• Title/Summary/Keyword: Lower extremity alignment

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Functional Taping Technique for Chronic Back Pain and Lower Extremity Pain - McConnell's Approach (만성 요통과 하지 통증에 대한 기능적 테이핑 기법 - McConnell 접근법 -)

  • Kim, Suhn-Yeop;Oh, Duck-Won;Kim, Taek-Yean
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.14 no.2
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    • pp.50-59
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    • 2008
  • Taping techniques have been usually used by physical therapists long time ago, which have been considered a useful adjunct to treatment programs for a variety of musculoskeletal disorders. Also, taping techniques may be employed as effective prophylactic methods in clinical setting because of ease application and cost effectiveness. The aims of this study were to describe background information for the management of some chronic low back pain patients with/without leg pain that don't respond to conservative treatment, to demonstrate McConnell taping as successful therapeutic strategies for treating these patients, and to provide detailed application methods of McConnell taping in order that physical therapists can readily use the taping in clinical setting. This study emphasized to illustrate biomechanical benefits of McConnell taping in controlling undesirable muscle activation by decreasing mechanical loads on specific muscles. McConnell taping may be helpful for the inhibition of overactive synergist or antagonists, the facilitation of inactive synergists, the promotion of proprioception, the optimization of joint alignment, pain reduction, and unloading of irritable neural tissue. This study provides taping examples of low back pain, sacroiliac joint dysfunction and lower extremity symptoms associated with these conditions, and discusses the possible mechanisms for their successful application.

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Systematic Review of Reciprocal Changes after Spinal Reconstruction Surgery : Do Not Miss the Forest for the Trees

  • Kim, Chang-Wook;Hyun, Seung-Jae;Kim, Ki-Jeong
    • Journal of Korean Neurosurgical Society
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    • v.64 no.6
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    • pp.843-852
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    • 2021
  • The purpose of this review was to synthesize the research on global spinal alignment and reciprocal changes following cervical or thoracolumbar reconstruction surgery. We carried out a search of PubMed, EMBASE, and Cochrane Library for studies through May 2020, and ultimately included 11 articles. The optimal goal of a truly balanced spine is to maintain the head over the femoral heads. When spinal imbalance occurs, the human body reacts through various compensatory mechanisms to maintain the head over the pelvis and to retain a horizontal gaze. Historically, deformity correction has focused on correcting scoliosis and preventing scoliotic curve progression. Following substantial correction of a spinal deformity, reciprocal changes take place in the flexible segments proximal and distal to the area of correction. Restoration of lumbar lordosis following surgery to correct a thoracolumbar deformity induces reciprocal changes in T1 slope, cervical lordosis, pelvic shift, and lower extremity parameters. Patients with cervical kyphosis exhibit different patterns of reciprocal changes depending on whether they have head-balanced or trunk-balanced kyphosis. These reciprocal changes should be considered to in order to prevent secondary spine disorders. We emphasize the importance of evaluating the global spinal alignment to assess postoperative changes.

Biomechanical Characteristics of Comprehensive Ankle Joint Complex between Chronic Ankle Instability (CAI) and Healthy Control (만성 발목 불안정성(CAI) 환자와 건강 대조군 간 종합적 발목관절복합체의 생체역학적 특성)

  • Kim, Byong Hun;Jeong, Hee Seong;Lee, Inje;Jeon, Hyung Gyu;Lee, Sae Yong
    • Korean Journal of Applied Biomechanics
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    • v.31 no.3
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    • pp.168-175
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    • 2021
  • Objective: To investigate the static and dynamic analysis of ankle joint complex between subjects with chronic ankle instability (CAI) and healthy controls. Method: A total of 38 subjects and CAI group (N=19) and healthy control (N=19) participated in this first study. Variables that were measured in this study were as follows: 1) Subtalar joint axis inclination and deviation 2) Rearfoot angle 3) Navicular drop test 4) Heel alignment view in alignment analysis. Intra Correlation Coefficient (ICC) is used for reliability. A secondary 17 subjects are recruited including 9 of CAI and healthy for gait analysis between group. Lower extremity sagittal, frontal, and transverse kinematics were measured. All data were analyzed to ensemble curve analysis. Results: 1) There were statistically significant differences in standing rearfoot, navicular drop, heel alignment view, subtalar joint (STJ) inclination and deviation. 2) Only in sagittal, meaningful difference is showed during walking in gait analysis. Conclusion: Morphological problem can affect ankle sprain in aspect of structure with no relation to compensation of neuromuscular.

