• The Journal of the Korean bone and joint tumor society
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• v.3 no.1
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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

• Archives of Plastic Surgery
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• v.35 no.3
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• pp.295-302
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• 2008

Purpose: The lower leg often has poor vascularity, proximity to bone, and insufficient soft tissue. The island flaps offer a feasible one stage reconstruction and has a remarkable vascularization and high quality results for soft tissue defect with or without bony problems to occur on regions below the knee. So we reported our experience of island flaps with review of the literatures. Methods: We reconstructed 29 cases of soft tissue and 2 cases of bony defect on regions below the knee by using various island flaps at our hospital from December, 1991 to January, 2006. We used 2 fibular osteocutaneous island flaps, 15 reverse sural island flaps, 6 extensor digitorum brevis muscular island flaps, 2 medial plantar island flaps, 5 saphenous island flaps, and a dorsalis pedis island flap. Results: Partial necrosis was developed in 4 out of 15 reverse sural island flaps and 1 out of 5 saphenous island flaps, but they were healed with secondary skin graft. There was partial loss of skin graft on the donor sites in 2 cases. Conclusion: Island flaps are very useful for reconstruction of regions below the knee because island flaps have good vascularity and less risk of infection. Generous flap size, easy operative technique, lower cost, shorter operative time, and minimal morbidity at the donor site are other advantages. We attained satisfactory results.

• Korean Journal of Applied Biomechanics
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• v.25 no.3
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• pp.311-322
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• 2015

Objective : The purpose of this study was to investigate the effects of landing height and knee joint muscle fatigue on the movement of the lower extremity during cutting after landing. Method : Subjects included 29 adults (age: $20.83{\pm}1.56years$, height: $172.42{\pm}9.51cm$, weight: $65.07{\pm}10.18kg$). The subjects were asked to stand on their dominant lower limb on jump stands that were 30 and 40 cm in height and jump from each stand to land with the dominant lower limb on a force plate making a side step cutting move at a $45^{\circ}$ angle with the non-dominant lower limb. The fatigue level at 30% of the knee extension peak torque using an isokinetic dynamometer. Results : The results showed that the difference of landing height increased maximum range of motion and angular velocity of hip, knee, and ankle joints in the sagittal plane, and in the angular velocity of motion of the hip joint in the sagittal plane. The maximum range of motion of the knee joint in the sagittal plane and the frontal plane decreased on landing from both heights after the fatigue exercise. The angular velocity of the hip joint in the sagittal plane, and the maximum range of motion of the hip joint in the transverse plane decreased for both landing heights after the fatigue exercise. The angular velocity of the hip joint in the frontal plane decreased for the 30 cm landing height after the fatigue exercise. On the other hand, the angular velocity and maximum range of motion of the ankle joint in the sagittal plane for both landing heights, and the angular velocity and maximum range of motion of the ankle joint in the frontal plane increased on landing from the 40 cm height after the fatigue exercise. Conclusion : Different landing heights of 30 and 40 cm and 30% fatigue of peak torque of knee extensor found a forefoot and stiff landing strategy, when cutting after landing. These results might be due to decline in the shock absorption capability of the knee joint and the movement capability related to cutting while increasing the contribution of the ankle joint, which may cause increased ankle joint injuries.

• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.2
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• pp.77-81
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• 2003

Purpose: The biomechanics and kinematics of knee joint were reviewed in this article. And then the common sports injuries were presented. Anatomy and Kinetics: None of the pairs of bearing surfaces in the knee joint is exactly congruent This allows the knee six degrees of freedom of motion. Tibiofemoral Kinematics: In flexion and extension, the axis of motion is not perpendicular to the medial-lateral plane of the joint, nor is it perpendicular to the axis of longitudinal rotation. This results in coupled varus angulation and internal rotation with flexion and in valgus angulation and external rotation with extension. Patellofemoral Articulation: Loads across the patellofemoral joint are indirectly related to the angle of knee flexion and directly related to the force generated within the quadriceps mechanism. Fractures of the Patella: Nonoperative treatment is indicated if the extensor mechanism is intact and if displacement of fragment is minimal. The specific type of internal fixation depends on the fracture pattern. It is important to repair retinaculum. Acute and Recurrent Patellar Instability: The degree of dysplasia and the extent of the instability play a large part in determining the success of nonoperative treatment. Patients who experience recurrent dislocations and patients with major anatomic variations require surgery to minimize their instability. Sports Injuries in School-age Atheletes: Patellar pain in young athletes groups a number of conditions, including Idiopathic Adolescent Anterior Knee Pain, Osgood- Schlatter Disease, and Sinding-Larsen-Johansson Disease.

