• Journal of Korean Physical Therapy Science
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• v.24 no.2
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• pp.53-60
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• 2017

Purpose: This study aimed to investigate the effect of physiotherapy on the range of motion (ROM) of patients with hemophilic arthropathy after total knee replacement (TKR) during treadmill gait. Method: Nineteen patients (age range, 30-61 years) who received physiotherapy at the Korea Hemophilia Foundation (KHF) Clinic in Seoul between 2011 and 2013 after TKR were recruited. Protocol rehabilitation was performed (KHF Clinic, Department of Physiotherapy) with an average follow-up of 70 days (range, 6-141 days). Result: Physiotherapy after TKR improved the ROM parameters, including the post-operative average ROM. The post-operative and follow-up ROM also significantly increased. Conclusion: Patients with hemophilia require different physiotherapeutic techniques and need dedicated post-operative care in comparison with the general population.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.3
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• pp.1-11
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• 2019

PURPOSE: This study compared the changes in the range of motion (ROM ) on the knee joint according to three different isometric contraction intensities when applying Evjenth - Hamberg stretching (EHS) to the hamstring muscles of healthy subjects. METHODS: Forty eight healthy subjects aged between 20 and 39 years were allocated randomly to four groups; performing EHS at 10% maximum voluntary isometric contraction (MVIC) group, EHS at 50% MVIC group, EHS at 100% MVIC group, and control group (CG) pre-, and post-intervention. The flexibility of the hamstring muscles was evaluated using a digital goniometer for measuring the knee joint ROM motion. A Chattanooga stabilizer was used to adjust the MVIC intensity by 10%, 50%, and 100%, respectively. RESULTS: These results show that the pre- and post-intervention knee joint ROM were significantly different in all four groups (p<.05). The post-intervention knee joint ROM showed a significant difference between the 100% MVIC group and non-MVIC group (p<.05). The knee joint ROM difference between the pre- and post-interventions was similar in the 10% MVIC and 50% MVIC groups but significant differences were observed among the other groups (p<.05). CONCLUSION: EHS of the hamstring muscles was effective in improving the knee joint ROM with an isometric contraction intensity of 10%, 50%, or 100% MVIC, and of these, 100% MVIC was most effective.

• Physical Therapy Korea
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• v.23 no.4
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• pp.1-8
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• 2016

Background: Various methods are used for recovery of knee flexion range of motion (ROM) due to a tightened rectus femoris muscle (RFM) or limited inferior glide of the patella. Stretching methods are common interventions for restoring the tightened RFM length. Also patellar inferior gliding (PIG) technique can recover tightened RFM length too. However, effect of applying the PIG to passive knee flexion (PKF) has not been studied. Objects: The purpose of this study was to investigate the effect of combining PIG with RFM stretching for improving knee flexion ROM in subjects with RFM tightness. Methods: Twenty-six subjects with RFM tightness were recruited. Two different methods of knee stretching were tested: 1) PKF during modified Thomas test (MTT) and 2) PKF with PIG during MTT. The passive stretching forces was controlled by hand-held dynamometer. The knee flexion ROM angle was measured by a MTT with ImageJ software. Differences between the conditions with and without PIG were identified with a paired t-test. Results: The knee flexion ROM was significantly greater for PKF with PIG ($114.44{\pm}9.33$) than for PKF alone ($108.97{\pm}9.42$) (p<.001). Conclusion: A combination of passive knee flexion exercise and PIG can be more effective than PKF in increasing knee flexion ROM in individuals with RFM tightness.

• Journal of The Korean Society of Integrative Medicine
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• v.6 no.3
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• pp.33-42
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• 2018

Purpose : The purpose of this study was to investigate the characteristics of the Flex-OA shoe, a specific functional shoe, in terms of the range of motion (ROM) of hip and knee joint during walking when compared to a standardized shoe. Methods : Twenty-six healthy adults (18 males, 6 females) participated in this study. Subjects performed 8 walking trials consisting of two different shoe conditions to evaluate the hip and knee ROM using a three-dimensional motion capture system. Visual 3D motion analysis software was finally used to coordinate the kinematic data. Result : The total ROM and maximal abduction range of the hip joint in the coronal planes when wearing the Flex-OA shoe were significantly increased during walking compared to wearing a standard shoe (p<.05). On the other hand, significantly increased ROM was observed in the sagittal plane when wearing the Flex-OA shoe in the knee joints compared to a standard shoe (p<.05). Conclusion : Although clinical application of the specific functional shoe has known clearly positive effects on knee moments, the results of this study could provide important clues to explain the background of these effects in terms of the hip and knee joints when applying a specific functional shoe.

