Purpose: The anterolateral thigh flap has many advantages over other conventional free flaps. But the anterolateral thigh flap has yet to enter widespread use because perforating arteries exhibit a wide range of anatomic variations and are difficult to dissect when small. The aim of this study is to identify the vascular variability of perforating arteries and pedicle in the anterolateral thigh free flap. Methods: We studied 12 cadavers and dissected 23 thighs. An anterolateral thigh flap ($12{\times}12cm$) was designed and centered at the midpoint of the line drawn from anterior superior iliac spine to the superolateral border of the patella. After we identifed the perforating arteries we dissected up to their origin from lateral circumflex femoral artery along descending branch of lateral circumflex femoral artery. We then investigated the number and the position of perforating arteries, length and diameter of vascular pedicle and pattern of lateral circumflex femoral arterial system. Results: On average $2.3{\pm}1.1$ perforating arteries per thigh were identified. The musculocutaneous perforators were 63.1%. In those perforators five perforators were arose from transverse branch of lateral circumflex femoral artery and two were arose from rectus femoral artery. Most of the perforators were near the intermuscular septum between rectus femoris muscle and vastus lateralis muscle. The length and diameter of pedicle were $11.9{\pm}3.5cm$ and $3.1{\pm}0.8mm$ on average. Conclusion: This study will be helpful for the success in anterolateral thigh free flap.
Bronchiolitis obliterans organizing pneumonia (BOOP) preceding polymyositis is rare. In this report, a 40-year-old patient with fever, chillness, generalized myalgia and progressive exertional dyspnea, had bilateral interstitial infiltrates on chest radiograph. High-Resolution CT showed subpleural and peribronchial distribution of airspace consolidation. Open lung biopsy was consistent with BOOP. Prednisolone therapy led to improvement, but during tapering of prednisolone for 3 months to 30 mg, he complained of weakness of both lower legs. One month later, prednisolone was tapered to 15 mg a day, fever. chillness and generalized myalgia were recurred. He complained of weakness of both arms. The creatine kinase (CK) with MM isoenzyme, lactate dehydrogenase (LDH) and aspartate aminotransferase (AST) were elevated. Anti-Jo1 antibody was positive. Vastus lateralis muscle biopsy was compatible with polymyositis. After injection of methylprednisolone for 1 week, the patient became afebrile, the dyspnea resolved, the pulmonary infiltrates decreased, and the muscle strength improved. The serum CK, LDH, AST levels declined significantly. Patients with idiopathic BOOP should have follow-up for the possible development of connective tissue disorders including polymyositis.
Park, Seung-Bum;Lee, Kyung-Deuk;Kim, Dae-Woong;Yoo, Jung-Hyeon;Kim, Kyung-Hun;An, Chang-Shin;Lee, Tae-Yong
Korean Journal of Applied Biomechanics
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v.20
no.2
/
pp.221-230
/
2010
The purpose of this study was to analyze biomechanical factors of trail running shoes applied to korean shoe-lasts. 10 healthy male subjects with an average age of 37.2 years(SD=8.28), weight of 69.6 kg(SD=10.56) and a height of 171 cm(SD=4.93) were recruited for this study. Ten males walked on a treadmill wearing four different shoes. Foot pressure data was collected using a Pedar-X mobile system(Novel Gmbh., Germany) operating at the 1000 Hz. Surface EMG signals for tibialis anterior, gastrocnemius, vastus lateralis and biceps femoris were acquired at 1000 Hz using Noraxon TeleMyo DTS system(Noraxon Inc., USA). Foot pressure and leg muscle fatigue were measured and calculated during walking. The results are as follows: After walking 60 minutes, Type A showed a lower MPF. MPF values were significantly different from each muscle(p<.05). Therefore, Type A shoe might decrease muscle fatigue in the legs while walking. In addition, Type It showed that Type A shoe has the highest contact area and the lowest maximum pressure. As a result of the analysis, Trail running shoes will use a new design to reduce muscle fatigue and are expected to increase comfort and fitting.
