• 한국운동역학회지
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• 제28권1호
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• pp.61-67
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• 2018

Objective: The human body is often modelled as a spring-mass system. Lower extremity stiffness has been considered to be one of key factor in the performance enhancement of running, jumping, and hopping involved sports activities. There are several different classification of lower extremity stiffness consisting of vertical stiffness, leg stiffness, joint stiffness, as well as muscle and tendon stiffness. The primary purpose of this paper was to review the literature and describe different stiffness models and discuss applications of stiffness models while engaging in sports activities. In addition, this paper provided a current update of the lower extremity literature as it investigates the relationships between lower extremity stiffness and both functional performance and injury. Summary: Because various methods for measuring lower extremity stiffness are existing, measurements should always be accompanied by a detailed description including type of stiffness, testing method and calculation method. Moreover, investigator should be cautious when comparing lower extremity stiffness from different methods. Some evidence highlights that optimal degree of lower extremity stiffness is required for successful athletic performance. However, the actual magnitude of stiffness required to optimize performance is relatively unexplored. Direct relationship between lower extremity stiffness and lower extremity injuries has not clearly been established yet. Overall, high stiffness is potentially associate risk factors of lower extremity injuries although some of the evidence is controversial. Prospective injures studies are necessary to confirm this relationship. Moreover, further biomechanical and physiological investigation is needed to identify the optimal regulation of the lower limb stiffness behavior and its impact on athletic performance and lower limb injuries.

• 대한정형도수물리치료학회지
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• 제16권1호
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• pp.1-8
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• 2010

Purpose : This study aimed to examine the relationships among five clinical measures for functional alignment of the lower extremity. Methods : Thirty healthy subjects (15 males and 15 females) were recruited for the study. The five clinical measures of functional alignment of the lower extremity included navicular drop, quadriceps angle, internal rotation of hip, and anterior and lateral pelvic tilt angles. The level of navicular drop was calculated by the difference between the height of the navicular bone in the sitting (non-weight bearing) and standing (weight bearing) positions. The quadriceps angle and internal rotation of hip were measured using a standard goniometer with photographic markers while the subjects were lying in a prone position on a table with their knee at $90^{\circ}$ flexion. Anterior and lateral pelvic tilt angles were determined using a inclinometer. Results : Correlation and a simple linear regression analysis were used to assess relationships between the clinical measures. There were significant correlations between navicular drop and quadriceps angle (p<.05), between navicular drop and internal rotation of hip (p<.05), and between quadriceps angle and internal rotation of hip (p<.01). In simple linear regression analysis, the navicular drop appeared to be a factor affecting the quadriceps angle and internal rotation of hip (p<.05). The findings suggest that navicular drop has a great impact on lower extremity alignment. Conclusion : This study might help us to examine lower extremity function and clarify its role as a potential injury risk factor.

• Journal of Trauma and Injury
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• 제32권1호
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• pp.40-46
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• 2019

Purpose: We perform an analysis of infection risk factors for fracture patients and confirm that the risk factors reported in previous studies increase the risk of actual infection among fractured patients. In addition, injury severity score (ISS) which is used as an evaluation tool for morbidity of trauma patients, confirms whether there is a relationship with infection after orthopedic fracture surgery. Methods: We retrospectively reviewed 1,818 patients who underwent fixation surgery at orthopedic trauma team, focused trauma center from January 1, 2015 to December 31, 2017. Thirty-five patients were infected after fracture surgery. We analyzed age, sex, open fracture criteria based on Gustilo-Aderson classification 3b, anatomical location (upper extremity or lower extremity) of fracture, diabetes, smoking, ISS. Results: Of 1,818 patients, 35 (1.9%) were diagnosed with postoperative infection. Of the 35 infected patients, nine (25.7%) were female and five (14.0%) were upper extremity fractures. Three (8.6%) were diagnosed with diabetes and eight (22.8%) were smokers. Thirteen (37.1%) had ISS less than nine points and six (17.1%) had ISS 15 points or more. Of 1,818 patients, 80 had open fractures. Surgical site infection were diagnosed in 12 (15.0%) of 80. And nine of 12 were checked with Gustilo-Aderson classification 3b or more. Linear logistic regression analysis was performed using statistical analysis program Stata 15 (Stata Corporation, College Station, TX, USA). In addition, independent variables were logistic regression analyzed individually after Propensity scores matching. In all statistical analyzes, only open fracture was identified as a risk factor. Conclusions: The risk factors for infection in fracture patients were found to be significantly influenced by open fracture rather than the underlying disease or anatomical feature of the patient. In the case of ISS, it is considered that there is a limitation. It is necessary to develop a new scoring system that can appropriately approach the morbidity of fracture trauma patients.

