• 한국운동역학회지
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• 제21권1호
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• pp.107-114
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• 2011

Closed kinematic chain exercises such as squatting have been widely indicated for knee rehabilitation in patients with patellofemoral disorders such as osteoarthritis and patellofemoral pain. Patellofemoral disorders are thought to be associated with abnormal patellar kinematics. In addition, the Q-angle may be undervalued in patients with patellofemoral pain and a laterally displaced patella. The purpose of this study was to assess patellar kinematics and the Q-angle during double-leg semi-squat and wall-slide semi-squat exercises. In this study, 28 asymptomatic subjects(16 male, 12 female) were assessed. Patellar tilt, patellar spin, and Q-angle were recorded using a motion analysis system during double-leg semi-squat and wall-slide semi-squat exercises. The Q-angle and patellar tilt were significantly increased, whereas patellar spin was significantly decreased, at $45^{\circ}$ of knee flexion compared with $0^{\circ}$. No differences were observed for the Q-angle, patellar tilt, and patellar spin during double-leg semi-squat and wall-slide semi-squat exercises. However, a significant interaction was observed between squat type and knee angle for patellar spin. We found that the patella is laterally tilted during semi-squat exercises and that there was no difference in patellar tracking between knee flexion during double-leg semi-squat and wall-slide semi-squat exercises.

• 한국임상수의학회지
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• 제34권5호
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• pp.318-324
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• 2017

The objective of this study was to establish kinematic reference ranges for the femorotibial (FT) joint and the patellofemoral (PF) joint in healthy small-breed dogs by measuring 3D kinematics at the walk. Single-plane fluoroscopy was used to image the stifle joints of five healthy beagle dogs while the dogs were walking. 3D bone models of the femur, patella, and tibia were reconstructed by computed tomography scanning of the beagle dogs' hind limbs. The shape-matching technique was used to measure kinematic data from the fluoroscopic images and the 3D bone models. The cranial translation of the tibia during walking was inversely proportional to the FT joint flexion. There were significant correlations between the patellar motion and the tibial motion. The FT joint flexion had a strong correlation with the patellar proximodistal translation and flexion. Additionally, the tibial mediolateral translation had a strong correlation with the patellar shift and tilt. In this study, normal in vivo 3D FT joint and PF joint kinematics were demonstrated, and the average kinematic parameters were determined in walking beagle dogs.

• 한국전문물리치료학회지
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• 제30권2호
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• pp.110-119
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• 2023

Background: Osteoarthritis is a common condition with an increasing prevalence and is a common cause of disability. Osteoarthritic pain decreases the quality of life, and simple gait training is used to alleviate it. Knee osteoarthritis limits joint motion in the sagittal and lateral directions. Although many recent studies have activated orthotic research to increase knee joint stabilization, no study has used patellar tendon straps to treat knee osteoarthritis. Objects: This study aimed to determine the effects of patellar tendon straps on kinematic, mechanical, and electromyographic activation in patients with knee osteoarthritis. Methods: Patients with knee osteoarthritis were selected. After creating the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), leg length difference, Q-angle, and thumb side flexion angle of the foot were measured. Kinematic, kinetic, and muscle activation data during walking before and after wearing the orthosis were viewed. Results: After wearing the patellar tendon straps, hip adduction from the terminal stance phase, knee flexion from the terminal swing phase, and ankle plantar flexion angle increased during the pre-swing and initial swing phases. The cadence of spatiotemporal parameters and velocity increased, and step time, stride time, and foot force duration decreased. Conclusion: Based on the results of this study, the increase in plantar flexion after strap wearing is inferred by an increase due to neurological mechanisms, and adduction at the hip joint is inferred by an increase in adduction due to increased velocity. The increase in cadence and velocity and the decrease in gait speed and foot pressure duration may be due to joint stabilization. It can be inferred that joint stabilization is increased by wearing knee straps. Thus, wearing a patellar tendon strap during gait in patients with knee osteoarthritis influences kinematic changes in the sagittal plane of the joint.

