• PNF and Movement
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• v.19 no.1
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• pp.9-17
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• 2021

Purpose: This study aims to verify the effectiveness of sit-to-stand training with visual feedback to improve balance ability and knee extensor strength of total knee replacement patients. Methods: In this study, 15 patients with total knee replacement participated in this study. Subjects were assigned to two groups: a feedback group (experimental group)(n = 8) and a control group (n = 7). They all received 30 min of continuous passive motion (CPM) and sit-to-stand training for 15 min five times per week for two weeks. Knee extensor and balance ability were measured. Knee extensor was measured by Biodex system 3; balance ability was measured by Balancia software. Results: After the intervention, there was a significant difference in the strengthening of the knee extensor muscles in the feedback group, area 95%, weight distribution of the affected side, and the sit-to-stand test repeated five times (p < 0.05). Conclusion: The results of this study showed that sit-to-stand training with visual feedback was more effective in increasing knee extensor muscle strength and balance ability than the sit-to-stand training without visual feedback. Therefore, in order to improve the knee extensor muscle and the balance of total knee replacement patients, it is necessary to consider providing visual feedback during sit-to-stand training.

• Korean Journal of Applied Biomechanics
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• v.23 no.4
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• pp.357-367
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• 2013

The purposes of this study were investigated physical compensation for gait on induced knee stiffness in normal subjects. Ten subjects were participated in the experiment(age: $26.0{\pm}6.3$ yrs, height: $175.5{\pm}5.3$ cm, weight: $69.1{\pm}6.1$ kg). The study method adopted 3D analysis with five cameras and ground reaction force with two force-plate. Induced knee stiffness level were classified as gait pattern on ROM of knee(free level, $30^{\circ}$ restriction level, fix level). The results were as follows; In angular displacement of hip joint, left hip joint was the more extended in mid-stance on induced right knee stiffness. In angular displacement of knee joint, there was no physical compensation on induced right knee stiffness, but free knee level gait was more flexed in swing phase of right knee joint. In angular displacement of ankle joint, right ankle joint was the more dorsiflexed on induced right knee stiffness, and $30^{\circ}$ restriction level and fix level gait were less plantarflexed in TO2. In trunk tilt, free and $30^{\circ}$ restriction level gait was more backward tilt on induced right knee stiffness. In ROM of each joint, right knee joint was more larger and trunk tilt was more lower on induced right knee stiffness. In GRF, Fx was more bigger lateral force in free and $30^{\circ}$ restriction level gait, and was more bigger medial force in fix level gait. Fy was more bigger propulsion force in free level gait, and was was more bigger braking force in $30^{\circ}$ restriction level gait. Left braking force in $30^{\circ}$ restriction level gait was more bigger. Fz was no significant.

• Korean Journal of Applied Biomechanics
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• v.28 no.3
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• pp.175-180
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• 2018

Objective: Anterior cruciate ligament reconstruction (ACLR) has been considered the primary treatment for anterior cruciate ligament (ACL) injured patient. However, there is little biomechanical evidence regarding bilateral knee joint biomechanics during landing and cutting task after ACLR. Method: Eighteen females with ACLR participated in this investigation. Double leg jump landing (DLJL) and single leg jump cut (SLJC) biomechanics were assessed. Results: During DLJL, the healthy knee showed greater knee valgus angle at initial contact ($^{\circ}$) compared to the injured knee (Injured: $2.93{\pm}2.59$, Healthy: $4.20{\pm}2.46$, t=2.957, p=0.009). There was a significant difference in anterior tibial shear force ($N{\times}N^{-1}$) with greater in the injured knee (Injured: $1.41{\pm}0.39$, Healthy: $1.30{\pm}0.35$, t=2.201, p=0.042). During SLJC, injured knee showed greater knee extension moment ($N^*m{\times}[N^*m]^{-1}$) compared to healthy knee (Injured: $0.51{\pm}0.19$, Healthy: $0.47{\pm}0.17$, t=2.761, p=0.013). However, there was no significant differences between the knees in the other variables. Conclusion: ACLRfemales exhibited a greater knee valgus angle at initial contact and lesser anterior tibial shear force on the healthy knee during double leg jump landing. In addition, ACLR females showed a greater knee extension moment on the injured knee during single leg jump cut.

