• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.2
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• pp.55-67
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• 2021

Background: This study aimed to use the muscle energy technique (MET) with total knee replacement (TKR) during the chronic phase in a clinical setting and confirm its effects on the knee extensor strength and ROM, balance, and walking ability. Methods: A total of 20 female patients who underwent TKR 1~4 years ago were assigned to two groups (Control: Q setting exercise+general physical therapy, n=10; Exp: MET+general physical therapy, n=10). Interventions were performed three times a week for 4 weeks. The strength of the knee extensor was evaluated using an aneroid sphygmomanometer, and ROM was evaluated using degrees at the end range on active knee flexion. The main balance outcomes were evaluated using two standard scale (TSS) and timed up and go (TUG) test, whereas the walking ability was evaluated using the 10 meter walk test (10MWT). Results: Analysis showed that both groups had significant increases in strength, ROM, TSS, TUG, and 10MWT. Differences in all variables were significant between the control and Exp groups at the post-intervention evaluation (p<.05). However, no significant difference was observed in strength and TUG. Conclusion: Results of this study demonstrated that MET would help improve the strength, ROM, balance, and walking ability of patients with chronic TKR who want to enhance their abilities and performance in activities of daily living.

• Journal of the Korean Society for Precision Engineering
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• v.17 no.11
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• pp.17-24
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• 2000

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.11 no.1
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• pp.39-44
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• 2013

Purpose : The purpose of present study is to evaluate the joint angles of legs in the standing posture for six patients with unilateral knee osteoarthritis. Methods : The participants underwent unilateral total knee replacement. A motion analysis was used to measure the joint angles of the hip, knee, and ankle. The measurements were taken before the surgery, one week and two weeks after the surgery. Both sides of the legs were evaluated. Results : This result showed that after a certain healing period, both hip joint angles showed a significant difference while there was no significant difference in the knee and ankle joint angles. After surgery, the angle of ankle dorsiflexion was smaller on the operated side than the opposite side compared to the pre-surgery measurements. Conclusion : After surgery, the asymmetry in a standing position left unchanged due to contracture of the knee joint and tightness in the hamstring muscle. Therefore, when physiotherapists plan an initial exercise programs for TKR patients, it is essential to apply adequate exercises which consider the contracture of the leg joints.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.24 no.1
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• pp.77-83
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• 2018

Background: The purpose of this study is to investigate that effect of manual therapy using pelvic compression belt on hip abductor strength and balance ability in total knee replacement (TKR) patients. Methods: The subjects consisted of twenty two post-TKR patients. Participants were randomly assigned to a pelvic belt group (n=11) and a placebo group (n=11). All participants underwent manual therapy including range of motion exercise, soft tissue mobilization around knee joint, strengthening exercise (Quad set, SLR, sidelying hip abduction, standing hamstring curls, sitting knee extension, step-up, wall slide to $45^{\circ}$ knee flexion). Manual therapy was executed five times a week for 2 weeks. Outcome measures included hip abductor strength by using Biodex system 4 pro, anterior to posterior balance, medial to lateral balance, total balance by using Biodex balance system SD. Results: After the completion of the manual therapy, hip abductor strength was showed statistically significant improvements in pelvic belt group (p<.05). Anterior to posterior balance, medial to lateral balance, total balance were showed statistically significant improvements in pelvic belt group and placebo group (p<.05). There was a statistically significant difference between the two groups in hip abductor strength and there was no statistically significant difference in balance. Conclusions: This results suggest that manual therapy using pelvic compression belt has could be used for selective muscle activation of the hip abductor muscle and has useful in hip abductor strength and balance ability in TKR patients.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2006.10a
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• pp.445-446
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• 2006

• The Korean Journal of Pain
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• v.34 no.3
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• pp.271-287
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• 2021

Background: Postoperative pain management is crucial for patients undergoing total knee arthroplasty (TKA). There have been many recent clinical trials on post-TKA peripheral nerve block; however, they have reported inconsistent findings. In this meta-analysis, we aimed to comprehensively analyze studies on post-TKA analgesia to provide evidence-based clinical suggestions. Methods: We performed a computer-based query of PubMed, Embase, the Cochrane Library, and the Web of Science to retrieve related articles using neurothe following search terms: nerve block, nerve blockade, chemodenervation, chemical neurolysis, peridural block, epidural anesthesia, extradural anesthesia, total knee arthroplasty, total knee replacement, partial knee replacement, and others. After quality evaluation and data extraction, we analyzed the complications, visual analogue scale (VAS) score, patient satisfaction, perioperative opioid dosage, and rehabilitation indices. Evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results: We included 16 randomized controlled trials involving 981 patients (511 receiving peripheral nerve block and 470 receiving epidural block) in the final analysis. Compared with an epidural block, a peripheral nerve block significantly reduced complications. There were no significant between-group differences in the postoperative VAS score, patient satisfaction, perioperative opioid dosage, and rehabilitation indices. Conclusions: Our findings demonstrate that the peripheral nerve block is superior to the epidural block in reducing complications without compromising the analgesic effect and patient satisfaction. Therefore, a peripheral nerve block is a safe and effective postoperative analgesic method with encouraging clinical prospects.

