Park, Jaemyoung;Cha, Jaeyun;Kim, Hyunjin;Asakawa, Yasuyoshi
Physical Therapy Rehabilitation Science
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제3권1호
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pp.38-42
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2014
Objective: In this study, we applied a neurodynamic sciatic nerve sliding technique to healthy adults to elucidate its effects on hamstring flexibility and postural balance. Design: Cross-sectional study. Methods: This study targeted twenty four healthy adults (16 men, 8 women). A neurodynamic sciatic nerve sliding technique was applied 5 times to all subjects' dominant leg. The subjects were asked to sit on the bed while performing cervical and thoracic flexion, as well as knee flexion with ankle plantar flexion. Then, they were asked to perform cervical and thoracic extension and knee extension with their ankle in dorsiflexion and maintain the position for 60 s. For postural balance, we measured postural sway while the subjects maintained a one-legged standing posture using the Good Balance System and measured the hip joint flexion range of motion using a standardized passive straight leg raise (SLR) test. Results: SLR test increased significantly from $79^{\circ}$ before the intervention to $91.67^{\circ}$ after the intervention (p<0.05). Regarding the participants' balance evaluated using the one-legged standing test, the X-speed decreased significantly from 18.61 mm/s to 17.17 mm/s (p<0.05), the Y-speed decreased from 22.28 mm/s to 20.52 mm/s (p<0.05), and the velocity moment was significantly decreased from $89.33mm^2/s$ to $74.99mm^2/s$ after the intervention (p<0.05). Conclusions: Application of the neurodynamic sciatic nerve sliding technique exhibited improved hamstring flexibility and postural balance of healthy adults.
Objectives : The objective of this study is to report the effect of Koran medical treatment and CPM exercise on recovery after reconstruction surgery of torn anterior cruciate ligament Methods : A 27-year-old male patient who had anterior cruciate ligament reconstruction surgery was treated by Korean medical treatment and CPM exercise from March 24th 2015 to April 16th 2015. Results : After treatments, VAS were generally decreased, ROM of Lt. knee got better from $95^{\circ}/10^{\circ}$(flexion/extension) to $120^{\circ}/-5^{\circ}$ (flexion/extension), Lysholm Score increased from 26 to 63. Conclusions : This study showed that Korean medical treatments and CPM exercise has meaningful effect on recovery after reconstruction surgery of anterior cruciate ligament. And it is considered that we need to apporoach recovery of these kinds of operation with more active Korean medical treatment, and further researches should be done steadily.
Background: Whole-body vibration (WBV) has been used to alleviate proprioceptive damage by musculoskeletal and neurological conditions. However, no study has determined whether wearing shoes while applying WBV can affect proprioception precision of the knee joint. Objects: This study aimed to determine the differences in the proprioceptive precision of the knee joint before and after WBV and to compare the proprioceptive precision of the knee joint between barefoot and shoe-wearing conditions. Methods: This study recruited 33 healthy participants. A passive-to-active angle reproduction test was used to measure the proprioception precision of the knee joint using an electrogoniometer, and the target angle was set to a knee flexion of 30°. Proprioception precision was calculated using the error angle (angular difference from 30°). Proprioceptive precision was measured in weight-bearing and non-weight-bearing positions before and after applying WBV for 20 minutes at 12 Hz in barefoot and shoe-wearing conditions. Mixed repeated analysis of variance was used to determine the differences in changes in the proprioceptive precision of the knee joint according to foot conditions. Results: There were significant improvements in the weight-bearing (p = 0.002) and non-weight-bearing (p < 0.001) proprioceptive precision of the knee joint after applying WBV. However, there was no significant difference in the change in proprioceptive precision of the knee joint after applying WBV between the barefoot and shoe-wearing conditions. Conclusion: WBV stimulation had an immediate effect on improving the proprioceptive precision of the knee joint. However, foot conditions (barefoot or shoe-wearing) during WBV application did not influence the proprioceptive precision of the knee joint.
Recently, the incidence of anterior cruciate ligament injury is rapidly increasing because many young Korean are actively participating in sports activities including basketball, skiing and soccer. Sometimes acute ACL injuries arc misdiagnosed as sprain because of pain and muscle spasm. An accurate physical examination and careful history taking are very important to diagnose the ACL injuries. Therefore author described the skill of history taking and the technique of physical examination to diagnose ACL injuries. The most sensitive test is the Lachman's test, which is performed with the knee in 200 of flexion, the femur stabilized with full flexed examiner's knee placed behind patient's distal thigh and one hand of examiner, and the proximal tibia grasped with the other. The pivot shift test is a passive motion test that attempts to subluxate the tibia anteriorly, then have it reduce rapidly. The pivot shift test is very sensitive test to diagnose the chronic ACL injuries.
