• 한국운동역학회지
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• 제27권2호
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• pp.133-140
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• 2017

Objective: The purpose of this study was to determine the relationship between center of pressure (CoP) and local stability of the lower joints, which was calculated based on approximate entropy (ApEn) during walking in elderly women. Method: Eighteen elderly women were recruited (age: $66.4{\pm}1.2yrs$; mass: $55.4{\pm}8.3kg$; height: $1.56{\pm}0.04m$) for this study. Before collecting data, reflective marker triads composed of 3 non-collinear spheres were attached to the lateral surface of the thigh and shank near the mid-segment to measure motion of the thigh and shank segments. To measure foot motion, reflective markers were placed on the shoe at the heel, head of the fifth metatarsal, and lateral malleolus, and were also placed on the right anterior-superior iliac spine, left anterior-superior iliac spine, and sacrum to observe pelvic motion. During treadmill walking, kinematic data were recorded using 6 infrared cameras (Oqus 300, Qualisys, Sweden) with a 100 Hz sampling frequency and kinetic data were collected from a treadmill (Instrumented Treadmill, Bertec, USA) for 20 strides. From kinematic data, 3D angles of the lower extremity's joint were calculated using Cardan technique and then ApEn were computed for their angles to evaluate local stability. Range of CoP was determined from the kinetic data. Pearson product-moment and Spearman rank correlation coefficient were applied to find relationship between CoP and ApEn. The level of significance was determined at p<.05. Results: There was a negative linear correlation between CoP and ApEn of hip joint adduction-abduction motion (p<.05), but ApEn of other joint motion did not affect the CoP. Conclusion: It was conjectured that ApEn, local stability index, for adduction/abduction of the hip joint during walking could be useful as a fall predictor.

• Journal of Chest Surgery
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• 제56권6호
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• pp.387-393
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• 2023

Background: The aim of this study was to evaluate the clinical efficacy of a modified surgical procedure for the treatment of varicose veins. Methods: This retrospective analysis was conducted on lower extremities with symptomatic great saphenous vein (GSV) incompetence that underwent stripping from the groin to the knee, with preservation of the superficial epigastric vein (SEV), between January 2015 and April 2022. Follow-up assessments were performed using Doppler ultrasound, Venous Clinical Severity Score (VCSS), and the Aberdeen Varicose Vein Questionnaire (AVVQ) at 6 and 12 months after surgery. Results: The study included 179 limbs from 120 patients (47 men and 73 women). The mean patient age was 56.5 years (range, 20-78 years), and the distribution of preoperative Clinical-Etiology-Anatomy-Pathophysiology clinical classes was 8% C0-C1, 88% C2, and 4% C3-C6. The preoperative diameter of the saphenofemoral confluence averaged 6.9 mm (range, 2.7-15.8 mm). After a mean postoperative follow-up period of 24 months, evidence of neovascularization around the stump of the saphenofemoral junction (SFJ) was observed in 2 limbs (1.1%). Additionally, varicose vein recurrence was found in 1 limb (0.6%) and was associated with an incompetent thigh perforator. At postoperative follow-up, both VCSS and AVVQ scores were significantly lower than the preoperative scores. Conclusion: Modified surgical treatment of GSV incompetence, involving preservation of the SEV and stripping of a short segment up to the knee, demonstrated favorable clinical results in terms of postoperative complication rate, neovascularization rate around the SFJ stump, varicose vein recurrence rate, and improvement in lower extremity symptoms.

• 한국운동역학회지
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• 제19권2호
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• pp.399-406
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• 2009

본 연구의 목적은 롤러 신발과 조깅 신발 착용 후 보행 시 운동학적 변인에 대하여 비교 분석 하는데 있다. 이를 위해 하지 근골격계에 이상이 없는 중학생 8명을 피험자로 선정하여 3차원 동작 분석을 실시하였다. 분석 결과, 활보장, 인체무게 중심변위 및 선속도, 관절각 및 각속도에서 집단 간 통계적으로 유의한 차이를 보였다. 특히 롤러 집단의 경우 지지 시 발목 관절각이 증가하고 무릎각의 각속도가 감소하는 결과를 나타내었다. 이는 롤러 신발의 경우 장착된 휠에 의해 지지 시 적절한 배측굴곡이 이루지지 못하고, 불안정성을 극복하기 위해 무릎의 과도한 굴곡이 나타난 것으로 사료되어 진다. 이러한 운동학적 변인의 차이는 롤러 신발 보행 시 정상 패턴과는 다른 불안정한 보행 동작을 유발시키고 이러한 동작이 지속적으로 이루어진다면 하지 근골격계에 변화를 유발시켜 부상 유발의 가능성이 있을 것으로 생각된다. 따라서 본 연구 결과를 토대로 향후 보다 안정성 높은 롤러 신발을 개발할 수 있을 것으로 기대된다.

