• 한국운동역학회지
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• 제25권2호
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• pp.191-198
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• 2015

Objective : The purpose of this study was to conduct biomechanical analysis of varying backpack loads on the lower limb movements during downhill walking over $-20^{\circ}$ ramp. Method : Thirteen male university students (age: $23.5{\pm}2.1yrs$, height: $175.7{\pm}4.6cm$, weight: $651.9{\pm}55.5N$) who have no musculoskeletal disorder were recruited as the subjects. Each subject walked over $20^{\circ}$ ramp with four different backpack weights (0%, 10%, 20% and 30% of body weight) in random order at a speed of $1.0{\pm}0.1m/s$. Five digital camcorders and two force plates were used to obtain 3-d data and kinetics of the lower extremity. For each trial being analyzed, five critical instants were identified from the video recordings. Ground reaction force, loading rate, decay rate, and resultant joint moment of the ankle and the knee were determined by the inverse dynamics analysis. For each dependent variable, one-way ANOVA with repeated measures was used to determine whether there were significant differences among four different backpack weight conditions (p<.05). When a significant difference was found, post hoc analyses were performed using the contrast procedure. Results : The results of this study showed that the medio-lateral GRFs at RHC in 20% and 30% body weight were significantly greater than the corresponding value in 0% of body weight. A consistent increase in the vertical GRFs as backpack loads increased was observed. The valgus joint movement of the knee at RTO in 30% body weight was significantly greater than the corresponding values in 0% and 10% body weight. The increased valgus moment of 30% body weight observed in this phase was associated with decelerating and stabilizing effects on the knee joint. The results also showed that the extension and valgus joint moments of the knee were systematically affected by the backpack load during downhill walking. Conclusion : Since downhill walking while carrying heavy external loads in a backpack may lead to excessive knee joint moment, damage can occur to the joint structures such as joint capsule and ligaments. Therefore, excessive repetitions of downhill walking should be avoided if the lower extremity is subjected to abnormally high levels of load over an extended period of time.

• 대한정형외과스포츠의학회지
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• 제11권2호
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• pp.69-74
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• 2012

목적: 슬관절의 신전 또는 굴곡 시 슬와 동맥의 위치 변화를 확인하고 슬관절의 후방 관절낭 유리술을 시행 후의 슬와 동맥의 위치 변화를 측정하여 슬관절 수술 시 슬와 동맥의 손상을 최소화 할 수 있는 자세 및 후방 관절낭 유리술의 유용성에 대해 알아보고자 하였다. 대상 및 방법: 중년의 남성 및 여성, 총 2구의 신선 동결 전신 사체로서, 모두 4례의 슬관절을 대상으로 하였다. 슬관절을 0도, 30도, 60도, 90도 각도로 굴곡하여, 각각의 각도에서 관절면 및 관절면으로부터 원위 1 cm 및 2 cm에서 경골 후방 피질골로 부터 슬와 동맥과의 거리를 측정하였다. 관절경을 이용하여 후방 관절낭 유리술을 시행하였고, 같은 방법으로 경골 후방 피질골로부터 슬와 동맥과의 거리를 측정하였다. 결과: 슬와 동맥에서 후방 경골 피질까지의 거리는 관절면, 관절면 원위 1 cm, 관절면 원위 2 cm에서 0도 굴곡 시 평균 6.3 mm (4.5~7), 4.6 mm (3.6~6), 4.9 mm (3.9~5.8), 30도 굴곡 시 평균 7.4 mm (5.2~9), 4.9 mm (3.6~7.2), 5.3 mm (3.8~6.6), 60도 굴곡 시 평균 8.7 mm (5.4~11), 5.2 mm (4.9~7.3), 6.2 mm (5.4~9.6), 90도 굴곡 시 9.8 mm (5.8~12.1), 5.5 mm (5.1~7.4), 6.5 mm (5.4~10.7) 이었다. 후방 관절낭 유리술 시행 후에는 관절면, 관절면 원위 1 cm, 관절면 원위 2 cm에서 0도 굴곡 시 6.5 mm (5.5~7.5), 5.8 mm (3.9~7.2), 5.2 mm (3.8~7.0), 30도 굴곡 시 7.7 mm (5.5~9,1), 7.1 mm (4.6~7.6), 5.5 mm (4.1~6.9), 60도 굴곡 시 8.9 mm (5.7~11.2), 8.5 mm (5.5~9.2), 6.4 mm (5.3~10.1), 90도 굴곡 시 10.2 mm (6.3~13.6), 9.5 mm (6.5~11), 6.6 mm (5.9~9.8)로 측정되었다. 결론: 슬관절을 굴곡시킬수록 슬관절 관절면에서 관절면 원위 2 cm 사이에서는 경골 후방 피질골과 슬와 동맥 사이의 거리를 증가되어 슬관절 수술시 슬와 동맥 손상을 줄일 수 있다. 또한 후방 관절낭 유리술을 시행하게 되면 경골 후방 피질골과 슬와 동맥 사이의 거리를 더 증가시켜 슬와 동맥 손상을 보다 더 줄일 수 있을 것이다.

