• 한국소음진동공학회논문집
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• 제22권6호
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• pp.502-508
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• 2012

An analytical model for a human body is important to predict muscle and joint forces. Because it is difficult to estimate muscle or joint forces from a human body, the objective of this study is the development of a reliable analytical model for a human body to evaluate the lower extremity muscle and joint forces. The musculoskeletal system of the human lower extremity is modeled as a multibody system employing the Hill-type muscle model. Muscle forces are determined to minimize energy consumption, and we assume that motion is constrained in the sagittal plane. Muscle forces are calculated through an equilibrium analysis while rising from a seated position. The musculoskeletal model consists of four segments. Each segment is a rigid body and connected by frictionless revolute joints. Muscles of the lower extremity are simplified to seven muscles with those that are not related to the sagittal plane motion are ignored. Muscles that play a similar role are combined together. The results of the present study are compared with experimental results to validate the lower extremity model and the assumptions of the present study.

• PNF and Movement
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• 제15권1호
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• pp.97-104
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• 2017

Purpose: This study seeks to determine the effect of a lower extremity strengthening exercise that uses proprioceptive neuromuscular facilitation (PNF) on the gait and balance ability of a stroke patient. Methods: In this case study, a lower extremity strengthening exercise that used PNF was performed by the subject for 30 minutes 4 times per week for a 4-week period alongside typical rehabilitation therapy. The lower extremity pattern used flexion-abduction-internal rotation with knee flexion, extension-abduction-internal rotation, bilateral leg extension pattern. The 10 m walk test and 6 minute walk test were used to assess gait ability. The Berg balance scale was used to assess balance ability. Results: After the intervention, the time for the 10 m walk test decreased by 5.72 sec, the distance for the 6 minute walk test decreased by 20 meters, and the score on the Berg balance scale improved by 7 points, which indicates the effectiveness of this therapy for stroke patients. Conclusion: The results of this study indicate that a lower extremity strengthening exercise using PNF can improve the gait ability and balance ability of stroke patients.

• PNF and Movement
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• 제12권4호
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• pp.225-232
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• 2014

Purpose: The purpose of this study is to determine the effects of proprioceptive neuromuscular facilitation on the lower extremity function of chronic stroke patients. Methods: The participants consist of 26 chronic stroke patients. They were randomly assigned to either an experimental group (n=13) or a control group (n=13) and engaged in exercise three times per week for eight weeks. The experimental group engaged in proprioceptive neuromuscular facilitation exercises and the control group engaged in general mat exercises. To measure lower extremity strength, the sit to stand test and the static balance test (standing on one leg) were used. To measure the stability index (SI) and weight distribution index (WDI), a Tetrax Portable Multiple System (Tetrax Ltd, Israel) was used in addition to a static balance test (standing on one leg). Results: : Lower extremity strength and static balance showed a significant improvement in the experimental group (p<.05). The SI and WDI were significantly improved in the experimental group (p<.05) for tests of standing with their eyes open, standing with their eyes closed, and standing on a sponge with their eyes open. Conclusion: Proprioceptive neuromuscular facilitation exercises have confirmed that lower extremity function improves after exercise interventions in chronic stroke patients.

• Journal of Acupuncture Research
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• 제30권5호
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• pp.65-76
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• 2013

Objectives : This study was designed to find out the differences of the acupuncture sensation by body parts. Methods : Sixty-three subjects got acupuncture at five acupoints which represent five different body parts ; head($GV_{20}$), abdomen($ST_{25}$), back($BL_{24}$), upper extremity($LU_9$), lower extremity($GB_{40}$). All subjests were asked to complete questionnaire rating the intensity of 13 kinds of acupuncture sensation(acupuncture sensation scale, ASS). We compared the subjective acupuncture sensation between the body parts. Results : Intensity of acupuncture sensation of $GV_{20}$ was significantly lower than $LU_9$(p=0.001) and $GB_{40}$(p=0.000). Sum of acupuncture sensation of $GV_{20}$ was also significantly lower than $BL_{24}$(p=0.011), $LU_9$(p=0.004) and $GB_{40}$(p=0.033). Among the 13 types of acupuncture sensation scale, tingling and aching were well sensed at $GV_{20}$ and $ST_{25}$, aching, tingling and sharp pain were well sensed at $LU_9$, $GB_{40}$, dull pain, deep pressure and heaviness were well sensed at $BL_{24}$. Conclusions : Head showed significantly lower intensity of acupuncture sensation than upper extremity and lower extremity. Among the acupuncture sensation scales, tingling and aching were well sensed at head and abdomen, aching, tingling and sharp pain were well sensed at upper extremity and lower extremity, dull pain, deep pressure and heaviness were well sensed at back.