• Physical Therapy Korea
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• v.14 no.3
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• pp.23-31
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• 2007

The purpose of this study was to determine the influence of high-heeled shoes on walking of obese women as it was already proven an extrinsic factor of knee osteoarthritis in women with normal weight. In this study the aimed therefore in particular was to utilize high-heeled shoes in proving it's causal influence on knee osteoarthritis by measuring the angle and torque of the knee joint. Fifteen obese women (BMI>25 $kg/m^2$) were measured in their twenties. Each angle and torque of their knee joints during walking on 6.5 cm high-heeled shoes and with a bare feet, were compared with each other and analyzed with a 3D motion analysis system. There was no significant difference in walking speed, cadence and stride length between the two conditions. However, there was a significant increase in a double limb support time and the stance phase when walking on high-heeled shoes as when walking with bare feet. The peak knee flexion angle and peak knee varus torque was higher when walking on high-heeled shoes than with bare feet. On the contrary, the peak knee flexion angle in the swing phase was not statistically different. The prolongation of peak knee varus torque was also proven. There was a significant increase in peak knee varus torque in the initial and last stance phases during walking on high-heeled shoes as compared to walking on bare feet. Through the above results, it was proven that when obese women walked on high-heeled shoes, rather than with bare feet, peak knee flexor and varus torque increased along with the changes of the in knee joint angle. Therefore, the influence of high-heeled shoes might be a significant intrinsic factor in knee osteoarthritis of obese women.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.1
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• pp.101-108
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• 2021

Purpose : The purpose of this study is to verify the effect of selective muscle strengthening of the knee joint extensor muscles using a pressure biofeedback unit to improve knee extensor strength and the balance ability of total knee replacement patients. Through this, we tried to provide clinical information. Methods : In this study, 12 patients with total knee replacement were recruited from a rehabilitation hospital. They were divided into two groups: a feedback group (n=6) and a control group (n=6). All patients received 30 minutes of continuous passive motion and leg-strengthening exercises for 15 minutes five times a week for two weeks. Subjects performed knee extension exercises with or without biofeedback units in the sitting position. The knee extensor strength and balance ability were measured before and after exercise. Knee extensor strength was measured by Biodex system 3 and balance ability was measured by Balancia software. Results : Both the experimental group and the control group showed a significant difference in the muscle strength of the knee joint extensor muscles after intervention (p<.05). In comparison, the experimental group showed a significant difference than the control group (p<.05). Both the experimental group and the control group showed a significant difference in the velocity average, path length, area 95 % center of pressure (COP), weight distribution, five times sit to stand test (FTSST) after intervention. In comparison, the experimental group showed a significant difference in velocity average, area 95 % COP, and FTSST than the control group (p<.05). Conclusion : In order to strengthen the knee extensor muscle and improve the balance ability in total knee replacement patients, it is necessary to consider providing pressure biofeedback unit during leg strengthening exercises.

• Journal of International Academy of Physical Therapy Research
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• v.12 no.1
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• pp.2279-2285
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• 2021

