• Title/Summary/Keyword: Lower Extremity

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When We Consider Neurolymphomatosis in Patient with Lumbosacral Plexopathy with an Extreme Leg Pain? (통증을 동반한 신경총병증에서 언제 신경림프종증을 고려해야 하는가?)

  • Ahn, Jun Young;Seok, Hyun;Kim, Sang-Hyun;Kim, Hyun Jung;Cho, Yeon Hee;Oh, Back Min;Lee, Seung Yeol
    • Clinical Pain
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    • v.20 no.1
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    • pp.53-57
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    • 2021
  • We report a case of neurolymphomatosis of lumbosacral plexus. A 63-year-old man, who had no past history except for diabetes mellitus, complained of severe pain and weakness on left lower extremity. Idiopathic lumbosacral plexopathy was diagnosed by electromyography. There were no abnormal findings except for FDG-PET/CT and MRI. They showed high uptake and thickening lesion in sciatic nerve and sacral plexus. However, about 7 months later, mass like lesion in left thigh was detected by FDG-PET/CT and MRI. Also, multiple hypermetabolic lesions were found in brain. Through brain biopsy, diffuse large B-cell lymphoma was confirmed. When a patient with idiopathic lumbosacral plexopathy complains of severe pain, it is necessary to consider FDG-PET/CT and MRI to differentiate neurolymphomatosis, even in patients who have no past history of lymphoma before. Especially, if FDG-PET/CT and MRI show sciatic and/or lumbosacral plexus lesion, neurolymphomatosis of lumbosacral plexus should be considered.

Fragmented Split-Thickness Skin Graft Using a Razor Blade in Burn Induced Diabetic Foot (화상을 동반한 당뇨발 환자에게 Razor Blade를 이용한 부분층피부조각 이식술의 효용성)

  • Park, Cheol-Heum;Choi, Manki;Kang, Chan-Su;Kim, Tae-Gon
    • Journal of the Korean Burn Society
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    • v.23 no.1
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    • pp.20-24
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    • 2020
  • Diabetic patients have an increased risk of burn injuries on foot. Because of their diabetic neuropathy, they could contact with hot water or warming device without being aware of it. Split-thickness skin graft (STSG) is successful in treatment of various wound types; however, donor site wounds are sometimes problematic, and complications such as pain and impaired healing often occur. Although, donor site wounds in healthy young individuals can rapidly heal without complications, the wound-healing capacity of elderly patients or those with a comorbidity has been reported to be low. The dermatome is the most commonly used tool because it can harvest a large skin graft in one attempt. However, it is difficult to harvest tissues if the area is not flat. Furthermore, because the harvested skin is usually rectangular, additional skin usually remains after skin grafting. Therefore, use of razor blade and fragmented STSG on a large defect area is advantageous for harvesting a graft with a desired size, shape, and thickness. From January 2018 to July 2018, fragmented STSG was used in 9 patients who suffered from burn induced open wound on foot with diabetic neuropathy. With this approach, healing process was relatively rapid. The mean age of patients was 70 (57~86 years) and all of 9 patients had diabetes mellitus type 2. In all patients, the skin graft on the defect site healed well and did not result in complications such as hematoma or seroma.

Acute Compartment Syndrome Induced by Rhabdomyolysis Due to Antipsychotic Drug Overuse (항정신병 약물 과량 복용 후 발생한 횡문근융해증으로 인한 급성 구획증후군)

  • Hwang, Seok-Ha;Hong, Sung-Ha;Suh, Seung-Pyo;Kim, Joo-Young
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.276-280
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    • 2020
  • A 49-year-old male was found unconscious at his accommodation and visited the emergency room. He was on antipsychotic and antidepressant drugs (vortioxetine hydrobromide, mirtazapine, sertraline hydrochloride, quetiapine, and alprazolam) for schizophrenia and major depression. At the time of discovery there were signs of overdose of the drugs around the patient. A physical examination revealed, pain, pallor, and edema in the left buttocks and lateral thigh. Active ankle movements below the left ankle were not possible and sensations in the tibia and peroneal nerves were lost. The pressure in the buttock compartment was measured at 42 mmHg. Magnetic resonance imaging revealed edema and high intensity signals in the left hip muscles and surrounding soft tissue. An emergency fasciotomy was performed and partial restoration of the lower extremity sensation and muscle strength were achieved after 24 hours.