• Vascular Specialist International
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• 제34권4호
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• pp.103-108
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• 2018

Purpose: Surgery is the most common risk factor for pulmonary embolism (PE) in patients with a recent venous thromboembolism (VTE). This study reviewed clinical outcomes of preoperative inferior vena cava filter (IVCF) use in patients with acute VTE during abdominal-pelvic cancer or lower extremity orthopedic surgeries. Materials and Methods: We retrospectively analyzed 122 patients with a recent VTE who underwent IVCF replacement prior to abdominal-pelvic cancer or lower extremity orthopedic surgery conducted between January 2010 and December 2016. Demographics, clinical characteristics, postoperative IVCF status, risk factors for a captured thrombus, and clinical outcomes were collected for these subjects. Results: Among the 122 study patients who were diagnosed with acute VTE in the prior 3 months and underwent preoperative IVCF replacement, 70 patients (57.4%) received abdominal-pelvic cancer surgery and 52 (42.6%) underwent lower extremity orthopedic surgery. There were no perioperative complications associated with IVCF in the study population and no cases of symptomatic PE postoperatively. A captured thrombus in the filter was identified postoperatively in 16 patients (13.1%). Logistic regression analysis indicated that postoperative anticoagulation within 48 hours significantly reduced the risk of a captured thrombus (odds ratio [OR], 0.28; 95% confidence interval [CI], 0.08-0.94; P=0.032). Conclusion: A captured thrombus in preoperative IVCF was identified postoperatively in 16 patients (13.1%). Postoperative anticoagulation within 48 hours reduces the risk of captured thrombus in these cases.

• 한국운동역학회지
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• 제24권2호
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• pp.173-180
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• 2014

The purpose of this study was to investigate the effect of combined exercise on injury risk factors of lower extremity during landing. Ten sports talented athletes participated in this study. Sports talented athletes participated in a combined exercise (sports talented exercise, coordination) for 16 weeks. A three-dimensional motion analysis was performed using eight infrared cameras (sampling rate of 100 Hz), one force plate, and electromyography system (sampling rate of 1000 Hz) during landing. Kinetic, and kinematics analysis including average impulsive force, angle of lower extremity, vertical stiffness, onset of muscle activation were calculated by Matlab2009a software. Paired t-test was performed at alpha=.05. The average impulsive force in landing phase was not statistically significant (t=-.748, p=.474). The hip joint angle was more decreased in post test compared to pre test (E1: t=2.682, p=.025, E2: t=5.609, p=.000, E3: t=2.538, p=.032). The knee joint (E1: t=-.343, p=.739, E2: t=1.319, p=.220, E3: t=.589, p=.570) and ankle joint (E1: t=.081, p=.937, E2: t=.784, p=.453, E3: t=.392, p=.704) angle were tended to decrease after combined exercise. The vertical stiffness was tended to decrease after combined exercise (t=1.972, p=.080). Onset of quadriceps femoris (t=.698, p=.503) and medial gastocnemius (t=1.858, p=.096) were tended to be faster than biceps femoris (t=-.333, p=.747) after combined exercise. Although thses findings were not statistically significant except on a hip joint angle, risk factors of lower extremity such as joint angle, vertical stiffness and onset of quadriceps femoris, medial gastrocnemius were positively changed after the combined exercise but an additional training for improved onset of biceps femoris would be required in the future.

