• 한국전문물리치료학회지
• /
• 제30권1호
• /
• pp.23-31
• /
• 2023

Background: Several factors contribute to shoulder pain, including abnormal neck posture, repeated use of the upper limbs, work involving raising the upper limbs above the head, and the effects of vibration. However, previous study has reported that constant vibration exposure could impact improvement of the stability on joints related with muscle recruitment and activation. For this difference reason, we need to verify for the complex study of relationship with repetitive upper limb movements, poor head posture, and constant vibration exposure. Objects: Our study was made to investigate the influence of vibration exposure on the shoulder muscle activity during forward-head and over-head tasks with isometric shoulder flexion. Methods: In a total of 22 healthy subjects, surface electromyography (EMG) data were collected from shoulder muscles (upper/lower trapezius, serratus anterior, and lumbar erector spinae) on tasks (neutral-head task [NHT], forward-head task [FHT], and over-head task [OHT]) with and without vibration exposure. Results: In all tasks, the EMG data of the upper trapezius and serratus anterior significantly increased with vibration exposure (p < 0.05). Furthermore, the EMG data of the lumbar erector spinae significantly increased with vibration exposure in the NHT and FHT (p < 0.05). Conclusion: We suggest that continuous vibration exposure during the use of hand-held tools in the tasks could be associated with harmful effects in the workplace. Lastly, we clinically need to examine the guidelines regarding the optimal posture and vibration exposure.

• 대한정형외과학회지
• /
• 제54권2호
• /
• pp.177-181
• /
• 2019

급성 구획 증후군은 정형외과적 응급 질환이며, 구획 내의 압력이 증가하여 비가역적인 조직의 괴사를 유발한다. 이것은 기능적 장애, 하지의 손실 및 심할 경우 신 기능 저하를 유발하여 사망까지 이를 수 있다. 환자가 초기에 통증과 종창을 호소하는 경우 심부 정맥 혈전증과 유사하여 두 질환 간의 감별이 매우 중요하다고 알려져 있다. 저자들은 마사지 후 좌측 하퇴부의 통증과 종창을 보이는 환자를 심부 정맥 혈전증으로 오인하였고 항응고제를 투여하여 발생한 급성 구획 증후군에 근막 절개술을 시행하였고 만족스러운 치료 결과를 얻었으며, 문헌 고찰과 함께 본 증례를 보고하고자 한다.

• Archives of Plastic Surgery
• /
• 제50권5호
• /
• pp.507-513
• /
• 2023

Background Free tissue transfer is considered the gold standard option for the reconstruction of distal leg defects. Free tissue transfer using recipient vessels in the contralateral leg (cross-leg bridge) is a potential option to supply the flap if there are no suitable recipient vessels in the injured leg. Most studies have described this technique using end-to-end anastomosis which sacrifices the main vessel in the uninjured leg. This study evaluated the use of a cross-leg free latissimus dorsi muscle flap for the reconstruction of defects in single-vessel legs, using end-to-side anastomosis to recipient vessels in the contralateral leg without sacrificing any vessel in the uninjured leg. Methods This is a retrospective study that included 22 consecutive patients with soft tissue defects over the lower leg. All the reconstructed legs had a single artery as documented by CT angiography. All patients underwent cross-leg free latissimus dorsi muscle flap using end-to-side anastomosis to the posterior tibial vessels of the contralateral leg. Results The age at surgery ranged from 12 to 31 years and the mean defect size was 86 cm². Complete flap survival occurred in 20 cases (91%). One patient had total flap ischemia. Another patient had distal flap ischemia. Conclusion Cross-leg free latissimus dorsi muscle flap is a reliable and safe technique for the reconstruction and salvage of mutilating leg injuries, especially in cases of leg injuries with a single artery. As far as preservation of the donor limb circulation is concerned, end-to-side anastomosis is a reasonable option as it maintains the continuity of the donor leg vessels.

