• 한국운동역학회지
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• 제14권1호
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• pp.133-144
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• 2004

The purpose of this study was to analyze the joint moment on lower extremity during a developpe devant. Data were collected by Kwon3D, KwonGRF program. Two professional modem female dancers were participated in this experiment. Subjects performed a developpe devant in meddle heights. On the axes of X, Y, Z, it was shown that the maximum joint moment was occurred in hip joint. The moments are plotted during developpe devant. The ankle muscles generate a plantar flexion moment and the knee muscles generate a flexion moment and The hip muscles generate a extension moment. So these muscles of joint muscles were known to play a key role in keeping the body balance while doing developpe devant. In addition adduction moment occurred at hip, knee, an ankle in the order of amount, we could assume from this data that him out motion started from the hip joint. There was small active turn out possible below the hip joint. A small amount of extra turn out could be obtained when standing because of flexion between the foot and floor, which could be used to give a passive external rotation force to the whole leg and this could produce a rotation between the knee and foot. This passive external rotation could produce very damaging results. Therefore, lower extremity joint muscles such as hip, knee, and ankle muscle should be trained to keep the body balance and prevent injury during developpe devant performance. And for the safe and perfect turn ort performance, hip joint abduction, the most important external rotating muscle for him out is needed to train and full stretching should be done in advance.

• PNF and Movement
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• 제17권2호
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• pp.263-274
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• 2019

Purpose: This article was conducted to determine the immediate effects of unilateral contract-relax (CR) stretching on contralateral knee extension range and to compare both sides of the knee extension range between experimental and control groups. Methods: This study recruited 16 adult males and females with straight leg raising abilities below $90^{\circ}$. The subjects were randomly divided into an experimental group and a control group comprising 8 subjects each. The experimental group performed direct CR stretching on the right hamstring muscles with straight hip extension adduction, and the control group performed indirect CR stretching on the right hamstring muscles with straight hip flexion abduction. Each group performed CR stretching 4 times with 4 repetitions comprising 10 sec of contraction and a 10 sec break between repetitions. Before and after the CR stretching exercises, the subjects' passive knee extensions were measured at the hip in a $90^{\circ}$ flexed position. The subjects' peak force on the right leg and peak pressure on the left leg during each CR stretching exercise were also measured. Results: After doing CR stretching 4 times, each group showed a significantly increased passive knee extension range on both sides, and there was no difference in the passive knee extension ranges between the groups. The peak force on the right leg was significantly higher in the experimental group than the control group. There was no difference in peak pressure between the groups. Conclusion: After applying unilateral CR stretching, the study subjects experienced a significantly increased passive knee extension range on the contralateral side. For patients who find it difficult to apply stretching techniques to knee joints directly, the use of the proprioceptive neuromuscular facilitation technique of CR stretching may be useful in improving the range of the knee joint on the contralateral side without direct treatment.

• Journal of Mechanical Science and Technology
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• 제20권8호
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• pp.1183-1194
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• 2006

The aim of this study was to identify the characteristics of the flexion withdrawal reflex modulated by the hip angle and hip movement in spinal cord injury (SCI). The influence of the hip position and passive movement were tested in 6 subjects with chronic SCI. Each subject placed in a supine position and lower leg was fixed with the knee at 5 -45 degree flexion and the ankle at 25-40 degree plantar flexion. A train of 10 stimulus pulses were applied at 200 Hz to the skin of the medial arch to trigger flexion reflexes. From results of the regression analysis, static properties of normalized muscle activation of flexor muscles have the linear relationship with respect to hip angle (P< 0.05). In order to verify the neural contribution of flexion reflex, we compared the static and dynamic gains of estimated muscle activations with measured EMG of ankle flexor muscle. Form this study, we postulate that the torque and muscle response of flexion withdrawal reflex have linear relationship with hip angle and angular velocity.