• 대한관절경학회지
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• 제9권2호
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• pp.109-114
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• 2005

Recently, the interest on anatomical ACL reconstruction with double bundle technique is increased to reproduce the original load distribution, and kinematics of the knee. We developed an arthroscopic double bundle ACL reconstruction technique using autogenous quadriceps tendon with 2 splitted graft and patellar bone plug. The anteromedial bundle and posteolateral bundle of the ACL is replicated with each splitted graft of quadriceps tendon and fixed with biodegradable interference screw on the 2 femoral tunnels. The patellar bone plug of quadriceps tendon is fixed with biodegradable interference screw within the 1 tibial tunnel. We suggest that our technique using quadriceps tendon may be an alternative in arthroscopic double bundle ACL reconstruction.

• 대한정형외과 초음파학회지
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• 제7권1호
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• pp.39-44
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• 2014

슬개골 덜컹 증후군은 인공 관절 전치환술 후 슬개골 버튼 근위부에 섬유성 결절이 형성되어 통증, 염발음, 잠김 현상등의 증상이 발생하는 슬개 대퇴 합병증이다. 주로 후방 안정형 삽입물을 사용한 후에 발생하며, 굴곡시 섬유성 결절이 과간 절흔에 포착되었다가 신전시 이탈하면서 증상을 유발한다. 대퇴 삽입물의 구조적 특징이 가장 큰 원인으로 추정되고 초기의 후방 안정형 삽입물에서 발생 빈도가 높았다. 이후 새로운 형태의 삽입물에서는 구조가 개선되어 발생 빈도가 감소하였으나 최근까지도 슬개골 덜컹 증후군의 발생이 보고되고 있다. 진단은 주로 증상에 의해 이루어지며, 영상의학적 검사도 진단에 도움이 된다. 특히, 초음파 검사는 대퇴 사두건의 섬유성 결절을 쉽고 간편하게 발견할 수 있다. 저자들은 초음파를 이용하여 진단된 슬개골 덜컹 증후군 1례를 경험하여 보고하고자 한다.

• 한국전문물리치료학회지
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• 제23권1호
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• pp.11-19
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• 2016

Background: Investigation in gender differences of kinetics and kinematics for individuals with patellar femoral pain syndrome (PFPS) was not sufficiently performed. Objects: The purpose of this study is that whether there is a difference depending on gender from muscle activity and strength and knee valgus angle during controlled single-leg squat which is widely used as clinical movement test for the patient with PFPS. Methods: 20 young adults (10 men, $20.0\pm}2.1$years; 10 women, $20.4{\pm}2.1$years) with PFPS were voluntarily recruited in this study. Muscle activity and strength and knee valgus angle were collected during single-leg squat. Independent t-test and Mann-Whitney test were used to compare the differences between groups of male and female. Results: Rectus femoris (t=-2.204, p=.041) and vastus medialis oblique (t=-2.151, p=.045) muscle activity of women were significantly higher than male group. Normalized muscle strength of hip and knee muscles showed a significant difference between men and women (p<.05). Valgus angle of the knee in women (t=-2.450, p=.025) were increased significantly than men. Conclusion: The therapist would consider the characteristics of these gender differences during performing movement test, exercise, and education for the individuals with PFPS.

• 대한정형외과스포츠의학회지
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• 제2권2호
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• pp.77-81
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• 2003

목적: 슬관절 주위 골격의 기초과학을 생체역학을 중심으로 설명하고 빈도가 높은 스포츠 손상들에 대해 기술하고자 한다. 해부 밀 운동학: 슬관절은 순수한 경첩 관절이 아니며 적합하지 않으므로 여섯 방향의 운동이 가능하다. 경골대퇴간 운동역학: 슬관절의 굴곡-신전 축은 시상면에 수직이 아닐 뿐 아니라, 관상면상 관절선과 평행하지 않으므로, 경골대퇴관절은 굴곡 시 내반과 내회전이 동반되고 신전 시에는 외반과 외회전이 동반된다. 슬개대퇴 관절: 슬개대퇴 관절 압박력은 슬관절의 굴곡 각도와 사두고근력에 비례한다 슬개골은 신전기전의 moment arm을 증가시켜 신전기전의 효율을 증대시키고 지렛대 역할을 한다. 슬개골 골절: 비전위성 골절이면서 하지 직거상 운동이 보존된 경우에 비수술적 치료의 적응증이 되며 수술적 치료 시 고정 방법의 선택은 골절 양상에 따라 결정되겠으나 어느 술식을 선택하여도 신전지대의 봉합은 필수적이며 중요하다 슬개골 불안정성: 선행 해부학적 이상을 조사해야 하며 급성 탈구에서도 골연골 골절편이 있거나 재발의 위험이 높은 운동선수에서 인대 봉합을 고려할 수 있다. 비수술적 치료 및 재활에도 불수하고 계속되는 재발성 아탈구나 탈구는 수술이 필요하다 학령기 스포츠 손상: Idiopathic Adolescent Anterior Knee Pain, Osgood-Schlatter Disease, Sinding-Larsen-Johansson Disease 등이 흔하다