• 한국체육학회지인문사회과학편
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• 제57권3호
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• pp.345-356
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• 2018

이 연구의 목적은 여성 노인들을 대상으로 낙상자와 비낙상자 간 보행 시 하지의 국부적 안정성과 근 활동 양상을 후향성 접근을 통해 규명하고자 했다. 이를 위해 보행 시 낙상 경험이 있는 20명과 낙상 경험이 없는 20명이 선정되었다. 트레이드밀 보행 시 3차원 운동 캡쳐 시스템과 무선 근전도 장비를 이용해 운동학적 좌표와 근전도 신호를 수집했다. 운동좌표를 이용해 무릎과 발목 관절의 3차원 각 변위를 산출했으며, 이들의 국부적 안정성을 Lyapunov 지수를 통해 계산했다. 근 활성도는 근전도 신호를 이용해 대퇴직근과 대퇴이두근, 전경골근과 비복근을 살펴봤으며, 또한 이들의 동시 수축 지수를 정량화했다. 연구 결과 무릎 관절의 내·외전 움직임의 국부적 불안정성은 비낙상자 집단이 낙상자 집단보다 컸으며(p<.05), 전경골근의 근활성도는 낙상자 집단이 비낙상자 집단보다 적게 나타났다(p<.05). 또한 비복근과 전경골근의 동시 수축 지수는 낙상자 집단이 비낙상자 집단보다 컸다(p<.05). 그 밖에 낙상자 집단에서 비복근과 전경골근의 동시 수축 지수와 발목 관절의 굴신 움직임에 대한 국부적 안정성과는 유의한 상관관계를 보였다(p<.05). 따라서 보행 시 낙상을 예방하기 위해서는 무릎 관절의 내·외전 움직임에 관여하는 근들을 강화하고, 발목 관절의 굴신에 작용하는 비복근과 전경골근을 균형적으로 강화할 필요가 있다고 판단된다.

• Journal of Chest Surgery
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• 제50권2호
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• pp.133-136
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• 2017

A 27-year-old female patient was referred due to an edematous left lower extremity. Both saphenous veins had been ablated with an endovenous laser procedure used to treat varicose veins. Venography revealed that the left common femoral vein had been divided and that thrombosis was present at the site of division. No veins were available around the thighs. The patient was treated using a staged procedure. During the first stage, a ringed polytetrafluoroethylene graft was used to repair the common femoral vein, and an arteriovenous fistula was constructed from the femoral artery to the graft using a short segment of cephalic vein to increase graft patency. The edema was relieved postoperatively and the graft was patent. During the second stage, which was performed 6 months later, the fistula was occluded by coil embolization. The staged procedure described herein provides an alternative for venous reconstruction when autologous vein is unavailable.

• 한국운동역학회지
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• 제24권3호
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• pp.239-248
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• 2014

The purpose of this study was to quantify kinematic and kinetic characteristics of Yin-yang Bo gait according to their motor expertise, one of the Seokmun Ilwol martial art gait patterns. Yin-yang Bo gait pattern shows initial forefoot contact instead of heel contact, and increased time of stance phase time, internal-external rotation of ankle-knee-hip joints and pelvic. It aims to produce and store the more energy through continuous homeostasis of center of gravity (COG) and performance of stretch-shortening cycle. Some of these characteristics also were similar to the gait modification strategies for reducing knee adduction moment such as toe-out progression, medial thrust, internal rotation of hip joint. To identify the characteristics, four factors of expert Yin-yang Bo gait performance group were compared to that of none expert group; 1) angles of COG displacement and rotation 2) distal joint pre-rotation in internal-external rotation of ankle-knee-hip joints and pelvic, 3) invariability pelvic potential and pelvic segment total energy 4) knee abduction moment. Six healthy(three male) subjects participated in the experiment to perform Yin-yang gait pattern. Three-dimensional and force plate data were collected. Kinematic and kinetic data were compared between two groups using t-tests. Results showed that 1) the peak point of COG internal rotation angle was reduced in expert group, 2) kneeexternal and hip joint -internal and pelvic rotation angle peak frames were more near points in expert group.

