• 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

• 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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• 제12권3호
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• pp.22-30
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• 2005

This study was designed to identify the effect of various decline boards and postures of lower extremities on surface electromyographic (EMG) activity of knee muscles during isometric single-leg decline squat exercises. The subjects were twenty young male adults who had not experienced any knee injury and their Q-angles were within a normal range. They were asked to perform single-leg decline squat exercises in five various conditions. The EMG activities of the gluteus maximus (GM), vastus lateralis (VL), vastus medialis (VMO), tibialis anterior (TA), and gastrocnemius (GCM) muscles were recorded in five various single-leg decline squat exercises by surface electrodes and normalized by maximal voluntary isometric contraction (MVIC) values. The normalized EMG activity levels were compared using one-way ANOVA with repeated measures. The results of this study were as follows: 1) Exercises 2 and 4 produced significantly greater EMG activity of VMO than did exercise 1 ($p_{adj}$<.05/10), 2) The VMO/VL ratio of EMG activity of exercise 4 was the highest, producing a significantly greater ratio than exercise 1 ($p_{adj}$<.05/10). These results show that single-leg lateral oblique decline squat exercise is the best exercise for selective strengthening of VMO, and the posture of the contralateral leg does also affect strengthening of VMO, but we'll need to research patellofemoral joint compression for clinical application of single-leg lateral oblique decline squat exercises.

• 한국전문물리치료학회지
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• 제12권2호
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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.

• Biomaterials and Biomechanics in Bioengineering
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• 제3권1호
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• pp.27-35
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• 2016

Anterior knee pain is a major problem among adolescents and young adults especially those who participates in sports. The most common pathogenesis of anterior knee pain can arise from compression and shear forces in the patellofemoral joint. It is also caused by impingement of infrapatellar fat pad. Fat pad impingement can occur when the fat pad becomes swollen and inflamed due to a direct blow or chronic irritation. As a result, the bottom tip (or inferior pole) of the patella can pinch the fat pad. One of the many causes of swollen fat pad can be secondary to anterior cruciate ligament (ACL) injury. The aim of this study was to compare the infrapatellar fat pad volume in patients with acute ACL injury and a group of age-, gender-, and activity- matched controls with intact ligament. Axial magnetic resonance (MR) images have been performed on 32 patients with torn ACL and 40 control patients. The volume of the fat pad was measured digitally from MR image by using a 3d Reconstruction software, ellipsoidal approximation, and a MATLAB code. The results were compared between patients with torn ACL and control group. Patients with a torn ACL had a significantly larger fat pad than the controls (P=0.01). There was no significant difference between the methods used to measure the infrapatellar fat pad volume (P=0.83-0.87). Thus, lesions of the infrapatellar fat pad is often associated with ACL injury.

• 융합정보논문지
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• 제7권4호
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• pp.39-43
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• 2017

본 연구의 목적은 앉은 자세에서 일어날 때 비탄력 테이핑을 이용한 무릎뼈의 안쪽 활주와 아래 안쪽 활주가 안쪽넓은근과 가쪽넓은근의 근활성도 비율에 미치는 영향에 대해 알아보고자 하는 것이었다. 측정 결과, 안쪽 활주와 비교하여 아래 안쪽 활주를 적용했을 때 안쪽넓은근의 근활성도가 전체 근활성도 대비 비율이 더 높게 나타나는 것을 확인할 수 있었다. 무릎뼈의 안쪽 활주보다 아래 안쪽 활주가 무릎관절의 안정성에 더 큰 기여를 하며, 특히 무릎넙다리 통증증후군의 증상 완화 및 예방에 효과적일 것으로 사료된다. 이와 관련하여 무릎뼈를 아래 안쪽 방향으로 활주 시킬 수 있는 보조기 및 운동복 등의 개발은 무릎관절의 건강을 확보할 수 있는 새로운 방법이 될 것으로 기대한다.

• 대한인간공학회지
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• 제35권5호
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• pp.307-317
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• 2016

Objective: This study looks into biomechanical variables occurring when one moves in a sitting posture, and presents objective references to make improvements in work environments of farm workers. Background: The farmers have more common musculoskeletal disorders compared to other professions, because they are much more exposed to biomechanical risk factors. The sitting posture that is the representative form of the squatted, can cause typical knee joint diseases, such as osteoarthritis or patellofemoral pain syndrome of the knee joint. Therefore, a quantitative study of knee load upon the movement in a squatting posture is required. Method: In order to proceed with its investigation, the study examined movements in a sitting posture with and without a lower body supporter through a threedimensional image analysis and by using Surface EMG. The study compared and analyzed the average muscle activity and the maximum muscle activity as well. Results: Every movement in a sitting posture is related to loads onto the knee joints and, when the farm workers move to sides, the study observed a high level of bowlegged moment. The study also noticed differences in muscle activity of medial gastrocnemius with and without the lower body supporter. Conclusion and Application: The study argues that what has been discussed so far is evidence to prove how the farm working environments should be improved in consideration of these movements observed when the farm workers move in a sitting posture.