• Journal of Korean Physical Therapy Science
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• v.17 no.1_2
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• pp.41-52
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• 2010

Purpose: The purpose of this study was to compare the effects of continuous passive motion(CPM) and continuous active motion(CAM) on proprioception of the knee after total knee replacement(TKR). Methods: Twenty patients with TKR were randomly allocated into two groups, the CPM group(n=10) and the CAM group(n=10). All subjects were evaluated for levels of pain, passive range of motion and angle reproduction of the knee. An angle reproduction test was used to assess the proprioceptive deficit. Two types of angle reproduction test were used: a passive angle reproduction(PAR) test and an active angle reproduction(AAR) test. The relevant examinations were performed before and after intervention(on the 5th day and the 10th day). The statistical significance were calculated using a t-test and a one-way repeated ANOVA. Results: A pre-intervention significant difference was not found between the two groups. Significantly better results were before and after the intervention at 10 days, for the PAR(flexion direction) test; however, only in the CAM group. There were no significant difference, either before or after the intervention, for the AAR test(flexion and extension direction) in both group. Both groups experienced similar levels of pain and passive range of knee motion before and after the intervention. Conclusion: This study revealed that CAM was a better effect to restore position sense of the knee joint after TKR.

• Physical Therapy Rehabilitation Science
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• v.11 no.1
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• pp.16-23
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• 2022

Objective: This study aimed to investigate the effect of adding hip abductor strengthening to conventional rehabilitation on muscle strength and physical function following total knee replacement (TKR) for knee osteoarthritis. Design: Randomized controlled trial Methods: Thirty-five participants were randomly allocated to exercise groups I (n=18) and II (n=17). Group I underwent hip abductor training and conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. Group II underwent conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. The participants in both groups also received continuous passive motion therapy for 15 min per day, 5 days per week for 4 weeks. To investigate the effect of the intervention, the Biodex dynamometer was used to measure the peak torque of both knee extensors and hip abductors. This study used the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) to assess physical function, as well as the figure-of-8 walk test (F8W) and the stair climb test (SCT). Results: According to the interventions, exercise groups I and II showed significantly improved muscle strength and KOS-ADLS, F8W, and SCT scores (p<0.001). Compared with that of exercise group II, exercise group I showed significantly improved hip abductor strength (p<0.001) and KOS-ADLS, F8W, and SCT scores (p<0.05). Conclusions: The results of this study indicate that the combination of hip abductor strengthening and conventional rehabilitation is an effective exercise method to increase hip abductor muscle strength and physical function after TKR.

• Journal of the Korean Society for Precision Engineering
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• v.21 no.9
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• pp.188-195
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• 2004

Severe osteoarthrosis of the knee joint often requires total knee arthroplasty(TKA) to yield adequate knee function. The knee joint with TKA is expected ideally to restore the characteristics, however, this is not necessarily 1.ue in the clinical cases. In this study the motion of the intact joint and the joint after. TKA were investigated numerically using computer simulation. For active knee extension from 90 degrees of flexion to full extension, the intact knee joint exhibited anterior tibial translation near the full extension and it showed only rotation at other flexion angles. Physiologic external rotation of the tibia near full extension known as screw home movement was also noted in the analytical model. The analysis of the tibial insert of three different shapes (flat, semicurved, and curved types) demonstrated characteristic rotational and sliding motion as well as different contact forces.

• The Journal of the Korea Contents Association
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• v.12 no.3
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• pp.222-232
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• 2012

This study was conducted to compare the task-oriented exercise and weight-shifting exercise program has effectiveness on the static and dynamic balance in patients with total knee replacement. The participants were allocated randomly into 2 group : task-oriented exercise group(n=12) and weight-shifting exercise group(n=12). To evaluate the effects of exercise, subjects were evaluated by using Gaitveiw System and functional reaching test for static balance and Balance System for dynamic balance test. The data was analyzed using a paired t-test and independent t-test to determine the statistical significance. Static balance test and dynamic balance test in task-oriented exercise had statistical significance than weight-shifting exercise program(p<0.05). So this results were suggested that the task-oriented exercise was effective on static and dynamic balance in patients with total knee replacement.