• Title/Summary/Keyword: Lower Extremity

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Analysis of Muscle Activities and Driving Performance for Manipulating Brake and Accelerator Pedal by using Left and Right Hand Control Devices (장애인용 핸드컨트롤을 이용한 가속 및 제동 페달을 동작할 때의 상지 근육 EMG 분석 및 운전 성능 평가)

  • Song, Jeongheon;Kim, Yongchul
    • Journal of Biomedical Engineering Research
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    • v.38 no.2
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    • pp.74-81
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    • 2017
  • The purpose of this study was to investigate the EMG characteristics of driver's upper extremity and driving performance for manipulating brake and accelerator pedal by using left and right hand control devices during simulated driving. The people with disabilities in the lower limb have problems in operation of the motor vehicle because of functional loss for manipulating brake and accelerator pedal. Therefore, if hand control device is used for adaptive driving controls in people with lower limb impairments, the disabled people can improve their quality of life by driving a motor vehicle. Six subjects were participated in this study to evaluate driving performance and muscle activities for operating brake and accelerator pedal by using two different hand controls (steering column mounted hand control and floor mounted hand control) in driving simulator. We measured EMG activities of six muscles (posterior deltoid, middle deltoid, triceps, biceps, flexor carpi radialis, and extensor carpi radialis) during pushing and pulling movement with different hand controls for acceleration and braking. STISim Drive 3 software was used for the performance test of different hand control devices in straight lane course for time to reach target speed and brake reaction time. While pulling the hand control lever toward the driver, normalized EMG activities of middle deltoid, triceps and flexor carpi radialis in subjects with disabilities were significantly increased (p < 0.05) compared to the normal subjects. It was also found that muscle responses of posterior deltoid were significantly increased (p < 0.05) when using the right hand control than left hand control. While pushing the hand control lever forward away from the driver, normalized EMG activities of posterior deltoid, middle deltoid and extensor carpi radialis in subjects with disability were significantly increased (p < 0.05) compared to the normal subjects. It was shown that muscle responses of middle deltoid, biceps and extensor carpi radialis were significantly increased when using the right hand control than left hand control. Brake reaction time and time to reach target speed in subjects with disability was increased by 12% and 11.3% on average compared to normal subjects. The subjects with physical disabilities showed a tendency to relatively slow acceleration at the straight lane course.

A case of Transverse Myelitis due to Multidrug-Resistant Tuberculosis (다제내성 결핵에 의한 횡단척수염 1예)

  • Lee, Kwang Ha;Ra, Seung Won;Park, I-Nae;Choi, Hye Sook;Jung, Hoon;Chon, Gyu Rak;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.3
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    • pp.353-356
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    • 2006
  • Acute transverse myelitis (TM) is a neurological syndrome caused by inflammation of the spinal cord. TM is rare but is frequently caused by viral or bacterial infections. TM caused by tuberculosis (TB) is extremely rare and there are no reports of TM caused by multidrug-resistant TB (MDR-TB). We report a case of acute TM due to MDR-TB in a 40-year-old man. The patient had been diagnosed with pulmonary TB and was started on the first-line anti-TB treatment. However, the chest radiographic findings were aggravated and neurological symptoms such as weakness in both lower extremities, sensory changes, and voiding difficulty were newly developed. The T2-weighted magnetic resonance image of the spine showed diffusely increased signal intensity in the spinal cord, particularly at the lower cervical and upper thoracic levels, without any definite evidence of myeloradicular compression, which is consistent with a diagnosis of TM. A drug susceptibility test revealed MDR and second-line anti-TB drugs were prescribed. The chest radiographic findings showed improvement after treatment, the mycobacterial culture converted to negative, the MRI findings improved, and there was partial improvement in the low extremity weakness. The patient has been prescribing second-line anti-TB medications for 14 months.

