• The Journal of Korean Physical Therapy
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• v.20 no.3
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• pp.35-43
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• 2008

Purpose: We investigated the effect of isometric resistance exercise on the vastus medialis oblique muscle with inelastic tape and EMG biofeedback training applied to the patello-femoral joints of patients with patella malalignment. Methods: The 39 elderly subjects that had patella malalignment but no neuromuscular disorders were divided into a control group, taping group, and EMG biofeedback training group. Evaluations of function improvement performed before and after the treatment, as well as 4 weeks after treatment. Results: Change in pain in the knee joint were significantly different among groups (p<0.05). Maximum voluntary isometric contractility in the quadriceps muscle was significantly in the EMG biofeedback group (p<0.001). The WOMAC (Western Ontairo & McMaster Questionnaire) index showed a significant change (p<0.05) in pain, function, and total score. Taping and EMG biofeedback training showed a lasting effect until measurement 4 weeks after treatment. SF-36 (Medical outcome short form-36), which assesses the quality of life, did not significantly change. Conclusion: In osteoarthritis patients with a loss of patello-femoral joint function, isometric resistance exercise of the vastus medialis oblique muscle with taping seems effective.

• The Journal of Korean Physical Therapy
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• v.27 no.1
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• pp.7-11
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• 2015

Purpose: This study was conducted in order to determine the effects of knee malalignment including genu varum, valgum, and recurvatum on static and dynamic postural stability. Methods: A total of 80 subjects were enrolled in this study. Subjects who showed over 3 cm in the distance between the knees were classified as the genu varum group, and subjects who showed over 3 cm in the distance between the ankles were classified as the genu valgum group. Subjects who showed over 1 cm in the distance between the patella and a table in prone position were classified as the genu recurvatum group. Static and dynamic stability were measured as overall, anterioposterior, and mediolateral balance index using a Biodex Balance System. Results: This study showed that knee alignment affected static and dynamic postural stability. In particular, there were significant differences in the mediolateral stability index among genu varum, valgum group, and the other groups, but no differences in overall and anteriolateral stability index. Significant differences in the anterioposterior stability index were observed between genu recurvatum and the other groups, however, there were no differences in overall and mediolateral stability index. Conclusion: The findings were that knee malalignment affects postural stability toward a specific direction. Treatment to improve postural stability for treatment of knee malalignment or to prevent falling or injuries is needed and postural stability toward a specific direction according to the knee alignment conditions should be considered.

• Korean Journal of Radiology
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• v.23 no.6
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• pp.674-687
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• 2022

Patellofemoral instability (PFI) is common in pediatric knee injuries. PFI results from loss of balance in the dynamic relationship of the patella in the femoral trochlear groove. Patellar lateral dislocation, which is at the extreme of the PFI, results from medial stabilizer injury and leads to the patella hitting the lateral femoral condyle. Multiple contributing factors to PFI have been described, including anatomical variants and altered biomechanics. Femoral condyle dysplasia is a major risk factor for PFI. Medial stabilizer injury contributes to PFI by creating an imbalance in dynamic vectors of the patella. Increased Q angle, femoral anteversion, and lateral insertion of the patellar tendon are additional contributing factors that affect dynamic vectors on the patella. An imbalance in the dynamics results in patellofemoral malalignment, which can be recognized by the presence of patella alta, patellar lateral tilt, and lateral subluxation. Dynamic cross-sectional images are useful for in vivo tracking of the patella in patients with PFI. Therapeutic approaches aim to restore normal patellofemoral dynamics and prevent persistent PFI. In this article, the imaging findings of PFI, including risk factors and characteristic findings of acute lateral patellar dislocation, are reviewed. Non-surgical and surgical approaches to PFI in pediatric patients are discussed.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.6 no.1
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• pp.31-42
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• 2008

This study performed in order to investigate the effect of isometric resistance exercise for vastus medialis oblique muscle with EMG(electromyography) biofeedback training which are applied to the patello-femoral joint of patients with osteoarthritis on the improve of function. The subjects had no neuromuscular disorders, and they were elder patients with osteoarthritis, 20 women. And the experiment was performed in control group, taping with EMG biofeedback training group respectively, and the measurement was carried out before and after the treatment and 4 weeks after the treatment. Motor unit action potential analysis with surface electromyography showed a significant change in RMS(root mean square) amplitude and MDF(median frequency) in vastus medialis oblique muscle(p<0.05). VMO/VL(vastus medialis oblique/vastus lateralis oblique) MDF ratio showed a significant change between groups(p<0.05). Taping with EMG biofeedback training applied to patello-femoral joint of osteoarthritis patients appeared to be effective for muscle function improvement. However, increase of muscular force in vastus medialis oblique muscle appears to have a positive effect on improve of function along with correction effect on patella malalignment. In conclusion, in case of osteoarthritis patients with loss of patello-femoral joint function, it appears to be effective to practice isometric resistance exercise of vastus medialis oblique muscle selective with taping.