Background: The spinal nerves, which start at the lumbar level, are connected to the nerve innervation in the knees. Currently, there is a lack of research on the treatment of knee pain through lumbar mobilization. Objectives: To investigate the effects of lumbar joint mobilization (LJM) and transcutaneous electronic nerve stimulation (TENS) on proprioception and muscular strength in volleyball players with chronic knee pain. Design: Two group pre-posttest. Methods: A total of 26 professional volleyball players with chronic knee pain were allocated to the LJM (n=13) and TENS (n=13) groups. In the LJM group, grade III - IV amplitude was applied 3 times for 1 minute (80 times per minute) at the affected lumbar (L2-3) facet joint in the prone position. In the TENS group, the TENS treatment device was used to directly apply or 15 minutes to the area of chronic knee pain (100 Hz, 150 ㎲). Proprioception was measured by knee flexion and extension angles, and muscle strength was evaluated using an isokinetic test. Measurements were taken before and after interventions. Results: In the eye opened conditiond, proprioception significantly increased during both knee extension and flexion after LJM, while only knee extension was significantly increased in the TENS group. There was also a significant difference in knee extension between the two groups. In the eye close conditiond, proprioception was significantly improved only during knee extension in the LJM group, and the difference in knee extension between the groups was also significant (P<.05). The maximum torque of the affected knee joint was significantly improved at 60°/sec in both groups (P<.05); however, there was no difference between the two groups. There was no significant difference in the maximum flexion torque within or between the groups. Conclusion: This study suggests that LJM improved proprioception and muscular strength in volleyball players with chronic knee pain.

• Journal of Korean Physical Therapy Science
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• v.7 no.2
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• pp.711-725
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• 2000

The purpose of this study was to determine the effects of knee flexor isokinetic training on the mean peak torque of knee muscles and hamstrings-to-quadriceps ratio(H/Q ratio) in hemiplegia able to walk independently for more than 10 meters, to analyze the effect of torque increasing on functional aspects; fatigability and ambulation times, also. Forty-one adult subjects with hemiplegia secondary to a stroke partipated in this study. All participants were in/out patients at the College of Medicine, Pocheon CHA University, Pundang CHA General Hospital. The patients were allocated to two groups: one group exclusively for isokinetic maximal voluntary knee flexor training at $150^{\circ}$/sec(n=20) and the other exclusively for isokinetic maximal voluntary knee flexor training from $30^{\circ}$/sec to $150^{\circ}$/sec (n=21) gradually. The allocation was performed according to patient age, sex, affected side to minimize imbalance between the two training groups. Training was carried out from February 14th, 2000 to April 15th, 2000. Analysis of the data was done by means of t-test, x2-test, paired t-test, ANOVA, and multiple regression analysis. The results of this study were as follows: 1. There were no significant differences between the two groups in mean peak torque of knee muscles and relative decreases in knee extensor mean peak torque with increased knee flexor velocities before training (P<.05). 2.There was no significant differences between the two groups in the H/Q ratio, and no relative increases with increased knee flexor velocities before training. 3. there were significant changes in mean peak torque in group A after training(P<.05), but no significant differences as the velocity increased 4.there were significant changes in mean peak torque in group B after training(P<.05), but no significant differences as the velocity increased 5.there were no significant differences between the two groups, and no significant differences in mean peak torque increase rate between the groups with increased knee flexor velocities after training 6.H/Q ratio increased with increased knee flexor velocities between the two groups, but not statistically And there was no significant differences between the groups with increased knee flexor velocities 7.After training, Ambulation time and its decreasing rate decreased significantly in group B (P<.05) 8Before and after training, there was no significant differences between the groups in the fatiguability 9. In the multiple regression analysis, mean peak torque increase rate of the knee extensor and flexor were higher in group B than A(P<.05), and significantly higher with increased knee flexor velocities (P<.05) Also, training method influenced on Ambulation times decreases significantly(P<.05). Results indicated that knee flexor isokinetic training was effective to knee extensor and flexor mean peak torque increase in the hemiplegia able to walk independently for more than 10 meters. Therefore, we were able to conclude that gradual training from low to high velocity was more effective in the increase of mean peak torque of knee joint and decrease of Ambulation times than training only at high velocity.