Differences in Static Lower Extremity Alignment according to the History of Lateral Ankle Sprain: Efficacy and Limitation of Static Lower Limb Alignment Measurement as a Predictor of Lateral Ankle Sprain (외측 발목 염좌 병력에 따른 정적 하지 정렬 차이: 외측 발목 염좌의 예측인자로서 정적 하지 정렬 검사의 효용성과 한계점)

  • Jeon, Hyung Gyu;Ha, Sunghe;Lee, Inje;Kang, Tae Kyu;Kim, Eun Sung;Lee, Sae Yong
    • Korean Journal of Applied Biomechanics
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    • v.31 no.1
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    • pp.1-15
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    • 2021
  • Objective: The aim of this study was to investigate 1) the difference in static lower extremity alignment (SLEA) according to a history of lateral ankle sprain (LAS), 2) to identify SLEA factors affecting LAS, and 3) to present the cut-off value and 4) the usefulness and limitations of the SLEA measurement. Method: This case-control study recruited 88 men (age: 27.78±4.69 yrs) and 39 women (age: 24.62±4.20 yrs) subjects with and without LAS. SLEA measurement protocol included Q angle, tibiofemoral angle, genu recurvatum, rear foot (RF) angle, tibal varum and torsion, navicular drop, ankle dorsiflexion range of motion (DF ROM). Independent t-test, logistic regression and receiver operating characteristic (ROC) curve were used for statistical analysis. Results: Men with a history of LAS had significantly smaller Q angles both in standing and in supine position, while women with a history of LAS had significantly greater DF ROM in non-weight bearing (NWB; p < 0.05). Logistic regression model suggests tibial varum (OR = 0.779, p = 0.021) and WB DF ROM (OR = 1.067, p = 0.045) were associated with LAS in men. In case of women, there were no significant SLEA factors for LAS, however, ROC curve analysis revealed standing RF angle (AUC = 0.647, p = 0.028) and NWB DF ROM (AUC = 0.648, p = 0.026) could be affecting factors for LAS. Conclusion: There are differences in SLEA according to the history of LAS, furthermore, the identified items were different by sex. In case of men, tibial varum and WB DF ROM affect LAS occurrence. Standing RF angle and NWB DF ROM of women could be a predictor for LAS. However, since the sensitivity and specificity in most of the SLEA measurements are low, kinematic in dynamic tasks should be considered together for a more accurate evaluation of LAS risk.

Relationship of the Frontal Knee Alignment Measured by the HKA-Angle with the Relative Activation of the Quadriceps Muscles

  • Kim, Jaehee;Bae, Jinsol;Lee, Yesol;Lee, Nakyung
    • Journal of The Korean Society of Integrative Medicine
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    • v.4 no.4
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    • pp.67-75
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    • 2016
  • Purpose: The purpose of this study was to compare Hip-Knee-Ankle(HKA) angle and muscle activation ratio between vastus medialis(VM), rectus femoris(RF), and vastus lateralis (VL), and by this, to examine their relationship. It is aimed to explore how the activation ratio among the muscles involved in patellofemoral kinetics would vary in relation with the frontal alignment of the lower extremity. Subjects and Methods: 26 healthy subjects were recruited for the study. The HKA angles were measured with radiograph. The VM, RF, VL muscle activation level were measured by surface electromyography while each participant performed 4 different types of movement (isometric knee extension, squat, ambulation, step-up) and VM/RF, VM/VL, RF/VL ratios were calculated. Pearson correlation was used to estimate the relationship between the HKA angle and the muscle ratio. Results: There was significant moderate correlation between HKA angle and VM: RF on the left side during ambulation (p<0.05). Moderate correlations were also observed during step-up and squat with less significance (p<0.1). Conclusion: The frontal alignment of the knee measured by the HKA angle was conditionally associated with muscle activation ratio between VM and RF (VM:RF); On the left, during ambulation, step-up, and squat, the more valgus knee tended to correlate with the more VM muscle activation ratio, which is expected to induce more stabilizing effect to the patella and its tracking. It suggests that the frontal alignement measured by the HKA-angle can affect PF kinetics. It also indicates a possibility that increase in valgus alignment of the knee, by the HKA measurement, may not act unfavorably to generate PFP.