• 한국운동역학회지
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• 제26권4호
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• pp.433-441
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• 2016

Objective: The purpose of this study was to understand the injury mechanism and to provide quantitative data to use in prevention or posture correction training by conducting kinematic and kinetic analyses of risk factors of lower extremity joint injury depending on the change of direction at different angles after a landing motion. Method: This study included 11 men in their twenties (age: $24.6{\pm}1.7years$, height: $176.6{\pm}4.4cm$, weight: $71.3{\pm}8.0kg$) who were right-leg dominant. By using seven infrared cameras (Oqus 300, Qualisys, Sweden), one force platform (AMTI, USA), and an accelerometer (Noraxon, USA), single-leg drop landing was performed at a height of 30 cm. The joint range of motion (ROM) of the lower extremity, peak joint moment, peak joint power, peak vertical ground reaction force (GRF), and peak vertical acceleration were measured. For statistical analysis, one-way repeated-measures analysis of variance was conducted at a significance level of ${\alpha}$ <.05. Results: Ankle and knee joint ROM in the sagittal plane significantly differed, respectively (F = 3.145, p = .024; F = 14.183, p = .000), depending on the change of direction. However, no significant differences were observed in the ROM of ankle and knee joint in the transverse plane. Significant differences in peak joint moment were also observed but no statistically significant differences were found in negative joint power between the conditions. Peak vertical GRF was high in landing (LAD) and after landing, left $45^{\circ}$ cutting (LLC), with a significant difference (F = 9.363, p = .000). The peak vertical acceleration was relatively high in LAD and LLC compared with other conditions, but the difference was not significant. Conclusion: We conclude that moving in the left direction may expose athletes to greater injury risk in terms of joint kinetics than moving in the right direction. However, further investigation of joint injury mechanisms in sports would be required to confirm these findings.

• International Journal of Contents
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• 제9권3호
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• pp.62-66
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• 2013

Insulin resistance is a risk factor for stroke or recurrent stroke. Sedentary behavior increases insulin resistance. This study aimed to identify the relationship between physical impairments and functions and insulin resistance, examining which physical impairments specifically influence insulin resistance the most. The subjects of this study were 63 stroke patients. The subject's insulin resistance and physical impairments and functions were measured using the Chedoke-McMaster Stroke Assessment (CMSA) and Stroke Impairment Assessment Set (SIAS). The study results exhibited that insulin resistance is statistically significantly related to the variable of foot according to the CMSA(r=.95, p<.05) and to the variable of lower extremity sensory function (touch) in relation to the SIAS(r=.91, p<.05). This study also revealed close correlations between insulin resistance and the variables of ankle control(${\beta}=-1.05$, p<.05) and low extremity tactile sensations(${\beta}=-1.82$, p<.05).

• Journal of Chest Surgery
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• 제47권6호
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• pp.517-522
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• 2014

Background: This study reports the result of endovascular treatment for arterial occlusive disease limited to femoropopliteal lesions, focusing on the recurrence of symptoms instead of patency. Methods: This was a retrospective, single-center study. From April 2007 to November 2011, 48 limbs in 38 patients underwent endovascular stenting or balloon angioplasty to treat femoropopliteal arterial occlusive disease. The factors affecting the recurrence of symptoms were analyzed. Results: The mean age of the patients was $69.60{\pm}7.62$ years. Among the baseline characteristics of the patients, initial hyperlipidemia was the most important factor affecting the recurrence of symptoms (relative risk=5.810, p=0.031). The presence of a dorsal arch was also a significant factor (relative risk=0.675, p=0.047). Conclusion: The major factors that affect the recurrence of symptoms after endovascular treatment for femoropopliteal arterial occlusive lesions are hyperlipidemia and the presence of a dorsal arch. Therefore, the usage of lipid-lowering agents after endovascular treatment and taking the presence of a dorsal arch into consideration are important elements of managing the recurrence of symptoms.

