• Title/Summary/Keyword: Upper and lower extremity

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Reconstruction of Soft Tissue Defect of Lower Extremity with Anterolateral Thigh Perforator Flap (전외측 대퇴부 천공지 피판을 이용한 하지 연부조직 결손의 재건)

  • Kim, Kyung-Chul;Chung, Chae-Ik;Kim, Seong-Eoun;Kim, Hak-Soo;Rhyou, In-Hyeok
    • Archives of Reconstructive Microsurgery
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    • v.15 no.2
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    • pp.70-76
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    • 2006
  • This study investigated the clinical application of anterolateral thigh (ALT) perforator flap in reconstruction of soft tissue defect of lower extremity. There were twenty-one patients who had been taken soft tissue reconstruction with anterolateral thigh perforator flap. There were 19 males and 2 females between 3 and 65 years (mean, 36 years). This study included 4 cases of pedatric case of under 10-year-old. All cases were a cutaneous flap. Flap size averaged $160\;cm^2\;(20{\sim}450\;cm^2)$. 19 cases were musculocutaneous perforator flaps and 2 were septocutaneous perforator. T-shaped pedicle were used to reconstruct and to preserve major artery of lower extremity in 2 cases. 19 cases flaps survived completely and 2 cases flap were marginal necrosis partially. There was venous congestion in one case of type of reverse island flap but that was improved after salvage procedure with leech. While the donor sites were closed directly in 5cases, 16 cases underwent skin graft. ALT flap is suitable for coverage of defects in lower extremity where have various condition and reliable in children as in adult.

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Comparison of the Repetitive Nerve Stimulation Test(RNST) Findings Between in Upper and Lower Extremity Muscles in Myasthenia Gravis (중증근무력증 진단시 상지와 하지근육들에서의 반복신경자극검사 양성률의 비교)

  • Jung, Yun Seuk;Lee, Jun;Lee, Se Jin;Hah, Jung Sang;Kim, Wook Nyeon
    • Journal of Yeungnam Medical Science
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    • v.17 no.2
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    • pp.129-136
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    • 2000
  • Background and Purpose: This study was undertaken to compare the sensitivity of the Repetitive Nerve Stimulation Test (RNST) between the upper and lower extremity muscles in myasthenia gravis(MG) patients. Material and Methods: The study population consisted of 20 normal persons(control group) and 10 MG patients(MG group). Using Stalberg's method. RNST was systemically performed in orbicularis oculi muscle. upper extremity muscles(flexor carpi ulnaris. abductor digiti quinti), and lower extremity muscles(tibialis anterior. extensor digitorum brevis. vastus medialis). Results: There were statistical differences of decremental response($mean{\pm}SD$) in orbicularis oculi and upper extremity muscles between the control and MG groups(p<0.05 or p<0.01). However, there was no statistical difference of decremental response($mean{\pm}SD$) to RNST in lower extremity muscles between the control and MG groups. There were highersensitivity in orbicularis oculi and upper extremity muscles than lower extremity muscles. Although positive reponse were detected in the lower extremity muscles, the positive response rates of lower extremity muscles were lower than o.oculi and upper extremity muscles. Conclusions: When the response rates of RNST in facial and upper extremity muscles are normal, may not be required RNST in lower extremity muscles.

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The Effect of Trunk Muscle Activity on Applied Normal Timing According to Angular Motion in PNF Patterns (PNF 패턴에서 각도에 따른 Normal Timing의 적용이 체간 근육활성에 미치는 영향)