• The Journal of Korean Physical Therapy
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• 제30권5호
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• pp.159-165
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• 2018

Purpose: The aims of this study were to determine if game-based training with constraint-induced movement therapy (CIMT) is effective in improving the balance ability in female patients with a total knee replacement, and to provide clinical knowledge of CIMT game-based training that allows the application of total knee replacement. Methods: Thirty-six patients who had undergone a total knee replacement were assigned randomly to CIMT game training (n=12), general game training (n=12), and self-exercise (n=12) groups. All interventions were conducted 3 times a week for 4 weeks. All patients used a continuous passive motion machine 5 times a week and 2 times a day for 4 weeks. The visual analog scale (VAS), muscle strength of knee flexion and extension, and range of motion (ROM) of knee flexion and extension were assessed, and the functional reach test (FRT), and timed up and go (TUG) test were performed to evaluate the balance ability. Results: All 3 groups showed significant improvement in the VAS, knee flexion and extension muscle strength, FRT, and TUG test after the intervention (p<0.05). Post hoc analysis revealed significant differences in FRT, and TUG of the CIMT game training group compared to the other group (p<0.05). Conclusion: Although the general game training and CIMT game training improved both the knee extension muscle strength and dynamic balance ability, CIMT game training had a larger effect on dynamic balance control.

• 대한물리치료과학회지
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• 제30권1호
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• pp.31-40
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• 2023

Hamstring flexibility is an important factor that affects muscle performance of the lower extremities and is closely associated with sports injuries. Therefore, evaluation of flexibility is important in clinical practice. Results of evaluation are determined by types of tests and cut-off values used; therefore, accurate and detailed understanding of these is necessary before examination. Although the straight leg raise and sit and reach tests are used to evaluate hamstring extensibility, structures including the nerves, fascia, and other muscles can significantly confound the results of these tests. The knee extension test is performed at 90° of hip flexion to minimize the posterior pelvic tilt that occurs during the straight leg test. The knee extension test is most recommended for selective evaluation of hamstring flexibility. The knee extension test is classified into active and passive tests. The cut-off value is usually set at 20° for the active and at 10° for the passive knee extension test. Although a strong association is observed between the two tests, the active knee extension test is preferred in clinical practice because it can be performed by a single examiner, which serves as an advantage. Age, sex, and warm-up exercise tend to affect flexibility; therefore, results should be interpreted with caution. Detailed understanding of each flexibility test is important for reliable evaluation.

• 한국전문물리치료학회지
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• 제22권3호
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• pp.23-32
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• 2015

The purpose of this study was to identify the effects of mechanical traction applied to the knee joint on pain, knee range of motion (ROM), timed up and go (TUG) and Western Ontario and MacMaster Universities Osteoarthritis (WOMAC) in patients with knee osteoarthritis (KOA) of Kellgren-Lawrence radiological rating scale II or III. Twenty three patients participated in the experiment for a period of four weeks. After baseline assessment, the patients with KOA were randomized into two groups: the traction group ($n_1=12$), which received traction with general physical therapy; and the control group ($n_2=11$), which received general physical therapy only on unilateral knee joints. Patients received interventions once a day, three times a week, for four weeks. Wilcoxon signed-rank test was used to analyze the change of dependent variances within the group during pre and post intervention. Mann-Whitney U test was used to analyze the change of dependent variances as TUG and passive ROM between the two groups. Analysis of covariance was used to analyze the change of dependent variances as numeric pain rating scale (NPRS) and WOMAC score between the two groups. In Wilcoxon signed-rank test, the traction group improved significantly with regard to NPRS (p<.01), passive knee flexion ROM (p<.01), passive knee extension (p<.05), TUG (p<.01) and WOMAC scores (p<.01) after intervention for four weeks, but not for the control group. In the Mann-Whitney U test and analysis of covariance, no significant difference was seen among all the dependent variances after intervention for four weeks between the two groups. These outcomes suggest that further studies should be carried out to determine the effects of mechanical traction prior to using it for the treatment of patients with knee osteoarthritis.

• 임상간호연구
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• 제17권1호
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• pp.81-89
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• 2011

Purpose: The purpose of this study was to examine the effects of early passive range of motion (ROM) exercise on ROM of lower extremities and foot edema in hemiplegic patients after stroke. Methods: The data were collected between August 2009 and April 2010 from 11 patients in the experimental group and 13 in the control group. The passive ROM exercise was performed twice a day for 2 weeks. Results: In the experimental group, ROM of lower extremities (flexion of hip, flexion of knee and ankle) increased significantly compared to that of the control group. There was no significant difference in foot edema between the two groups. Conclusion: The results indicated that the early passive ROM exercise can improve the ROM of lower extremities, but not the foot edema in patients after stroke.