• Physical Therapy Rehabilitation Science
• /
• 제13권1호
• /
• pp.8-17
• /
• 2024

Objective: This study aims to explore the relationship between isokinetic strength training and the enhancement of physical function in older adults. It also evaluates the effectiveness of isokinetic strength training equipment. Method: This study randomly divided twenty healthy adults into two groups.The experimental group engaged in isokinetic strength training for 30 minutes, three times a week, over a four-week period. In contrast, the control group did not participate in any exercise regimen. We assessed several outcome measures including physical functions (sit-to-stand test, flexibility, Timed Up and Go test), grip strength, balance, thigh circumference, the Korean version of the Patient Health Questionnaire-9 (PHQ-9), and the Korean version of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Additionally, the experimental group's self-perceived improvement in lower limb condition was evaluated using the Global Rating of Change (GROC) scale. Results: The experimental group showed significant improvements compared to the control group in various aspects: reduced sit-to-stand test duration (7.00±2.05 seconds), increased flexibility (4.69±3.90 cm), improved grip strength (1.54±1.74 kg), increased thigh circumference (left: 1.29±1.19 cm, right: 1.19±1.27 cm), enhanced Timed Up and Go test performance (-1.47±0.86 seconds), better balance (eyes open stance: -8.08±4.03 cm, eyes closed stance: -0.27±0.13 cm/s), and a decrease in depression severity (-0.15±1.51 points). Furthermore, significant increases were observed in the experimental group's maximal isokinetic strength at 90°/s for both flexion (19.62±7.03 Nm) and extension (19.60±14.65 Nm) over the study period. Conclusion: The findings suggest that isokinetic strength training equipment can significantly enhance physical functions in seniors when incorporated into an exercise regimen.

• 한국의류학회지
• /
• 제17권4호
• /
• pp.622-637
• /
• 1993

The Purposes of this study were to investigate the significant correlation among the length changes of body surface total lines and between the length changes of body surface total lines and those of component body surface segment lines, and to reveal anticipated relation among body surface length changes by the lower limb movement including all movement direction of hip joint, knee joint & ankle joint for the more functional clothing making & designing. 10 Crosswise & 5 lengthwise body surface total lines and 48 crosswise & 39 lengthwise body surface segment lines of 26 female college students aged from 18 to 24 years were measured directly on the body surface and analyzed by ANOYA & Multiple Comparison Test(Tukey), and the length changes of them were calculated as the difference of the mean length at Fl movement from the mean length at each movement and were analyzed by PEARSON CORRELATION. The results were as following : 1. Correlation among the length changes of body surface total lines (1) Correlation among the length changes of body surface total lines significantly changed by the movement ; 1) The more GA5 expanded, the more GA6 & GA7 each expanded, and the more GA18 expanded, the more GA1 & GA3 each expanded. 2) The more GA15 expanded, the less GA14 each contracted. 3) The more GA7 expanded, the larger GA17 contracted. 4) The more GA1 & GA18 expanded, the larger GA16 contracted, and the larger GM contracted, the less GA16 contracted. (2) Only GA7 and GA17(at F4) showed high (over r=0.7) correlation coefficient, But others' correlation coefficients were r=0.4~0.7. (3) Correlation coefficients among & between girth items and length items 1) Correlation coefficients among girth items were shown + ; between GA3 and GA4, GA5, GA8, between GA5 and GA6, GA7, GA9 each, between GA1 and GA6 and between GA4 and GA7. 2) Correlation coefficients among length items were shown + or - ; shown + between GA14 and GA15 and between GA17 and GA16 ; but Shown - Between GAlS and GA16. 3) Correlation coefficients between girth items and length items were mainly shown - : shown-between GA1 and GA16, GA17, between, GA4 and GA16, between GA6, GA7 each and GA17, between GA8 and GA18 ; but shown + between GA1, GA3 each and GA18 and between GA8 and GA14 were shown +. 2. Correlation between the length changes of body surface total lines and those of component body surface segment lines. (1) All correlation coefficients were + except A147 of GA14. (2) Correlation coefficient over r=0.7 was shown ; between GA3 and CB3, A35 each, between GA5 and A054, between GA6 and A63, between GA7 and A72, A74 each, between GA8 and A83, A84 each, between GA15 and A153, between GA16 and Al64, Al65 each, between GA18 and A189 : but was not shown between GA4, GA17 and it's component body surface segment lines each. (3) Characteristics of correlation between the length changes of body surface total lines and those of body surface segment lines ; 1) If significant correlation of body surface total lines were expansion parts, it's component body surface segment lines was also expansion segment and the otherwise were the same. But exception was shown between expansion line GA3 and A031 (at F4), between GA18 and AlS9 (at F6) and between GA14 and A147, so to speak GA3 & lines and GA14 was contraction total line oppositely A147 was expansion. 2) The more GA3, GAlS expanded, the less A031, A189 contracted. 3) The more GA14 contracted, the more A147 expanded. 4) All correlation except the above 2), 3), the more total lines (GA1, GA3, GA5, GA15, GA16, GA18) expanded, the more segment lines (A15, CB1, A31, A34, CB3, A52, A54, A153, A169, A181) expanded, or the larger total lines (GA14, GA16, GA17) contracted, the larger segment lines (A141, A142, A161, A164, A165, A172) contracted.