  • Kim, Kyung-Hwan;Youn, Hye-Jin;Park, Sung-Hun;Lim, Jin-Woo
    • PNF and Movement
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    • v.13 no.2
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    • pp.81-88
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    • 2015
  • Purpose: The purpose of this study was to analyze the effect of normal timing according to angular motion in PNF patterns on electromyography (EMG) activity in rectus abdominis, internal oblique abdominal muscle, external oblique abdominal muscle, and erector spinae. Methods: Ten healthy adults volunteered to participate in this study. The participants were required to complete following two PNF extremity patterns; upper extremity extension- adduction-internal rotation pattern with $180^{\circ}$, $90^{\circ}$, $30^{\circ}$ and lower extremity flexion- adduction-external rotation pattern with $0^{\circ}$, $60^{\circ}$, $90^{\circ}$. A paired t-test was used to determine the influence of the two PNF patterns on muscle activity in each muscle. Descriptive statistics were used to determine the ratio of local muscle activity to global muscle activity. Results: In terms of their effect on applied normal timing, the upper and lower extremity pattern significantly affected the rectus abdominis, internal oblique, external oblique, and erector spinae (p < .05). The upper extremity pattern (at an extension angle of $30^{\circ}$) and the lower extremity pattern ((at a flexion angle of $90^{\circ}$) influenced the rectus abdominis, internal oblique, external oblique, and erector spinae (p < .05). Conclusion: The effect of the upper and lower extremity patterns on applied normal timing was significant in that these patterns increased trunk muscle activation. The upper extremity pattern (at an extension angle of $30^{\circ}$) and the lower extremity pattern (at a flexion angle of $90^{\circ}$) increased trunk muscle activation. Normal timing is required to increase trunk muscle strength and extremity movement.

Movement Patterns for Rising from Supine to Erect Stance of Children and Adolescent (아동기와 청년기의 똑바로 누운 자세에서 일어서기 운동형태)

  • Bae Sung-Soo;Park Sang-Ock;Kwon Mi-Ji
    • The Journal of Korean Physical Therapy
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    • v.7 no.1
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    • pp.21-31
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    • 1995
  • This study was described the movement patterns when rising from supine to erect stance. Two hundred eighty seven subjects, ranging in age from 6 year to 28 were filmed while rising from a supine position. Movement Patterns were classified using categorical descriptions of the action of three body regions-the upper and lower extremity, head-trunk region. This study was designed to determine whether within the rising task the movement patterns of different regions of the body vary with age level and sex. The incidence of each movement pattern was calculated and graphed with respect to age level and sex. The most common form of rising for subject in the 6, 7 year mate group usually involved push and reach pattern with upper extremity, half kneel pattern with lower extremity, partial rotation pattern with head-trunk. In the 6, 7 year female group usually involved symmetrical push pattern with upper extremity, symmetrical squat with balance step pattern with lower extremity, symmetrical interrupted by rotation pattern with head - trunk. In the teenage and twenties both sex group usually involved symmetrical push pattern with upper extremity, symmetrical squat pattern with lower extremity, partial rotation pattern with head-trunk.

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The Effects of Lower Extremity Strengthening Program on Balance, Gait and Upper Limb Function in Patients with Stroke (뇌졸중 환자에게 하지 근력강화 프로그램이 균형, 보행과 상지 기능에 미치는 효과)

  • Kim, Ju-O;Lee, Byoung-Hee
    • The Journal of the Korea Contents Association
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    • v.20 no.6
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    • pp.114-123
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    • 2020
  • The purpose of this study was to determine the effect of lower extremity strengthening program on balance, gait and upper limb function in patients with stroke. This study was a hospital-based with Central nerve system lesion patients, randomized controlled trial with a blinded assessor. Twenty four hemiparetic stroke patients were divided into two groups: a Lower extremity strengthening program group (LESPG)(n=12) and a Treadmill training group (TTG)(n=12). The LESPG performed a Lower extremity strengthening program on the affected side. The TTG exercised on a treadmill for 30 minutes a day. Assessment tools included the Timed Up and Go test (TUG), the Functional Gait Assessment (FGA) and the Manual Function Test (MFT). There was a significant difference in TUG, FGA, and MFT scores between the two groups in the LESPG for the balance, gait, and upper limb function than for the TTG(p<.01). Results of the present study indicated that the effect of lower extremity strengthening program for 4 weeks had an effect on balance, gait and upper limb function of hemiplegic patients after stroke.

