• Title/Summary/Keyword: Lower Extremity

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The Relationship Between Upper Extremity, Trunk and Hip Muscle Strength and the Modified Upper Quarter Y-balance Test

  • Joo-young Jeon;Jun-hee Kim;Oh-yun Kwon
    • Physical Therapy Korea
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    • v.30 no.3
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    • pp.245-252
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    • 2023
  • Background: Various functional tests such as upper quarter Y-balance test (UQYBT) are used to evaluate shoulder stability and mobility in clinical or sports fields. Previous studies have been conducted to determine the correlation between the scapular or trunk muscle and UQYBT. However, the correlation between UQYBT and hip flexor, which can be considered as a core muscle, has not been confirmed. Objects: To verify the relationship between the UQYBT and scapular muscle (scapular protractor and lower trapezius [LT]), trunk muscle, and hip flexor strengths in healthy male participants. Methods: A total of 37 healthy male participants were recruited and underwent UQYBT in the push-up posture. The isometric strength of the scapular protractor, LT, trunk flexor and extensor, and hip flexors were measured using a smart KEMA strength sensor (KOREATECH Inc.). Results: The superolateral direction of the UQYBT was moderately to strongly related to trunk extensor (r = 0.443, p < 0.01), scapular protractor (r = 0.412, p < 0.05), LT (r = 0.436, p < 0.01), and both sides of the hip flexors (supporting-side: r = 0.669, p < 0.01; non-supporting-side: r = 0.641, p < 0.01). The inferolateral direction of the UQYBT was moderately related to the scapular protractor (r = 0.429, p < 0.01), LT (r = 0.511, p < 0.01), and both sides of hip flexors (supporting-side: r = 0.481, p < 0.01; non-supporting-side: r = 0.521, p < 0.01). The medial direction of the UQYBT was moderately to strongly related with the scapular protractor (r = 0.522, p < 0.01), LT (r = 0.541, p < 0.01), and both sides of hip flexors (supporting-side: r = 0.605, p < 0.01; non-supporting-side: r = 0.561, p < 0.01). Conclusion: This study showed that the strength of the scapular muscles, trunk muscles, and hip flexor muscles correlated to the UQYBT. Therefore, the strength of not only the scapular and trunk muscles but also the hip flexor muscles should be considered to improve the UQYBT.

Effects of a Real-time Plantar Pressure Feedback during Gait Training on the Weight Distribution of the Paralyzed Side and Gait Function in Stroke Patients

  • Kim, Tae-Wu;Cha, Yong-Jun
    • Journal of the Korean Society of Physical Medicine
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    • v.17 no.2
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    • pp.53-62
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    • 2022
  • PURPOSE: This study was conducted to investigate the effect of a real-time pressure feedback provided during gait training on the weight weight distribution of the inner part of mid-foot in paralyzed side and gait function in stroke patients. METHODS: A total of 24 patients with hemiplegic stroke in a rehabilitation hospital were randomly assigned to the experimental and control group. All participants (n = 24) performed 15 min of comprehensive rehabilitation therapy 5 times a week for a period of 4 weeks. Additionally, the experimental group and control group underwent gait training with a real time feedback and general gait training, respectively, for 15 min five times a week for 4 weeks. Weight distribution and gait function were measured before and after the 4-week training. RESULTS: Significant increases in the weight distribution (WD), stance time (ST) and step length (SL) of the paralyzed side, and a significant decrease in the 10 m walking test (10 MWT) observed after training in the two groups (p < .05). The experimental group showed larger changes in the all variables than the control group (WD, +10.5 kg vs. +8.8 kg, p < .05; ST, 12.8 s vs. 4.9 s, p < .05; SL, 4.9 cm vs. 1.7 cm, p < .05; 10 MWT, -3.5 s vs. -1.0 s, p < .05, respectively). CONCLUSION: Gait training with a real-time feedback might be effective in improving the normalization of weight bearing of the paralyzed lower extremity and gait function of stroke patients, and be considered to be a more effective gait training for improving the abilities than the general gait training.