The lower-extremity muscle co-activation of flat-footed subjects wearing high-heels while descending stairs. (평발 대상자가 하이힐을 신고 계단을 내려갈 때 하지의 근활성도 변화)

  • Kim, Na-Hee;Choi, Bo-ram
    • Journal of the Korea Convergence Society
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    • v.9 no.11
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    • pp.385-391
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    • 2018
  • The purpose of this study was to examine the lower-extremity muscle activation of flat-footed and normal-footed subjects descending stairs while wearing high-heels, thereby identifying any imbalance between the medial and lateral muscles.Thirty female students volunteered to participate in this study. The navicular drop test (NDT) was applied to the selection criteria for the flat-footed group and the normal-footed group. Surface electromyographic data was collected from the medial and lateral quadriceps, hamstrings, and gastrocnemius. Activation of MG and LG was significantly lower in the flat-footed group than in the normal-footed group. Both groups showed significant increases in MQMH and MHMG, but the co-activation in the medial and lateral muscles was lower in the flat-footed group. The co-activation ratios showed a significantly greater MQMH/LQLH in the flat-footed group. Flat-footed subjects who wear high-heels are more likely to experience impaired knee joint alignment than normal-footed subjects. Therefore, flat-footed subjects should use caution when descending stairs while wearing high-heels.

Kinematic Analysis of Lower Extremity and Evaluation of Skill of Skier Using Parameters of Inertial Sensors During Ski Simulator Exercise (스키 시뮬레이터 운동 시 하지 운동특성 분석 및 관성센서 파라미터를 이용한 스키 숙련도 평가)

  • Kim, Jungyoon;Ahn, Soonjae;Park, Sunwoo;Shin, Isu;Kim, Gyoosuk;Kim, Youngho
    • Journal of Biomedical Engineering Research
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    • v.35 no.3
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    • pp.35-41
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    • 2014
  • In this study, joint angles of the lower extremity and inertial sensor data such as accelerations and angular velocities were measured during a ski simulator exercise in order to evaluate the skill of skiers. Twenty experts and twenty unskilled skiers were recruited for the study. All expert skiers held the certificates issued by the Korea Ski Instructors Association. A three-dimensional motion capture system and two inertial sensors were used to acquire joint movements, heel acceleration and heel angular velocity during ski simulator exercises. Pattern variation values were calculated to assess the variations in ski simulator motion of expert and unskilled skiers. Integral ratio of roll angular velocity was calculated to determine the parallel alignment of the two feet. Results showed that ski experts showed greater range of motion of joint angle, peak-to-peak amplitude(PPA) of heel acceleration and PPA of heel angular velocity than unskilled skiers. Ski experts showed smaller pattern variations than unskilled skiers. In addition, the integral ratio of roll angular velocity in ski experts was closer to 1. Inertial sensor data measurements during the ski simulator exercises could be useful to evaluate the skill of the skier.