• The Journal of Korean Academic Society of Nursing Education
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• v.11 no.1
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• pp.30-38
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• 2005

Purpose: The purpose of this study was to testify effects of Balance Taping Therapy on the pain and range of motion of the knee joint in the female elderly with degenerative knee arthritis. Method: The research design was one group pretest-posttest design. The data were collected from November 15 to December 25, 2004. The subjects were 23 female elderly with degenerative knee arthritis who were registered at one public health center in Busan. Balance Taping Therapy was conducted twice a week for 5 weeks. The data were analyzed such as the number, percentage, paired t-test, Kolmogorov-Smirnov test using SPSS 10.0 WIN Program. Result: The pain in the female elderly with degenerative knee arthritis significantly decreased from 8.82 to 6.04 after Balance Taping Therapy(t=16.781, p=0.001). The knee flexion joint range of motion in the female elderly with degenerative knee arthritis significantly increased from 119.73 to 123.13 after Balance Taping Therapy (t=-6.003, p=0.001). The knee extention joint range of motion statistically significantly increased from 112.74 to 117.83 after Balance Taping Therapy(t=-8.940, p=0.001). Conclusion: Balance Taping Therapy proved an effective nursing intervention in decreasing pain and increasing the range of motion of the knee joint in the female elderly with degenerative knee arthritis.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.1
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• pp.143-152
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• 2020

PURPOSE: This study examined the effects of videoconferencing-based telerehabilitation exercise program on the gait, knee function, and quality of life of patients with knee osteoarthritis. METHODS: Forty-eight subjects, who were diagnosed with osteoarthritis of the knee by the radiologic findings, history, and a physical examination, were assigned randomly to a Control group, Experiment group I, and Experiment group II. The control group did not perform any exercise program and were educated in understanding and managing the disease of knee osteoarthritis for only one hour. Experimental groups I and II were provided with an exercise guidelines book for knee osteoarthritis, and the same exercise programs were conducted by face-to-face visits and non-face-to-face using telerehabilitation for eight weeks, respectively. To verify the effectiveness of each exercise program, the gait speed, knee disability index, and health related quality of life were measured. All assessments were conducted twice before and after the intervention. RESULTS: The participants who underwent both face-to-face and telerehabilitation exercise programs showed an improved gait speed, knee function, and health-related quality of life. In particular, there was no significant difference between the telerehabilitation exercise group and the direct face-to-face exercise group in improving the knee joint function and health related quality of life. CONCLUSION: A these findings the telerehabilitation exercise program for patients with knee osteoarthritis can alternate or supplement the face-to-face exercise program. Therefore, the telerehabilitation exercise program should be used not only as a substitute supplement program but also as an intervention for various diseases.

• Korean Journal of Applied Biomechanics
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• v.27 no.2
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• pp.125-132
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• 2017

Objective: The aim of this study was to investigate the effect of targeted knee flexion angle on biomechanical factors of knee joint between upward and downward phases during the forward lunge. Method: Eight elderly subjects (age: $22.23{\pm}1.51years$, weight: $69{\pm}6.63kg$, height: $174.88{\pm}6.85cm$) participated in this study. All reflective marker data and ground reaction force during a forward lunge were collected. The knee joint movement and reaction force and joint moment at maximum knee flexion angle were compared by repeated measures one-way analysis of variance (ANOVA) (p<.05). The peak knee joint reaction force and joint moment between upward and downward phases were compared by repeated measures two-way ANOVA (p<.05). Results: The anterior and vertical knee joint movements, reaction force, and extensor moment of $80^{\circ}$ targeted knee flexion condition at maximum knee flexion angle was greater than both $90^{\circ}$ and $100^{\circ}$ conditions (p<.05). The $80^{\circ}$ knee flexed angle condition had greater peak joint reaction force and extensor moment compared with both $90^{\circ}$ and $100^{\circ}$ conditions between upward and downward phases during the forward lunge. Conclusion: As the targeted knee joint flexion angle increases, knee joint movement and kinetic variables become greater during the forward lunge exercise.