• Archives of Plastic Surgery
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• v.50 no.5
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• pp.507-513
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• 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.

• Archives of Plastic Surgery
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• v.37 no.6
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• pp.835-838
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• 2010

Purpose: Reconstruction of soft tissue defects in the distal lower leg, especially in the distal third, largely depends on free tissue transfer and local fasciocutaneous flaps. But several local muscle flaps have also been proposed as useful alternative reconstructive manner. In this report, the authors present the successful use of the flexor digitorum longus muscle flaps in the distal lower leg reconstruction. Methods: Case 1: An 81-year-old woman with a dog bite wound in the left distal lower leg was admitted. She had a $10{\times}8\;cm$ wound with tibial exposure along the medial aspect of the leg. Soft tissue reconstruction with a flexor digitorum longus muscle flap and a split-thickness skin graft was performed. Case 2: A 77-year-old woman had a squamous cell carcinoma in the right distal lower leg. After wide excision, a $5{\times}4\;cm$ wound was developed with exposure of the tibia. The flexor digitorum longus muscle flap was transposed and covered with a split-thickness skin graft. Results: The flexor digitorum longus muscle flaps were shown to be useful to cover tibial defects in the distal lower leg. During the follow-up period, no significant donor site morbidity was found. Conclusion: The flexor digitorum longus muscle flap can be used to cover the exposed distal tibia, especially when a free tissue transfer is not an option. The relative ease of dissection and minimal functional deficits were the major advantages of this flap, while the extent of reach into the lower third has a limitation.

• The Journal of Korean Physical Therapy
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• v.34 no.5
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• pp.267-271
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• 2022

Purpose: This study examined the effects of a kettlebell and aqua bag on the gluteus maximus, gluteus medius, and vastus medialis lower extremity muscle strength during a one-leg deadlift, a top-down exercise. Methods: Twenty healthy adults were enrolled in the one-leg deadlift exercise under two conditions. The muscle activity of the gluteus maximus, gluteus medius, and vastus medialis was measured by surface electromyography (S-EMG). A paired t-test was used for statistical analysis, and the statistical significance criteria were set to p<0.05. Results: A comparison of the muscle activity according to the degree of contraction of the gluteus maximus revealed low muscle activity in AD exercise compared to KD exercise (p<0.05), and there was no significant difference in the gluteus medius and vastus medialis (p<0.05). Conclusion: These results suggest that when the one-leg deadlift exercise is performed according to the weight characteristics, the gluteus maximus is suitable for intervention using a kettlebell, and the gluteus medius and vastus medialis are more suitable for intervention by providing instability using an aqua bag.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.4
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• pp.569-576
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• 2010

Purpose : This study was aimed at determining the effects of community-based exercise program to improve leg muscle strength and balance for elderly women. Methods : This study was nonequivalent control group pre-post test design. Subjects were assigned to two different groups(exercise group=11, control group=7). Exercise group performed community-based exercise program for 8 weeks. Outcome measures included leg muscle strength, balance, walking velocity, activities of daily living(ADL), exercise self-efficacy and health-related quality of life(QoL). The collected data analyzed by independent t-test and paired t-test. Results : Leg muscle strength, walking velocity and mental component summary(QoL) were significantly improved in the exercise group. But balance and exercise self-efficacy were significantly worsened in the control group. There were no significant difference between groups after 8 weeks of community-based exercise. Conclusion : These results suggested that the community-based exercise program is effective for elderly women in improving leg muscle strength, walking velocity and mental component summary(QoL).

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.20 no.2
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• pp.9-14
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• 2014

Background: This study aims to examine correlations between quadriceps angle, lower extremity muscle strength and leg length discrepancy. Methods: This study selected 96 healthy women university students as the subjects of research. Quadriceps angle, lower extremity muscle strength and leg length discrepancy were measured. The statistical analysis of the data SPSS/window (version 12.0) were analyzed using the pearson correlation analysis. Results: There were negative correlations between the muscle strength of the right hamstring muscles and the right quadriceps angle in supine and standing positions. Functional leg length discrepancy of left and right quadriceps angle in supine and standing position showed positive correlations. Conclusions: The quadriceps angle affect the knee. An abnormal angle caused weakening of balance. Muscle strength, leg length discrepancy, and affected lower extremity alignment and knee function. These conclusions may prevent exercise limitation or disorders in the subjects and treating the patients with knee injury or patellofemoral pain syndrome with basic therapy intervention.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.24 no.2
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• pp.29-36
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• 2018

Background: The purpose of this study was to investigate the effect of leg lift difference on serratus and upper trapezius when exercising in a scapula in a prone position, a typical waist stabilization exercise for subjects with a winged scapula. Method: Twenty normal adults and 20 subjects with winged scapula participated in the experiment. The surface EMG recordings were obtained from external oblique muscle and internal oblique muscle during scapula protraction exercise. The presence or absence of winging of the shoulder bone was measured using an electronic digital caliper for the distance the medial border of the scapula is lifted to the rear. In prostrate pier movement posture in both groups, both legs supporting, dominant leg lifting, and non-dominant leg lifting including the scapula protraction were conducted respectively. Results: In the results of comparison between the two groups, the dominant external oblique muscle and the non-dominant internal oblique muscle tended to increase according to the difference of the leg lifting of normal people. In the winged scapula group, internal oblique muscle showed increased muscle activity more than external oblique muscle. Conclusion: It was most effective to exercise with lifting the same position leg for strengthening the same external oblique muscle, and the opposite internal oblique muscle. Also, it is effective to exercise in prone pier movement posture for trunk stability. In addition, internal oblique muscle shows increased muscle activity in subjects with winged scapula. Therefore, appropriate adjustment of external oblique muscle and internal oblique muscle may have a positive effect on scapula dysfunction for trunk stability.