• 수면정신생리
• /
• 제12권1호
• /
• pp.58-63
• /
• 2005

목 적：중추신경계 질환의 병발 여부에 따라 렘수면 행동 장애 환자들을 두 군으로 나눈 후, 인구학적 특성, 임상양상, 수면 변인들을 비교하여 차이점과 특성을 관찰하고자 하였다. 방법：서울대학교병원에서 야간수면다원검사를 통해 렘수면 행동장애로 확진받은 81명을 대상으로 하였다. 의무기록과 수면다원검사 소견을 후향적으로 조사하였고 필요한 경우 전화문진을 통해 자료를 보완하였다. 중추신경계 질환력과 뇌 자기공명검사 소견을 근거로 전체 대상을 중추신경계 질환을 동반한 병발성 렘수면 행동장애군과 그렇지 않은 특발성 렘수면 행동장애군으로 이분하였다. 그 후 두 군 사이의 인구학적 특성, 임상양상, 수면 변인을 비교분석하였다. 결 과：전체 대상군 81명 중 남자는 64명, 여자는 17명이었다. 그리고 전체 대상중에 21명(25.9%)에서 중추신경계 질환이 동반되어 병발성 렘수면 행동장애군으로, 나머지 60명(74.1%)에서 그렇지 않아 특발성 렘수면 행동장애군으로 분류하였다. 동반된 중추신경계 질환은 파킨슨병(11명), 올리브뇌교소뇌위축(olivopontocerebellar atrophy)(3명), 다발신경계위축증(multiple system atrophy)(2명), 파킨슨병을 동반하지 않은 치매(2명), 뇌경색(1명), 뇌교부종(1명), 뇌종양(1명)이었다. 전체 대상에서 수면장애가 병발된 경우는 74.1%로서 주기성 사지운동증과 폐쇄성무호흡증이었다. 주기성 사지운동증(사지운동 지수>5)과 폐쇄성 수면무호흡증(호흡장애지수>5)의 유병율이 병발성 렘수면 행동장애군에서 유의하게 높았다(각각 p<0.001, p=0.0042, Fisher 검증). 심한 정도를 나타내는 주기성 사지운동지수와 호흡장애지수도 병발성 렘수면 행동장애군에서 유의하게 높았다(각각 p<0.001, p=0.017, 독립 t-test). 수면변인 중 서파수면분율과 수면효율은 병발성 렘수면 행동장애군에서 유의하게 낮았다(각각 p<0.001, p=0.017, 독립 t-test). 고 찰：렘수면 행동장애 환자의 25%에서 중추신경계 질환이 동반되어 있음을 확인하였다. 중추신경계 질환이 동반된 렘수면 행동장애에서는 주기성 사지운동증과 폐쇄성 수면 무호흡증 같은 다른 수면장애가 더 흔하게 병발하였고 그 정도 역시 더 심하게 나타났다. 수면구조에서도 특발성 렘수면 행동장애에 비해 서파수면과 수면효율이 모두 더 감소하는 소견을 보였다.