• The Korean Journal of Pain
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• 제19권2호
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• pp.181-186
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• 2006

Background: Although cervical epidural block can be a useful therapeutic treatment for head, neck and upper extremities pain, there is no consensus regarding the volume of injection required for pain management. Herein, the spreading in the vertebral segments after a cervical epidural injection of either a 5 or 10 ml volume was studied. Methods: A total of 78 patients, suffering from head, neck and upper extremity pain, were selected. Cervical epidural blocks were performed consecutively with 5 ml (n = 42) and 10 ml (n = 36) of 0.4% mepivacaine and 222 mg I/ml iopamidol at the C7⁣-T1 levels. Both anteroposterior (AP) and lateral radiographs were obtained under fluoroscopy, and the upper and lower epidural spreading of the contrast media in relation to the vertebral level was evaluated. Results: The cervical epidural blocks were performed without complications. The rostral spreading of the contrast media in the vertebral segments in groups 1 and 2 were $5.6{\pm}1.1$ and $6.1{\pm}1.1$, respectively. The caudal spreading of the contrast media in the vertebral segments in groups 1 and 2 were $5.4{\pm}3.4$ and $7.2{\pm}3.9$, respectively. The total numbers of segments with vertebral spreading of the contrast media in both directions showed significant differences between the two groups. The numbers of patients who showed spreading of the contrast media up to C2 vertebral segment showed no significant differences between the two groups. Conclusions: 5 and 10 ml epidural injection volumes may be adequate for the spread of contrast media to the entire cervical spine. A 5 ml epidural injection volume, compared to a 10 ml volume, may be ample when considering the possibility of unnecessary caudal spreading of drugs and volume related complications in the management of head, neck and upper extremity pain.

• 한국운동역학회지
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• 제16권3호
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• pp.149-163
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• 2006

The purpose of this study was to compare the lower extremity's joint and segment coupling patterns between forward and backward running in subjects who were twelve healthy males. Three-dimensional kinematic data were collected with Qualisys system while subjects ran to forward and backward. The thigh internal/external rotation and tibia internal/external rotation, thigh flexion/extension and tibia flexion/extension, tibia internal/external rotation and foot inversion/eversion, knee internal/external rotation and ankle inversion/eversion, knee flexion/extension and ankle inversion/eversion, knee flexion/extension and ankle flexion/extension, and knee flexion/extension and tibia internal/external rotation coupling patterns were determined using a vector coding technique. The comparison for each coupling between forward and backward running were conducted using a dependent, two-tailed t-test at a significant level of .05 for the mean of each of five stride regions, midstance(1l-30%), toe-off(31-50%), swing acceleration(51-70%), swing deceleration(71-90), and heel-strike(91-10%), respectively. 1. The knee flexion/extension and ankle flexion/extension coupling pattern of both foreward and backward running over the stride was converged on a complete coordination. However, the ankle flexion/extension to knee flexion/extension was relatively greater at heel-strike in backward running compared with forward running. At the swing deceleration, backward running was dominantly led by the ankle flexion/extension, but forward running done by the knee flexion/extension. 2. The knee flexion/extension and ankle inversion/eversion coupling pattern for both running was also converged on a complete coordination. At the mid-stance. the ankle movement in the frontal plane was large during forward running, but the knee movement in the sagital plane was large during backward running and vice versa at the swing deceleration. 3. The knee flexion/extension and tibia internal/external rotation coupling while forward and backward run was also centered on the angle of 45 degrees, which indicate a complete coordination. However, tibia internal/external rotation dominated the knee flexion/extension at heel strike phase in forward running and vice versa in backward running. It was diametrically opposed to the swing deceleration for each running. 4. Both running was governed by the ankle movement in the frontal plane across the stride cycle within the knee internal/external rotation and tibia internal/external rotation. The knee internal/external rotation of backward running was greater than that of forward running at the swing deceleration. 5. The tibia internal/external rotation in coupling between the tibia internal/external rotation and foot inversion/eversion was relatively great compared with the foot inversion/eversion over a stride for both running. At heel strike, the tibia internal/external rotation of backward running was shown greater than that of forward(p<.05). 6. The thigh internal/external rotation took the lead for both running in the thigh internal/external rotation and tibia internal/external rotation coupling. In comparison of phase, the thigh internal/external rotation movement at the swing acceleration phase in backward running worked greater in comparison with forward running(p<.05). However, it was greater at the swing deceleration in forward running(p<.05). 7. With the exception of the swing deceleration phase in forward running, the tibia flexion/extension surpassed the thigh flexion/extension across the stride cycle in both running. Analysis of the specific stride phases revealed the forward running had greater tibia flexion/extension movement at the heel strike than backward running(p<.05). In addition, the thigh flexion/extension and tibia flexion/extension coupling displayed almost coordination at the heel strike phase in backward running. On the other hand the thigh flexion/extension of forward running at the swing deceleration phase was greater than the tibia flexion/extension, but it was opposite from backward running. In summary, coupling which were the knee flexion/extension and ankle flexion/extension, the knee flexion/extension and ankle inversion/eversion, the knee internal/external rotation and ankle inversion/eversion, the tibia internal/external rotation and foot inversion/eversion, the thigh internal/external rotation and tibia internal/external rotation, and the thigh flexion/extension and tibia flexion/extension patterns were most similar across the strike cycle in both running, but it showed that coupling patterns in the specific stride phases were different from average point of view between two running types.