• 한방재활의학과학회지
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• 제27권2호
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• pp.109-115
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• 2017

The purpose of this study is to illustrate the potential for clinical improvement in treating a patient with a case of Posttraumatic Knee Stiffness with a combination of Korean medicine therapy. We treated the patient with acupuncture, electroacupuncture, CHUNA manual therapy and Interferential Current Therapy from $5^{th}$ December 2016 to $13^{th}$ January 2017 (total 29 times) by evaluating knee function with VAS score. After six weeks of treatment, this patient achieved effective outcome following the technique, showing that clinical symptom as able to walked and pain was relieved, VAS changed from 10 to 2 and the knee flexion ROM (active/passive) changed from 30/60 degrees to 120/140 degrees. This result shows that Korean Medicine therapy may be an effective option for Posttraumatic Knee Stiffness. Further clinical studies are needed to clarify the effect of Korean Medicine therapy on Posttraumatic Knee Stiffness.

• PNF and Movement
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• 제6권1호
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• pp.53-60
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• 2008

Purpose : To describes the important aspects of knee joint movement and function used when applying PNF technique to the lower limb. Method : The knee was a very important roles in the lower limb movement and ambulation. This study summarizes the physiologic movement of knee to the PNF lower extremity patterns. Result : The tibiofemoral joint is usually described as a modified hinge joint with flexion-extension and axial rotation by two degrees of freedom movement. These arthrokinematics are a result of the geometry of the joints and the tension produced in the ligamentous structures. The patellofemoral joint is a sellar joint between the patella and the femur. Stability of the patellofemoral joint is dependent on the passive and dynamic restraints around the knee. In a normal knee the ligaments are inelastic and maintain a constant length as the knee flexes and extends, helping to control rolling, gliding and translation of the joint motions. Conclusions : It is important to remember that small alterations in joint alignment can result in significant alterations in patellofemoral joint stresses and that changes in the mechanics of the patellofemoral joint can also result in changes in the tibiofemoral compartments. Successful treatment requires the physical therapist to understand and apply these arthrokinematic concepts. When applied to PNF low extremity patterns, understanding of these mechanical concepts can maximize patient function while minimizing the risk for further symptoms or injury.

• 대한정형도수물리치료학회지
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• 제5권1호
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• pp.39-51
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• 1999

Background and Purpose. Objective measurements of hamstring muscle length are needed to quantify baseline limitations and to document the effectiveness of therapeutic interventions. Several indirect clinical tests for measuring hamstring muscle length are available, but influence of their test procedure is not well documented. The purpose of this study were 1) to describe hamstring muscle length as reflected by use of six tests(active straight leg raising(ASLR), passive straight leg raising(PSLR), passive straight leg raising with the lower back flat(PSLRB), active knee extension(AKE), passive knee extension(PKE), hip joint angle(HJA). 2) to examine the correlation among the tests. Subjects, Sixty subjects(30 men. 30 women) ranging in age from 18 to 25 years(mean 20.2 years) and with no limitation hamstring flexibility and no neurological and orthopedical problems. Methods. All subjects performed six tests. A inclinometer was used to determine the end point of range of motion. HJA was measured using an inclinometer placed over the sacrum. PSLRB were tested PSLR with the low back flat and the opposite thigh slightly flexed and support on pillows. Results, A mean ASLR value of 85.9 degrees, PSLR value of 99.9 degrees, PSLRB value of 109.8 degrees, AKE value of 77.2 degrees PKE value of 83.1 degrees and HJA value of 73.0 degrees were obtained for all subjects. A dependent t-test showed significant difference between the angles of ASLR and PSLR(p<0.001). There was a significant difference between the angles of PSLR and PSLRB(p<0.001). There was a significant difference between the angles of AKE and PKE(p<0.001). The highest correlation was between PSLR and PSLRB(r=0.915, p<0.001). All SLR tests were significants related(p<0.001), as well as AKE and PKE(p<0.001). The lowest correlation was between PKE and HJA(r=0.171. p>0.05). Conclusion and Discussion. The results indicated that the hip flexion angles for ASLR, PSLR and PSLRB were a difference, and the knee extension angles for AKE and PKE were a difference.