• Title/Summary/Keyword: Knee flexion range of motion

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Reconstruction of Anterior Cruciate Ligament With Bone-Patellar tendon-Bone Allograft (동종 슬개건을 이용한 전방십자인대 재건술)

  • Chun, Churl Hong;Lee, Byoung Chang;Kim, Young Jin;Yang, Hwan Duk
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.102-108
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    • 1999
  • Purpose : The purpose of this study was to evaluate the clinical results of bone-patellar tendon-bone(B-PTB) allograft for ACL reconstruction without mechanical tensioning device. Material and Method : Forty-six knees in 43 patients were reviewed and evaluated with subjective evaluation, objective evaluation, Telos stress arthrometer and modified Feagin Scoring System. The average age at the time of operation was 27 years(range, 18-42) and the average follow up period was 41 months(range, 22-79). Authors reconstructed ACL using B-PTB allograft which was prepared by rehydration preoperatively without tensioning by mechanical tensioning device. The tension for allograft was obtained by full flexion and extension intraoperatively. All operation were performed arthroscopically by two-tunnel method to avoid the mismatching of allograft tendon length. Result : The modified Feagin Scoring System revealed 39 cases(84.7%) with excellent or good results and 7 cases(15.3%) with fair or poor results. The mean follow-up Lysholm Knee Score was 84. Telos arthrometer revealed 41 cases had an injured-to-uninjured difference of 5 mm or less(mean 2.3mm). The range of motion of knee was nearly normal and there was no extension lag in any cases at last follow up. Conclusion : Clinical results using B-PTB allograft showed less morbidity than B-PTB autograft. The intraoperative tensioning method by full flexion and extension without mechanical tensioning device was not bad. Therefore, B-PTB allograft is a good substitute material in reconstruction of the ACL.

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Discoid Meniscal Cyst -Report of 3 Cases- (원판형 연골 낭포 - 3예 보고 -)

  • Cho Sung-Do;Ko Sang-Hun;Hwang Soo-Yeon;Lee Ju-Yong
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.220-225
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    • 2003
  • The meniscal cyst of knee joint is a rare disease, and the discoid meniscal cyst has not been reported in Korea. We report 3 cases of the discoid meniscal cyst confirmed by MRI and arthroscopy. In physical examination, all cases have tenderness of the knee joint. One has palpable mass of knee joint and the other one has limitation of knee motion with knee flexion contracture of 10 degrees and positive McMurray test at external rotation of the knee. All cases are complete discoid meniscus, which are, one medial discoid meniscus and two lateral discoid meniscus through MRI. We confirmed horizontal tear of meniscus in all cases and the location of meniscal cysts are anterior hem of meniscus in one and body of meniscus in two. We could get excellent results in all 3 cases that return to normal knee range of motion.

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Comparison of Six Tests for Assessing Hamstring Muscle Length (슬괵근 유연성 평가에 관한 연구)

  • Kim, Suhn-Yeop
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.5 no.1
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    • pp.39-51
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    • 1999
  • Background and Purpose. Objective measurements of hamstring muscle length are needed to quantify baseline limitations and to document the effectiveness of therapeutic interventions. Several indirect clinical tests for measuring hamstring muscle length are available, but influence of their test procedure is not well documented. The purpose of this study were 1) to describe hamstring muscle length as reflected by use of six tests(active straight leg raising(ASLR), passive straight leg raising(PSLR), passive straight leg raising with the lower back flat(PSLRB), active knee extension(AKE), passive knee extension(PKE), hip joint angle(HJA). 2) to examine the correlation among the tests. Subjects, Sixty subjects(30 men. 30 women) ranging in age from 18 to 25 years(mean 20.2 years) and with no limitation hamstring flexibility and no neurological and orthopedical problems. Methods. All subjects performed six tests. A inclinometer was used to determine the end point of range of motion. HJA was measured using an inclinometer placed over the sacrum. PSLRB were tested PSLR with the low back flat and the opposite thigh slightly flexed and support on pillows. Results, A mean ASLR value of 85.9 degrees, PSLR value of 99.9 degrees, PSLRB value of 109.8 degrees, AKE value of 77.2 degrees PKE value of 83.1 degrees and HJA value of 73.0 degrees were obtained for all subjects. A dependent t-test showed significant difference between the angles of ASLR and PSLR(p<0.001). There was a significant difference between the angles of PSLR and PSLRB(p<0.001). There was a significant difference between the angles of AKE and PKE(p<0.001). The highest correlation was between PSLR and PSLRB(r=0.915, p<0.001). All SLR tests were significants related(p<0.001), as well as AKE and PKE(p<0.001). The lowest correlation was between PKE and HJA(r=0.171. p>0.05). Conclusion and Discussion. The results indicated that the hip flexion angles for ASLR, PSLR and PSLRB were a difference, and the knee extension angles for AKE and PKE were a difference.