• 한국응용과학기술학회지
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• 제36권2호
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• pp.424-433
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• 2019

본 연구는 양발 착지 시 성별에 따른 상해 경험이 무릎과 엉덩관절의 움직임 및 수직 지면반력에 미치는 영향을 분석하는데 목적이 있었다. 20대 남성 20명(상해 경험 8명, 비상해 경험 12명), 여성 20명(상해 경험 11명, 비상해 경험 9명)을 연구대상자로 선정하였다. 높이 45cm 박스에서 양발 착지를 통해 얻어진 운동역학적 변인을 Two-way mixed ANOVA를 실시하였으며, bonferroni adjustment를 이용하여 사후검증 하였다(p<.05). 본 연구결과 상해를 경험한 여성 그룹은 무릎 관절의 외반 및 내측회전 그리고 엉덩관절의 굴곡 및 외측회전 운동을 증가시켜 최대 수직 지면반발력의 감소를 유도할 수 있었던 것으로 판단된다. 상해를 경험하지 않은 여성 그룹의 경우 최대 무릎 굴곡각도가 가장 작게 나타났을 뿐만 아니라 엉덩관절의 굴곡과 외측회전 각도에서 가장 적은 수치를 나타내었고 최대 수직 지면반발력은 가장 높게 나타났다. 반면, 상해를 경험하지 않은 여성 INE 그룹의 경우 IE 그룹에 비해 상대적으로 무릎과 엉덩관절을 활용하지 못함으로서 높은 수직 지면반발력을 나타내었고, 이는 상대적으로 상해 위험성에 많이 노출되어 있음을 의미한다. 따라서 성별에 따른 상해 경험이 무릎과 엉덩관절의 운동과 최대 수직 지면반발력의 크기에 요인들에 영향을 주는 요인들임을 알 수 있었다.

• 한국운동역학회지
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• 제31권1호
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• pp.1-15
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• 2021

Objective: The aim of this study was to investigate 1) the difference in static lower extremity alignment (SLEA) according to a history of lateral ankle sprain (LAS), 2) to identify SLEA factors affecting LAS, and 3) to present the cut-off value and 4) the usefulness and limitations of the SLEA measurement. Method: This case-control study recruited 88 men (age: 27.78±4.69 yrs) and 39 women (age: 24.62±4.20 yrs) subjects with and without LAS. SLEA measurement protocol included Q angle, tibiofemoral angle, genu recurvatum, rear foot (RF) angle, tibal varum and torsion, navicular drop, ankle dorsiflexion range of motion (DF ROM). Independent t-test, logistic regression and receiver operating characteristic (ROC) curve were used for statistical analysis. Results: Men with a history of LAS had significantly smaller Q angles both in standing and in supine position, while women with a history of LAS had significantly greater DF ROM in non-weight bearing (NWB; p < 0.05). Logistic regression model suggests tibial varum (OR = 0.779, p = 0.021) and WB DF ROM (OR = 1.067, p = 0.045) were associated with LAS in men. In case of women, there were no significant SLEA factors for LAS, however, ROC curve analysis revealed standing RF angle (AUC = 0.647, p = 0.028) and NWB DF ROM (AUC = 0.648, p = 0.026) could be affecting factors for LAS. Conclusion: There are differences in SLEA according to the history of LAS, furthermore, the identified items were different by sex. In case of men, tibial varum and WB DF ROM affect LAS occurrence. Standing RF angle and NWB DF ROM of women could be a predictor for LAS. However, since the sensitivity and specificity in most of the SLEA measurements are low, kinematic in dynamic tasks should be considered together for a more accurate evaluation of LAS risk.