• Korean Journal of Applied Biomechanics
• /
• v.24 no.2
• /
• pp.167-172
• /
• 2014

The purpose of this study was to investigate walking standard time and joint powers of the lower extremities on the changes of illuminations in the elderly women. Ten older women ($70.90{\pm}3.28$ years, $154.70{\pm}3.47$ cm, $53.80{\pm}5.39$ kg) with normal vision and no gait disabilities participated in this study. All the experiments were performed on a level walkway from low to high lighting (six conditions). A 3-dimensional motion capturing system, force-plate, and EMG were used to acquire and analyze walking motion, force, and muscle activity data; the sampling frequency was 100 Hz, 1000 Hz and 1000 Hz respectively. To test the differences on walking standard time and joint powers of the lower extremities between the six lighting conditions, one-way repeated ANOVAs were evaluated. The following results were drawn: First, mean standard time was about 1.3 sec/stride, and velocities were smaller with lighting increasing except 100 Lx. Second, the joint power patterns of ankle and knee were not consistent, but only hip joint power was a greatest in 6 Lx and a smallest in 400 Lx. Third, standard times(100 Lx<300 Lx, 400 Lx) were statistically significant, and hip joint max powers (100 Lx>others) were also statistically significant. But ankle and knee joint max power were not statistically significant. These results showed that standard times from low to high lighting were not consistent, and hip joint of 100 Lx has a greatest rotational torque. We suggested that gait strategies of them as to changing illuminations were not consistent and findings may represent a lack of adaptability in the elderly women.

• Journal of the Korean Society of Physical Medicine
• /
• v.13 no.4
• /
• pp.131-138
• /
• 2018

PURPOSE: This study was conducted to compare the muscle activity of the proximal muscles of the lower limb according to the distance between the front and rear foot during lunge and to determine the most effective foot position for activation of the proximal muscle in the limb. METHODS: A total of 49 young adults were enrolled in this study. All subjects performed lunge by positioning the big toe of the back foot and the heel of the front foot at intervals of 40%, 60%, and 80% of the subject's own leg length. Muscle activity of the vastus medialis oblique, rectus femoris (RF), vastus lateralis oblique (VLO), gluteus medius, biceps femoris, and semitendinosus (ST) was then measured during three intervals of lunge operation. Each operation was measured three times for 10 seconds each, after which the average value was calculated and analyzed. RESULTS: There were significant differences in muscle activities of RF, VLO, and ST among the three intervals of the foot (p<.05). Post hoc, comparisons revealed lunge at 40% intervals resulted in higher RF and VLO activity than at 60% and 80% intervals (p<.05). In the semitendinosus muscle, 80% leg length intervals showed higher muscle activity than 40% (p<.05). CONCLUSION: Strengthening of the proximal muscles of the lower extremities during lunge exercise is considered to be most effective when placing the fore- and rear foot at intervals corresponding to 40% of the leg length.

• Journal of the Korean Society of Physical Medicine
• /
• v.14 no.1
• /
• pp.53-61
• /
• 2019

PURPOSE: This study examined the dynamic range of motion (ROM) of the hip, knee, and ankle joint when wearing different shoe sole lifts, as well as the limb asymmetry of the range according to the leg length discrepancy (LLD) during normal speed walking. METHODS: The participants were 40 healthy adults. A motion analysis system was used to collect kinematic ROM data. The participants had 40 markers attached to their lower extremities and were asked to walk on a 6 m walkway, under three different shoe lift conditions (without an insole, 1 cm insole, and 2 cm insole). Visual3D professional software was used to coordinate kinematic ROM data. RESULTS: Most of the ROM variables of the short limbs were similar under each insole lift condition (p>.05). In contrast, when wearing a shoe with a 2 cm insole lift, the long limbs showed significant increases in flexion and extension of the knee joint as well as; plantarflexion, dorsiflexion, pronation, eversion, and inversion of the ankle joint (p<.05). Of the shoes with the insole lifts, significant differences in all ROM variables were observed between the left and right knees, except for the knee internal rotation (p<.05). CONCLUSION: As the insole lift was increased, more ROM differences were observed between the left and right limbs, and the asymmetry of the bilateral lower limbs increased. Therefore, appropriate interventions for LLD are needed because an artificial mild LLD of less than 2.0 cm could lead to a range of musculoskeletal problems of the lower extremities, such as knee and ankle osteoarthritis.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.27 no.3
• /
• pp.1-15
• /
• 2021