Bilateral foot drop caused by T12 infectious spondylitis after vertebroplasty: a case report

  • Kim, Dong Hwan;Shin, Yong Beom;Ha, Mahnjeong;Kim, Byung Chul;Han, In Ho;Nam, Kyoung Hyup
    • Journal of Trauma and Injury
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    • v.35 no.1
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    • pp.56-60
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    • 2022
  • The most common cause of foot drop is lumbar degenerative disc herniation, particularly at L4/5. We present a rare case of spinal cord injury accompanied by a thoracolumbar lesion that presented with bilateral foot drop. A 69-year-old male patient presented with sudden-onset severe bilateral leg pain and bilateral foot drop. Radiologic findings revealed T12 spondylitis compressing the conus medullaris. He had undergone vertebroplasty for a T12 compression fracture after a fall 6 months before. A physical examination showed bilateral foot drop, paresthesia of both L5 dermatomes, increased deep tendon reflex, and a positive Babinski sign. An acute bilateral L5 root lesion and a conus medullaris lesion were suspected based on electromyography. A surgical procedure was done for decompression and reconstruction. After the operation, bilateral lower extremity muscle strength recovered to a good grade from the trace grade, and the patient could walk without a cane. The current case is a very rare report of bilateral foot drop associated with T12 infectious spondylitis after vertebroplasty. It is essential to keep in mind that lesions of the thoracolumbar junction can cause atypical neurological symptoms. Furthermore, understanding the conus medullaris and nerve root anatomy at the T12-L1 level will be helpful for treating patients with atypical neurological symptoms.

Effects of Calf Sleeve on the Muscle Function of Ankle Joint (종아리 기능성 의류가 발목 관절 근기능에 미치는 영향)

  • Kim, Al-Chan
    • Journal of the Korea Convergence Society
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    • v.13 no.5
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    • pp.307-312
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    • 2022
  • The purpose of this study was to investigate the effects of wearing functional clothing over calf muscles on the muscle function of the calf and to verify whether functional clothing can increase calf muscle function. The participants of the study were 21 male students from University B who had no lower extremity abnormality. The measurement method was measured at 30°/sec and 120°/sec angle speed before and after wearing functional clothing on the right and left calves using Humac Norm of CSMI, a constant speed muscle function measuring instrument. No significant difference was observed during dorsiflexion when wearing functional clothing, but in plantar flexion, muscle strength and muscle endurance were significantly increased. Therefore, wearing functional clothing over the calves showed a positive effect on improving exercise function, and future research suggests a study comparing the degree of muscle function improvement between those wearing functional clothing and those not wearing it for athletes training ahead of the competition.

Effects of Heel Raising Exercise whith Kinesio Taping on Triceps Surae Muscle Activity and Balance in 20s Adults (키네시오 테이핑을 결합한 발 뒤꿈치 들기 운동이 건강한 성인의 하지 근활성도 및 균형에 미치는 영향)