Static and Dynamic Balance Comparison Between the Involved and Uninvolved Sides in Patients Who had Anterior Cruciate Ligament Reconstruction: One-year Follow-up Study

  • Kim, Jin-seong;Choi, Moon-young;Kong, Doo-hwan;Chung, Kyu-sung;Hwang, Ui-jae;Kwon, Oh-yun
    • Physical Therapy Korea
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    • v.27 no.4
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    • pp.286-291
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    • 2020
  • Background: Anterior cruciate ligament reconstruction (ACLR) causes a reduction in the balance of the lower extremities. Static and dynamic balance were evaluated separately to confirm the decrease in balance in patients underwent ACLR. The commonly used methods include the Biodex Balance System (BBS) for static balance and the Y balance test (YBT) for dynamic balance. No study has evaluated whether the static and dynamic balance of the involved side recovers as much as the uninvolved side one year after ACLR. Objects: The purpose of this study was to investigate the recovery of static and dynamic balance between the involved and the uninvolved sides. Methods: The BBS (overall, anteroposterior index, and mediolateral index) and YBT (anterior, posterolateral, and posteromedial) of 58 patients underwent ACLR were measured one year postoperation. Both sides of the BBS and the YBT were compared using the paired t-test. Results: All the index of the BBS showed no difference between the involved and the uninvolved sides, while all the scores of the YBT showed a significant difference in both sides. The YBT anterior result was 54.64 ± 5.62 cm in the involved side and 56.90 ± 5.41 cm in the uninvolved side (p = 0.001). The YBT posterolateral results were 90.12 ± 10.51 cm and 92.34 ± 9.85 cm (p = 0.013). The YBT posteromedial results were 93.72 ± 8.84 cm and 96.14 ± 9.37 cm (p = 0.002). Conclusion: A year after ACLR, the static balance showed no difference, while the dynamic balance showed a significant difference in the involved and the uninvolved sides. The static balance of the involved side recovered as much as the uninvolved side, but the dynamic balance did not. Therefore, dynamic balance training should be considered in the rehabilitation program for patients underwent ACLR.

The Kinetic Analysis of Arabesque Turn Motion in Modern Dance by Upper Extremity Usage (상지이용유무에 따른 현대무용 아라베스크 턴 동작의 운동역학적 분석)

  • Park, Yang-Sun;Kim, Ji-Hye
    • Korean Journal of Applied Biomechanics
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    • v.19 no.3
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    • pp.457-466
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    • 2009
  • This study puts the purpose in providing the scientific basis of dance motion as an artistic expression by analyzing the kinematic variable and the distribution factor of power affecting the motion, which is connected to the turn, right after the arabesque motion according to the existence and non existence of using the arm in the arabesque motion of modern dance. As a result of this study, arabesque turn motion, not using the upper limbs, used more turning force of head and body than the arabesque turn motion, using the upper limbs, and arabesque turn using the upper limbs obtained the turning force, using the right shoulder. The range of the hip joint on the left and the position change of left tiptoe in the Arabesque turn motion using the upper limbs is largely ascended to the vertical axis, while, the position of tiptoe in the Arabesque turn motion, not using the upper limbs is dropped to the lower part of each event. In the replacement of body center, Arabesque turn motion using the upper limbs is moved more to the turning axis than arabesque turn motion not using the upper limbs. As a result of maximum vertical ground reaction force, Arabesque turn motion using the upper limbs appeared to be a lower value than the Arabesque turn motion not using the upper limbs.

A Literatural Study on the Traditional Korean Medical Physiotherapy (한방물리요법에 대한 문헌적 고찰)