• 한국방사선학회논문지
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• 제17권1호
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• pp.53-62
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• 2023

Lower Extremity CT Angiography 검사 시 환자의 심박동 수(HR)에 따라 하지 혈관의 조영증강 차이를 비교 분석하여 최적화된 영상 기법을 찾고 유용성을 평가하고자 한다. 2022년 1월부터 22년 8월까지 아주대 병원을 내원하여 Lower Extremity CT Angiography 검사를 진행한 외래환자 139명을 대상으로 하였으며, 심박동 수(HR)에 따라 A 그룹(HR ≤65), B 그룹(65<HR<80), C 그룹(80≤ HR)으로 나누었다. 추가로 지연시간을 설정하여 D 그룹(HR ≤65), E 그룹(65<HR<80), F 그룹(80≤ HR) 으로 나누어 조영제 도달시간과 조영증강 평균값을 비교 분석하였다. 결과적으로 심박동 수(HR)의 차이는 하지 혈관 조영증강 강도에 영향을 주었고, 그룹별 정량적 평가 결과 Heart Rate가 65회 이상인 B, C 그룹은 A 그룹에 비해 슬와 동맥의 HU 값이 우수하였다(p<0.001^***). 지연시간을 적용한 D 그룹은 A 그룹에 비하여 하지 동맥의 조영증강 효과가 개선이 되었음을 확인할 수 있었고(p<0.001^***), 다른 그룹과의 비교한 분석은 유의미하지 않았다. 심박동 수(HR) 활용한 Lower extremity CTA 검사 방법은 유의미 하였고, 특히 심박동 수(HR)가 65이하로 낮은 경우에는 환자에게 적절한 지연시간을 적용하여 검사하는 것이 도움이 된다

• Archives of Reconstructive Microsurgery
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• 제8권2호
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• pp.130-138
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• 1999

The lower extremity injuries are extremely increasing with the development of industrial & transportational technology. For the lower extremity injuries that result from high-energy forces, particularly those in which soft tissue and large segments of bone have been destroyed and there is some degree of vascular compromise, the problems in reconstruction are major and more complex. In such cases local muscle coverage is probably unsuccessful, because adjacent muscles are destroyed much more than one can initially expect. Reconstruction of the lower extremity has been planned by dividing the lower leg into three parts traditionally The flaps available in each of the three parts are gastrocnemius flap for proximal one third, soleus flap for middle one third and free flap transfer for lower one third. Microvascular surgery can provide the necessary soft tissue coverage from the remote donnor area by free flap transfer into the defect. Correct selection of the appropriate recipient vessels is difficult and remains the most important factor in successful free flap transfer. Vascular anastomosis to recipient vessels distal to the zone of injury has been advocated and retrograde flow flaps are well established in island flaps. Retrograde flow anastomosis could not interrupt the major blood vessels which were essential for survival of the distal limb, the compromise of fracture or wound healing might be prevented. During 5 years, from March 1993 to Feb. 1998, we have done 68 free flap transfers in 61 patients to reconstruct the lower extremity. From analysis of the cases, we concluded that for the reconstruction of the lower extremity, free flap transfer yields a more esthetic and functional results.

• The Journal of Korean Physical Therapy
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• 제7권1호
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• pp.21-31
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• 1995

This study was described the movement patterns when rising from supine to erect stance. Two hundred eighty seven subjects, ranging in age from 6 year to 28 were filmed while rising from a supine position. Movement Patterns were classified using categorical descriptions of the action of three body regions-the upper and lower extremity, head-trunk region. This study was designed to determine whether within the rising task the movement patterns of different regions of the body vary with age level and sex. The incidence of each movement pattern was calculated and graphed with respect to age level and sex. The most common form of rising for subject in the 6, 7 year mate group usually involved push and reach pattern with upper extremity, half kneel pattern with lower extremity, partial rotation pattern with head-trunk. In the 6, 7 year female group usually involved symmetrical push pattern with upper extremity, symmetrical squat with balance step pattern with lower extremity, symmetrical interrupted by rotation pattern with head - trunk. In the teenage and twenties both sex group usually involved symmetrical push pattern with upper extremity, symmetrical squat pattern with lower extremity, partial rotation pattern with head-trunk.

