• Title/Summary/Keyword: Lower Extremities

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The Effect of Proprioceptive Neuromuscular Facilitation Exercise Patterns Targeting the Lower Extremity on Lateral Muscle Activity of the Opposite Lower Extremity in Chronic Hemiplegia Patients (PNF 하지패턴이 편마비 환자의 반대편 하지 측부 근육 활성도에 미치는 영향)

  • Kim, Kyung-Hwan;Park, Sung-Hun;Pak, Noh-Wook;Lee, Hye-Jin
    • PNF and Movement
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    • v.16 no.1
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    • pp.143-150
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    • 2018
  • Purpose: The purpose of this study was to investigate the influence of opposite lower extremity lateral muscle activation by proprioceptive neuromuscular facilitation (PNF) exercise targeting the lower extremities. Methods: Nineteen patients with chronic hemiplegia volunteered to participate in this study. PNF flexion, abduction, and internal rotation patterns; initial, end range, and extension patterns; abduction and internal rotation patterns; and initial and end range patterns were applied to the dominant lower extremity. Activation of lateral muscles (multifidus, gluteus medius, tensor fascia lata, and peroneous longus) of the paralyzed leg was then measured by electromyography (EMG). Results: There were significant differences in lateral muscle activation, depending on the PNF pattern applied, with the differences more significant in flexion, abduction, internal rotation, and end range patterns. Conclusion: PNF flexion, abduction, and internal rotation patterns can improve lateral muscle activation of one leg in the standing position in the gait cycle.

Effects of Elastic Band Exercise Combined with Swiss Ball Exercise on Lower Extremity Muscle Strength, Balance, and Pain in Middle-Aged Women with Osteoarthritis

  • Yohan Yoo;Jongeun Yim
    • Physical Therapy Rehabilitation Science
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    • v.12 no.3
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    • pp.355-364
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    • 2023
  • Objective: The aim of this study is to test the effects of elastic band exercise accompanied by Swiss ball exercise on lower limb muscle strength, balance and pain in middle-aged women with osteoarthritis. Design: A randomized controlled trial. Methods: Thirty-five participants were randomly assigned to the experimental group (n=18), which performed elastic band exercise combined with Swiss ball exercise, and the control group (n=17), which performed elastic band exercise only. Both groups did a 30-minute session of exercise three times a week for eight weeks and were assessed for lower extremity muscle strength, static and dynamic balance, and pain levels before the first therapy session. All participating patients underwent outcome assessment after eight weeks of therapy without any additional treatment. Results: The experimental group made a significant increase in muscle strength of the lower extremities, static and dynamic balance ability, and pain level (p<0.05). The control group made a significant improvement in lower limb muscle strength, dynamic balance ability and pain level (p<0.05) with no such improvement in static balance ability. The exercise group made a significant increase in static and dynamic balance ability and pain level compared to the control group (p<0.05). Conclusions: These results demonstrated that both Swiss ball exercise and elastic band exercise were effective for middle-aged women with osteoarthritis and found that elastic band exercise combined with Swiss ball exercise produced more significant effects on their balance and pain.

Differentiation of Malignant from Benign Soft-Tissue Solid Tumors: Clinical and MR Finding Complex (연조직고형종양의 악성과 양성 감별: 임상과 자기공명영상 복합소견)

  • Moon, Tae-Yong;Kim, Jung-Il;Shin, Su-Mi;Choo, Hye-Jeung;Choi, Hyun-Wook;Kim, Soo-Jin
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.2
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    • pp.79-87
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    • 2004
  • Purpose: The recent development of MR has made to possible radiological diagnosis in various soft tssue tumors. But multifarious components within soft tissue tumors and their periodic change have made to difficult even differentiation of malignant from benign soft tissue tumors solely on the MR. So authors retry to differentiate malignant from benign soft tissue tumors with clinical and MR finding complex. Materials and methods: We were analysed 82 pathologically confirmed soft tissue solid tumors (37 cases as malignancy including intermediate tumors and 45 cases as benign including inflammatory masses) which are correlated with clinical findings such as age, size, and location, MR findings such as tumor border, texture on T2 and contrast-T1 images, and enhancement area retrospectively. Many typical lipoma and cysts including of ganglion and abscess are rejected in the benign soft tissue tumor group because not difficult to diagnose on MR. Results: Malignant soft tissue tumors were more frequent in 21~40 and 61~80 years old of the age, above 3.0 cm of the size, trunk-pelvis-lower extremities of the location, and MR findings with irregular border and above 50% of the enhancement area than those of benign soft tissue tumors. Conclusion: The clinical finding that divided to two locations as trunk-pelvis-lower extremities and upper extremities-shoulder-spine was statistically significant to differentiate malignant from benign soft tissue solid tumors. However, the others would provide some useful informations to differentiate them never specific.