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The Effects of Physical Therapy Intervention with Local Vibration on Physical Function in Patients with Traumatic Patella Fracture: Case Series (외상으로 인한 슬개골 골절을 가진 환자의 국소진동을 동반한 물리치료 중재가 신체기능에 미치는 영향: 사례군 연구)

  • Seung-won, Ahn
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.28 no.3
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    • pp.89-99
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    • 2022
  • Background: The purpose of this study was to investigate the effects of physical therapy intervention with local vibration on the physical function of patients with traumatic patella fractures. Methods: This study recruited 6 subjects who had suffered traumatic patella fractures. The study was conducted for an average of 12.8 weeks. Before the treatment (2 weeks post-surgery), they were evaluated using the numeric pain rating scale (NPRS), the Korean-version of the impact of event scale-revised (IES-R-K), pressure pain threshold (PPT), range of motion (ROM) of the knee joint, and the Korean knee injury and osteoarthritis outcome score (K-KOOS) and were reevaluated after 7 and 12 weeks, post-surgery. This study was conducted according to ORIF Patella Fracture Post-Operative Rehabilitation Protocol after applying local vibration. The protocol consists of Phases 1~5 and this study has been applied from phase 2. Results: A comparison of the performance of the participants before and after the intervention showed a decrease in NPRS (9.83±.41→4.83±.98), IES-R-K (68.67±2.73→23.83±2.40), and K-KOOS (Function, Daily living: 70.5±5.96→34.0±3.35, Function, Sports and Recreational activities: 22.83±2.32→10.77±1.37, Quality of Life: 19.33±7.33→7.33±.52) scores. And the ROM (Knee flexion: 30.0±4.47°→128.73±3.6°, Knee extension: -6.83±2.48°→-1.33±1.03°) and PPT (9.67±.52kg/cm2→22.44±2.33kg/cm2) scores increased. Conclusion: These results show that physical intervention with local vibration using a Blackroll® booster and head can help to improve pain, physical function, and psychological status. Also, it was possible to select interventions depending on the patient's condition and the desired goal, using physical intervention with the Blackroll® booster technique.

The 3-D Motion Analysis of Kinematic Variety on Lower Extremities During Ramp Descent at Different Inclinations (정상인의 내림 경사로 보행 시 경사각에 따른 하지 관절의 삼차원적 동작 분석)

  • Han, Jin-Tae;Kim, Sik-Hyun;Bae, Sung-Soo
    • Physical Therapy Korea
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    • v.13 no.2
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    • pp.16-25
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    • 2006
  • The aim of this study was to investigate the kinematics of young adults during descent ramp climbing at different inclinations. Twenty-three subjects descended four steps at four different inclinations (level, $-8^{\circ}$, $-16^{\circ}$, $-24^{\circ}$). The 3-D kinematics were measured by a camera-based Falcon System. The data were analyzed using one-way ANOVA and the Student-Newman-Keuls test. The kinematics of descent ramp walking could be clearly distinguished from the kinematics of level walking. On a sagittal plane, the ankle joint was more plantar flexed at initial contact with $-16^{\circ}/-24^{\circ}$ inclination, was decreased in the toe off position with all inclinations (p<.001),and was decreased at maximum plantar flexion during the swing phase (p<.001). The knee joint was more flexed at initial contact with the $-24^{\circ}$ inclination (p<.001), was more flexed in the toe off position with all inclinations (p<.001), and was more flexed at minimum flexion during stance phase and at maximum flexion during swing phase with $-16^{\circ}$, $-24^{\circ}$ inclination (p<.001). The hip joint was more flexed in the toe off position with $-16^{\circ}$, $-24^{\circ}$ inclination and was deceased at maximum extension during stance phase with $-16^{\circ}$, $-24^{\circ}$ inclination (p<.05). In the frontal plane, the ankle joint was more everted at maximum eversion during stance phase with $-16^{\circ}/-24^{\circ}$ inclination (p<.01) and was decreased at maximum inversion during swing phase with $-16^{\circ}$, $-24^{\circ}$ inclination (p<.01). The knee joint was more increased at maximum varus during stance phase with $-16^{\circ}/-24^{\circ}$ inclination (p<.001). The hip joint was deceased at maximum adduction during stance phase with $-24^{\circ}$ inclination (p<.05). In a horizontal plane, only the knee joint was increased at maximum internal rotation during stance phase with $-24^{\circ}$ inclination (p<.05). In descent ramp walking, the different gait patterns occurred at an inclination of over $16^{\circ}$ on the descending ramp in the sagittal and frontal planes. These results suggest that there is a certain inclination angle or angular range where subjects do switch between level walking and descent ramp walking gait patterns.