• The Journal of Korean Physical Therapy
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• 제14권3호
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• pp.355-372
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• 2002

The purpose of this study was to evaluate the effect of multiaxial lower extremity orthosis on correction of genu valgum. 20 volunteers among people visited department of Rehabilitation Medicine, chungnam national university hospital, who had been diagnosed as genu valgum without other musculoskeletal problems were included. 10 individuals(mean age: 9.gyrs) who had been taken multiaxial lower extremity orthosis at least 12month were included in experimental group and the other 10 individuals(mean age: 11.7yrs) refused taking this orthosis in the control group. We measured the Q-angle & femorotibial angle using plain roentgenogram images at visiting day and repeat same test after 1year follow up. Multiaxial lower extremity orthosis consist of proximal horizontal bar with both thigh cuff, central vertical bar and distal horizontal bar with both shoes. we narrowed inter-shoes distance from start to 6th month and inter-thigh cuff distance together with above correction for next 6month in the frontal plane and from 10th month, dorsiflexed both shoes in sagittal plane. Also, we rotate the both shoes externally and retract the proximal vertical bar every month. This orthosis have to be taken at least 4 hours during sleep. The result were as follows 1. There were no statistical significant difference in each parameter between the right and left Q-angle before multiaxial lower extremity orthosis. 2. The left Q angle reduced $-11^{\circ}$ between 1st day and after 1year follow up showed statistical significant difference between multiaxial lower extremity orthosis taking group and non-taking(p<0.001). 3. The right Q angle reduced $-13^{\circ}$ between 1st day and after 1year follow up showed statistical significant difference between multiaxial lower extremity orthosis taking group and non-taking(p<0.001). 4. There were no statistical significant difference in each parameter between the right and left femorotibial angle before multiaxial lower extremity orthosis. 5. The left femorotibial angle reduced $-10.1^{\circ}$ between 1st day and after lyear follow up showed statistical significant difference between multiaxial lower extremity orthosis taking group and non-taking(p<0.001). 6. The right femorotibial angle reduced $-11.2^{\circ}$ between 1st day and after 1year follow up showed statistical significant difference between multiaxial lower extremity orthosis taking group and non-taking(p<0.001).

• Journal of Trauma and Injury
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• 제21권1호
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• pp.36-45
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• 2008

Purpose: We conducted this retrospective epidemiological study to assess the incidence and severity of lower extremity injuries in Korea Methods: For this study, we retrospectively reviewed nationwide lower-extremity injury data compiled from 2001 to 2003 based on the National Injury Database, what included National Health Insurance Corporation (NHIC), Car Insurance, and Industry Insurance data. Data were standardized in terms of demographic characteristics, region, and socioeconomic status by using NHIC data. To assess the degree of the injuries, we used the Modified Abbreviated Injury Scale (MoAIS), what has been changed from the International Classification of Disease-10 (ICD-10) code. By using the Excess Mortality Ratio-adjusted Injury Severity Score (EMR-ISS), we classified the degree of severity into four categories: mild, moderate, severe and critical. Results: From 2001 to 2003, lower extremity injuries increased slightly, with a yearly average of 2,437,335. Insurance data should that lower-extremity injuries were the most common, followed by upper-extremity injuries. Significant difference were seen in the numbers of lower extremity injuries based on gender and age. As for provinces, Seoul and Gyeongi provinces had the highest numbers of cases. Junlabukdo had the highest rate of 55,282 cases per 1 million people for standardized gender and population. The annual incidence of the insured patients with lower extrimity injuries was higher than the employer's medical insurance contributions to the medical insurance program. Daily cases occur most often in May and June, with the lowest occurrences being in January and February. Conclusion: The result of this study shows that lower extremity injuries comprised common cause of all injuries. In addition, differences associated with gender, location and socioeconomic status were observed. Further studies are needed to find reasons and then this knowledge will allow strategies to prevent the lower extremity injuries.

• Archives of Reconstructive Microsurgery
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• 제13권2호
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• pp.123-129
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• 2004

Lower extremity injuries are frequently accompanied with large soft-tissue defects. Such Injuries are difficult to manage for its poor vascularity, rigid tissue distensibility, easy infectability and a relatively long healing period. Also, osteomyelitis, and/or non-union of the fractured bones are relatively common in lower extremity injuries and its weight-bearing role should be considered. Therefore, it is important to select appropriate reconstruction method of the lower extremities, which is applicable to a variety of surgical techniques according to these considerations. The goal of flap coverage in the lower extremity should not only be satisfactory wound coverage, but also acceptable appearance and minimal donor site morbidity. In this article, we have tried to establish a reconstruction method in the lower extremity based on our experiences and clinical analysis of soft tissue reconstruction using free muscle flap transfer in 27 cases from Jan. 2000 to Dec. 2002. The results showed 96% flap survival, and flap failure noted in one of the cases due to vascular insufficiency. In conclusion, we believe that in cases of lower extremity soft-tissue defects especially with open comminuted fractures and infections, muscle free flaps should be considered as the first line of treatment.