Objective: The purpose of this study was to examine the differences in joint position sense (JPS), force sense (FS), and performance level of the upper extremities according to the injury and pain experiences of Korean elite archers. Methods: A total of 15 subjects were briefed about the purpose of this study and agreed to participate voluntarily. JPS was evaluated using the laser-point attached to the wrist while aiming at the target. The difference when relocating while aiming was used as JPS factor. FS was evaluated using load cell through reproduces same muscle strength. Fear-Avoidance Beliefs Questionnaire (FABQ) was used to evaluate psychosocial factors, Kerlan-Jobe Orthopedic Clinic overhead athlete scores (KJOC) and numerical rating scale (NRS) was used to evaluate pain. and performance was evaluated by tournament match score. Results: There is a strong correlation between the current pain and KJOC. Moreover, moderate correlation between KJOC and FABQ also current pain and both upper trapezius and lower trapezius in elite archers. The mean (SD) between groups based on current pain display relatively large margin in force sense than without pain group. The result presents that there is a significant difference in performance and pain. There is a significant difference in the force sense of the upper and lower trapezius and pain. Conclusions: Result present there is a significant difference in functional level in the average comparison between groups according to the presence of absence of current pain. There is a significant difference in the force sense of the upper trapezius as well as lower trapezius and without pain group present a relatively low joint position sense error compared to the groups.

• Journal of Korean Foot and Ankle Society
• /
• v.28 no.1
• /
• pp.27-30
• /
• 2024

Several types of soft tissue masses occur in the lower extremities. A mass associated with blood vessels is often difficult to diagnose. A 15-year-old male patient visited the author's hospital with discomfort and edema in his right calf that had persisted for six months. A physical examination showed no palpable mass other than mild edema. Three masses were found during the ultrasound scan along the small saphenous vein. The masses had a cyst-like appearance and were filled with thrombus. In duplex ultrasound, vascular reflux was represented inside the masses. During surgery, it was suspected that vascular deformation occurred in the small saphenous vein, and simple ligation and resection treatments were performed. The patient was finally diagnosed with venous aneurysms accompanied by thrombosis based on the histology tests. The symptoms disappeared after surgery, and there were no recurrences or unusual findings at the follow-up one year later. Venous aneurysms occurring in the superficial veins of the lower extremities are rarely reported, but treatment and diagnosis are important. This paper reports a case of an aneurysm on the small saphenous vein.

• Physical Therapy Korea
• /
• v.25 no.2
• /
• pp.1-12
• /
• 2018

Background: It is very difficult for hemiplegic patients to effectively perform the sit-to-stand (STS) movements independently because of several factors. Moreover, the analysis of STS motion in hemiplegic patients has been thus far confined to only muscle strength evaluation with little information available on structural and environmental factors of varying chair height and foot conditions. Objects: This study aimed to analyze the change in biomechanical factors (ground reaction force, center of mass displacement, and the angle and moment of joints) of the joints in the lower extremities with varying chair height and foot conditions in hemiplegic patients while they performed the STS movements. Methods: Nine hemiplegic patients voluntarily participated in this study. Their STS movements was analyzed in a total of nine sessions (one set of three consecutive sessions) with varying chair height and foot conditions. The biomechanical factors of the joints in the lower extremities were measured during the movements. Ground reaction force was measured using a force plate; and the other abovementioned parameters were measured using an infra-red camera. Two-way repeated analysis of variance was performed to determine the changes in biomechanical factors in the lower extremities with varying chair height and foot conditions. Results: No interaction was found between chair height and foot conditions (p>.05). All measured variables with varying chair height showed a significant difference (p<.05). Maximum joint flexion angle, maximum joint moment, and the displacement of the center of mass in foot conditions showed a significant difference (p<.05); however the maximum ground reaction force did not show a significant difference (p>.05). Conclusion: The findings suggest that hemiplegic patients can more stably and efficiently perform the STS movement with increased chair height and while they are bare-foot.

• Physical Therapy Korea
• /
• v.22 no.3
• /
• pp.33-40
• /
• 2015

The purpose of this study was to investigate the effect of multi joint-joint position sense (MJ-JPS) training on joint position sense, balance, and gait ability in stroke patients. A total of 18 stroke patients participated in the study. The subjects were allocated randomly into two groups: an experimental group and a control group. Participants in the experimental group received MJ-JPS training (10 min) and conventional treatment (20 min), but participants in the control group only received conventional treatment (30 min). Both groups received training for five times per week for six weeks. MJ-JPS is a training method used to increase proprioception in the lower extremities; as such, it is used, to position the lower extremities in a given space. MJ-JPS measurement was captured via video using a Image J program to calculate the error distance. Balance ability was measured using Timed Up and Go (TUG) and the Berg Balance Scale (BBS). Gait ability was measured with a 10 m walking test (10MWT) and by climbing four flights of stairs. The Shapiro-Wilk test was used to assess normalization. Within-group differences were analyzed using the paired t-test. Between-group differences were analyzed using the independent t-test. The experimental group showed a significant decrease in error distance (MJ-JPS) compared to the control group (p<.05). Both groups showed a significant difference in their BBS and 10MWT results (p<.05). The experimental group showed a significant decrease in their TUG and climbing results (p<.05), but the control group results for those two tasks were not found to be significant (p>.05). There was significant difference in MJ-JPS and by climbing four flights of stairs on variation of pre and post test in between groups (p<.05), but TUG and BBS and 10MWT was no significantly (p>.05). We suggest that the MJ-JPS training proposed in this study be used as an intervention to help improve the functional activity of the lower extremities in stroke patients.