• The Journal of Korean Physical Therapy
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• v.34 no.2
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• pp.63-67
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• 2022

Purpose: The purpose of this study was to investigate the effect of assistance tools such as gym balls, wedges, and straps on lower extremity muscle activity and the increase in the range of motion made possible by the use of these tools. The subjects were divided into two groups: a group capable of deep-squatting (PS) and the second finding it impossible or having difficulty in performing such squats (IS). Methods: Twenty-three subjects participated in this study. Surface electromyography was used to measure the muscle activation of the rectus femoris (RF), vastus medialis (VM), and tibialis anterior (TA) muscles during deep squats, normal squats (NS), gym ball squats (GS), wedge squats (WS), and strap squats (SS). A motion analysis system was used to measure the range of motion of the knee joint during each of these exercises. Results: There was a significant difference in the RF muscle activity between the possible squat (PS) and the impossible squat (IS) groups in the GS, and there were significant differences in the RF and TA muscle activity between the groups in the WS. Both the PS group and the IS group showed a significant difference in the TA muscle activity depending on the tool used. There were also significant differences in the range of motion of the knee joints between the intervention methods using NS and those using the tools. Conclusion: In both groups, the muscle activity of the TA muscles was lower when GS, WS, and SS were performed compared to NS. In addition, compared to NS, the range of motion of the knee joint increased when the three tools were used. This study shows that the activity of the RF, VM, and TA muscles decreased and the range of motion of the knee joint increased during deep squats for both the PS and IS groups when tools were used.

• Korean Journal of Applied Biomechanics
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• v.25 no.3
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• pp.311-322
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• 2015

Objective : The purpose of this study was to investigate the effects of landing height and knee joint muscle fatigue on the movement of the lower extremity during cutting after landing. Method : Subjects included 29 adults (age: $20.83{\pm}1.56years$, height: $172.42{\pm}9.51cm$, weight: $65.07{\pm}10.18kg$). The subjects were asked to stand on their dominant lower limb on jump stands that were 30 and 40 cm in height and jump from each stand to land with the dominant lower limb on a force plate making a side step cutting move at a $45^{\circ}$ angle with the non-dominant lower limb. The fatigue level at 30% of the knee extension peak torque using an isokinetic dynamometer. Results : The results showed that the difference of landing height increased maximum range of motion and angular velocity of hip, knee, and ankle joints in the sagittal plane, and in the angular velocity of motion of the hip joint in the sagittal plane. The maximum range of motion of the knee joint in the sagittal plane and the frontal plane decreased on landing from both heights after the fatigue exercise. The angular velocity of the hip joint in the sagittal plane, and the maximum range of motion of the hip joint in the transverse plane decreased for both landing heights after the fatigue exercise. The angular velocity of the hip joint in the frontal plane decreased for the 30 cm landing height after the fatigue exercise. On the other hand, the angular velocity and maximum range of motion of the ankle joint in the sagittal plane for both landing heights, and the angular velocity and maximum range of motion of the ankle joint in the frontal plane increased on landing from the 40 cm height after the fatigue exercise. Conclusion : Different landing heights of 30 and 40 cm and 30% fatigue of peak torque of knee extensor found a forefoot and stiff landing strategy, when cutting after landing. These results might be due to decline in the shock absorption capability of the knee joint and the movement capability related to cutting while increasing the contribution of the ankle joint, which may cause increased ankle joint injuries.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.1
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• pp.1-14
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• 2020