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Treatment of the Soft Tissue Defect in Extremities by Forearm Free Falp (전완부 유리피판술을 이용한 연부조직 결손의 치료)

  • Lee, Kwang-Suk;Byun, Young-Soo;Woo, Kyung-Jo;Bae, Cheol-Hyo
    • Archives of Reconstructive Microsurgery
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    • v.4 no.1
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    • pp.58-64
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    • 1995
  • The radial forearm flap was first designed at the Ba-Ba Chung Hospital of People's Republic of China in 1978. The flap consists of the skin of the volar surface of the forearm, the subcutaneous fat, the underlying fascia, and the intramuscular fascia which includes the radial vessels. It is very useful flap in soft tissue coverage of skin defects of the upper and lower extremities. The authors have reported 13 cases of forearm free flap treated in the Korea University Hospital from January 1991 to Jun 1995 with a review of literature. The results were as follows. 1. We had good results in soft tissue coverage for all patients 2. The average size of flaps was $54cm^2$ and the average ischemic time of flaps was 74minutes. 3. The postoprative complication was occurred in three of 13 cases, two of three cases were arterial thrombosis treated with thrombectomy in postoperative 2 days, and one case was venous thrombosis resulted in superficial necrosis of the flap treated with STSG. 4. Forearm free flap with sensory innervation is a good donor site for reconstruction of weight-bearing areas of heel and sole. 5 The forearm free flap is suitable for soft tissue coverage of the upper and lower extremities, and can be used by skillful microsurgeon with high success rate.

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The Effects of Strengthening Exercise for the Lower Extremities on Associated Reaction of the Upper Extremities in Patients With Hemiparesis (뇌졸중 편마비 환자에서 하지 근력강화운동이 상지 연합반응에 미치는 영향)

  • Park, Hyung-Ki;Kim, Jong-Man;Kim, Won-Ho
    • Physical Therapy Korea
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    • v.13 no.2
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    • pp.52-60
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    • 2006
  • Muscle weakness in the hemiplegia following stroke is an important factor which determines the quality of life in the future. Therefore, muscle strengthening exercise is essential for functional recovery in hemiplegic patients. Even though the popular conception is that muscle strengthening exercise causes spasticity and associated reaction that hemiplegia patients don't want, and that it disturbs functional recovery, recently there have been many new reports against that opinion. Therefore, the effects of strengthening exercise programs on functional recovery in hemiplegic patients are still controversial. The purpose of this study was to determine the effects of strengthening exercise programs for the knee joint using isokinetic exercise on the associated reaction of the upper extremities. Comparing the muscle activities of biceps brachii and triceps brachii during, before, and immediately after 2 and 5 minute intervals of isokinetic exercise, we examined the increase and decrease of associated reaction. Twenty stroke inpatients participated in this study. Surface electromyography was used to get muscle activity data from biceps brachii and triceps brachii. The major findings of this study were as follows: 1. The flexor and extensor peak torque were significantly higher on the sound side than the affected side (p<.05). 2. Before and after strengthening exercise, there was no significant difference in muscle activities (surface electromyographic root mean square values) between the sound and affected side. 3. Muscle activities were examined during, before, and immediately after 2 and 5 minute intervals of isokinetic exercise. There were significant differences in muscle activities between, before and during the exercises, during exercise and 5 minutes after exercise in the biceps brachii (p<.05), and during exercise and 5 minutes after exercise in the triceps brachii (p<.05). In conclusion, there was no relation between strengthening exercise and associated reaction in the upper extremities. Rather, muscle activities after exercise had a tendency to decrease relative to before the exercise. Thus, it is considered that intensive strengthening exercise contributes to improvement of functional recovery without increase in associated reaction in hemiparetic patients.

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Clear Cell Ependymoma Occurring in the Cauda Equina

  • Kim, Dong-Joon;Kim, Tae-Wan;Kim, Yoon-Jung;Park, Kwan-Ho
    • Journal of Korean Neurosurgical Society
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    • v.48 no.2
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    • pp.153-156
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    • 2010
  • The authors present a rare case of clear cell ependymoma that developed in the cauda equina. A 54-year-old man was admitted to hospital with intermittent lower back pain. A neurological examination conducted on admission revealed no sensory or motor disturbance. Deep tendon reflexes in both lower extremities were normal. Magnetic resonance images demonstrated a 1.0 cm-sized intradural mass at the filum terminale. Gross total resection was performed via total laminectomy of L1 and L2. The tumor was confirmed to be clear cell ependymoma by histopathologic examination. His symptom was relieved after surgery.