Objective: The purpose of this study is to compare the workload level at each lower limbs posture and suggest the ergonomic workstation guideline for working period by evaluating the imbalanced lower limbs postures from the physiological and psychophysical points of view. Background: Many workers like welders are working in various imbalanced lower limbs postures either due to the narrow working conditions or other environmental conditions. Method: Ten male subjects participated in this experiment. Subjects were asked to maintain 3 different lower limbs postures(standing, squatting and bending) with 3 different working conditions(balanced floor with no scaffold, imbalanced floor with 10cm height of scaffold, and imbalanced floor with 20cm height of scaffold). EMG data for the 4 muscle groups(Retus Femoris, Vastus Lateralis, Tibialis Anterior, Gastrocnemius) from each lower limbs posture were collected for 20 seconds every 2 minutes during the 8 minutes sustaining task. Subjects were also asked to report their discomfort ratings of body parts such as waist, upper legs, lower legs, and ankle. Results: The ANOVA results showed that the EMG root mean square(RMS) values and the discomfort ratings(CR-10 Rating Scale) were significantly affected by lower limbs postures and working time(p<0.05). The correlation was analyzed between the EMG data and the discomfort ratings. Also, prediction models for the discomfort rating for each posture were developed using physical condition, working time, and scaffold height. Conclusion: We strongly recommend that one should not work more than 6 minutes in a standing or squatting postures and should not work more than 4 minutes in a bending posture. Application: The results of this study could be used to design and assess working environments and methods. Furthermore, these results could be used to suggest ergonomic guidelines for the lower limbs postures such as squatting and bending in the working fields in order to prevent fatigue and pain in the lower limbs body.
Objective: The aim of this study was to investigate the influence of seat heights for optimizing the ingress/egress performance in the elderly people. Background: Recently elderly users have been increasing in number and the ease of ingress/egress of the vehicle becomes an important issue. Method: Seven elderly subjects participated in this study(age: 71.7${\pm}$3.6yr, height: 167.7${\pm}$5.4cm, weight: 68.1${\pm}$11.5kg). Each subject performed the sitting and rising task from comfortable seated position on the chair under the following conditions: (1) with a lumbar support and (2) without a lumbar support. We measured EMG activities of seven muscles(tibialis anterior, soleus, gastrocnemius, vastus lateralis, rectus femoris, biceps femoris and erector supinae) and ranges of motion in lower limb during sitting and standing from three different heights (400mm, 500mm and 600mm from ground) of slide-up seat. Results: Muscle activities and angular movements of hip and knee joints during standing-up and sitting-down with a high seat height(600mm) were reduced mean 30.4% in extensor muscles, 57.11% in flexor muscle, 18.74% in erector muscle and 31.0% in joints compared with a low seat height(400mm). Conclusion: Muscle activities and joint movements in hip and knee were reduced when rising/sitting from a high seat height(600mm) compared with a low seat height(400mm). Application: This study can be used to design vehicle that are easy to get in and out of by older peoples with or without impairments.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.17
no.2
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pp.25-32
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2011
Background: This study was to examine the effect of applying leg exercise using visual informations on improving stroke patient's muscle power, balance and gait. Methods: The subjects of this study were hemiplegic patients by stroke, 30 patients were picked up, who were agreed with this research and were having hospital care for 8 weeks at RS, RB and HH medical centers. The study group was 15 and comparison group was 15, totally 30 patients were confirmed. leg exercise using visual informations was applied to study group, leg exercise without visual informations was applied to comparison group. These were proceeded for 8 weeks (5 days a week, 20 minutes a day), change of muscle power, balance and gait was checked to investigate the effect. Electromyography apparatus was used for checking muscle power, K-BBS (Korean version of Berg Balance Scale) and COP (center of pressure) were used for balance, then Functional Gait Assessment (FGA), timed up and go test (TUG) were used for checking the capacity of gait. Results: Vastus lateralis (p=.002), biceps femoris (p=.000), K-BBS (p=.000), COP (p=.007), FGA (p=.002), TUG (p=.009) are significant difference between the two groups. Conclusion: This study showed that visual informations impact change of muscle activity, balance and locomotor ability in stroke patients.
The Work-Related Musculoskeletal Disorders (WMSDs) can be occurred by various factors such as repetition, forceful exertions and awkward postures. Especially, occurrences of the WMSDs on the waist and lower limb are reported in workplaces, demanded standing postures for a long time, in service and manufacturing industry. The static and standing postures without movement for a long time increase work loads to the lower limb and the waist. Accordingly, anti-fatigue mat or anti-fatigue insole is used as a preventing device of the WMSDs. However anti-fatigue mats are limited in space and movement. In this study, multi-elastic insoles are designed and shown the effects of the workload reduction for a long time under the standing work. The foot pressures and EMG (Electromyography) are measured at 0 hour and after 2 hours by 6 health students in their twenties. The 6 prototype insoles are designed with three elastic (Low, Medium and High). These insoles are compared with no insole (insole type 7) as control group. The EMG measurement was conducted to waist (erector spinae muscle), thigh (vastus lateralis muscle) and calf (gastrocnemius muscle). The foot pressure is analyzed by mean pressure value and the EMG analysis is investigated through MF (Median Frequency), MPF (Mean Power Frequency) and ZCR (Zero Crossing Rate). The results of the foot pressure show that the multi-elastic insoles had smaller foot pressure value than that of no-insole. Moreover, Insole 2 and Insole 3 have the smallest increasing rate in foot pressure. The EMG results show that the multi-elastic insoles had smaller EMG shift value than that of no-insole in 2 hour, and then shift value shows the smallest value in Insole 2. Therefore, this study presents that the multi-elastic insoles have reducing effects of the work load for a long time standing work in both side of foot pressure and EMG.