A Case Report of Scalp Acupuncture and Chuna Manual Therapy for a Patient with Idiopathic Parkinson's Disease with Walking Disorders due to Lower Extremity Rigidity (하지 강직으로 인한 보행장애를 동반한 특발성 파킨슨병 환자에 대한 두침 및 추나 치료 임상증례 보고)

  • Siyoung Song;Esther Jang;Joonyong Noh;Jae-Uk Sul
    • The Journal of Internal Korean Medicine
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    • v.44 no.5
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    • pp.894-903
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    • 2023
  • The purpose of this study is to report the case of a patient with idiopathic Parkinson's disease treated with scalp acupuncture and Chuna manual therapy. A total of 10 sessions of scalp acupuncture and Chuna manual therapy were performed. At the beginning of the treatment, the Korean version of modified Barthel index (K-MBI) was 25 points, and the range of motion (ROM) of both knee joints was 150° in passive flexion, while active movement was impossible. In addition, both knee joints were flexed and contracted at -40° on the right and -30° on the left. Over the course of treatment, the ROM of both knee joints improved to -20° on the right and -10° on the left. The patient was even able to maintain a standing position and was allowed to walk approximately 10 steps with support. Temporary improvement was observed as a result of applying scalp acupuncture treatment and Chuna manual therapy to a patient whose symptoms were gradually worsening.

Effects of Limited Dorsiflexion Range of Motion on Movement Strategies during Landing (발등굽힘 관절가동범위 제한이 착지 시 움직임 전략에 미치는 영향)

  • Inje Lee;Donggun Kim;Hyeondeukje Kim;Hyunsol Shin;Jiwon Lee;Yujin Jang;Myeongwoo Pi
    • Korean Journal of Applied Biomechanics
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    • v.33 no.4
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    • pp.147-154
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    • 2023
  • Objective: This study aimed 1) to compare the Landing Error Scoring System (LESS) score and movement patterns during landing of the lesser dorsiflexion range of motion (LDFROM) group to that with the greater dorsiflexion range of motion group, and 2) to identify the correlation between the weight-bearing dorsiflexion range of motion (WBDF ROM), LESS score, and movement patterns during landing. Method: Fifty health adults participated in this study. WBDF ROM was measured using the weight bearing lunge test while movement patterns during landing was assessed using the LESS. The joint angles of the ankle, knee and hip joints during landing were analyzed using the 2D video analysis. After mean value of WBDF ROM was calculated, participants were divided into two groups (GDFROM and LDFROM) based on the mean value. The Mann-Whiteny 𝒰 test was used to identify differences in movement strategies during landing between two groups and the Pearson's correlation analysis was performed to determine relationships between WBDF ROM and movement strategies. Results: The LDFROM group showed the poorer LESS score and stiffer landing kinematics during landing compared to the GDFROM group (p<0.05). In addition, DFROM was significantly related to the LESS score and landing kinematics (p<0.05) except for total hip excursion (p=0.228). Conclusion: Our main findings showed that the LDFROM group had poorer landing quality and stiffer landing movements compared to the GDFROM group. In addition, increase of WBDF ROM significantly improved landing quality and soft-landing movements. To reduce shock during landing such as ground reaction forces, individuals need to better utilize WBDF ROM and lower extremity movements based on our findings. Therefore, intervention programs for safer landings should include exercises that increase WBDF ROM and utilize eccentric contraction.

Bilateral Persistent Sciatic Arteries Complicated with Aneurysmal Dilatation and Thrombotic Occlusion: A Case Report (동맥류와 혈전성 폐색이 동반된 양측 잔류좌골동맥: 증례 보고)

  • Seo Jin Jang;Yoonhee Han;Jae Hyun Kwon
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1517-1522
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    • 2020
  • Persistent sciatic artery (PSA), a rare congenital vascular anomaly, increases susceptibility to aneurysms and accounts for 40-61% of the cases. Here, we describe a case of PSA in a 70-yearold man with a history of alcoholic liver cirrhosis. Bilateral complete PSAs were detected incidentally on computed tomography angiography during evaluation for spontaneous intramuscular bleeding in the thigh due to cirrhosis-related coagulopathy. Selective angiography of the left PSA revealed aneurysmal dilatation and thrombotic occlusion of the PSA, which was partially removed with aspiration thrombectomy. Intramuscular bleeding was succesfully managed with empirical embolization of the deep femoral artery.