• The Journal of Korean Physical Therapy
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• 제26권2호
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• pp.74-81
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• 2014

Purpose: The purpose of this study is to compare kinematics and kinetics on the knee joint between stair gait with unstable shoes and barefoot in healthy adult women. Methods: Seventeen healthy adult women were recruited for this study. The subjects performed stair ascent and descent with unstable shoes and barefoot. The experiment was repeated three times for each stair gait with unstable shoes and barefoot. Measurement and analysis of the movements of the knee joint were performed using a three-dimensional analysis system. Results: Statistically significant differences in the knee muscle force of semimembranosus, biceps femoris-long head, biceps femoris-short head and sartorius, patellar ligament, medial gastrocnemius, and lateral gastrocnemius were observed between unstable shoes and barefoot gait during stair ascent. Statistically significant differences in the knee muscle force of sartorius, rectus femoris, medial gastrocnemius, and lateral gastrocnemius were observed between unstable shoes and barefoot gait during stair descent. Statistically significant differences in the knee flexor moment of semitendinosus, biceps femoris-long head, biceps femoris-short head, sartorius, rectus femoris, vastus intermedialis, medial gastrocnemius, and lateral gastrocnemius were observed between unstable shoes and barefoot gait during stair ascent. Conclusion: Therefore, wearing unstable shoes during stair gait in daily life is considered to influence knee joint kinematics and kinetics due to the unstable shoes, and thus suggest the possibility that reducing the risks of pain, and knee osteoarthritis, stabilizing the knee joint caused by changes in the loading of the knee joint.

• 대한골관절종양학회지
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• 제3권1호
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• pp.18-25
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• 1997

Prosthetic replacement is one of the most common methods of reconstruction after resection of malignant tumor around the knee. Gait analysis provides a relative objective data about the gait function of patients with prosthesis. The purpose of this study was to compare the gait pattern of the patients who underwent limb salvage surgery with prosthesis for distal femur and that of patients with prosthesis for proximal tibia. This study included ten patients (4 males, 6 females, mean age 22.7 years, range 14-36) who underwent a wide resection and Kotz hinged modular reconstruction prosthesis replacement and six normal adult(Control). The site of bone tumor was the distal femur (Group 1) in six patients and proximal tibia (Group 2) in 4 patients. The follow-up period ranged from 15 to 82 months (mean : 33 months). The evaluation consisted of clinical assessment, radiographic assessment, gait analysis using VICON 370 Motion Analysis System. The gait analysis included the linear parameters such as, walking velocity, cadence, step length, stride length, stance time, swing time, single support and double support time and the three-dimensional kinematics (joint rotation angle, velocity of joint rotation) of ankle, knee, hip and pelvis in sagittal, coronal and transverse plane. For the kinetic evaluation, the moment of force (unit: Nm/kg) and power (unit: Watt/kg) of ankle, knee and hip joint in sagittal, coronal and transverse plane. In the linear parameters, cadence, velocity, step time and single support were decreased in both group 1 and group 2 compared with control. Double support decreased in group 2 compared with control significantly(p<.05). In contrast to our hypothesis, there was no significant difference between group 1 and group 2. In Kinematics, we observed significant difference (p<.05) of decreased knee flexion in loading response (G2