Dorsal Extradural Lumbar Disc Herniation Causing Cauda Equina Syndrome : A Case Report and Review of Literature

  • Kim, Jin-Sung;Lee, Sang-Ho;Arbatti, Nikhil J.
    • Journal of Korean Neurosurgical Society
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    • v.47 no.3
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    • pp.217-220
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    • 2010
  • A 73-year-old male presented with a rare dorsally sequestrated lumbar disc herniation manifesting as severe radiating pain in both leg, progressively worsening weakness in both lower extremities, and urinary incontinence, suggesting cauda equina syndrome. Magnetic resonance imaging suggested the sequestrated disc fragment located in the extradural space at the L4-L5 level had surrounded and compressed the dural sac from the lateral to dorsal sides. A bilateral decompressive laminectomy was performed under an operating microscope. A large extruded disc was found to have migrated from the ventral aspect, around the thecal sac, and into the dorsal aspect, which compressed the sac to the right. After removal of the disc fragment, his sciatica was relieved and the patient felt strength of lower extremity improved.

Recruitment Patterns of Lumbar Extensor and Hip Extensors in Trunk Flexion and Extension (체간 굴곡과 신전 시에 요부 신근과 고관절 신근의 동원패턴)

  • Lee, Hyun-Ok;Gu, Bong-Oh
    • The Journal of Korean Physical Therapy
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    • v.21 no.1
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    • pp.57-63
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    • 2009
  • Purpose: We determined the recruitment pattern of lumbar elector spinalis, gluteus maxims, inner and outer hamstring muscle during trunk flexion and extension. Methods: Thirty healthy subjects(male; 15, female; 15) without low back pain and other problems in lower extremities participated in this study. To measure the recruitment pattern, the onset times of electromyographic activity of the muscles were recorded during trunk flexion and return(extension) to standing position. Results: The medial and lateral hamstring muscle was activated first, next elector spinalis, the last, gluteus maximus in trunk flexion. In trunk extension to standing position, the order of recruitment was similar to trunk flexion although the frequency is different. There were different between male and female in flexion and extension movement. Conclusion: The recruitment order of lumbar extensor and hip extensors in trunk flexion and extension will provide database in evaluation and intervention of lower back pain and lumbo.pelvic rhythm disorder.

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Lumbar Sympathetic Block for Spinal Cord Infarction Patient -A case report- (요부교감신경차단으로 척수경색 환자의 하지통증 치료 -증례보고-)

  • Kim, Dong Hee;Park, Sang Wook;Kim, Hyung Jee
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.237-240
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    • 2006
  • This report describes a case of spinal cord infarction after acupuncture. The patient was treated with lumbar sympathetic block with using C-arm fluoroscopy. A 66-year-old patient with chronic low back pain and radiating pain in the lower limb was treated with acupuncture and he suddenly had a loss of motor and sensory of both lower extremities. His clinical presentaion and neuroimaging studies were consistent with spinal cord infarction. He was treated with steroid megatherapy and he showed improved in motor function, but there was no pain relief despite the phamacological treatments that were combined with caudal blockade. He visited to our hospital and had lumbar sympathetic blockade performed. The pain was relieved without any related complication after 1 month (VAS $9/10{\rightarrow}2/10$), and he has been content with the results of treatment.

Effects of Muscle Activity of Lower Extrimity with Contact Laterally Wedged Insoles with Strapping of Varying Elevations (밀착형 외측 쐐기 스트랩 깔창의 높이에 따라 하지의 근활성도에 미치는 영향)

  • Lee, Sang-Yong;Bae, Sung-Soo;Gong, Won-Tae
    • Journal of the Korean Society of Physical Medicine
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    • v.1 no.1
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    • pp.37-47
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    • 2006
  • Purpose : The purpose is to assess the effects of muscle activity of normal person with contact laterally wedged insoles with strapping of varying elevations of 9, 15, 21mm. Methods : The subjects were adult males and women who had not experienced any knee injury. They were asked to performed from isometric contraction exerciese in four postures using lateral wedged. The normalized EMG activity levels(%MVC) of the vastus lateralis, vastus medialis, tibialis anterior, soleus for the four postures of the lower extremities were compared using one way repeted measures ANOVA. Results : Comparison of EMG amplitudes across all postures revealed no significant differences among all muscles(P>0.05). Conclusion : Further studies of the effect of wedged insole angle on knee varus torque in patients with medial-lateral knee osteoarthritis are needed.

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