• Journal of Korean Orthopaedic Sports Medicine
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• v.7 no.2
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• pp.75-83
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• 2008

과사용 증후군은 정상적인 조직에 최대하 부하(submaximal stress)가 지속되어 발생하는 것이다. 이와 같은 현상은 연부조직의 접합부(junction)에서 주로 일어나며 힘의 전달이 집중되는 곳, 조직의 역학적 성질이 변화되는 곳, 그리고 성장시 빨리 변화하는 성질이 있는 곳에 주로 생긴다. 근육의 불균형이 과사용 증후군의 가장 많은 원인이다. 과거의 부상 이후 부적절한 재활치료 및 각형성 또는 회전 부정정렬(angular and rotational malalignment) 등이 과사용 증후군의 원인이 될 수 있다. 스포츠 훈련 방법의 실수로도 과사용 증후군이 생길 수 있다. 전방 슬관절 동통시 감별해야 할 질환들은 jumper's knee, 슬개건염 혹은 대퇴 사두건염, Osgood-Schlatter 병, Sinding-Larsen-Johansson 병, 슬개골 연골 연화증, 슬개골 전(prepatellar) 혹은 슬개골 하(infrapatellar) 점액낭염, Hoffa's fat pad의 염증, 그리고 특발성 전방 슬관절 동통 증후군(idiopathic anterior knee pain syndrome)등이 있다. 후방 슬관절 통증의 원인 질환으로는 만성 슬와근 염좌, 슬괵건 점액낭염, 경골 골간단의 피로 골절 등이 포함되며 외측 슬관절 통증의 원인으로는 장경대 충돌 증후군(iliotibial band friction syndrome)등이 있을 수 있다. 이외 과사용 증후군과 관련된 슬관절 통증의 원인으로 다분 슬개골(multipartite patella), 내측 경골 스트레스 증후군(medial tibial stress syndrome), 박리성 골연골염, 반월상 연골의 퇴행성 변화 등이 있을 수 있다. 과사용 증후군의 진단 및 치료의 일반적인 접근법은 다섯가지 단계의 프로그램으로 요약될 수 있다. 첫째, 원인 요소를 확인하고, 둘째, 요소를 변경시키고, 셋째, 통증을 조절하고, 넷째, 능동적 재활을 시키고, 그리고 다섯째, 유지시키는 것이다.

• Physical Therapy Korea
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• v.12 no.2
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• pp.11-19
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• 2005

Patellofemoral pain syndrome (PFPS) is often attributed to malalignment and maltracking of patella within the patellofemoral joint. Most exercise for PFPS has focused on selectively strengthening the vastus medialis oblique muscle (VMO). This study was designed to identify the effect of medial, lateral wedge and difference of Quadriceps angle (Q-angle) on vastus medialis oblique/vastus lateralis muscle (VL) activity ratios. The subjects were twenty young adult males who had not experienced any knee injury. They were asked to perform isometric contraction exercises in three postures using medial and lateral wedge. The EMG activity of the VL and VMO were recorded in three postures by surface electrodes and normalized by %MVC values derived from seated, isometric knee extensions. The normalized EMG activity levels (%MVC) of the VL and VMO for the three postures of the lower extremities were compared using 2-way repeated measures ANOVA with 1 between-subject factor (group), and 1 within-subject factor (wedge). Results of repeated measures of ANOVA's revealed that the medial wedge isometric contraction exercise produced significantly greater EMG activity of VMO/VL ratios in Group I (Q-angle $18^{\circ}$ or less) (p<.05). But, the medial wedge isometric contraction exercise was no significant difference of VMO/VL ratios in Group II (Q-angle $19^{\circ}$ or more) (p>.05). These results have important implications for selective VMO muscle strengthening exercises in PFPS patients.

• Journal of Korean Orthopaedic Sports Medicine
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• v.9 no.1
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• pp.7-15
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• 2010

Anterior knee pain syndrome would best be defined as a painful condition that arises in or around the patellofemoral joint and is insidious in onset and bilateral, with an enigmatic entity with multiple causes. Although its etiology is uncertain, the cause is often considered to be abnormal lower limb biomechanics, pathology of extensor mechanism, disorder of patellofemoral joint, malalignment or lateral tracking of the patella, soft tissue tightness, muscle weakness. The measurement of patellar alignment has come to be accepted as an integral part of the examination of anterior knee pain syndrome. Various measurement techniques exist, both clinical and radiological, and these have been frequently used in the diagnosis and treatment of the condition.?Treatment depends on the underlying cause of anterior knee pain and should be directed to the cause rather than to the results. Most often, this involves non-surgical measures, such as anti-inflammatory medications, quadriceps exercises, and hamstring stretching. Shin splint, or medial tibial stress syndrome refers a syndrome of pain running along the inner distal 2/3 of tibia shaft. Shin splint is a common problem for athletes whose sport involves a repeated, jarring impact to the leg. A major factor determining the efficacy of the treatment is that correct diagnosis be made of the problem. The varied etiology has led to the development of several theories as to the cause, treatment, rehabilitation and prevention of shin splint. The management is rest, ice massages, pain relief by medication, and muscle strengthening exercise. Proper rehabilitation and preventative measures can ensure that there is no further recurrence.