  • Choi, Bo-Mi;Hong, Seo-Young
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.2
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    • pp.211-226
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    • 2011
  • Objectives : The purpose of this study is to establish literatural evidence about traditional Korean medical physiotherapy through literatural review. Methods : Applicable paragraphs which were related to the traditional Korean medical physiotherapy were phrased from in "Hwang-je-nae-gyung(黃帝內經)", "Yumun-sa-chin(儒門事親)", "Geum-guei-yo-ryack(金匱要略)", "Eui-hack-ip-mun(醫學入門)", "Gyung-ack-jeon-seo(景岳全書)", "Eui-hack-gang-mock(醫學綱目)", "Dong-eui-bo-gam(東醫寶鑑)" where were archiving of Oriental or Korean medicine literatures. Searched paragraphs were analysed for establishing historical and theoretical bases of Korean medical physiotherapy. Results : 1. Theromtherapy is originated from yu(熨), hot hand, warm, water bath, warm earth, fumigation, lamp, torchlight and brazier. Matching indications are various musculoskeletal pain and diseases, skin diseases such as chronic inflammation, frostbite, gynecological and urogenital diseases such as uterine myoma, lower abdominal pain, metrorrhagia, breast diseases, digestive tract diseases such as vomiting, diarrhea, stomachache and also it treats cardiovascular disease. Other matching indications are sunstroke, rhinorrhea, psycosis and anal pain. And it used helping acupuncture therapy. 2. Cryotherapy is originated from lengfu(冷敷), lengtie(冷貼), cold stone and cold water. Matching indications are various fever disease, skin diseases such as acute inflammation, wound, fever skin disease, otorhinolaryngological diseases such as acute sore throat, otitis, stomatitis, nasal bleeding and contusions, abrasions, burn and dysuria. In addition, it treats extremity coldness, chillness, stomachache caused to accumulate fever. 3. Physiotherapy by circulating meridian system is originated from manipulation such as pushing, massage and beating to therapy point. Matching indications are musculoskeletal diseases such as various muscular pain, heavy sensation, convulsion, urogenital diseases such as dysuria, lower abdomen pain, digestive tract diseases such as stomachache, and paralysis due to blocked meridian system. And other matching indications are psycosis, leprosy, hypoesthesia, acute stroke. In addition it helps other therapy methods. In addition, the power of manipulation classify to strengthen and reduce. 4. Physiotherapy by balancing meridian system is originated from sunshine, magnet, horn, bamboo and tube. Sunshine helps improving self's care and cure inflammatory skin disease. Magnet's matching indications are paralysis, various injuries, abscess, fever and eye disease. Cupping therapy treats to skin diseases and internal diseases such as tuberculosis. Conclusions : Traditional Korean medical physiotherapy was widely used in traditional Korean medicine since ancient time based on the traditional Korean medical principle and anatomical knowledge. With modern physiotherapy and traditional Korean medicine together, effects of treatment are enhanced. And traditional Korean medical physiotherapy is appropriated to world physiotherapy's expectation.

The Cross-Leg Gastrocnemius Muscle Flap for Leg Reconstruction of the Difficult and Unfavorable Conditions (비복근을 이용한 교차하지 근육 피판술)

  • Kim, Ji Ye;Yang, Eun Jung;Hwang, Eun A;Kim, Sug Won
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.583-590
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    • 2009
  • Purpose: In the cases of a vascular compromised condition in an injured lower extremity, soft tissue coverage with free tissue transfer presents a challenging problem to the reconstructive surgeon. For this reason, cross - leg flaps are still used in unusual circumstances. Advances in surgical technique has made the cross - leg free flap possible although it may require long operation time along with significant donor site morbidity. Therefore, a pedicled cross - leg muscle flap may be an alternative treatment modality when local flap or free flap is not possible. Methods: Twelve patients(9 males and 3 females) underwent the operation between October of 2001 and December of 2008. The patients' age ranged from 6 to 82 years. The unusual defects included the regions such as the knee, popliteal fossa, distal third of the tibia, dorsal foot, and the heel. Indications for the cross - leg gastrocnemius flap are inadequate recipient vessels for free flap(in eight cases), extensive soft tissue injuries(in three cases) and free flap failure(in one case). The muscle flap was elevated from contralateral leg and transferred to the soft tissue defect on the lower leg while both legs were immobilized with two connected external fixator systems. Delay procedure was performed 2 weeks postoperatively, and detachment was done after the establishment of the adequate circulation. The average period from the initial flap surgery to detachment was 32 days (3 to 6 weeks). Mean follow - up period was 4 years. Results: Stable coverage was achieved in all twelve patients without any flap complications. Donor site had minimal scarring without any functional and cosmetic problems. No severe complications such as deep vein thrombosis or flap necrosis were noted although mild to moderate contracture of the knee and ankle joint developed due to external fixation requiring 3 to 4 weeks of physical treatment. All patients were able to walk without crutches 3 months postoperatively. Conclusion: Although pedicled cross - leg flaps may not substitute free flap surgery, it may be an alternative method of treatment when free flap is not feasible. Using this modification of the gastrocnemius flap we managed to close successfully soft tissue defects in twelve patients without using free tissue transfers.