The Clinical Study about Qualitative and Quantitative Characteristics of Acupuncture Sensation According to the Body Parts (인체 부위별 경혈에 따른 득기감의 질적, 양적 특성에 관한 연구)

  • Oh, Hyun Jin;Lee, Eun Sol;Lee, Yoon Joo;Lee, Seung Deok;Kim, Kap Sung;Kim, Eun Jung
    • Journal of Acupuncture Research
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    • v.30 no.5
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    • pp.65-76
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    • 2013
  • Objectives : This study was designed to find out the differences of the acupuncture sensation by body parts. Methods : Sixty-three subjects got acupuncture at five acupoints which represent five different body parts ; head($GV_{20}$), abdomen($ST_{25}$), back($BL_{24}$), upper extremity($LU_9$), lower extremity($GB_{40}$). All subjests were asked to complete questionnaire rating the intensity of 13 kinds of acupuncture sensation(acupuncture sensation scale, ASS). We compared the subjective acupuncture sensation between the body parts. Results : Intensity of acupuncture sensation of $GV_{20}$ was significantly lower than $LU_9$(p=0.001) and $GB_{40}$(p=0.000). Sum of acupuncture sensation of $GV_{20}$ was also significantly lower than $BL_{24}$(p=0.011), $LU_9$(p=0.004) and $GB_{40}$(p=0.033). Among the 13 types of acupuncture sensation scale, tingling and aching were well sensed at $GV_{20}$ and $ST_{25}$, aching, tingling and sharp pain were well sensed at $LU_9$, $GB_{40}$, dull pain, deep pressure and heaviness were well sensed at $BL_{24}$. Conclusions : Head showed significantly lower intensity of acupuncture sensation than upper extremity and lower extremity. Among the acupuncture sensation scales, tingling and aching were well sensed at head and abdomen, aching, tingling and sharp pain were well sensed at upper extremity and lower extremity, dull pain, deep pressure and heaviness were well sensed at back.

Efficacy and patient satisfaction regarding lymphovenous bypass with sleeve-in anastomosis for extremity lymphedema

  • Chung, Jae-Ho;Baek, Si-Ook;Park, Ho-Jin;Lee, Byung-Il;Park, Seung-Ha;Yoon, Eul-Sik
    • Archives of Plastic Surgery
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    • v.46 no.1
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    • pp.46-56
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    • 2019
  • Background When performing lymphovenous anastomosis, it is sometimes difficult to find venules in the proximity of an ideal lymphatic vessel that have a similar diameter to that of the lymphatic vessel. In this situation, larger venules can be used. Methods The authors evaluated the efficacy of and patient satisfaction with lymphovenous bypass with sleeve-in anastomosis. Between January 2014 and December 2016, we performed this procedure in 18 patients (eight upper extremities and 10 lower extremities) with secondary lymphedema. Lymphovenous bypass with sleeve-in anastomosis was performed under microscopy after injecting indocyanine green dye. The circumferential diameter was measured before lymphovenous bypass and at 1, 2, and 6 months after the procedure. An outcomes survey that included patients' qualitative satisfaction with lymphovenous bypass was conducted at 6 months postoperatively. Results Almost all patients showed quantitative improvements after surgery. The circumferential reduction rate in patients with stage II lymphedema of both the upper and lower extremities was significantly greater than in their counterparts with stage III/IV lymphedema. The circumferential reduction rate was lower in lower-extremity patients than in upper-extremity patients. Conclusions Lymphovenous bypass surgery with sleeve-in anastomosis in lymphedema patients is beneficial, and appears to be effective, when adequately-sized venules cannot be found in the proximity of an ideal lymphatic vessel.