Purpose : The purpose of this study was to investigate the effect of an exercise program with patella mobilization on range of motion, muscle strength, and gait in patients with total knee arthroplasty. Methods : Thirty patients under the age of 65 who visited the T hospital in Daegu Metropolitan City and underwent total knee arthroplasty surgery were selected for this study. Fifteen patients were randomly assigned to the experimental group and took part in an exercise program with patella mobilization, and fifteen patients were randomly assigned to the control group and took part in just the exercise program. Each group took part in their intervention three times a week for four weeks. The measurement tools used included a goniometer, handheld dynamometer, and 10-meter walking test. In the statistical analysis results, to compare the about pre and post test differences within each group, a paried t-test was used, and to compare the differences between each group, an independent t-test was used. Results : There was a significant difference (p<.05) in the range of motion, muscle strength of the quadriceps femoris and, hamstrings, and 10-meter walking test within each individual group and between the two groups before and after the intervention (p<.05). Conclusion : All the results for the experimental group were significant. Therefore, it is expected that an exercise program with patella mobilization will be helpful for the recovery of the knee joint in patients who have undergone total knee arthroplasty.

• PNF and Movement
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• v.16 no.2
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• pp.229-238
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• 2018

Purpose: This study aimed to compare the immediate effects of various contract-relax (CR) techniques on the peck force and passive range of motion (ROM) of knee extension. Methods: This study recruited 17 adult males and females who obtained below $90^{\circ}$ in straight leg raising. The subjects randomly performed one of three different CR techniques (direct CR, indirect CR, and modified CR) on the right knee extension four times per day for three days. The subjects' peck force during each CR and their passive knee extension on the hip at a $90^{\circ}$ flexed position before and after each CR were measured. Results: The peck force was significantly higher in the direct and modified CR than in the indirect CR. The ROM in the passive knee extension significantly increased after direct and indirect CR. Comparing between each CR, the passive knee extension range was significantly more improved in the direct and indirect CR than in the modified CR. Conclusion: Direct and indirect CR are more effective than modified CR in the ROM of passive knee extension. The study results suggest that the modified CR did not have the same effect on the ROM of the knee extension as the direct and indirect CR and that further research is needed to recruit more subjects and to determine the effects on different muscles after modified CR.

• Journal of Korean Medicine Rehabilitation
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• v.27 no.3
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• pp.33-45
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• 2017

Objectives The objective of this study is to report the evidence that continuous passive motion (CPM) therapy combined with Korean Medicine is effective for knee injuries. Methods We searched 2 Korean medical electronic databases, and 2 Chinese electronic databases to find randomized controlled clinical trials (RCTs) that treat knee injuries with Korean Medicine combined with CPM therapy. We selected studies by screening. We extracted data from selected RCTs, and analyzed RCTs by using Cochrane's Risk of bias criteria. Results 386 studies are searched, and 7 RCTs are selected. According to the study, several kinds of Korean Medicine such as hydrotherapy, decoction, acupuncture, moxibustion, and manual therapy are used with CPM therapy for the knee joint postoperative rehabilitation. We found the encouraging evidence that Korean Medicine and CPM combined therapy is more effective than single CPM therapy by alleviating pain, increasing range of motion, and improving knee function, etc. However, the risk of bias in most RCTs was judged to be uncertain. Conclusions Combination of Korean Medicine and CPM therapy can compensate the defect of single CPM therapy, and promotes the recovery of knee joint function.

• Journal of The Korean Society of Integrative Medicine
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• v.5 no.4
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• pp.41-48
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• 2017

Purpose : The purpose of this study was to verify the relationships among the knee adduction moment, hip rotation range, strength of hip rotators, and Foot Posture Index of healthy young adults. Method : Thirty-two healthy adults(24 male, 8 females) participated in this study. Subjects performed 5 walking trials to evaluate the knee adduction moments using a three-dimensional motion analysis system. Hip rotation ranges and hip rotator strengths were measured using a standard goniometer and a handheld dynamometer, respectively. The mean of three trials of clinical tests was used for data analysis. Results : The first peak knee adduction moment was significantly correlated with the hip rotation ranges and hip rotator strengths (P<.05). The second peak knee adduction moment was showed significant correlations with hip external rotation and rotation ratio. There were no correlations between Foot Posture Index and all knee adduction moments (P>.05). Conclusion : This study suggests that imbalances of the range of motion and strength of the internal and external rotation of the hip joint can affect knee adduction moments. The impact may exacerbate musculoskeletal disorders such as osteoarthritis of the knee. Therefore, further studies should be conducted to evaluate the effects of clinical interventions to correct these imbalances on the reduction of the knee adduction moments in patients with knee osteoarthritis.