• 근관절건강학회지
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• 제25권2호
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• pp.61-74
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• 2018

Purpose: The purpose of this study was to examine the factors affecting changes in Korean Knee Score (KKS) and ranges of motion (ROM) of the knee after the structured exercise programs for the patients with total knee arthroplasty. Methods: This was a retrospective study using electronic medical records from January 2015 to February 2017, and the subject of this study was a total of 124 out of 434 patients underwent total knee replacement operation. They took part in a structured step-by-step exercise program conducted by orthopedic nurses, and then were evaluated for KKS and Knee ROM for 12 weeks after operation. Results: Post-intervention scores increased significantly in the KKS subdomains including pain and symptoms (t=-22.31, p<.001), function (t=-20.68, p<.001), evaluation of floor life (t=-14.18, p<.001), socioemotional function (t=-28.94, p<.001) over time. As for the change in the ROM, knee extension (t=9.23, p<.001) and knee flexion (t=4.04, p<.001) showed a statistically significant changes over time. Conclusion: This study illuminated the factors affecting the changes in pain and symptom, physical function, evaluation of floor life, socioemotional function and range of motion after structured exercise training programs for knee arthritis patients.

• 한국통신학회논문지
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• 제39C권6호
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• pp.490-496
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• 2014

무릎 관절 연골은 두께가 얇아 대부분 무릎 질환의 원인이 되고 있다. 그러므로 무릎 자기공명영상에서 관절 연골 분할은 무릎 질환의 정확한 진단을 위한 필수조건이다. 특히 수동이 아닌 전자동 방식으로 무릎 관절 연골을 분할하여야만 효과적인 무릎 질환 진단을 할 수 있다. 본 논문에서는 뇌 자기공명영상에서 대표적으로 사용되는 레벨 셋 기반의 영상 분할 기법을 분석하여 무릎 자기공명영상에 적용 시 문제점을 파악하고 이를 해결함으로써, 무릎 자기공명영상에 레벨 셋 기반 영상분할 방식을 적용하였다. 이는 본 논문에서 제안하는 분할기법을 사용할 경우 무릎 관절 연골 분할에 대한 모든 과정이 전자동화 되어 기존 반자동화 방식보다 빠른 처리가 가능하며, 3차원 형상화를 통해 보다 정확한 진단에 도움을 줄 수 있다. 또한 우리는 제안하고 있는 분할기법이 기존 대표적인 무릎 관절 분할보다 더 높은 정확도를 갖는 것을 실험을 통해 확인할 수 있었다.

• 융합정보논문지
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• 제9권7호
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• pp.153-158
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• 2019

본 연구의 목적은 여자 배구선수와 탁구 선수 사이에 무릎 관절의 등속성 근력 수준을 비교하는 것이다. 총 27명의 엘리트 배구 선수와 27명의 탁구 선수가 이 연구에 참여하였다. 본 연구는 등속성 근력 측정을 통해 여자 배구선수 및 탁구 선수 무릎 굽힘근 근력과 폄근 근력의 양을 측정하였다. 최대 토크는 $60^{\circ}/s$에서 3회 최대 수의적 굽힘과 폄 수축을 수행하여 측정하였다. 여자 배구 선수는 여자 탁구선수 보다 무릎 폄과 굽힘근 근력이 높았다. 탁구 선수들은 왼쪽과 오른쪽 무릎 근력에 유의한 차이가 없었다. 하지만 배구 선수들은 양쪽 무릎 근력에 차이를 보였다. 또한, 신장과 체중은 무릎 근력과 양의 상관관계를 보였다. 본 연구를 통해 여자 배구 선수는 탁구 선수보다 무릎 근력이 더욱 높은 수준에 있음을 알 수 있었다. 또한 배구 선수가 비대칭적 무릎 근력이 있음을 발견하였다. 향후 연구에서는 등속성 근력강도에 대한 연구가 다른 스포츠 선수와 비교하여 확인될 것을 기대한다.

• Journal of International Society for Simulation Surgery
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• 제1권1호
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• pp.19-22
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• 2014

As computer technology develops and this is applied to medical image field, three dimensional image reconstruction technology using computer simulation is utilized in various categories that include anatomical study and biomechanics study of human body. Especially orthopedic surgeons are able to investigate biomechanical function and be provided information for operations with this technology in terms of ligament reconstruction of knee. And this technology can be utilized in preparing preoperative planning and instructions and training. This review is about three dimensional image reconstruction technology which is utilized in ligament reconstruction of knee.