PURPOSE: This study examined whether a task-oriented training program is an effective intervention to improve the body function, activity, and participation of children with cerebral palsy (CP). METHODS: Ten children with CP (7-13 years old) performed a task-oriented training program for eight weeks (three sessions per week, 30 minutes each). The taskoriented training program consisted of eight activities. The subjects' body function was assessed using a handheld dynamometer, goniometer, Modified Ashworth Scale (MAS), Balance Performance Monitor (BPM), and the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP). The subjects' activity and participation were assessed using the Gross Motor Function Measure (GMFM) and Timed Up and Go (TUG) test. RESULTS: Task-oriented training provided significant improvements in the subjects' body function. The subjects improved the bilateral isometric muscle strength of the hip flexors, extensors and abductors, knee flexors and extensors, and ankle dorsi- and plantar flexors (p<.05). Bilateral passive hip flexion, abduction, and external rotation, knee flexion, and ankle dorsi- and plantar flexion were also increased (p<.05). In addition, the MAS score of the hip adductors decreased (p<.05) and the BOTMP score increased after training (p<.05). The subjects' activity and participation also improved significantly after training, increasing the GMFM score (p<.05) and decreasing the TUG score (p<.05). On the other hand, the BPM score did not change after training. CONCLUSION: This study suggests that a task-oriented training program can be an effective intervention to improve the body function, activity, and participation for children with CP.
Stroke is a major cause of death and long-term disability. Because muscle weakness is one of the most prominent consequences of stroke, it was considered important to determine whether exercise in order to improve muscle strength and range of motion could have an effect in limiting the learned disuse of the affected side. The purpose of the study was to identify the effects of an 8 week rehabilitation program on physical and cognitive ability in stroke patients. A total of 18 patients who were admitted to the oriental medicine unit of a K medical center in Seoul were recruited : ten for the experimental group and eight for the control group. The rehabilitation program consisted of three level's of active and passive exercises for prevention of muscle contracture and at range of motion. Muscle strength, flexibility of the upper and lower extremity, perceived balance, functional independence, depression, and quality of life for the two groups were compared at the pretest and 4 and 8 weeks after the rehabilitation program. The results are as follows : 1) When measuring muscle strengths of shoulder abduction and elbow flexion, hip flexion and knee extensor, ankle dorsi-flexor and muscle strength of knee flexor. Muscle strength of knee flexor for the experimental group was significantly higher than the comparison group at the 4 weeks. 2) Muscle strength and flexibility of the ankle dorsi -flexor for the experimental group was significantly better than for the control group at 8 weeks. 3) Functional independence, perceived balance, and Tinetti balance for the experimental group as measured at 4 and 8 weeks were better than for the control group. Also, there were changes over time in physical balance and functional ability, but there was no significant differences between the groups. 4) The experimental group showed a higher quality of life and lower depression than the control group at 8 weeks. 5) Muscle strength and flexibility of ankle dorsi -flexor were significantly changed over time and an interaction between group and time. The findings suggested that the rehabilitation program would improve the physical and psychological status of the stroke patients. Thus, the gains in actual or perceived ability to perform physical activities was marked.
Purpose: Stiffness in the first metatarsophalangeal joint after surgery for hallux valgus has been reported. The goal of this study was to test the efficacy of releasing plantar aponeurosis for improving the range of extension in the first metatarsophalangeal joint that was limited after hallux valgus surgery. Materials and Methods: Thirteen patients (1 man, 12 women [17 feet]; median age, 54.4 years; range, 44~69 years) with limited first metatarsophalangeal joint extension after hallux valgus surgery, who underwent an additional procedure of plantar aponeurosis release between March 2015 and August 2015, were included. Subsequently, the passive range of extension in the first metatarsophalangeal joint was evaluated via knee extension and flexion positions. Hallux valgus angle, inter-metatarsal angle, distal metatarsal articular angle, and talo-first metatarsal angle were measured on weightbearing dorsoplantar and lateral radiographs of the foot preoperatively. Results: The mean range of extension for the first metatarsophalangeal joint improved significantly, from $2.5^{\circ}$ to $40.9^{\circ}$ in the knee extension position (p<0.00). The mean extension range for the first metatarsophalangeal joint also improved, from $18.2^{\circ}$ to $43.2^{\circ}$ in the knee flexion position (p<0.00). In all patients, congruence of the first metatarsophalangeal joint was recovered. Conclusion: Plantar aponeurosis release is an effective additional procedure for improving the extension range of the first metatarsophalangeal joint after hallux valgus surgery.
