• Archives of Plastic Surgery
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• 제48권6호
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• pp.691-698
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• 2021

Background The reverse sural artery (RSA) flap is widely used for lower extremity reconstruction. However, patients sometimes suffer from donor site complications such as scar contracture and paresthesia, resulting in dissatisfaction with the aesthetic outcomes. This study investigated the characteristics of donor site morbidity associated with RSA flaps and described our experiences of dealing with complications by performing resurfacing surgery using thoracodorsal artery perforator (TDAP) flaps. Methods From April 2008 to August 2018, a total of 11 patients underwent contracture release and resurfacing surgery using TDAP flaps due to donor morbidity associated with RSA flaps. All affected donor sites were covered with a skin graft, the most common of which was a meshed split-thickness skin graft (six cases). Results Eight of the 11 patients (72.7%) suffered from pain and discomfort due to scar contracture, and seven (63.6%) complained of a depression scar. The donor sites were located 6.3±4.1 cm below the knee joint, and their average size was 140.1 cm². After resurfacing using TDAP flaps, significant improvements were found in the Lower Extremity Functional Scale (LEFS) scores and the active and passive ranges of motion (AROM and PROM) of the knee joint. The LEFS scores increased from 45.1 to 56.7 postoperatively (P=0.003), AROM increased from 108.2° to 118.6° (P=0.003), and PROM from 121.4° to 126.4° (P=0.021). Conclusions Planning of RSA flaps should take into account donor site morbidity. If complications occur at the donor site, resurfacing surgery using TDAP flaps achieves aesthetic and functional improvements.

• Physical Therapy Rehabilitation Science
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• 제5권2호
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• pp.106-112
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• 2016

Objective: This study was conducted to investigate the effects of resistant exercise on the gait performance of a patient with systemic lupus erythematosus (SLE) patient. Design: A case study. Methods: A 30-year-old male adult who had been diagnosed with systemic lupus erythmatosus (SLE) in April 2013, right middle cerebral artery infarction, and with left hemiplegia agreed to participate in this case study. Patient was unable to walk due to being affected with adynamia. Due to developing necrotizing vasculitis on the left lower extremity, patient underwent a myotomy on the left thigh. The patient was trained with a progressive resistant exercise program for 8 weeks. An intensity of 15 RM was used for the resistant exercises and the resistance level was increased progressively in order to improve the muscle power of the patient. Methods used to increase resistance included changing positions, providing mechanical resistance instead of manual resistance, transitioning from open kinetic chain to closed kinetic chain exercises, and changing the colors of the theraband to those with increase level of resistance. Outcome measures included the 5-repetition sit-to- stand test (5RSST), Timed Up & Go (TUG), and 10-meter walk test (10MWT). In addition, the GAITRite was used to assess the spatio-temporal gait variables, including gait speed, cadence, stride length of the left side, and double limb support pre and post-intervention. Results: The patient was able to perform sit-to- stand after two weeks of performing the resistant exercises. The patient was able to walk after 4 weeks, and the patient's overall gait performance had improved after 8 weeks. All of the variables had improved after each week. Conclusions: The results of this case study may be used to enhance future efforts to objectively evaluate resistant exercises during gait performance in persons affected by SLE.

• Journal of Acupuncture Research
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• 제28권5호
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• pp.135-142
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• 2011

Objectives : This study was to investigate on the hominis placenta pharmacopuncture of FBSS patient who were diagnosed as the cauda equina syndrome which has been described as a complex of low back pain, bilateral sciatica, saddle anesthesia and hypoesthesia in the lower extremity with bladder and bowel incontinence. Methods : The patient was treated with hominis placenta parmacopuncture at Samchosu($BL_{22}$), Shinsu($BL_{23}$), Sangryo($BL_{31}$), Charyo($BL_{32}$), Jungryo($BL_{33}$) and Haryo($BL_{34}$) with oriental medical conservative treatment. We estimated by visual analog scale and Oswestry disability index and nerve level dermatome test for evaluate the effect of Hominis Placenta Pharmacopuncture with oriental conservative treatment. Results : After treatment, patient's visual analogue scale score, Oswestry disability index score, bilateral sciatica, saddle anesthesia and hypoesthesia in the lower extremity with bladder and bowel incontinence were generally decreased. Conclusions : The hominis placenta pharmacopuncture with oriental medical conservative treatment might be an effective method to treat the FBSS patient who were diagnosed as the cauda equina syndrome.