• 대한임상전기생리학회지
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• 제1권2호
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• pp.31-38
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• 2003

This study was to compared the effectiveness of piroxicam gel phonophoresis with conventional ultrasound therapy in knee osteoarthritis. Eighteen patients with a means age of $55.7{\pm}5$ years were randomly assigned to phonophoresis or ultrasound groups. Continuous ultrasonic waves of 1 MHz frequency and $1\;W/cm^2\;SATA_i$ were applied for 5 minutes to the target knee joint. This study indicated their pain level by marking on a visual analog scale(VAS) at the start of treatment and at the end of 3day. Osteoarthritis VAS scores, pain on rest state, non weight bearing range of motion, 20 meters walking, and walking step by the patients were evaluated before and after therapy. Both therapeutic modalities were found to be effective and generally well tolerated after 3 therapy sessions. But piroxicam phonophoresis was not superior to conventional ultrasound in patients with knee osteoarthritis.

• 한국운동역학회지
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• 제27권3호
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• pp.189-195
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• 2017

Objective: The aim of this study was to examine the effect of foot landing type (forefoot vs. rearfoot landing) on kinematics, kinetics, and energy absorption of hip, knee, and ankle joints. Method: Twenty-five healthy men performed single-leg landings with two different foot landing types: forefoot and rearfoot landing. A motion-capture system equipped with eight infrared cameras and a synchronized force plate embedded in the floor was used. Three-dimensional kinematic and kinetic parameters were compared using paired two-tailed Student's t-tests at a significance level of .05. Results: On initial contact, a greater knee flexion angle was shown during rearfoot landing (p < .001), but the lower knee flexion angle was found at peak vertical ground reaction force (GRF) (p < .001). On initial contact, ankles showed plantarflexion, inversion, and external rotation during forefoot landing, while dorsiflexion, eversion, and internal rotation were shown during rearfoot landing (p < .001, all). At peak vertical GRF, the knee extension moment and ankle plantarflexion moment were lower in rearfoot landing than in forefoot landing (p = .003 and p < .001, respectively). From initial contact to peak vertical GRF, the negative work of the hip, knee, and ankle joint was significantly reduced during rearfoot landing (p < .001, all). The contribution to the total work of the ankle joint was the greatest during forefoot landing, whereas the contribution to the total work of the hip joint was the greatest during rearfoot landing. Conclusion: These results suggest that the energy absorption strategy was changed during rearfoot landing compared with forefoot landing according to lower-extremity joint kinematics and kinetics.

• 대한물리의학회지
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• 제9권4호
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• pp.455-463
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• 2014

PURPOSE: The purpose of this study was to compare the effects of Graston and self-myofascial release (SMR) techniques on knee joint flexibility, hamstring, and quadriceps strength. METHODS: Twenty subjects with hamstring shortness participated in this study. The subjects were assigned randomly to one of two groups: The Graston technique (GT) group received intervention using a Graston instrument for one minute, and the SMR group performed self-exercises using a foam roll for one minute. The range of motion (ROM) of the knee joint was measured by active knee extension test, and a handheld dynamometer was utilized to collect the hamstring and quadriceps muscle strength. This experiment was performed by two physical therapists. The significant level was set at ${\alpha}$=0.05. RESULTS: The results were as follows: 1) The ROM of the knee joint and quadriceps muscle strength were significantly increased in both groups. 2) Hamstring muscle strength was significantly reduced in both groups. 3) There were no significant differences between the GT group and SMR group for any variable. CONCLUSION: The results of this study suggest that SMR is an effective and easy technique for restoring proper muscle length and strength in subjects with hamstring shortness. We recommend that SMR technique be used for treat hamstring shortness in clinical setting and home-program.

• 대한정형외과스포츠의학회지
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• 제2권1호
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• pp.50-55
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• 2003

목적: 플라이오메트릭 훈련이 하지 슬관절의 굴곡과신전, 족관절의 배측굴곡과 족저굴곡의 등속성 총일량에 미치는 영향의 정도를알아보며이훈련법의효과검증을위해시도되었다. 대상및방법: 선택된 플라이오메트릭훈련 방식은 7가지로pike jump, double leg hop, double leg bound, single leg hop, stride jump cross over, alternate leg bound, box jump로구성되었다. 연구대상자는20 $\~$22세사이의대학생으로, 훈련시행군(N=5), 대조군(N=4)으로8주간 시행하고 훈련 전후 등속성 장비를 이용하여 슬관절과 족관절의 등속성 총일량을 측정하였다. 결과: 플라이오메트릭 훈련을 시행한군에서 높은 각속도의 슬관절과 족관절 운동의 총일량이 대조군에 비하여 증가하였다(p<0.05) .결론: 결과적으로 플라이오메트릭 훈련은 하지슬관절과족관절의등속성 총일량에 부분적으로영향을미치는것을알수있으며, 더나아가운동수행에도영향을미칠수있는것을의미한다.