What is the Appropriate Kettlebell Mass for a Kettlebell Swing? (케틀벨 스윙 시 적당한 케틀벨의 무게는 얼마일까?)

  • Kim, Bo Kyeong;Thau, Dao Van;Yoon, Sukhoon
    • Korean Journal of Applied Biomechanics
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    • v.31 no.4
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    • pp.308-313
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    • 2021
  • Objective: The purpose of this study was to investigate the effect of different kettlebell mass (30%, 40%, and 50% of the body mass) on kinematics and kinetic variables of kettlebell swing. Method: Total of 16 healthy male who had at least 1 year of kettlebell training experience were participated in this study (age: 31.69 ± 3.46 yrd., height: 173.38 ± 4.84 cm, body mass: 74.53 ± 6.45 kg). In this study, a 13-segments whole-body model (upper trunk, lower trunk, pelvis, both side of forearm, upperarm, thigh, and shank) was used and 26 reflective markers were attached to the body to identify the segments during the movement. A 3-dimensional motion analysis with 8 infrared cameras and 4 channeled EMG was performed to find the effect of kettlebell mass on its swing. To verify the kettlebell mass effect, a one-way ANOVA with a repeated measure was used and the statistical significance level was set at 𝛼=.05. Results: Firstly, in all lower extremity joints and thoracic vertebrae, a statistically significant change in angle was shown according to an increase in kettlebell mass during kettlebell swing (p<.05). Secondly, in both the up-swing and down-swing phases, the knee joint and ankle joint ROM showed a statistically significant increase as the kettlebell mass increased (p<.05) but no statistically significant difference was found in the hip joint and thoracic spine (p>.05). Lastly, the hamstrings muscle activity was statistically significantly increased as the kettlebell mass increased during up-swing phases (p<.05). Also, as the kettlebell mass increased in P4 of the down swing phase, the gluteus maximus showed a statistically significantly increased muscle activation, whereas the rectus femoris showed a statistically significantly decreased muscle activation (p <.05). Conclusion: As a result of this study, hip extension decreased and knee extension increased at 40% and 50% of body mass, and the spine also failed to maintain neutrality and increased flexion. Also, when kettlebell swings are performed with 50% of body mass, synergistic muscle dominance appears over 30% and 40% of body mass, which is judged to have a risk of potential injury. Therefore, it is thought that for beginners who start kettlebell exercise, swing practice should be performed with 30% of body mass. In addition, even in the case of experienced seniors, as the weight increases, the potential injury risk may increase, so it is thought that caution should be exercised when performing swings with 40% and 50% of body mass. In conclusion, it is thought that increasing the weight after sufficiently training with 30% of the weight of all subjects performing kettlebell swing is a way to maximize the exercise effect as well as prevent injury.

The Study of Correlation Between the Balance, Cognition and Activity of Daily Living in Stroke Patients (뇌졸중 환자의 균형, 인지, 일상생활 평가의 상관성 연구)

  • Kang, Bo-Ra;Jeong, Eun-Song;Kim, Jae-Hee;Ha, Yoo-Na
    • Journal of Korean Society of Neurocognitive Rehabilitation
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    • v.10 no.2
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    • pp.45-52
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    • 2018
  • The purpose of the present study was to determine correlations between the Berg Balance Scale (BBS), Montreal Cognitive Assessment-Korean (MoCA-K) and Modified Barthel Index (MBI) targeting stroke patients, and it seeks to analyze the influence among each factor to establish the fundamental research in evaluating the functional performance capability of stroke patients. The study was conducted between December 2017 and March 2018 and the target of the study was 34 stroke patients who are hospitalized and treated in Y rehabilitation hospital located in Goyang city. Following in criteria of how participants were selected. First, a person without the onset of 6months or more. Second, a person who can communicate and score over 20 points on MMSE-K. Third, a person without unilateral neglect. Fourth, a person without lower motor neuron lesion and orthopedic disease on the bilateral lower extremity. Fifth, a person without audiovisual problem and history of using drug or surgery that influence athletic function. sixth, patients who agreed on participating in the study. The evaluation was processed by measuring BBS, MoCA-K, and MBI with the occupational therapist and physical therapist. Also, one assistant was participated in measuring balanced ability for the safety reason. It was found that significantly correlates (p<.01) with BBS and MoCA-K (r=.459), BBS and MBI (r=.550), MoCA-K and MBI (r=.565). This study is meaningful that it provided the basis for the active use of BBS, MoCA-K and MBI as a clinical evaluation tool and its usefulness.