• 대한통합의학회지
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• 제9권4호
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• pp.283-289
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• 2021

Purpose : The purpose of this study is to investigate the effect of mid frequency electrical stimulation during squat exercise on the muscle activity and muscle activity ratio of vastus medialis oblique and vastus lateralis, and to prepare scientific basic data for exercise intervention using mid frequency electrical stimulation. Methods : This study was conducted with students from University C located in Busan, and among a total of 123 subjects, 12 subjects who complained of knee joint dysfunction between 80 and 90 points using the Kujala patellofemoral score (KPS) were used. All subjects participated in the experiment for 3 days, and MVIC values were measured for normalization of muscle activity values on the first day. For the two days, participants participated in the experiment and performed squat exercise or squat exercise receiving mid-frequency electrical stimulation in random order. Measurements were taken in the squat position immediately after the squat exercise, and muscle activities of vastus medialis oblique and vastus lateralis were measured. The measured data were compared through the dependent t test, and the statistical significance level was set to .05. Results : According to the results of this study, in the case of applying mid-frequency electrical stimulation together in the ratio of vastus medialis oblique and vastus lateralis muscle activity during squat exercise, higher values were observed compared to the case of not applying mid-frequency electrical stimulation together, and statistically significant. Also, when mid-frequency electrical stimulation was applied to both vastus medialis oblique and vastus lateralis activities during the squat exercise, higher values were shown compared to the case where the mid-frequency electrical stimulation was not applied together, but there was no statistically significant difference. Conclusion : The results of this study reported that mid-frequency electrical stimulation provided to vastus medialis oblique increased the muscle activity ratio of vastus medialis oblique and vastus lateralis. Therefore, the improvement of coordination due to the enhancement of the activity of vastus medialis oblique through mid-frequency electrical stimulation will be more helpful in the treatment of patellofemoral pain syndrome patient. In addition, it is hoped that the electrical stimulation method applied to exercise will be widely used.

• 대한관절경학회지
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• 제1권1호
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• pp.98-101
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• 1997

Acute patellar dislocation is a painful, terrifying experience that always occurs suddenly. The recurrence is unfortunately common and each experience is just as painful to the patient. With each acute dislocation, additional intraarticular derangement occurs. Therefore the goals of treatments are not only to relieve acute pain by prompt reduction of the dislocation but also to remove any chondral or osteochondral fragments that may be present within the knee joint and to restore normal patellofemoral anatomy, thereby preventing recurrent dislocation and avoiding future patellar subluxation. To present the details of arthroscopic medial retinacular repair in acute patellar dislocation. we report 2 patients with treatment of acute patellar dislocation with osteochondral loose body.

• The Journal of Korean Physical Therapy
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• 제16권3호
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• pp.192-204
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• 2004

The surface electromyographic(sEMG) analyses were knee joint angle during open kinetic chain exercise (OKC) and close kinetic chain exercise (CKC) in vastus medialis (VM), vastus lateralis (VL), and rectus femoralis (RF). Ten subjects with normal , aged 20 to 30(X=27.4, SD=3.23), were randomized Statistical techniques for data analysis were applied paired t-test. The 0.05 level of significane was used as the critical level for rejection of the null hypotheses for the study. And the results were: 1) Both OKC and CKC improved the strength of quadriceps muscle as the knee joint flexion was increased. 2) In OKC, the strength of VM was improved the most at the 30 degree angle. 3) In CKC, the strength of VM was improved the most at the 30 degree angle. 4) The VM/VL ratio was the largest at the 10 and 20 degree angles in OKC and CKC. 5) The VM/VL ratio at 10, 20, and 30 degree angles was significantly different between OKC and CKC (P < 0.05). Base on the results, the OKCE is recommended for the knee joint patients, especially for the patellofemoral pain syndrome patients, during the early phase of rehabilitation. In order to improve strength of the quadriceps, muscle strength training at 30 degree angle is recommended. In order to improve VM/VL ratio, 10 and 20 degree angles are recommended during OKCE and CKCE, respectively. Future researches are warranted comparing electromyographic analysis between OKCE and CKCE in the quadriceps at a certain work lead, and muscle strength performance in the quadriceps at different positions of foot.