• 대한인간공학회지
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• 제30권5호
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• pp.613-619
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• 2011

Objective: The purpose of this study is to compare the muscle activities of lumbar and lower extremity muscles between left and right sides using EMG(Electromyogram) when patients are transferred by physical therapists. Background: Asymmetrical lift was recognized as a major cause of musculoskeletal disorder. Several studies show that physical therapists' transferring patients needs caution as it could cause a lumbar pain to patients but there is not sufficient data to support. Method: Forty healthy rehabilitation hospital physical therapists joined for this study. The subjects were transferred from wheelchair to treatment mat(from left to right) by connecting the EMG device to the patients' body both on erector spine and rectus fermoris. At the moment when subjects were being transferred, the EMG device collected data from both erector spine and rectus femoris and it was normalized as %MVC. Then the EMG data was statistically analyzed using paired t-tests. Results: The EMG data show that the left erector spinae and rectus femoris are more activated than right erector spinae and rectus femoris in all position(p<.05) in a significant degree. Conclusion: The result implies that physical therapists' asymmetrical lifting when patients are transferred by them has a potential cause of musculoskeletal disorder of patients. Further studies will be conducted to find out a same tendency in other muscles of a body and to see if there are other factors to affect to patients during asymmetrical lifting. Application: These results can be used to provide baseline information for more understanding to asymmetrical lift loading.

• The Journal of Korean Physical Therapy
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• 제4권1호
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• pp.27-42
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• 1992

The purpose of this study is to investigate the occurence properties of the complications in spinal cord injured patients. Clinical observation were for 116 cases in and out wards, were carried out during one year from july, 1990 to June, 1991 at 4 general hospitals in Taegu, Korea. The results of this study is summarized as follows : 1. Among the 116 cases, $67.7\%$ was male and $35.3\%$ was female. The largest groups were noted in $60.7\%$, of the forties by age, in $34.5\%$ of the middle school by educational career, in $27.6\%$ of the administer by professional division. 2. The number of complications in a patient in the largest group was two-type. The next groups were three-type, $23.3\%$ and five-type, $20.7\%$. Of each factors, the largest numbers of two-type recorded tuberculosis of spine$(71.4\%)$, thoracic cord injury$(63.4\%)$, incomplete paraplegia$(48.4\%)$, and inwards during 1-2 months $(47.4\%)$. 3. Total number of the complications were counted to 367 cases. The largest group of complications was pain, $24.8\%$. The next groups were pressure sores, $19.9\%$. spasticity, $12.5\%$, and urinary tract infection, $9.3\%$. 4. The number of the 4 major complications(pain, pressure sores, joint contracture, spasticity) was counted to 280 cases. The largest group of the major complications was pain, $32.5\%$. The next groups were pressure sores, $26.1\%$, joint contracture, $25.9\%$ and spasticity, $16.4\%$. Of each factors, the largest numbers of the pain recorded female$(40.5\%)$, thirties$(49.2\%)$, non-educate $(53.8\%)$, labor$(38.2\%)$, traffic accidents$(32.8\%)$, thoracic cord injury$(34.4\%)$, complete paraplegia$(58.1\%)$, and inwards during above 13 months$(37.5\%)$. 5. The largest group of the pain portion was shoulder. $49.4\%$. The non groups were lower extremity, $25.2\%$, hip, $11.0\%$, and all bodies, $4.3\%$. The largest numbers of the shoulder pain recorded thirties$(59.4\%)$, traffic accidents $(52.7\%)$, cervical cord injury$(67.2\%)$. complete quadriplegia$(81.8\%)$, and inwards during above 13 months$(100.0\%)$. 6. The largest group of the pressure sores sites was sacral portion, $83.6\%$. The next groups were hip, $6.8\%$, maleollus, $4.1\%$. The largest numbers of pressure sores formation in the sacral portion recorded below 19 and above $60(100.0\%)$, falling objects$(100.0\%)$, lumbar cord injury$(100.0\%)$, incomplete paraplegia$(100.0\%)$, and in wards during 3-4 months$(95.9\%)$. 7. The largest group of the joint contracture portion was lower extremity, $61.4\%$, follows was upper extremity, $38.6\%$. The largest numbers of the joint contrcture portions recorded thirties$(100.0\%)$, traffic accidents$(86.1\%)$, cervical cord injury$(80.4\%)$, complete quadriplegia$(86.7\%)$, and inwards during 3-4 months $(82.2\%)$ 8. The largest group of spasticity portion was lower extremity, $53.0\%$. The next groups were hip. 23.9, 23.9, ankle, $8.7\%$, and elbow, $4.3\%$. The largest numbers of the spasticity portions recorded above $60(100.0\%)$, falling $(100.0\%)$, cervical cord injury$(71.4\%)$, incomplete quadriplegia$(71.4\%)$, and inwards during 1-2 months $(100.0\%)$.