Effect of Taping Therapy and Inner Arch Support on Plantar Lower Body Alignment and Gait

  • Lee, Sojung;Jeong, Dawun;Kim, Dong-Eun;Yi, Kyungock
    • Korean Journal of Applied Biomechanics
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    • v.27 no.3
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    • pp.229-238
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    • 2017
  • Objective: The purpose of this study was to identify the effects of taping therapy and inner arch support on pes planus lower extremity alignment and gait. Method: The study was conducted on 13 women in their 20s who had pes planus and no gait problems. Independent variables were the condition of wearing basic socks (S1) and the condition of wearing socks with taping therapy and inner arch support (S2). The dependent variables were resting calcaneal stance position (RCSP), plantar pressure distribution during gait, and underlying and medial longitudinal arch angle measured using radiography. Statistical analysis was performed using the Wilcoxon test with SPSS 23.0 for comparison of S1 and S2. Results: In the RCSP measurement, the angle range of S2 changed to normal. Meary's angle appeared to be less than the angle of S1, indicating alleviation of the degree of pes planus. The calcaneal pitch angle increased at S2 from that at S1. The plantar pressure distribution was divided into four areas (toe, forefoot, midfoot, and hindfoot). At S2, the maximum pressure increased in the toe and midfoot. The maximum force increased significantly in the toe and midfoot but decreased significantly in the forefoot and hindfoot. In addition, the contact area increased overall especially at the midfoot and hindfoot. Contact time decreased in the toe and forefoot, but increased in the midfoot and hindfoot. Conclusion: Taping therapy and inner arch support showed structural improvement of the pes planus. In addition, the force and pressure applied to the foot during walking are distributed evenly in the area of the sole, thus positively affecting walking.

Evolution of Exercise Performance and Medical Assessments in U-12 Youth Football Players (U-12 유소년 축구선수의 운동수행력 및 의학적 평가)

  • Seo, Sang-Won;Lee, Ho-Seong
    • 한국체육학회지인문사회과학편
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    • v.56 no.5
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    • pp.665-677
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    • 2017
  • This study aimed to examine the evolution of exercise performance and medical assessments in U-12 youth football players. Participants were recruited from an youth football players (YFG, n=15; $11.2{\pm}0.9yrs$) and normal youth (CON, n=15; $11.5{\pm}0.6yrs$). Both groups were tested for exercise performance (health related physical fitness, skill related physical fitness, functional movement screen; FMS and Y-balance) and medical assessments (lower extremity alignment, range of motion; ROM and manual muscle test; MMT). YFG showed a positive effects on pacer in health related physical fitness, 50-m run and Single-leg standing with eyes closed in skill related physical fitness, active straight leg raise and rotary stability in FMS, non-dominant composite score in Y-balance, respectively compared to CON. However, YFG showed a negative effects on Q-angle of dominant and non-dominant in lower extremity alignment, dorsiflexion of non-dominant, plantarflexion of dominant and non-dominan in ROM, hip extension and abduction, knee flexion and extension of dominant, knee flexion and extension of non-dominant in MMT, respectively compared to CON. These results indicated that U-12 youth football players have shown excellent exercise performance, but medical assessments has proved negative effects.

A Study on the One-leg Drop landing Pattern and Muscular Activity depending on Chronic Ankle instability among Basketball Club members (농구동호인의 만성발목관절불안정성에 따른 한발착지패턴과 근활성도에 관한 연구)

  • Jeong, Kyoung-Yeol;Kim, Tae-Gyu
    • Journal of Digital Convergence
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    • v.19 no.2
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    • pp.481-488
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    • 2021
  • This study aimed to identify and to compare the difference the changes of one-leg drop landing pattern depending on chronic ankle instability (CAI) among basketball club members. For 30 basketball club members who are currently participating in recreational basketball games in Busan Metropolitan City, 21 CAI groups and 9 CON groups were classified according to the CAI standards provided by the International Ankle Consortium. The one-leg drop landing pattern was measured with the alignment of the lower extremity and joint movement at the initial contact (IC), and the point of peak knee flexion. In addition, the one-leg drop landing pattern was tested with the muscular activity of tibialis anterior, peroneus longus, medial gastrocnemius and gluteus medius at the initial contact (IC), heel contact (HC), and the point of peak knee flexion. The results of this study showed that there was no significant difference in lower limb alignment and lower limb muscular activity among single leg drop landing. These results showed no significant differences in the one leg drop landing pattern and muscular activity depending on CAI. The further studies should classify the types of chronic ankle instability and consider the physical demands and movement characteristics depending on their playing position for providing useful information on prevention of CAI in basketball club members.