Surgical Treatment for Primary Lymphedema: A Systematic Review of the Literature

  • Miguel Angel Gaxiola-Garcia;Joseph M. Escandon;Oscar J. Manrique;Kristin A. Skinner;Beatriz Hatsue Kushida-Contreras
    • Archives of Plastic Surgery
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    • v.51 no.2
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    • pp.212-233
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    • 2024
  • This is a retrospective review of surgical management for primary lymphedema. Data were extracted from 55 articles from PubMed MEDLINE, Web of Science, SCOPUS, and Cochrane Central Register of Controlled Trials between the database inception and December 2022 to evaluate the outcomes of lymphaticovenous anastomosis (LVA) and vascularized lymph node transfer (VLNT), and outcomes of soft tissue extirpative procedures such as suction-assisted lipectomy (SAL) and extensive soft tissue excision. Data from 485 patients were compiled; these were treated with LVA (n = 177), VLNT (n = 82), SAL (n = 102), and excisional procedures (n = 124). Improvement of the lower extremity lymphedema index, the quality of life (QoL), and lymphedema symptoms were reported in most studies. LVA and VLNT led to symptomatic relief and improved QoL, reaching up to 90 and 61% average circumference reduction, respectively. Cellulitis reduction was reported in 25 and 40% of LVA and VLNT papers, respectively. The extirpative procedures, used mainly in patients with advanced disease, also led to clinical improvement from the volume reduction, as well as reduced incidence of cellulitis, although with poor cosmetic results; 87.5% of these reports recommended postoperative compression garments. The overall complication rates were 1% for LVA, 13% for VLNT, 11% for SAL, and 46% for extirpative procedures. Altogether, only one paper lacked some kind of improvement. Primary lymphedema is amenable to surgical treatment; the currently performed procedures have effectively improved symptoms and QoL in this population. Complication rates are related to the invasiveness of the chosen procedure.

Difference of muscle activity and muscle contraction onset time of the trunk and lower extremity according to object weights and leg length discrepancy during lifting tasks (물건 들기 시 다리길이 차이 유무와 물건 무게에 따른 몸통과 다리의 근활성도와 근수축 개시시간 차이)

  • Hyeon Nam Ryu;Sung Jun Han;Jin Tae Han
    • Journal of Korean Physical Therapy Science
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    • v.31 no.2
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    • pp.30-40
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    • 2024
  • Background: The purpose of this study is to identify the difference in muscle activity and muscle contraction onset time according to a LLD and object weight When subjects performed a lifting task. Design: Repeated measure design Methods: 15 male adults participated in this study. When subjects performed a lifting task, we measured a difference of muscle activity and muscle contraction onset time in the rectus abdominis(RA), the erector spinae(ES), and the rectus femoris(RF) between both legs using the surface electromyogram (Telemyo DTS, Noraxon Inc., USA). When subjects performed a lifting task, the weight of the object was set to 0% kg, 10% kg, and 20% kg of the subject's body weight, excluding the weight of the box. Results: The difference in muscle activity in the RA, the ES, and the RF between both legs when lifting an object was larger in LLD condition than in non-LLD condition(p<0.05). In all of muscles, the difference of contraction onset time was generally increased as the object's weight increased. Specially, the difference in muscle contraction onset time in the RA, the ES between both legs was larger in the LLD condition than in the non-LLD condition(p<0.05). Conclusion: This study suggests that LLD affects the muscle activity and muscle contraction onset time during lifting objects. It can be used as data to prevent joint damage and muscle due to the LLD during work and movements of daily living.

A Comparative of Knee Joint Instability and Muscle Activity Due to Medial or Lateral Deviation of Knee while Lunge Exercise

  • Sijin Lee;Byeong-Jo Min;Jin-A Park;Hyeong-Geun Kim;Doochul Shin
    • Physical Therapy Rehabilitation Science
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    • v.13 no.2
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    • pp.163-170
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    • 2024
  • Objective: The purpose of this study was to compare the muscle activity of the vastus lateralis, vastus medialis, rectus femoris, and gluteus medius muscles according to the medial/lateral bias of the knee during lunge exercise. Design: Crossed-control group study Methods: This study recruited 20 healthy men and women in their 20s who were capable of lunge exercise and had no musculoskeletal or neurological abnormalities. All three postures were performed three times each during lunge exercise. In each posture, surface electromyography (EMG) equipment was used to measure muscle activity of the vastus lateralis, vastus medialis, rectus femoris, and gluteus medius during lunge exercise. Results: As a result of comparing lower extremity muscle activity in normal, medial and lateral knee-deviation postures according to lunge exercise, the muscle activity of the vastus medialis was 107.09±13.90% in the normal posture, 79.24±5.26% in the medial- deviation posture and 125.73±14.30% in the lateral- deviation posture, which was a statistically significant difference (p<0.05). However, In the case of the vastus lateralis, rectus femoris and gluteus medius there was no statistically significant difference in muscle activity in the medial and lateral deviation positions(p>0.05). Conclusions: As a result, it was found that the muscle activity of the vastus medialis during lunge exercise significantly increased in the lateral deviation posture compared to the normal and medial deviation postures. In the case of the vastus lateralis, rectus femoris and gluteus medius there was no significant difference in muscle activity for medial and lateral knee deviation.