• The Korean Journal of Pain
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• 제29권2호
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• pp.123-128
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• 2016

Phantom limb pain is a phenomenon in which patients experience pain in a part of the body that no longer exists. In several treatment modalities, spinal cord stimulation (SCS) has been introduced for the management of intractable post-amputation pain. A 46-year-old male patient complained of severe ankle and foot pain, following above-the-knee amputation surgery on the right side amputation surgery three years earlier. Despite undergoing treatment with multiple modalities for pain management involving numerous oral and intravenous medications, nerve blocks, and pulsed radiofrequency (RF) treatment, the effect duration was temporary and the decreases in the patient's pain score were not acceptable. Even the use of SCS did not provide completely satisfactory pain management. However, the trial lead positioning in the cauda equina was able to stimulate the site of the severe pain, and the patient's pain score was dramatically decreased. We report a case of successful pain management with spinal cauda equina stimulation following the failure of SCS in the treatment of intractable phantom limb pain.

• 대한인간공학회지
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• 제27권3호
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• pp.93-101
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• 2008

Wedged soles and rocker soles are widespread shoe designs used to prevent the disorders and reduce the pain of the lower extremity caused by arthritis or diabetic feet. In this study, the effect of a shoe with a laterally wedged sole and a rocker sole simultaneously was analyzed on the kinematics and kinetics of the ankle joint during normal walking. Eight male participants without a history of lower extremity disorders were recruited. Each participant performed twenty walking cycles for each of three walking conditions: bare foot, wearing normal shoes and wearing shoes with laterally wedged rocker soles. The differences between the three walking conditions were statistically investigated including spatio-temporal variables, angular displacements, joint moments and ground reaction forces. The results showed that the laterally wedged rocker sole decreased the sagittal variation of angular displacements as well as the frontal/sagittal average moment on the ankle joints compared to the flat sole. In addition, the rate of angular displacements and loading decreased during the heel contact phase.

• 척추신경추나의학회지
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• 제10권1호
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• pp.87-95
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• 2015

Background : Charcot Marie Tooth disease can cause muscle weakness and foot deformity. Ankle pain induced by foot deformity affect patients' gait pattern and quality of life. Objectives : The purpose of this study is to evaluate the traditional Korean medicine treatment for ankle pain induced with Charcot-Marie Tooth Disease, especially Chuna manual therapy on ankle joints. Methods : One patient was treated with acupuncture, phamacopuncture, herbal medication and chuna manual therapy on ankle joints. To evaluate the pain of ankle, lower back and lower extremity, visual analog scale(VAS) was measured. Results : After treatment for 5 week, the pain of ankle joint was declined from VAS 6 to VAS 2. Conclusions : Traditional Korean medicine treatment including acupuncture, pharmacopuncture, herbal medication and Chuna manual therapy is effective for ankle pain with foot deformity. But further studies are required to prove the effectiveness of Chuna manual therapy on ankle joints.

• 한국전문물리치료학회지
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• 제28권4호
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• pp.273-279
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• 2021

Background: Lunge exercises are lower extremity rehabilitation and strengthening exercises for patients and athletes. Most studies have shown the effectiveness of the forward and backward lunge exercises for treating patellofemoral pain and anterior cruciate ligament injuries (by increasing lower extremity muscle activity) and improving kinematics. Objects: However, it is not known how the two different lunge movements affect trunk muscle activities in healthy individuals. The purpose of this study was to investigate the electromyographic activity of the rectus abdominis and erector spinae muscles during forward and backward lunge exercises in healthy participants. Methods: Twelve healthy participants were recruited. Electromyographic activity of the rectus abdominis and erector spinae was recorded using surface electrodes during forward and backward lunges, and subsequently normalized to the respective reference voluntary isometric contractions of each muscle. Results: Activity of the erector spinae was significantly higher than that of the rectus abdominis during all stages of the backward lunge (p < 0.05). The activity of the erector spinae was significantly greater during the backward than forward lunge at all stages (p < 0.05). Conclusion: Backward lunging is better able to enhance trunk motor control and activate the erector spinae muscles.

• 한국전문물리치료학회지
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• 제30권3호
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• pp.169-173
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• 2023

Background: In terms of physical performance, elastic tape (ET) is known to contribute to injury prevention and performance enhancement. Objects: This study aimed to compare and analyze the effect on lower extremity muscle activity of young adult women with and without ET during squats. Methods: In this study, six healthy, young women were recruited as participants in a university laboratory. Participants were allocated to two groups of three after measuring muscle activity in a pre-test, and the experiment was conducted for a total of two weeks (two sessions). First, 10 half squats were taped once in the first week, and 10 half squats were performed without taping in the second week. The other group did this in reverse and measured muscle activity after the squat was over. Results: As a result of this study, there was no significant difference in the quadriceps with or without ET (Z = -0.11, p > 0.05). Similarly, no significant difference was found in hamstring (Z = -0.31, p > 0.05). Conclusion: No beneficial effect was found on changes in muscle activity following ET application during squats. Further studies require randomized controlled trials that increase the number of participants and the intensity of the intervention, and measure pain, function, and performance rather than muscle properties depending on the biomechanical lifting mechanism.