May-Thurner Syndrome with Deep Vein Trombosis after Total Knee Arthroplasty (인공 슬관절 전치환술 후 발생한 메이-터너 증후군 및 심부정맥 혈전증)

  • Lee, Hwa-Sung;Kim, Yong-Woo;Jung, Se-Hoon;Lee, Se-Won
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.343-347
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    • 2020
  • May-Thurner syndrome (MTS), also known as iliac vein compression syndrome, is a condition, in which compression of the common venous outflow tract of the left lower extremity can cause discomfort, swelling, pain or blood clots in the iliofemoral veins. The problem is due to left common iliac vein compression by the overlying right common iliac artery. This paper describes the case of a 75-year-old female with MTS after performing right total knee replacement arthroplasty. The authors diagnosed MTS through intravenous angiography and angiographic computed tomography on swelling and pain of the left lower extremities after performing right total knee replacement arthroplasty. The thrombus was removed using a thrombolytic agent and mechanical thrombectomy, and an intravenous stent then inserted after angioplasty. No case of MTS after performing total knee replacement arthroplasty has been reported in Korea. Therefore, this case is reported along with review of the relevant literature.

Sports Injuries in College Taekwondo Players: Retrospective Analysis of 47 Players (대학 태권도 선수들에서의 스포츠 손상: 47명에 대한 후향적 연구)

  • Jung, Hong-Geun;Park, Hee-Gon;Kim, Jong-Phil;Kim, You-Jin;Kim, Ki-Choul;Kim, Young-In;Lee, Sang-Min
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.1
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    • pp.69-74
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    • 2006
  • Purpose: To perform the retrospective analysis of the sports injuries sustained by the college Taekwondo athletes in the respect of the injury patterns, mechanism of injury and clinical outcome Materials and Methods: This study is based on 47 out of 49 college Takwondo athletes, who had experienced the Takwondo related musculoskeletal injuries severe enough to visit the clinic for medical treatment. The mean age at the time of injury was 18.8 years and 39 were males and 8 females. The Taekwondo career was average 9.6 years and the injuries were sustained at average 6.7 years of their career. The injuries were analyzed by the detailed interview with thorough physical examination. Results: Forty-seven Taekwondo athletes in the study experienced average 1.8 injury/person (total 85 cases) with 26 persons of one time experience(55.3%), 11 persons of 2 times(23.4%),4 persons of 3 times (8.5%),5 persons of 4 times (10.6%) and 1 person of 5 times (2.2%). Injuries occurred during training in 50 cases (58.8%), while during match in 35 cases (41.2%). Injuries occurred during the attack phase of the match are 26 cases (31.7%) while 49 cases (57.6%) during the defense phase. As for the pattern of injury, fracture was the most common with 49 cases (57.6%), followed by ligament injury with 21 cases (24.7%). The upper extremity injuries were 32 cases (37.7%) while the lower extremity injuries were 44 cases (51.8%) Mode of medical treatment were operation in 15cases(17.7%), cast in 21 cases(24.7%), splint in 33 cases (38.8%), physical therapy in 15cases(17.7%) and acupuncture in 1 case(1.1%) Conclusion: Almost all the college Taekwondo athletes (96%) experienced sports injuries severe enough to receive medical treatments with the fracture being the most common injury pattern. The injuries occurred more commonly during the defense phase of the competition.

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