• International Journal of Precision Engineering and Manufacturing
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• v.9 no.1
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• pp.30-33
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• 2008

Understanding the characteristics of amputee gait is key in developing more advanced prostheses. The aim of this study was to quantitatively analyze a stair-climbing task for transfemoral amputees with a prosthesis and to predict the muscle forces and joint moments at musculoskeletal joints using a dynamic analysis. A three-dimensional musculoskeletal model of the lower extremities was constructed from a gait analysis using transformation software for two transfemoral amputees and ten healthy people. The measured ground reaction forces and kinematical data of each joint from the gait analysis were used as input data for an inverse dynamic analysis. Dynamic analyses of an transfemoral amputee climbing stairs were performed using musculoskeletal models. The results showed that the summed muscle forces of the hip extensor of an amputated leg were greater than those of a sound leg. The opposite was true at the hip abductor and knee flexor of an amputated leg. We also found that higher moments at the hip and knee joints of the sound leg were required to overcome the flexion moment caused by the body weight and amputated leg. Dynamic analyses using musculoskeletal models may be a useful means to predict muscle forces and joint moments for specific motion tasks related to rehabilitation therapy.

• Physical Therapy Korea
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• v.1 no.1
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• pp.75-82
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• 1994

The purpose of this study is to determine cardiovascular reponses to concentric, eccentric and isometric exercise applied to the knee extensor muscle group. Exercise types studied were concentric, eccentric and isometric. The subjects were sixty healthy male volunteers who had no hypertension or cardiac disease. Heart rate, systolic and diastolic blood pressure were recorded prior to starting exercise. The subjects also performed 10RM on right lower extremity. A N-K table was used for three exercises to right knee extensors. Each exercise was selected randomly and applied to each subject 10 times in a 10 second. After each exercise, heart rate, systolic and diastolic blood pressure were recorded immediately. Findings were as follows concectric contractions had a greater effect on the increase of systolic blood pressure and heart rate than eccentric or isometric contractions. Diastolic blood pressure is influenced only by isometric contractions. Eccentric contractions have less effect on the increase of systolic blood pressure and heart rate than concentric or isometric contractions. We hope that the results of this experiment can be adapted to exercise programs for patients with cardiac disease.

• Korean Journal of Applied Biomechanics
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• v.26 no.4
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• pp.421-426
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• 2016

Objective: The purpose of this study was to investigate how different levels of compression exerted on the femoral region (known as the power zone) by coated fabric influences the activation and anaerobic capacity of the rectus femoris. Method: Three different levels of compression on the rectus femoris of the participants, namely 0% (normal condition), 9% (downsize), and 18% (downsize), were tested. The material of the fabric used in this study was nonfunctional polyurethane. Surface electromyography test was used to investigate the activation of the rectus femoris, while the isokinetic test (Cybex, $60^{\circ}/sec$) and Wingate test were used to investigate the maximum anaerobic power. Results: The different compression levels (0%, 9%, and 18%) did not improve the strength and anaerobic capacity of the knee extensor. However, knee flexor interfered with activation of the biceps femoris, which is an agonist for flexion, during 18% compression. Conclusion: Compression garments might improve the stretch shortening cycle effect at the time of eccentric contraction and during transition from eccentric to concentric contraction. Therefore, future studies are required to further investigate these findings.

• Journal of Biomedical Engineering Research
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• v.32 no.2
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• pp.165-176
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• 2011

The femoral nerve innervates the quadriceps muscles and its dermatome supplies anteromedial thigh and medial foot. Paralysis of the quadriceps muscles due to the injury of the femoral nerve results in disability of the knee joint extension and loss of sensory of the thigh. A child could walk independently even though he had injured his femoral nerve severely due to the penetrating wound in the medial thigh. We measured and analyzed his gait performance in order to find the mechanisms that enabled him to walk independently. The child was eleven-year-old boy and he could not extend his knee voluntarily at all during a month after the injury. His gait analysis was performed five times (GA1~GA5) for sixteen months. His temporal-spatial parameters were not significantly different after the GA2 or GA3 test, and significant asymmetry was not observed except the single support time in GA1 results. The Lower limb joint angles in affected side had large differences in GA1 compared with the normal normative patterns. There were little knee joint flexion and extension motion during the stance phase in GA1 The maximum ankle plantar/dorsi flexion angles and the maximum knee extension angles were different from the normal values in the sound side. Asymmetries of the joint angles were analyzed by using the peak values. Significant asymmetries were found in GA1with seven parameters (ankle: peak planter flexion angle in stance phase, range of motion; ROM, knee: peak flexion angles during both stance and swing phase, ROM, hip: peak extension angle, ROM) while only two parameters (maximum hip extension angle and ROM of hip joint) had significant differences in GA5. The mid-stance valleys were not observed in both right and left sides of vertical ground reaction force (GRF) in the GA1, GA2. The loading response peak was far larger than the terminal stance peak of vertical ground reaction curve in the affected side of the GA3, GA4, GA5. The measured joint moment curves of the GA1, GA2, GA3 had large deviations and all of kinetic results had differences with the normal patterns. EMG signals described an absence of the rectus femoris muscle activity in the GA1 and GA2 (affected side). The EMG signals were detected in the GA3 and GA4 but their patterns were not normal yet, then their normal patterns were detected in the GA5. Through these following gait analysis of a child who had selective injuries on the knee extensor muscles, we could verify the actual functions of the knee extensor muscles during gait, and we also could observe his recovery and asymmetry with quantitative data during his rehabilitation.