• Journal of Yeungnam Medical Science
• /
• v.7 no.2
• /
• pp.121-130
• /
• 1990

Plain 0.5% bupivacaine and hyperbaric 0.5% tetracaine were compared for spinal anesthesia in 40 patients undergoing operation of lower extremities. Lumbar puncture was performed with a 22 gauge spinal needle with the patient in the lateral recumbent position. The third lumbar interspace was chosen for the puncture, when a free flow of clear CSF was obtained, the local anesthetic solution (2.5ml of 0.5% bupivacaine or 2.0ml of hyperbaric 0.5% tetracaine) was injected at a rate of 0.1ml/sec without barbotage. After injection of anesthetics, clinical features were observed and compared between the two groups. The results were as follows : 1. The two groups were well matched for age, sex, height and weight. 2. In both groups, sensory block to $T_{12}$ dermatome was obtained within 4 minutes, mean maximal level of analgesia was $T_{6-7}$, and the mean time for maximal level was around 20 minutes. 3. The onset times of motor block were similar in both groups and complete motor block was obtained in all cases within 20 minutes. 4. The duration of analgesia above the $T_{12}$ dermatome was 3 hours, postoperative analgesia was 7 hours. These values were significantly prolonged than those of the tetracaine group(p<0.05). 5. The changes in systolic pressure in the bupivacaine group were significantly less than those of the tetracaine group(p<0.05). 6. The complications after spinal anesthesia were headache, numbness, urinary retention and backpain, and were no significant difference in both groups. From the obtained results, we concluded that plain 0.5% bupivacaine was a relatively satisfactory agent for spinal anesthesia for operation of lower extremities. The time of onset, height of block and the complications of postoperative period were similar in both groups. The advantages of plain 0.5% bupivacaine were less hypotension and long duration of analgesia.

• Archives of Plastic Surgery
• /
• v.45 no.2
• /
• pp.152-157
• /
• 2018

Background Intraoperative indocyanine green (ICG) lymphography can effectively detect functioning lymph vessels in edematous limbs. However, it is sometimes difficult to clearly identify their course in later-stage edematous limbs. For this reason, many surgeons rely on experience when they decide where to make the skin incision to locate the lymphatic vessels. The purpose of this study was to elucidate lymphatic vessel flow patterns in healthy upper extremities in a Korean population and to use these findings as a reference for lymphedema treatment. Methods ICG fluorescence lymphography was performed by injecting 1 mL of ICG into the second web space of the hand. After 4 hours, fluorescence images of lymphatic vessels were obtained with a near-infrared camera, and the lymphatic vessels were marked. Three landmarks were designated: the radial styloid process, the mid-portion of the cubital fossa, and the lower border of the deltopectoral groove. A straight line connecting the points was drawn, and the distance between the connected lines and the marked lymphatic vessels was measured at 8 points. Results There were 30 healthy upper extremities (15 right and 15 left). The average course of the main lymph vessels passed $26.0{\pm}11.6mm$ dorsal to the styloid process, $5.7{\pm}40.7mm$ medial to the mid-cubital fossa, and $31.3{\pm}26.1mm$ medial to the three-quarters point of the upper landmark line. Conclusions The main functioning lymphatic vessel follows the course of the cephalic vein at the forearm level, crosses the mid-cubital point, and travels medially toward the mid-axilla.

• The Journal of the Korean bone and joint tumor society
• /
• v.2 no.1
• /
• pp.88-93
• /
• 1996

Neurilemmomas are the most common benign tumor of the peripheral nerve trunks, and arises from the cells in the sheath of Schwann. Neurilemmomas are well encapsulated and may be separated easily from surrounding tissue and lie completely within a larger nerve trunk, with bundles of neurofibrils spread out over the surface of the tumor. A careful dissection and retraction of the nerve bundles will allow the tumor to be enucleated from the parent nerve without any significant interference with the function of the nerve. Resection of the involved nerve is seldom necessary and should be avoided if at all possible. Our aim in microscopic excision of neurilemmoma of extremities is to reduce any disturbance of the intact neurofibrils of the parent nerve. Thirteen cases of neurilimmomas were treated by microscopic excision at the Department of Orthopaedic Surgery, Korea University Hospital between January 1990 and March 1995. The results was as follows ; 1. The average age at surgical intervention was 40.1 years. Cases in fourth and fifth decades predominated. 2. In their anatomical distribution, 8 cases were in the upper extremity and 5 cases in the lower extremity. 11 cases were on the flexor surface. 3. On the operative field, all the tumors were well encapsulated, however 1 case of 13 was adherent to the periosteum of fibula. 4. In all cases, the tumor were enucleated from the parent nerve without any injury to nerve under high-power magnification, preserving individual fascicles, and sensory and motor function.