area, leg stiffness, and whole body stiffness showed more increased values relative to increase of load carriage. Also, men showed more increased COP area compared to women. Interaction showed in the 1st anterior-posterior force, and as a result of one-way variance analysis, it was found that a load main effect had a greater influence on the increase in the magnitude of the braking force than the gender. The data in this study explains that women require little kinematic alteration compared to men, while men in more stiff posture accommodate an added load compared to women during gait. Additionally, it suggests that dynamic stability is maintained by adopting different gait strategies relative to gender and load difference.

Arthroscopic Pull-out Suture Repair of Posterior Root Tear of the Medial Meniscus - Minimum 5 Years Follow-up Results - (내측 반월상 연골판 후방 부착부 파열의 관절경적 견인 봉합술 - 최소 5년 추시결과 -)

  • SaKong, Hyub;Shin, Hong Kwan;Lee, Young-Kook;Bae, Ki Cheor;Cho, Chul Hyun;Lee, Kyung Jae;Son, Eun-Seok;Kim, Doo Han
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.2
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    • pp.153-159
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    • 2012
  • Purpose: This study aims at evaluating our results with a 5-year follow up of arthroscopic pull-out suture repair of posterior root tear of the medial meniscus. Materials and Methods: This study enrolled 30 cases who underwent a arthroscopic pull-out suture repair to treat the posterior root tear of the medial meniscus from January 2001 to May 2005 and followed up at least 5 years. The average follow-up period was 76 months (range, 60-90 months). Clinical results by use of the Lysholm knee score and radiographic grade by use of the Kellgren-Lawrence classification were evaluated and second-look arthroscopy was done in all cases. The clinical results were compared with trauma history, obesity, varus deformity and time to operation. Results: At the last follow up, the Lysholm knee score improved from 55 points to 86 points. For the radiological results, 23 cases displayed maintenance or improvement of the medial joint space on the follow up X-ray, but 7 cases displayed decrease of the medial joint space, and 1 case was lately performed total knee replacement due to progressive osteoarthritic change. Conclusion: Arthroscopic pull-out suture repair has a good result at 27 cases (90%) in minimum 5 years follow-up. The clinical improvement was significantly reduced in more severe varus angle.

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The Effect of Exercise Intensity on Muscle Activity and Kinematic Variables of the Lower Extremity during Squat

  • Jung, Jae-Hu;Chae, Woen-Sik
    • Korean Journal of Applied Biomechanics
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    • v.27 no.3
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    • pp.197-203
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    • 2017
  • Objective: The purpose of this study was to determine how exercise intensity affects muscle activity and kinematic variables during squat. Method: Fifteen trainers with >5 years of experience were recruited. For the electromyography (EMG) measurements, four surface electrodes were attached to both sides of the lower extremity to monitor the rectus femoris (RF) and biceps femoris. Three digital camcorders were used to obtain three-dimensional kinematics of the body. Each subject performed a squat in different conditions (40% one-repetition maximum [40%1RM], 60%1RM, and 80%1RM). For each trial being analyzed, three critical instants and two phases were identified from the video recording. For each dependent variable, one-way analysis of variance with repeated measures was used to determine whether there were significant differences among the three different conditions (p<.05). When a significant difference was found, post hoc analyses were performed using the contrast procedure. Results: The results showed that the average integrated EMG values of the RF were significantly greater in 80%1RM than in 40%1RM during the extension phase. The temporal parameter was significantly longer in 80%1RM than in 40%1RM and 60%1RM during the extension phase. The joint angle of the knee was significantly greater in 80%1RM than in 40%1RM at flexion. The range of motion of the knee was significantly less in 80%1RM than in 40%1RM and 60%1RM during the flexion phase and the extension phase. The angular velocity was significantly less in 80%1RM than in 40%1RM and 60%1RM during the extension phase. Conclusion: Generally, the increase of muscle strength decreases the pace of motion based on the relation between the strength and speed of muscle. In this study, we also found that the increase of exercise intensity may contribute to the increase of the muscle activity of the RF and the running time in the extension phase during squat motion. We observed that increased exercise intensity may hinder the regulation of the range of motion and joint angle. It is suitable to perform consistent movements while controlling the proper range of motion to maximize the benefit of resistance training.

Kinematic Analysis of Deff Motion in High Bars (철봉운동 Deff 동작의 운동학적 분석)

  • Back, Jin-Ho
    • Korean Journal of Applied Biomechanics
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    • v.16 no.1
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    • pp.55-63
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    • 2006
  • The purpose of this study is to prove the kinematical characteristics of Deff motion, the high bar performance, in terms of flying phases so that we can provide basic sources for improving gymnastic performance. To do this, we selected and analyzed the performance of two athletes who did Deff motion in the high bar competition of male artistic gymnastic in the 22nd Universiade 2003 Daegu. We drew the conclusions from the kinematical factors that were came out through analyzing three-dimensional cinematography of the athletes' movements, by using a high speed video camera. To make a successful performance, a performer releases the bar at a height of a high bar vertically and at a height of 82cm horizontally, and the flying performance should be made without moving forward, as maintaining the proper balance, in order to rise over 118cm high during the flying phase. When the performer is releasing the bar, an increase of the vertical speed in the center of the body and extension of a knee joint and a hip joint contribute to increasing a flying height. And when the moving body is twisted, leaning to left side is caused by the winding movement of a knee joint, which causes an unstable bar grasp. To grasp the bar stably, just before releasing the performer should gain propulsive force from twisting rotation through increasing the speed of shoulder rotation. And before the peak point, the performer should make sure of a body rotation distance over $164^{\circ}$ so that he or she can do an aerial rotary performance smoothly. When grasping the high bar, the center of the body should be above the bar and the angle of shoulder rotation should be maintained close to $540^{\circ}$ simultaneously. he high point performance(S1) has more speed on an ascending phase and less speed on a descending phase than the low point performance (S2). At the peak point, both the rotation angle of the body and that of the shoulder in high point performance are big as well. In conclusion, it is shown that a performer can make a jump toward the high bar easily with the body straight because the performer can hold the upper part of the body erect early in a descending phase.