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Effect of Knee Joint Injury on Biomechanical Factors during the Uchi-mata (허벅다리걸기 시 무릎 관절 부상이 운동역학적 요인들에 미치는 영향)

  • Hyun Yoon
    • Journal of the Korean Applied Science and Technology
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    • v.40 no.4
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    • pp.642-649
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    • 2023
  • The purpose of this study was to analyze the effects of knee joint injury experiences of judo players on kinematic factors and center of pressure factors during uchimata. Among right-handed male college judo players specializing in uchimata, 13 people who had a knee joint injury experience(age, 20.69.1±0.75 years; height, 172.85±4.81 cm; body mass, 74.92±5.51 kg; and career, 8.92±0.95 years) and 13 people who did not have a knee joint injury experience(age, 21.08.1±0.76 years; height, 172.54±6.32 cm; body mass, 76.62±9.09 kg; and career, 9.46±0.94 years) within the last 2 years were divided into two groups and participated as subjects. The two groups were evaluated for differences in ankle, knee, and hip joint angle variables, COP range, and velocity components during uchimata. As a result of the study, the EIG group showed smaller values in the knee joint flexion angle at E3 and the hip joint extension angle at E4 during uchimata than the NIG group. In addition, the EIG group showed lower values in the range of motion of the COP and forward movement velocity of the COP in the one-leg support phase than the NIG group.

The Effects of the Health Promotion Program on Functional Status of the In-house Stroke Patients (건강증진프로그램이 재가뇌졸중환자의 기능상태에 미치는 효과)

  • Bak, Hae-Kyoung
    • The Korean Journal of Rehabilitation Nursing
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    • v.6 no.2
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    • pp.213-225
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    • 2003
  • The purpose of this study is to develop and evaluate the health promotion program to increase the functional status of the in-house stroke patients. The subjects for the experiment are 38 in-house stroke patients in a health center and welfare centers suffering from hemiplegia. The experimental group consists of 19 stroke patients and the control group consists of another 19 stroke patients. The program was applied to the experimental group for 8 weeks. The subjects were given health education at the first week. At the second and the fifth week they were given counselling on health by home visit. At the third, the fourth, the sixth and the seventh week they were interviewed by phone about health, and at the last week they shared their experiences through group meeting. The results of the study are as follows: 1. The degree of ADL in the experimental group increased significantly, compared with that of the control group. 2. In the experimental group the degree of Range of Motion in shoulder abduction, elbow flexion, hip flexion and ankle dorsiflexion increased significantly, compared with that of the control group. 3. In the experimental group the degree of muscle strength in elbow flexion, knee extension, and ankle dorsiflexion increased significantly, compared with that of the control group. 4. Systolic pressure, diastolic pressure in the experimental group decreased significantly, compared with that the control group. 5. HWR in the experimental group didn't decreased significantly, compared with that the control group. 6. The degree of depression in the experimental group decreased significantly, compared with that the control group. 7. The degree of social adaptation in the experimental group increased significantly, compared with that the control group. The results above show that the health promotion program for this study was effective in promoting the performance of lifestyle for health improvement of the in-house stroke patients. Therefore, it is considered that the program can be used as an efficient nursing intervention for the in-house stroke patients who need continuous health-improving behaviors.

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A Case Report of Scalp Acupuncture and Chuna Manual Therapy for a Patient with Idiopathic Parkinson's Disease with Walking Disorders due to Lower Extremity Rigidity (하지 강직으로 인한 보행장애를 동반한 특발성 파킨슨병 환자에 대한 두침 및 추나 치료 임상증례 보고)

  • Siyoung Song;Esther Jang;Joonyong Noh;Jae-Uk Sul
    • The Journal of Internal Korean Medicine
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    • v.44 no.5
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    • pp.894-903
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    • 2023
  • The purpose of this study is to report the case of a patient with idiopathic Parkinson's disease treated with scalp acupuncture and Chuna manual therapy. A total of 10 sessions of scalp acupuncture and Chuna manual therapy were performed. At the beginning of the treatment, the Korean version of modified Barthel index (K-MBI) was 25 points, and the range of motion (ROM) of both knee joints was 150° in passive flexion, while active movement was impossible. In addition, both knee joints were flexed and contracted at -40° on the right and -30° on the left. Over the course of treatment, the ROM of both knee joints improved to -20° on the right and -10° on the left. The patient was even able to maintain a standing position and was allowed to walk approximately 10 steps with support. Temporary improvement was observed as a result of applying scalp acupuncture treatment and Chuna manual therapy to a patient whose symptoms were gradually worsening.