  • Geun Hwan, Jang;Tae Sung, In;Kyung Hun, Kim
    • Journal of Korean Physical Therapy Science
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    • v.29 no.4
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    • pp.17-26
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    • 2022
  • Background: The aim of this study was to investigate the effects of heel raising with kinesio taping (HRKT) on triceps surae muscle activity and balance in 20s adults. Design: Two groups pre-post randomized controlled design. Methods: The total of 40 subjects were randomly divided in the HRKT group (experimental group, n=21) and heel raising with sham kinesio taping (control group, n=19). Both groups receive heel raising with kinesio taping and sham kinesio taping for 20 minutes a day, five day per week, for four weeks. Measurement were performed before training and 4 weeks after training. The triceps surae muscle activity was measured using the EMG. A functional reach test (FRT) was used to evaluate balance ability. The independent t-test was conducted to compare exercise methods depending on the taping effect on each group. Results: The both group showed significant differences in muscle activity of lower extremity and functional reach test in the pre-post intervention comparison (p<0.05). The experimental group showed significantly more improvement in triceps surae muscle activity and functional reach test compared to the control group(p<0.05). Conclusion: We confirmed that the effects of heel-raising with kinesio taping group on triceps surae muscle activity and balance ability in 20s adults. The result suggest that heel raising with kinesio taping for 20s adults should be further studied and considered.

Effectiveness of home-based therapy on gross motor function in children with cerebral palsy: A systematic review (뇌성마비 아동의 대동작 기능에 대한 가정중심치료 효과 : 체계적 고찰)

  • Jung-Hyun, Kim
    • Journal of Korean Physical Therapy Science
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    • v.29 no.4
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    • pp.27-42
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    • 2022
  • Background: Although children with cerebral palsy (CP) are able to walk independently, gait imbalance occurs due to abnormal muscle tone, musculoskeletal deformity, loss of balance, and selective motor control impairment. Gait restriction in the community and school is a major problem of rehabilitation in CP. Home-based therapy (HBT) provides a variety of interventions in which the therapist and the parent work together to resolve the activities and problems caused by the child's body structure. Therefore, we investigate the effectiveness of home-centered therapy on gross motor function in CP and try to present the possibility of clinical application. Design: A Systematic Review Methods: Research papers were published from Jan, 2012 to Jan, 2022 and were searched using Medline and PubMed. The search terms are 'family-centered' OR 'home-based' AND 'cerebral palsy'. A total of nine papers were analyzed in this study. The paper presented the quality level based on Physiotherapy Evidence Database (PEDro) scores to assess the quality of randomized clinical trials studies. Results: The results showed that HBT for strengthening exercise in lower extremity has a positive effect on the isokinetic torque and gross motor function. home-based treadmill therapy in CP is effective to perform at least 12 sessions of treadmill HBP in which the therapist determines the treadmill speed every week and the child's own gait pattern is modified. Conclusion: These results suggest that it will be important data for founding evidence on the effectiveness of home-centered therapy on gross motor function in children with cerebral palsy to advance clinical protocols.

Effect of Post-Activation Potentiation according to Sequence of Velocity Using Isokinetic Device on Short-Term Performance of Lower Extremity: Taekwondo Athletes and Healthy Adults

  • Sang-Woo Pyun;Seong-Eun Kim;Jong-Wan Kim;Dongyeop Lee;Ji-Heon Hong;Jae-Ho Yu;Jin-Seop Kim;Hyun Suk Yang;Seong-gil Kim
    • The Journal of Korean Physical Therapy
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    • v.34 no.6
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    • pp.298-303
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    • 2022
  • Purpose: The purpose of this study was to figure out how PAP (Post-Activation Potentiation) phenomenon affects short-term performance efficiently. Methods: This study was conducted with 18 Taekwondo athletes and 16 healthy adults. By using isokinetic dynamometer, two different intervention, TDP (Top-down program) and BUP (Bottom-up program), were performed to measure isokinetic parameter; (peak torque: PT, total work: TW, average power: AP, and average torque: AT) of knee extensor for intragroup, intergroup comparison and two-way ANOVA. Results: The Taekwondo athletes group showed statistically significant differences in all isokinetic parameters PT, TW, AP, and AT after TDP (p<0.05). However, in the healthy adult group, the difference in isokinetic parameters according to the exercise sequence was not statistically significant. (p>0.05). PT and TW at TDP were statistically significant (p<0.05) when the rate of change in TDP and BUP was compared and analyzed considering the difference in physical ability between the Taekwondo athlete group and the healthy adult group. However, AP and AT were not statistically significant. Finally, when examining the interaction between the two groups and two exercise sequence according to isokinetic parameters, only TW (p<0.05) showed a statistically significant interaction, while PT (P=0.099), AP (P=0.103), and AT (P=0.096) did not. This study suggests that short-term performance can be improved through the PAP phenomenon when TDP is applied to the Taekwondo group. Conclusion: According to our result, for Taekwondo athletes, if the goal is to improve short-term performance just before the main game, we suggest a training program through TDP.