Effect of push up plus on sling and stable surface on muscle activity and lung function in adults with forward head posture (슬링과 안정한 면에서의 푸쉬업 플러스 운동이 머리 전방 자세성인의 근활성도와 폐기능에 미치는 영향)

  • Yoon, Hee-Kang;Lee, Hong-Gyun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.4
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    • pp.624-631
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    • 2017
  • This study aimed to identify the effect of the push-up plus exercise with sling on the muscle activity and lung function in adults with forward head posture over a period of 8 weeks. A total of 16 adults with forward head posture were recruited. The participants were divided into two groups : control (n-=8) and experimental (n=8). From July 6 until Aug 28, 2015, the participants were instructed to perform the knee push-up plus exercise and knee push-up plus using sling exercise three times a week to begin with and progressing to three sets of push-ups on each occasion after 8 weeks. The participants in both groups showed an increase in their craniovertebral angle (both groups p<0.001) and a decrease in their crania rotation angle (control p<0.05, experimental p<0.001). The participants in both groups showed a decrease in their trapezius activity (both groups p<0.001), an increase in their serratus anterior and lower trapezius muscle activity (both groups p<0.001), (and an increase in their) lung function (control group p<0.01, experimental group p<0.001). These findings show that push-up plus exercise improves posture and increases activation of lung function, while the push-up plus exercise in the sling is more effective in improving the forward head posture. The push-up plus exercise in the sling was more effective in improving the forward head posture, but there was no significant difference in the lung function between the two groups. Therefore, the push-up plus exercise in the sling is recommended as an exercise that is effective for the improvement of the posture and lung function of persons with forward head posture.

A New Experimental Error Reduction Method for Three-Dimensional Human Motion Analysis

  • Mun, Joung-Hwan
    • Journal of Biomedical Engineering Research
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    • v.22 no.5
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    • pp.459-468
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    • 2001
  • The Average Coordinate Referenee System (ACRS) method is developed to reduce experimental errors in human locomotion analysis. Experimentally measured kinematic data is used to conduct analysis in human modeling, and the model accuracy is directly related to the accuracy of the data. However. the accuracy is questionable due to skin movement. deformation of skeletal structure while in motion and limitations of commercial motion analysis system . In this study. the ACRS method is applied to an optically-tracked segment marker system. although it can be applied to many of the others as well. In the ACRS method, each marker can be treated independently. as the origin of a local coordinate system for its body segment. Errors, inherent in the experimental process. result in different values for the recovered Euler angles at each origin. By employing knowledge of an initial, calibrated segment reference frame, the Euler angles at each marker location can be averaged. minimizing the effect of the skin extension and rotation. Using the developed ACRS methodology the error is reduced when compared to the general Euler angle method commonly applied in motion analysis. If there is no error exist in the experimental gait data. the separation and Penetration distance of the femoraltibial joint using absolute coordinate system is supposed to be zero during one gait cycle. The separation and Penetration distance was ranged up to 18 mm using general Euler angle method and 12 mm using the developed ACRS.

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Comparison of the Immediate Effects of the Neural Mobilization Technique and Static Stretching Exercise on Popliteal Angle and Hamstring Compliance in Young Women With Short Hamstring Syndrome (넙다리뒤근 단축 증후군이 있는 젊은 여성에서 오금각과 넙다리뒤근 순응성에 대한 신경가동화기법과 정적신장운동의 즉각적인 효과 비교)

  • Oh, Duck-won
    • Physical Therapy Korea
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    • v.24 no.2
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    • pp.9-18
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    • 2017
  • Background: Limitation of hamstring extensibility is often associated with various musculoskeletal problems such as alterations in posture and walking patterns. Thus, certain appropriate strategies need to be established for its management. Objects: The aim of this study was to compare the effects of the neural mobilization technique and static stretching exercises on popliteal angle and hamstring compliance in young women with short hamstring syndrome (SHS). Methods: Thirty-three women with SHS were randomly assigned to either group-1 ($n_1=17$) that underwent the neural mobilization technique or group-2 ($n_2=16$) that underwent the static stretching exercises. Outcome measures included the active popliteal angle (APA) and a hamstring's electromyographic (EMG) activity at a maximum popliteal angle of the baseline. Intervention for each group was performed for a total time of 3-min (6 sets of a 30-sec application). Results: There were significant interactions between time and group in the APA [group-1 (pre-test to post-test): $69.70{\pm}8.14^{\circ}$ to $74.14{\pm}8.07^{\circ}$ and group-2: $68.66{\pm}7.42^{\circ}$ to $70.52{\pm}7.92^{\circ}$] (F1,31=6.678, p=.015) and the EMG activity of the hamstring (group-1: $1.12{\pm}.30{\mu}N$ to $.69{\pm}.31{\mu}V$ and group-2: $1.19{\pm}.49{\mu}V$ to $1.13{\pm}.47{\mu}V$)(F1,31=6.678, p=.015). Between-group comparison revealed that the EMG activity of the hamstring was significantly different at post-test between the groups (p<.05). Furthermore, in within-group comparison, group-1 appeared to be significantly different for both variables between pre- and post-test (p<.05); however, group-2 showed significant difference in only the APA between pre- and post-test (p<.05). Conclusion: These findings suggest that the neural mobilization technique and static stretching exercises may be advantageous to improve hamstring compliance in young women with SHS, resulting in a more favorable outcome in the neural mobilization technique.