Electromyographic Analysis of Lower Extremity Lateral Stabilizer During Upper Extremity Elevation Movements

  • Jung, Ho-Bal
    • Journal of International Academy of Physical Therapy Research
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    • v.1 no.2
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    • pp.185-191
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    • 2010
  • Background: This study investigated effective posture for gluteus medius rehabilitation training and effects of isometric muscle activity by electrophysiology through EMG while performing dynamic isotonic behavior of weight placed differently on upper limbs. Method: 16 healthy male subjects 20 to 29 years of age volunteered for the study. Lateral stabilizer right gluteus medius activity was assessed using EMG while the right lower extremity maintains single limb support, and the left upper extremity elevation movement maintains 5 seconds without load, 1RM to 1 repetition, 5RM to 5 times, 10RM to 10 times, 5RM and 10RM maintain 5sec. Results: Comparison of the mean value of EMG data showed a statistically more significant difference in upper extremity elevation movement on opposite upper extremity added weight than one that was not added on a single limb weight bearing posture(p>.05). Weight supported side gluteus medius activity for 1RM, 5RM, 10RM weight difference and movement repetition did not differ(p>.05). Comparison in maximum value showed statistically significant differences in not adding weight on upper limb elevation exercise and 1RM, 5RM, 10RM repeated behavior. Elevation behavior and repetition appeared over 70% of MVIC. Conclusion: Unilateral weight bearing stance added weight in the opposite upper limb elevation movement was an indirect exercise to effectively stimulate gluteus medius activity. Applying various added weight will have effective exercise on the early stages of rehabilitation because activity gluteus medius did not differ through added weight.

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Improvement of Upper Extremity Function and Leisure Satisfaction of Children with Brain Lesions through Sports Stacking Activities: A Case Study

  • Ae-Lyeong Kwon;Ki-Jeon Kim
    • The Journal of Korean Physical Therapy
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    • v.36 no.2
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    • pp.53-60
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    • 2024
  • Purpose: This study aimed to investigate changes in upper extremity joints and leisure satisfaction in children with brain lesions through sports stacking activities. Methods: A sports stacking program was conducted on three children with brain lesions who had upper extremity joint limitations and joint range of motion lower than the normal range. It was conducted 10 times, 1 to 2 times a week, 40 minutes each time. Upper extremity joint angles were measured using a goniometer in the order of shoulder, elbow, wrist, and fingers, and leisure satisfaction was measured using a smile evaluation. Results: As a result of measuring the upper extremity joint angles, all three children showed slight angle changes in the shoulder, elbow, and wrist areas. Differences in joint angles appeared differently for each child. Smile evaluation results were evaluated in various psychological, educational, and physical aspects. Only child A was evaluated for Smile Evaluation No. 1. Conclusion: Sports stacking activities changed the upper extremity function of children with brain lesion disorders and showed differences in psychological, physical, and educational aspects of leisure satisfaction. As this is a short-term study result, the change in upper extremity function is minimal, but if sports stacking activities are continued, it will be a rehabilitation program that can prevent upper extremity dysfunction and improve physical strength. Accordingly, continuous attention should be paid to increasing accessibility and enjoyment of daily life according to individual characteristics and level.

Analysis of Transplantation of 99 Free Flaps (유리조직 이식술 99례 분석)

  • Lee, Jun-Mo;Kim, Ki-Nam
    • Archives of Reconstructive Microsurgery
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    • v.10 no.1
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    • pp.1-6
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    • 2001
  • Free flap transplantation demands meticulous microsurgical technique to cover the exposed vital structures which is important to restore and maintain functions of the extremities. From July 1992 through December 2000, 99 patients were received reconstructive microsurgery in the upper and lower extremity at Department of Orthopedic Surgery, Chonbuk National University Hospital. The most common cause in the upper extremity was industrial accident, 8 cases of total 15 cases and in the lower extremity was traffic accident, 66 cases of total 84 cases. The most commonly involved site was thumb and finger, 8 cases of total 15 cases and in the lower extremity was leg, 65 cases of total 84 cases. In upper extremity, the wrap around free flap was carried out in 4 cases(4.0%), first dorsal metatarsal artery flap and lateral arm flap were 3 cases(3.0%) each in 15 cases and in lower extremity, latissimus dorsi myocutaneous flap were 23 cases(23.2%), gracilis 20cases(20.2%), and rectus abdominis muscle flap 18(18.2%) in 84 cases. Overall 89 cases(89.9%) of 99 cases were survived and maintained and revealed good cosmetic results.

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