The objective of this work is to develop the knee joint model for representing various pendulum motions and quantifying the spasticity. Knee joint model included the extension and flexion muscles. The joint moment consists of both the active moment from the stretch reflex and the passive moment from the viscoelastic joint properties. The stretch reflex was modeled as nonlinear feedback of muscle length and the muscle lengthening velocity, which is Physiologically-feasible. Moreover, we modeled the spastic reflex as having dynamic threshold to account far the various pendulum trajectories of spastic patients. We determined the model parameters of three patients who showed different pendulum trajectories through minimization of error between experimental and simulated trajectories. The simulated joint trajectories closely matched with the experimental ones, which show the proposed model can predict pendulum motions of patients with different spastic severities. The predicted muscle force from spastic reflex appeared more frequently in the severe spastic patient, which indicates the dynamic threshold relaxes slowly in this patient as is manifested by the variation coefficient of dynamic threshold. The proposed method provides prediction of muscle force and intuitive and objective evaluation of spasticity and it is expected to be useful in quantitative assessment of spasticity.
Kim, Ye Jin;Park, Joo-Hee;Kim, Ji-hyun;Moon, Gyeong Ah;Jeon, Hye-Seon
한국전문물리치료학회지
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제28권1호
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pp.65-71
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2021
Background: The hamstring is a muscle that crosses two joints, that is the hip and knee, and its flexibility is an important indicator of physical health in its role in many activities of daily living such as sitting, walking, and running. Limited range of motion (ROM) due to hamstring tightness is strongly related to back pain and malfunction of the hip joint. High-frequency diathermy (HFD) therapy is known to be effective in relaxing the muscle and increasing ROM. Objects: To investigate the effects of HFD on active knee extension ROM and hamstring tone and stiffness in participants with hamstring tightness. Methods: Twenty-four participants with hamstring tightness were recruited, and the operational definition of hamstring tightness in this study was active knee extension ROM of below 160° at 90° hip flexion in the supine position. HFD was applied to the hamstring for 15 minutes using the WINBACK device. All participants were examined before and after the intervention, and the results were analyzed using a paired t-test. The outcome measures included knee extension ROM, the viscoelastic property of the hamstring, and peak torque for passive knee extension. Results: The active knee extension ROM significantly increased from 138.8° ± 9.9° (mean ± standard deviation) to 143.9° ± 10.4° after the intervention (p < 0.05), while viscoelastic property of the hamstring significantly decreased (p < 0.05). Also, the peak torque for knee extension significantly decreased (p < 0.05). Conclusion: Application of HFD for 15 minutes to tight hamstrings immediately improves the active ROM and reduces the tone, stiffness, and elasticity of the muscle. However, further experiments are required to examine the long-term effects of HFD on hamstring tightness including pain reduction, postural improvement around the pelvis and lower extremities, and enhanced functional movement.
The purpose of this study was to find the relationship between Achilles tendon angle, angular velocity from 2D cinematography utilized to easily analyze the functions of shoes, ankle joint moment, knee joint moment, and hip joint moment from 3D cinematography utilized to predict the injury. Also, this study was to provide the optimal standard to analyze the injury related to the shoes. Subjects in this study were 30 university male students and 18 conditions (2 types of running speed, 3 of midsole hardness, 3 of midsole height) were measured using cinematography and force platform. The results were as following. 1) Hip joint abduction moment was effected by many variables such as running speed, midsole height, maximum achilles tendon angle, ground reaction force. 2) Knee joint rotational moment in running was approximately 1/10 - 1/4 times of the injury critical value and eversion moment was approximately 1/4 - 1/2 times of the injury critical value. 3) Ankle joint pronation moment in running was 1/3 - 1/2 times of the injury critical value. 4) Knee joint rotational moment was found to be irrelevant with maximum achilles tendon angle or angular velocity. 5) Pronation from running was thought to be relevant to rather eversion moment activity than rotational moment activity of knee joint. 6) Plantar flexion abductor of ankle showed significant relationship with the ground reaction force variable. 7) When the loading rate for ground reaction force in passive region increased, extensor tended to be exposed to the injury. Main variables in biomechanical analysis of shoes were impact absorption and pronation. Among these variables, pronation factor was reported to be relevant with knee injury from long duration exercise. Achilles tendon angle factor was utilized frequently to evaluate this. However, as the results of this study showed, the relationship between these variables and injury relating variable of knee moment was so important. Studies without consideration on this finding should be reconsidered and reconfirmed.
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