Coordinated Intra-Limb Relationships and Control in Gait Development Via the Angle-Angle Diagram (보행 시 연령에 따른 하지 관절 내 운동학적 협응과 제어)

  • Lee, Kyung-Ok
    • Korean Journal of Applied Biomechanics
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    • v.14 no.3
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    • pp.17-35
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    • 2004
  • The purpose of this study is to explain developmental process of gait via angle-angle diagram to understand how coordinated relationships and control change with age. Twenty four female children, from one to five years of age were the test subjects for this study, and their results were compared to a control group consisting of twenty one adult females. The Vicon 370 CCD camera, VCR, video timer, monitor, and audio visual mixer was utilized to graph the gait cycle for all test subjects. Both coordinated Intra-limb relationships, and range of motion and timing according to quadrant were explained through the angle angle diagram. Movement in the sagittal plane showed both coordinated relationships and control earlier than movement in the coronal or transverse plane. In the sagittal plane, hip and Knee coordinated relationships developed first (from one year of age.) Coordinated relationships in the Knee and ankle and hip and ankle developed next, respectively. Both hip and ankle and knee and ankle development were inhibited by the inability of children to completely perform plantar flexion during the swing and initial double limb support phases. Children appeared to compensate for this by extending at their hip joint more than adults during the third phase, final double limb support. In many cases the angle angle diagram for children had a similar shape as adult's angle angle diagram. This shows that children can coordinate their movements at an early age. However, the magnitudes and timing of children's angle angle diagrams still varied greatly from adults, even at five years of age. This indicates that even at this age, children still do not possess full control of their movements.

Comparison of the Clinical Outcomes of a Single Injection Adductor Canal Block with the Concomitant Use of Transdermal Buprenorphine and Continuous Adductor Canal Block after Total Knee Arthroplasty (슬관절 인공관절 전치환술 후 일회 주사 내전근관 차단술 및 경피성 Buprenorphine 병합 요법과 도관 삽입 지속적 내전근관 차단술의 임상결과 비교)

  • Huh, Jung-Wook;Park, Man-Jun;Ko, Young-Chul;Ha, Dong-Jun;Park, Joon-Hyung;Lee, Woo-Myung
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.5
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    • pp.411-417
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    • 2019
  • Purpose: To compare the clinical outcomes of single injection adductor canal block (SACB), continuous adductor canal block (CACB), and the concomitant use of transdermal buprenorphine after total knee arthroplasty (TKA). Materials and Methods: A total of 125 patients who underwent TKA were divided into three groups and the clinical results were retrospecitively compared. Group I was comprised of patients with pain controlled by SACB (n=41). Group II consisted of patients with pain controlled by both SACB and transdermal buprenorphine (10 ㎍/h) (n=44). Group III contained patients with pain controlled by CACB (n=40). The visual analogue scale (VAS) was used as the pain control indicator and the patients were measured on a VAS for resting on the bed (VAS-Rest) at 12 hours, 24 hours, and 48 hours after surgery. The VAS while doing continuous passive motion (VAS-CPM) on the first and second postoperative day was also measured. In addition, the total amount of medications used (Butopahn, Tridol, and Ketorac) for the intravenous patient controlled analgesia (PCA) was counted for 48 hours after surgery. As the indicator of the functional recovery outcome, the incidence of nausea and vomiting was observed for 48 hours after surgery. The maximum knee joint flexion range and maximum walking distance on the first and second postoperative day, and the total length of stay at the hospital were compared. Results: The VAS-Rest was similar in the three groups at 12 hours after surgery, but at 24 hours and 48 hours after surgery, group II and III a lower VAS-CPM and total amount of medications used for PCA than group I (p<0.05). The three groups showed a low incidence of nausea and vomiting, maximum knee joint flexion range, and similar walking distance and total length of stay at the hospital. Conclusion: The combination of SACB and transdermal buprenorphine has great pain control effect initially. On the other hand, it is not associated with catheter complications and it is convenient to use and safety toward the renal function. Therefore, the concomitant use of SACB and transdermal buprenorphine can be an effective pain control method after TKA.