• Physical Therapy Korea
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• v.7 no.3
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• pp.81-89
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• 2000

The purpose of this study was to determine the effect of electrical stimulation biofeedback on motor learning of quadriceps muscle isometric exercise in 3 patients who have undergone total knee replacement surgery. A multiple baseline design across subjects was used. The electrical stimulation biofeedback was provided with each patient during quadriceps isometric exercise, which last 10 to 14 sessions with 10 repetitions each sessions. After training patients received 4 retention tests. Maximum muscle activity was measured pre- and post- electrical stimulation biofeedback training and retention test to evaluate the effect of biofeedback training. Maximum isometric muscle activity of quadriceps was increased after electrical stimulation biofeedback training in all subjects. The results indicate that a electrical stimulation biofeedback training is a useful method to improve motor learning of quadriceps isometric exercise in total knee replacement.

• The Journal of Korean Physical Therapy
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• v.25 no.2
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• pp.81-87
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• 2013

Purpose: The purpose of the current study was to examine the effects of electromyography (EMG)-biofeedback training on lower extremity muscle activity and balance of patients with total knee replacement (TKR). Methods: Subjects were randomly allocated to two groups: experimental and control group. Subjects in the experimental group (n=10) were provided with quadriceps setting exercise by EMG-biofeedback (QSE+BF) and those in the control group were provided with QSE. Subjects in both groups were provided with the respective training programs for 20 minutes per session, five times per week, for a period of six weeks. To test significance, data analysis was performed using repeated-ANOVAs. Results: Statistically significant differences in muscle activity of the rectus femoris muscle and the vastus lateralis, and dynamic balance ability were observed in the experimental group, compared with the control group. In comparison of the muscle activity of the rectus femoris muscle and the vastus lateralis, and dynamic balance ability between different training periods within the groups, both groups showed statistically significant differences. Conclusion: EMG-biofeedback training is effective in improving lower extremity muscle activity and balance ability of patients with TKR, and should be effective in patients with other diseases.

• Journal of IKEEE
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• v.7 no.1 s.12
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• pp.119-126
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• 2003

This paper presents a methodology for constructing a surgical simulation environment for the replacement of artificial knee join using CT image data. We provide a user interface of preoperative planning system for performing complex 3-D spatial manipulation and reasoning tasks. Simple manipulation of joystick and mouse has been proved to be both intuitive and accurate for the fitness and the wear expect of joint. The proposed methodology are useful for future virtual medical system where all the components of visualization, automated model generation, and surgical simulation are integrated.

• Journal of Computational Design and Engineering
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• v.1 no.1
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• pp.55-66
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• 2014

A knee joint's longevity depends on the proper integration of structural components in an axial alignment. If just one of the components is abnormally off-axis, the biomechanical system fails, resulting in arthritis. The complexity of various failures in the knee joint has led orthopedic surgeons to select total knee replacement as a primary treatment. In many cases, this means sacrificing much of an other-wise normal joint. Here, we review novel computational approaches to describe knee physiotherapy by introducing a new dimension of foot loading to the knee axis alignment producing an improved functional status of the patient. New physiotherapeutic applications are then possible by aligning foot loading with the functional axis of the knee joint during the treatment of patients with osteoarthritis.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2013.05a
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• pp.1507-1508
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• 2013

• Journal of Korean Physical Therapy Science
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• v.1 no.1
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• pp.145-163
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• 1994

This study was done to determine differences in effect of postoperative pain control in patients receiving auricular electroacustimulation vs transcutaneous electrical nerve stimualtion following total knee replacement surgery. Thirty-one cases referred to physical therapy department after treated by total knee replacement surgery by orthopedic surgery department at the Pohang St. Mary's Hospital from January 1993 through June 1994. Of 31 total knee replacement cases, 13 cases were auricular electroacustimulation group, 11 cases were transcutaneous electrical nerve stimulation group, and 7 cases were control group. The results of the study summerized are as follows: Thirty-one total knee replacement cases(male in 12 cases, female in 19 cases), ranging in age from 34 to 61 years(mean${\pm}$SD=49.90 7.56) with diagnoses of degenerative arthritis(20 cases), rheumatoid arthritis(9 cases), and other(2 cases). In auricular electroacustimulation group, there was a significant change of pain intensity, unpleasantness, and active range of motion after treatment(p<0.01). In transcutaneous electrical nerve stimulation group, there was a significant change of pain intensity, unpleasantness, and active range of motion after treatment(p<0.01). In control group, did not show significant pre-posttreatment differences in pain intensity, unpleasantness, active range of motion(p>0.05). The mean change in pain intensity and unpleasantness, active range of motion from pretreatment baseline for the 3 groups. Auricular electroacustimulation group showed the large magnitude of increase in pain intensity and unpleasantness, active range of motion when compared to its own pretreatment cycle. Transcutaneous electrical nerve stimulation group showed small magnitude of increase in pain intensity and unpleasantness, active range of motion when compared to its own pretreatment cycle. No significant changes were observed in control group. Highly significant differences in pain intensity, unpleasantness, and active rage of motion were found using an ANOVA measures between treatment groups and control group(p<0.01). The squares correlation coefficients of pain and function measures pretreatment-posttreatment differences for each group. In treatment group, there was significant correlation between pain scale and function(p<0.001). In control group, there was no correlation between the pain scale and function (p>0.05). The continuous study is needd for many interesting issues of auricular electroacustimulation in new future.