Walking shoes for walking and jogging have been used to enjoy lots of leisure time. Functional shoes such as walking shoes have special functions to improve body motility by changing of shoe shapes. The walking shoes could improve the motility by structural transformation of outsole as increase degrees of heel and toe. The study on insoles has not been conducted enough on the contrary of the study of outsole. The purpose of this study is to perform ergonomics analysis whether the Arch Supported insoles have an improving effect of muscle activities or not. Experiments were performed with 6 subjects who are health and haven't experienced any diseases past. EMG(Electromyography) and Foot Pressures were measured repeatedly for 5 seconds at 0 hour, after 1 hour and after 2 hours of walking. Insoles used for experiment are normal insole, insole inserted Arch Support and pad. The electrodes for EMG measurement were set on waist (erector spinae), and thigh (vastus lateralis), calf (gastrocnemius). Evaluations of EMG were analyzed by shift of MF (Median Frequency) and MPF (Mean Power Frequency). Foot Pressure was analyzed by mean pressure of feet and change of walking time. As results, Arch Support insole had larger frequency shift value than that of normal insole. Frequency shift between Arch Support insoles and normal insole showed significant difference on 95% confidence interval. And insole 1 has the highest value of frequency shift. For results of foot pressure, Arch Support insoles show continuous decreasing tendency when comparing with normal insoles by changing of times. Also, insole 1 has the highest decreasing value of foot pressure. Therefore, this study presented that the Arch Support insole can promote muscle activities and improves comfort for a prolonged walking.
Lee, Geoncheol;Kim, Jongsu;Kim, Sunghun;Kim, Myungkeun;Kim, Jiwon;Chu, Seolhui;Kim, Bora
Journal of The Korean Society of Integrative Medicine
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v.2
no.1
/
pp.15-21
/
2014
Purpose : The aim of this study was to find out differences between muscle activity of quadriceps according to hip angle. Method : 40 healthy adults produced maximum isometric muscle contraction of quadriceps femoris and each part of the quadriceps femoris were measured with a surface EMG in hip joint angle of $90^{\circ}$, $135^{\circ}$, $180^{\circ}$. Result : There was no significant difference between muscle activity of vastus medialis and lateralis according to hip angle. But there was significant difference in muscle activity of rectus femoris and the muscle activity was maximum at 135 degrees of hip angle. Conclusion : In conclusion, maximum muscle activation of rectus femoris is affected by hip angle, and the findings from this study may be helpful for physical therapists in selecting hip position when instructing patients to do Q-setting exercise. So, we suggest that patients perform Q-setting exercise at 135 degrees of hip angle for the best result.
Objective: The main purpose of this study was to investigate the effects of wearing an ankle weight belt while performing gait in water by focusing on the effect of using ankle weights have on the gait kinematics and the muscle activities for developing optimum training strategies. Method: A total of 10 healthy male university students were recruited for the study. Each participant was instructed to perform 3 gait conditions; normal walking over ground, walking in water chest height, and walking in water chest height while using ankle weights. All walking conditions were set at control speed of $4km/h{\pm}0.05km/h$. The depth of the swimming pool was at 1.3 m, approximately chest height. The motion capture data was recorded using 6 digital cameras and the EMG was recorded using waterproof Mini Wave. From the motion capture data, the following variables were calculated for analysis; double and single support phase (s), swing phase (s), step length (%height), step rate (m/s), ankle, knee, and hip joint angles ($^{\circ}$). From the electromyography the %RVC of the lower limb muscles medial gastrocnemius, rectus femoris, erector spinae, semitendinosus, tibialis anterior, vastus lateralis oblique was calculated. Results: The results show significant differences between the gait time, and step length between the right and left leg. Additionally, the joint angular velocities and gait velocity were significantly affected by the water resistance. As expected, the use of the ankle weights increased all of the lower leg maximum muscle activities except for the lower back muscle. Conclusion: In conclusion, the ankle weights can be shown to stimulate more muscle activity during walking in chest height water and therefore, may be useful for rehabilitation purposes.
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