• PNF and Movement
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• v.19 no.2
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• pp.153-162
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• 2021

Purpose: The purpose of this study was to investigate the difference in the dynamic balance and leg muscle activity of adults in their 20s with or without shoes. Methods: In this study, seven male and 11 female university students in their 20s were randomized to determine the order of being with or without shoes, and the dominant foot was supported on the central platform of dynamic balance according to the order procedure. Using the opposite foot, the distance of leg stretching in the anterior, posterior medial, and posterior lateral directions and the muscle activity of the supporting leg were measured. Muscle activity measurement sites were attached to the dominant vastus medialis oblique muscle, vastus lateral oblique muscle, tibialis anterior muscle, peroneus longus muscle, and lateral gastrocnemius muscle. Results: As a result of this study, the distance of leg stretching was significantly increased in the anterior, posterior medial, and posterior lateral directions when barefoot rather than when wearing shoes (p < 0.05). The muscle activity of the vastus medial and lateral oblique muscles was significantly increased in all three directions when barefoot rather than when wearing shoes (p < 0.05). The muscle activity of the tibialis anterior was significantly increased in the anterior direction when barefoot (p < 0.05), the peroneus longus muscle was significantly increased when it was barefoot in the posterior medial direction (p < 0.05), and the lateral gastrocnemius muscle activity significantly increased when barefoot in the posterior direction (p < 0.05). Conclusion: The movement of the legs is freed when barefoot as compared to when wearing shoes, and being barefoot can effectively activate muscle activity and improve balance ability.

• Journal of Physiology & Pathology in Korean Medicine
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• v.19 no.1
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• pp.289-293
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• 2005

The aim of this study was to investigate the importance of behavior habit and body exercise. We divided 164 volunteers into 2 groups. 82 volunteers was obese group($BMI{\geqq}25$), and the others was normal group(BMI<25). And we investigated the difference of water distribution and muscle circumference of arm, leg and trunk of between obese patient and normality. The results are as follows; Normal group was significantly higher than obese group in leg water distribution and muscle circumference rate as compared with arm(P<0.001). Normal group was significantly higher than obese group in leg water distribution and muscle circumference rate as compared with trunk(P<0.001). Each of the relation of water distribution and muscle circumference was significantly correlated with Pearson correlation analysis(r = 0.96, r = 0.6). In conclusion, there is very important that Low limb exercise and behavior habit in obese.

• Physical Therapy Rehabilitation Science
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• v.10 no.3
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• pp.304-310
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• 2021

Objective: This study aimed to investigate effective cueing methods for selective muscle activation of gluteus medius muscles. Design: Cross sectional study design. Methods: Using the inclusion criteria for this study, 20 healthy adults, both males and females were selected for the measurement of muscle activation of gluteus maximus, gluteus medius, and tensor fascia latae muscles while performing clamshell exercise, basic movements in leg raise in side-lying, and 3 different cueing methods. Electromyogram was used to measure muscle activation, and both muscle activation and muscle ratio were compared during the basic movements and different cueing methods. Results: Gluteus medius activation was highest using "try not to make your body rotate" (cueing method 2) in both clamshell exercise and leg raise side-lying (F=5.533, p<0.05, F=7.771, p<0.05), and muscle ratio was highest in clamshell exercise using cueing method 2 (p<0.05) and "don't move your tensor fascia late" (cueing method 1) in leg raise side-lying (p<0.05). This study showed that cueing method 1 in leg raise side-lying and cueing method 2 in clamshell exercise were the most effective cueing methods for selective muscle activation of gluteus medius muscle. Conclusions: The results of this study may be used as basic information for future studies on muscle activation and muscle ratio for different cueing methods and different muscles in various exercises.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.4
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• pp.55-62
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• 2019

PURPOSE: This study examined the muscle activity while stepping over obstacles with various heights and widths to provide basic data for training and preventing falls. METHODS: Fifteen normal young adults (seven males and eight females) were recruited. The participants walked on a 5m walkway with six obstacles. The heights of obstacles were 0%, 10%, and 40% of the subject's leg length, and the width of the obstacles was 7cm and 14cm. The participants traversed the course twice per obstacle. The muscle activities of the soleus, tibialis anterior (TA), vastus medialis (VM), and vastus lateralis (VL) were measured using surface electromyography. A Mann-Whitney test and Kruskal-Wallis test were used to examine the differences between obstacles. RESULTS: The muscle activities of the VL and the soleus of the stance leg and lead leg after crossing over the obstacles increased with increasing width, and there were significant differences in muscle activities between obstacle width (p<.05) except for the muscle activity of TA of the stance leg after crossing over the obstacles. A significant difference in muscle activities was observed according to the height of the obstacles with 14 cm (p<.05) except for the muscle activity of the VL, soleus of the leading leg, and TA of the stance leg CONCLUSION: The role of the VL and Soleus increased with increasing obstacle width, and the overall muscle activities of the lower extremities increased with increasing obstacle height. These results can be used to suggest a program to prevent falls.