• 제목/요약/키워드: Upper and lower extremity

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

  • 김경철;정재익;김성언;김학수;류인혁
    • Archives of Reconstructive Microsurgery
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    • 제15권2호
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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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중증근무력증 진단시 상지와 하지근육들에서의 반복신경자극검사 양성률의 비교 (Comparison of the Repetitive Nerve Stimulation Test(RNST) Findings Between in Upper and Lower Extremity Muscles in Myasthenia Gravis)

  • 정윤석;이준;이세진;하정상;김욱년
    • Journal of Yeungnam Medical Science
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    • 제17권2호
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    • pp.129-136
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    • 2000
  • 중종근무력증 환자들에게 반복신경자극검사를 시행함에 있어서 하지의 근육들의 진단적 민감성을 파악해 보기 위하여 건강한 남녀 20명과 영남대학교 의과대학 부속병원 신경과에 중증근무력증의 특징적인 증상을 주소로 내훤한 grade 2이상의 환자 10례를 대상으로 안윤근, 소지외전근, 척측수근굴근과 하지의 내경골근, 단지선근, 내광근에서 반복신경자극검사를 시행하여 다음과 같은 결과를 얻었다. 환자에서 반복신경자극검사에서 안면근육과 상지근육은 하지근육보다 민감도에서 높은 결과를 보여 주었고, 정상인과 중증근무력증 환자사이에서 안정기, 운동 직후, 운동 후 1분, 운동 후 3분에서의 감소성반응수치는 안면과 상지근육에서 통계적으로 유의한 차이 (P<0.01 or p<0.05)가 있었으나 하지근육에서는 유의한 차이를 보이지 않았다, 중증근무력증환자에서의 반복신경자극검사 결과 안윤근에서 20례, 척측수근굴근에서 14례, 소지외전근에서 12례에서 양성반응을 보였으며, 하지에서는 전경골근에서 4례, 단지선근에서 8례, 내광근에서 3례에서 양성반응이 나타났다. 이상의 결과로 볼 때, 중증근무력증이 의심되는 환자에게 반복신경자극검사를 시행할 경우에 안면과 상지근육에 정성소견이 보이면 하지근육에서 반복신경자극검사를 시행할 필요는 없는 것으로 생각되나, 빈도는 낮지만 하지근육애서도 양성반응을 보임에 따라서 추후에 좀 더 많은 환자에 대해서 하지근육의 반복신경자극검사를 시행해 볼 필요가 있을 것으로 생각된다.

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

  • 김경환;윤혜진;박성훈;임진우
    • PNF and Movement
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    • 제13권2호
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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.

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

  • 배성수;박상옥;권미지
    • The Journal of Korean Physical Therapy
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    • 제7권1호
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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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뇌졸중 환자에게 하지 근력강화 프로그램이 균형, 보행과 상지 기능에 미치는 효과 (The Effects of Lower Extremity Strengthening Program on Balance, Gait and Upper Limb Function in Patients with Stroke)

  • 김주오;이병희
    • 한국콘텐츠학회논문지
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    • 제20권6호
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    • pp.114-123
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    • 2020
  • 본 연구는 뇌졸중 환자에게 하지 근력강화 프로그램이 균형, 보행 및 상지 기능에 미치는 효과에 대해서 알아보았다. 신경계 손상 환자가 있는 병원을 기반으로 해서 하지 근력 강화에 대한 연구 방법을 만들어서 진행하였고, 무작위대조시험을 적용하였다. 24명의 뇌졸중 환자를 두 군으로 분류하였다. 하지 근력 강화 프로그램그룹 (Lower extremity strengthening program group, LESPG) (12명)과 트레드밀 훈련그룹 (Treadmill trainig group, TTG) (12명)으로 실험하였다. LESPG는 마비측에 하지 근력 강화프로그램을 수행하였다. TTG는 하루 30분 동안 트레드밀 운동을 적용하였다. 평가 도구는 일어나서 보행 검사(Timed Up and Go test, TUG), 기능적 보행평가 (Functional Gait Assessment, FGA) 및 뇌졸중 상지 기능검사(Manual Function Test, MFT)를 적용하였다. 균형, 보행 및 상지 기능에 대한 두 군 간의 TUG, FGA 및 MFT 점수는 LESPG가 TTG보다 유의한 차이가 있었다(p<.01). 4주간의 하지 근력강화 프로그램의 효과는 뇌졸중 후 편마비 환자의 균형, 보행 및 상지 기능에 효과가 있었다.

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

  • 오현진;이은솔;이윤주;이승덕;김갑성;김은정
    • Journal of Acupuncture Research
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    • 제30권5호
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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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    • 제46권1호
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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
    • 국제물리치료학회지
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    • 제1권2호
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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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    • 제36권2호
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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.

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

  • 이준모;김기남
    • Archives of Reconstructive Microsurgery
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    • 제10권1호
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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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