Analysis of Computed Tomography Scans for Radiation Safety Management in the Republic of Korea

  • Min Young Lee;Ji Woo Kim;Ga Eun Oh;Geon Woo Son;Kwang Pyo Kim
    • Journal of Radiation Protection and Research
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    • v.49 no.3
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    • pp.141-150
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    • 2024
  • Background: Computed tomography (CT) scans in the Republic of Korea have spiked, reaching approximately 9 million examinations annually in 2017. CT provides significant medical benefits, but radiation exposure remains a concern. This study aims to analyze CT scans in Korea, as a basis study for radiation safety management. Materials and Methods: The raw data of total CT scans was obtained from the Health Insurance Review & Assessment Service and analyzed by CT scan type, patients' age and sex, and medical facility type. CT scans trends were analyzed considering the disease incidence. Results and Discussion: In 2017, CT scans accounted for 8,977,300. Usage per capita was 0.18 in males and 0.17 in females. CT scans increased with age until the 50- to 59-year-old groups, then decreased. CT scans were high in abdominal/pelvic (35%), chest (26%), and head (22%) regions due to higher disease rates. Head CT was most frequently used for infants and children. Abdominal/pelvic, chest, and spine CT were more frequent for older groups. The CT scans in the upper and lower extremities was high in child and juvenile groups. Chest and abdominal/pelvic CTs were higher in males, whereas spine, whole spine, and CT densitometry were higher in females. The proportion of CT scans of tertiary and general hospitals, hospitals, and clinics accounted for ≥80%, 13%, and 5%, respectively. Abdomen/pelvis, chest, and head/neck CTs were mostly conducted in tertiary and general hospitals, spine CT in hospitals and clinics, extremity CT in hospitals, and CT densitometry in clinics. Conclusion: The trend of CT scans varied based on the incidence rate for each patient's sex and age, and serious illness diagnosis by medical facility type. The results of this study provide data and guidance for evaluating the radiation exposure of the Korean population by CT and developing management policies for medical radiation safety.

The Effects of Stair Climbing Using Wearable Robot Bot Fit's Resistance

  • Jang-hoon Shin;Hwang-Jae Lee;Dokwan Lee;Wan-hee Lee
    • Physical Therapy Rehabilitation Science
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    • v.13 no.2
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    • pp.205-212
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    • 2024
  • Objective: The purpose of this study is to confirm the exercise effect when combining wearable exercise assist robot, Bot fit's resist mode (Samsung Electronics) and stair climbing. Design: Cross-section study Methods: Targeting 53 adults and seniors, foot pressure and muscle activity were measured when climbing 3-story stairs using foot pressure measurement equipment (W-insole Science System) and surface muscle activity measurement equipment (sEMG; FreeEMG, BTS Bioengineering, Italy) using Bot Fit's resist mode. All subjects were measured without wearing Bot Fit, and the data between the two conditions were compared and analyzed. Results: The front area(p<0.01) and middle area(p<0.05) foot pressures of adults significantly increased when wearing the Bot fit. Frontal area foot pressure significantly increased in elderly people with knee arthritis and obesity(p<0.05). The gastrocnemius activity in all subjects significantly decreased after wearing Bot Fit(p<0.01). In elderly people with knee arthritis, the muscle activity of the rectus femoris was significantly reduced(p<0.05)., and in obese elderly people, the muscle activity of the gastrocnemius muscle was significantly reduced(p<0.05). Conclusions: Based on the results of this study, it is possible to induce correct stair climbing posture when climbing stairs using Bot fit resistance mode. In particular, it is expected to be an effective exercise for strengthening muscle endurance by increasing the activity of the rectus femoris muscle.