• Journal of Digital Convergence
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• v.13 no.2
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• pp.215-225
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• 2015

This study was conducted to develop a severity-adjusted LOS(Length of Stay) model for knee replacement patients and identify factors that can influence the LOS by using the Korean National Hospital Discharge in-depth Injury Survey data. The comorbidity scoring systems and data-mining methods were used to design a severity-adjusted LOS model which covered 4,102 knee replacement patients. In this study, a decision tree model using CCS comorbidity scoring index was chosen for the final model that produced superior results. Factors such as presence of arthritis, patient sex and admission route etc. influenced patient length of stay. And there was a statistically significant difference between real LOS and adjusted LOS resulted from health-insurance type, bed size, and hospital location. Therefore the policy alternative on excessive medical utilization is needed to reduce variation in length of hospital stay in patients who undergo knee replacement.

• Journal of Convergence for Information Technology
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• v.12 no.2
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• pp.174-183
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• 2022

This study was conducted to investigate the effect of the active exercise program using sling on the pain and balance of total knee replacement patients. Subjects were 20 patients who received total knee replacement and are hospitalized, 10 patients in each group were randomly assigned to a group (CPM group) that applied only CPM (Continuous passive motion) and a group (CSG) that combined CPM with a active exercise program using sling. CG was performed CPM 5 days a week, CSG performed CPM 2 days a week and a active exercise program using sling 3 days a week, and each intervention was performed for 40 minutes a day for a total of 4 weeks. Pain was evaluated using VAS (Visual analog scale), and balance was measured using BT4 (Balance training 4) to measure C90 area, trace length, and Sway average velocity with eyes open and closed. As a result, there was a significant decrease in pain in both groups, and there was also a significant difference in the amount of change between groups. In balance, all variables except C90 of CG showed significant changes after intervention, and there was a significant difference between C90 and Vel with eyes closed in the amount of change between groups. Therefore, we believe that CPM and active exercise program using sling are effective interventions to reduce pain and improve balance in total knee replacement patients.

• Journal of Life Science
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• v.14 no.3
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• pp.484-489
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• 2004

Artificial joint replacement is one of the major surgical advances of the 21th century. The primary purpose of a TKA (Total Knee Arthroplasty) is to restore normal knee Auction. Therefore, ideally, a TKA should: (a) maintain the natural leverage of the knee joint muscles to ensure generating adequate knee muscle moments to accomplish daily tasks such as rising from a chair or climbing stairs;(b) allow the same range of motion as an complete knee; and (c) provide adequate knee joint stability. Four individuals (2 peoples after surgery one year and 2 peoples after surgery three years) participated in this study. All they were prescreened for health and functional status by the same surgeon who performed the operations. Two days of accommodation practice occurred prior to the actual strength testing. The isometric strength (KIN-COM III) of the quadriceps and hamstring were measured at 60$^\circ$ and 30$^\circ$ of knee flexion, respectively. During isokinetic concentric testing, the range of motion was between 10$^\circ$ to 80$^\circ$ of knee flexion (stand-to-sit) and extension (sit-to-stand). for a given test, the trial exhibiting maximum torque was analyzed. A 16-channel MYOPACTM EMG system (Run Technologies, Inc.) was used to collect the differential input surface electromyographic (EMG) signals of the vastus medialis (VM), vastus lateralis(VL), rectus femoris (RF) during sit-to-stand and stand-to-sit tests. Disposable electrodes (Blue SensorTM, Medicotest, Inc.) were used to collect the EMG signals. The results were as follows; 1. Less maximum concentric (16% and 21% less for 1 yew man and 3 years mm, respectively) and isometric (12% and 29%, respectively) quadriceps torque for both participants. 2.14% less maximum hamstrings concentric torque for 1 year man but 16% greater torque for 3 years mm. However, 1 year man had similar hamstring isometric peak torque for both knees. 3. Less quadriceps co-contraction by 1 year man except for the VM at 10$^\circ$-20$^\circ$ and 30$^\circ$-50$^\circ$ range of knee flexion.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.2
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• pp.93-101
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• 2023

PURPOSE: The Western Ontario and McMaster Universities Arthritis (WOMAC) index has been used to measure the outcome of total knee replacement (TKR), but studies on its reliability and validity are limited. The present study examined the reliability and validity of this index for patients with knee osteoarthritis who underwent TKR. METHODS: Seventy-one inpatients and outpatients who underwent bilateral TKR for knee osteoarthritis were included in this study. The pain assessment scale and WOMAC index were used to evaluate the participants every two weeks to examine the test-retest reliability, internal consistency, and construct validity. RESULTS: The test-retest reliability scores for pain, stiffness, and physical function were .75-.92, .85-.90, and .75-.95, respectively. The corresponding intraclass correlation coefficients were .75-.88, .76-.88, and .71-.95, respectively. The internal consistency score in the first and second examinations was .92. Furthermore, the construct validity scores for pain, stiffness, and physical function were .83, .41, and .58, respectively. CONCLUSION: The application of the WOMAC index in patients who underwent TKR showed high test-retest reliability and internal consistency with the use of the WOMAC index and good validity with the use of the pain assessment scale.