• Journal of International Academy of Physical Therapy Research
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• v.1 no.2
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• pp.126-135
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• 2010

The purpose of this study is to investigate the effects of closed and open kinetic chain exercise for increasing knee joint function on the knee position sense in the normal adults. Thirty normal adults(male 15, female 15; mean age: $22.13{\pm}2.58$ years) were participated in this study into two groups, each with 15 people. The group I was trained that closed kinetic chain exercise on the knee joint and the group II was trained that open kinetic chain exercise on the knee joint. Exercise programs performed for 4 weeks, 3 times a week were using Shuttle 2000-1 closed kinetic chain exercise and Knee Extensor open kinetic chain exercise(HUR, Filand). The results of this study were as follows: 1) There were statistically significant decreasing of measuring error degree in $0-20^{\circ}$ were found between before and after training in closed kinetic chain exercise(p<.05). 2) There were statistically significant decreasing of measuring error degree in $21-40^{\circ}$ were found between before and after training in closed kinetic chain exercise(p<.05). 3) There were statistically significant decreasing of measuring error degree in $41-60^{\circ}$ were found between before and after training in closed kinetic chain exercise(p<.05). 4) There were statistically significant decreasing of measuring error degree in $0-20^{\circ}$ were found between before and after training in open kinetic chain exercise(p<.05). 5) There were statistically significant decreasing of measuring error degree in $21-40^{\circ}$ were found between before and after training in open kinetic chain exercise(p<.05). 6) There were statistically significant decreasing of measuring error degree in $41-60^{\circ}$ were found between before and after training in open kinetic chain exercise(p<.05). In conclusion, these results suggest that closed and open kinetic chain exercise has increased in the knee joint proprioception between before and after training. Especially, closed kinetic chain exercise could be more useful intervention than open kinetic chain exercise for increasing proprioceptive sense.

• Journal of Korean Academy of Nursing
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• v.29 no.3
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• pp.665-678
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• 1999

Stroke is a major cause of death and long-term disability. Because muscle weakness is one of the most prominent consequences of stroke, it was considered important to determine whether exercise in order to improve muscle strength and range of motion could have an effect in limiting the learned disuse of the affected side. The purpose of the study was to identify the effects of an 8 week rehabilitation program on physical and cognitive ability in stroke patients. A total of 18 patients who were admitted to the oriental medicine unit of a K medical center in Seoul were recruited : ten for the experimental group and eight for the control group. The rehabilitation program consisted of three level's of active and passive exercises for prevention of muscle contracture and at range of motion. Muscle strength, flexibility of the upper and lower extremity, perceived balance, functional independence, depression, and quality of life for the two groups were compared at the pretest and 4 and 8 weeks after the rehabilitation program. The results are as follows : 1) When measuring muscle strengths of shoulder abduction and elbow flexion, hip flexion and knee extensor, ankle dorsi-flexor and muscle strength of knee flexor. Muscle strength of knee flexor for the experimental group was significantly higher than the comparison group at the 4 weeks. 2) Muscle strength and flexibility of the ankle dorsi -flexor for the experimental group was significantly better than for the control group at 8 weeks. 3) Functional independence, perceived balance, and Tinetti balance for the experimental group as measured at 4 and 8 weeks were better than for the control group. Also, there were changes over time in physical balance and functional ability, but there was no significant differences between the groups. 4) The experimental group showed a higher quality of life and lower depression than the control group at 8 weeks. 5) Muscle strength and flexibility of ankle dorsi -flexor were significantly changed over time and an interaction between group and time. The findings suggested that the rehabilitation program would improve the physical and psychological status of the stroke patients. Thus, the gains in actual or perceived ability to perform physical activities was marked.