• Tuberculosis and Respiratory Diseases
• /
• 제45권5호
• /
• pp.1039-1046
• /
• 1998

연구배경: 주기성 사지운동장애(PLMD)는 여러 수면장애와 함께 공존하는 경우가 많으며, 특히 수면관련 호흡장애(SRBD)와의 관계는 밀접하다고 알려져 있다. PLMD는 반복적이고 상동증적인 사지의 움직임에 의하여 전기생리적인 각성을 일으키기 때문에 불면증과 주간 졸립증을 초래하므로 이에 대한 관심이 필요하다. 본 연구는 SRBD 환자에서 PLMD의 빈도를 조사하고, PLMD로 진단된 환자군의 특성을 조사함으로써, SRBD 환자에서 PLMD의 동반 이환에 대한 이해를 높이는데 있다. 대상 및 방법: 진단적인 수면다원 검사로 수면관련 호흡장애의 진단이 내려진 106명을 대상으로 이들의 수면기록을 후향적으로 조사하였다. 수면다원 검사의 기록과 판독은 표준적인 방법을 사용하였다. OSA 의 진단은 RDI가 10 이상인 경우 내렸고, UARS는 낮 동안에 심한 졸림증을 호소하고 수면다원 검사상 RDI가 5 이하이나 호흡노력의 증가에 이어서 짧은 각성이 반복되는 경우 내렸다. 수면중 주기성 사지운동장애의 진단은 주기성 사지운동지수가 5 이상일 때 내렸다. 자료처리는 SPSS/$PC^+$를 이용하였다. 곁 과: 평균연령은 49.5세였고, 성별은 남자 76명, 여자 30명이었다. 진단은 폐쇄성 무호흡증 78명, 상기도저항증후군 28명이었다. 전체 연구대상의 평균 수면효율은 76.3%, 평균 호흡장애 지수는 22.3/hr, 평균 혈중 산소포화도는 84.9%로 중등도의 수면중 호흡장애가 있음을 알 수 있다. 평균 주지성 사지운동 장애지수는 13.1/hr였으며 70% 이상의 환자들이 32/hr 이하에 분포하였고 개인차이가 많았다. 주기성 사지운동 장애지수가 5 이상으로 수면중 주기성 사지운동장애를 동반한다고 판단된 군이 47명으로 전체의 44.3%를 차지하였다. 수면중 주기성 사지운동장애를 동반하는 군과 동반하지 않는 군의 비교에서, 두 군간에 나이, 무호흡 지수, 성별, 1 단계 수면의 백분율에서 유의한 차이가 있었다. 결 론: 본 연구의 결과는 이전의 타 연구들보다 수면관련 호흡장애에서의 주기성 사지운동장애의 동반이환율이 더 높다. PLMD를 동반하는 군의 나이가 유의하게 더 많고, 여성에서의 동반율이 더 높고, 무호흡 지수(apnea index)가 유의하게 더 낮다. 수면중 주기성 사지운동장애는 수면관련 호흡장애와 함께 불면증과 주간 졸림증을 초래하고, 본 연구에서 뒷받침 하듯이 수면중 호흡장애 환자에서 흔히 함께 동반되기 때문에, 수면관련 호흡장애 환자의 진단 및 가료시 이에 대한 배려가 필요하다.

• 한국운동역학회지
• /
• 제17권2호
• /
• pp.113-121
• /
• 2007

The purpose of this study was to determine the effect of three different plates($0^{\circ}$, $10^{\circ$}, $20^{\circ}$)under heels on the lower limb muscles and erector spinae during squat exercise. Ten high school korean traditional wrestling players(age: $18.5{\pm}0.7$, weight: $1972.2{\pm}128.5N$, height: $177.8{\pm}6.0cm$, weight of barbell: $1004.5{\pm}132.4N$) performed squat exercise using three different tilting plates under heels at a cadence of 40beats/sec with 80% one repetition maximum load. Surface electrodes were placed on the participants' left and right erector spinae, and rectus femoris, vastus medialis, vastus lateralis, tibialis anterior, biceps femoris, medial gastrocnemius, and lateral gastrocnemius in the right lower extremity. One S-VHS camcorder(Panasonic AG456, 60fields/s) was placed 10m to the side of the participant. To synchronize the video and EMG data, a synchronization unit was used for this study. Average and Peak IEMG values were determined for each participant. For each variable, a one-way analysis of variance was used to determine whether there were significant differences among three different tilting plates under heels. When a significant difference was found in plates type, post hoc analyses were performed using the Tukey procedure. A confidence level of p<.05 was used to determine statistical significance. As a result of this study, maximum nEMG values of the tibialis anterior in $0^{\circ}$ plates was significantly higher than the corresponding values for the other plates during the knee extension. This increased activation in the tibialis anterior muscle indicates an increase in displacement of center of gravity of body. It is very likely that additional muscle activation are needed to stop the forward and backward movement. The results also showed that muscular activities of quadriceps femoris and erector spinae were decreased with increasing angle of plates. This suggests that increasing angle of plate may help to sustain the balance and posture of squat exercise. It is considered that very few significant differences were found among three different plates($0^{\circ}$, $10^{\circ}$, $20^{\circ}$) since elite players with much experience in squat exercise, were chosen as a participant of this study. In order to obtain meaningful results regarding the tilting angle of heel plates in squat exercise, kinetic and 3D kinematic analysis will be needed in the future study.