Hip Muscle Strength and Ratio Differences in Delivery Workers With and Without Iliotibial Band Syndrome

  • Eun-su Lee;Ui-jae Hwang;Hwa-ik Yoo;Il-kyu Ahn;Oh-yun Kwon
    • Physical Therapy Korea
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    • v.30 no.1
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    • pp.15-22
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    • 2023
  • Background: Delivery workers repeatedly get in and out of trucks and walk or run to deliver packages during work. Iliotibial band syndrome (ITBS) is a well-known non-traumatic overuse injury of the lateral side of the knee caused by frequent knee flexion and extension. Hip muscle strength is among the factors that prevent lower extremity injuries. Although many studies have examined the relationship between ITBS and hip muscle strengths, there was no study comparing hip muscle strength and ratio between delivery workers with and without ITBS. Objects: This study aimed to compare hip muscle strength and hip internal/external rotator and adductor/abductor strength ratios between delivery workers with and without ITBS. Methods: Fourteen delivery workers with ITBS matched inclusion criteria in the present study among 20 participants. Because total sample size was required 28 subjects by G*power program (ver. 3.1.9.4; University of Trier), 14 delivery workers without ITBS were recruited. Hip muscle strengths were measured in a side-lying position using a Smart KEMA pulling sensor (KOREATECH Co. Ltd.). An independent t-test was used to compare hip muscle strengths and hip internal/external rotator and hip adductor/abductor strength ratios between delivery workers with and without ITBS. Results: The adductor/abductor strength ratio was significantly greater in delivery workers without ITBS than in those with ITBS (p < 0.05). The strengths of the hip abductor, hip adductor, hip internal rotator, hip external rotator, and the ratio of internal/external rotator strengths were not significantly different between the delivery workers with and without ITBS (p > 0.05). Conclusion: This study's findings showed that delivery workers with ITBS had significantly lesser adductor/abductor strength ratio, while the strengths of the hip abductor and adductor muscles did not differ significantly. These results suggest that adductor/abductor strength ratio should be considered when evaluating and treating ITBS in delivery workers.

Comparative Evaluation Study with Axillary Crutch Design Variations (겨드랑이 목발의 디자인 비교 연구)

  • Yang, Sung Ho
    • Design Convergence Study
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    • v.15 no.6
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    • pp.243-253
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    • 2016
  • In this study, crutch and crutch gait for the handicapped in the lower extremity were discussed, and the study was conducted as a part of long-term research that suggests a practical solution for a crutch design. Three axillary crutches were evaluated in the study by a set of design guidelines for crutches delivered from the advanced research. In this comparative study with axillary crutch design variations, 31 healthy subjects were participated and three crutches were evaluated by ten guidelines. The result showed that Mobilegs-ultra and In-motion Pro were significantly greater than KM Crutch. However, no statistically significant difference was found between Mobilegs-ultra and In-motion Pro. While analyzing with guidelines, Mobilegs-ultra and In-motion Pro were significantly greater than KM Crutch for 6-guideline, but no significant difference was found among three crutches for the guidelines related with Lightweight and Economical feasibility and marketability. The result of the study is expected to be used for a solid foundation to evaluate for the reasonableness of the guidelines with comprehensive analysis for crutch gait evaluation in the further study.