• 대한의용생체공학회:의공학회지
• /
• 제38권4호
• /
• pp.143-152
• /
• 2017

The main purpose of this research was to examine the EMG characteristics of driver's upper limb and driving performance for operating accelerator and brake pedal by using four types of left hand control devices(Push/Pull, Push/Right angle, Push/Rock, Push/Twist) during simulated driving. The persons with disabilities in the lower extremity have problems in operation of the vehicle because of functional impairments for controlling accelerator and brake pedal. Therefore, if hand control device is used for adaptive driving controls in persons with lower extremity loss, the disabled people could improve their quality of mobility life by driving a car. Twenty subjects were involved in this research to assess driving performance and EMG activities for operating accelerator and brake pedal by using four types of left hand controls in driving simulator. We measured EMG responses of six muscles(posterior deltoid, middle deltoid, biceps, triceps, extensor carpi radialis, and flexor carpi radialis) during pulling and pushing movement with four types of left hand controls for acceleration and braking. STISim Drive 3 program was used for evaluation test of four types of left hand control devices in straight lane course for time to reach target speed and brake reaction time. While operating the four types of left hand controls for acceleration, EMG activities of posterior deltoid in normal subjects were significantly increased(p < 0.05) compared to the disabled subjects. It was also found that EMG responses of triceps and posterior deltoid were significantly increased(p < 0.05) when using the Push/Right angle type than Push/Pull type. While operating the four types of left hand controls for braking, EMG activities of flexor carpi radialis and triceps in subjects with disability were significantly increased(p < 0.05) compared to the normal subjects. It was shown that muscle responses of posterior deltoid, middle deltoid and triceps were significantly increased when using the Push/Right angle type than Push/Rock type. Time to reach target speed and brake reaction time in subjects with disability was increased by 2.5% and 4.6% on average compared to normal subjects. The person with disabilities showed a tendency to relatively slow performance in acceleration at the straight lane course.

• 대한기계학회논문집A
• /
• 제41권9호
• /
• pp.825-837
• /
• 2017

본 논문에서는 하지 보행 장애를 가진 환자가 사용하는 크러치에 로봇 기술이 적용된 새로운 타입의 착용식 족형 보행 재활 로봇에 대해 서술하였다. 개발된 로봇의 주된 특징은 크게 세 가지로 나뉜다. 첫 번째, 착용 방식의 특징으로서, 팔꿈치에 착용하여 환자를 보조하는 엘보 크러치와 달리 환자의 가슴부에 족형 로봇을 착용함으로써 보행 시 넓은 가슴 면적으로부터 하중을 분산시키고 팔에 작용하는 집중 하중을 제거하였으며, 팔과 손의 움직임을 자유롭게 하였다. 두 번째, 사용자의 보행 의지를 파악하는 방법으로서, 족형 로봇의 발에 부착된 3축 힘센서를 이용하여 지면 반발력의 크기와 방향으로부터 사용자의 보행의도를 추정하는 알고리즘을 제안하였고 이에 따라 가슴 착용형 로봇을 보행시켰다. 마지막으로, 계단 보행을 위한 근력 강화 방법으로서, 둔턱을 오르내리는 근력 훈련이 가능하도록 바닥 높낮이에 따라 상하 운동 궤적이 변화할 수 있는 둔턱 보행 기능을 구현하였다. 최종적으로 개발된 로봇이 보행 의도를 인지하고 로봇 다리로부터 보행 보조를 효과적으로 수행할 수 있다는 것을 실험을 통하여 확인하였고, 하지 근전도 측정을 통하여 보행 시 로봇이 하지 근력을 보조하는 성능을 정량적으로 검증하였다.