• 한방재활의학과학회지
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• 제27권3호
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• pp.33-45
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• 2017

Objectives The objective of this study is to report the evidence that continuous passive motion (CPM) therapy combined with Korean Medicine is effective for knee injuries. Methods We searched 2 Korean medical electronic databases, and 2 Chinese electronic databases to find randomized controlled clinical trials (RCTs) that treat knee injuries with Korean Medicine combined with CPM therapy. We selected studies by screening. We extracted data from selected RCTs, and analyzed RCTs by using Cochrane's Risk of bias criteria. Results 386 studies are searched, and 7 RCTs are selected. According to the study, several kinds of Korean Medicine such as hydrotherapy, decoction, acupuncture, moxibustion, and manual therapy are used with CPM therapy for the knee joint postoperative rehabilitation. We found the encouraging evidence that Korean Medicine and CPM combined therapy is more effective than single CPM therapy by alleviating pain, increasing range of motion, and improving knee function, etc. However, the risk of bias in most RCTs was judged to be uncertain. Conclusions Combination of Korean Medicine and CPM therapy can compensate the defect of single CPM therapy, and promotes the recovery of knee joint function.

• 한국지능시스템학회:학술대회논문집
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• 한국지능시스템학회 2008년도 춘계학술대회 학술발표회 논문집
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• pp.223-226
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• 2008

This paper presents an effectiveness of a four-link mechanism with a tip which has four joints, but only one is an active joint. Even though the degree-of-freedom of the mechanism is one, it can be applied to implement a combined joint motion adequately. So, this paper analyzes its motion for effective robotic applications.

• 국제물리치료학회지
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• 제7권2호
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• pp.1025-1030
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• 2016

The purpose of this study was to investigate the effects of combined wedge on the range of motion in ankle and knee joint, ankle eversion moment and knee adduction moment, and center of pressure excursion of foot for genu varus among adult men during gait. This study was carried out with 10 adult men for genu varus in a motion analysis laboratory in J university. The subjects of the experiment were measured above 5cm width between the knees on contact of both medial malleolus of ankle while standing. The width of their knees in neutral position was measured without the inversion or eversion of the subtalar joint by the investigator. The subjects of the experiment were ten who were conducted randomly for standard insole, insole with $10^{\circ}$ lateral on rear foot wedge, insole at $10^{\circ}$lateral on rear foot and $5^{\circ}$ medial on fore foot wedge. Before and after intervention, changes on the range of motion in ankle and knee joint, ankle eversion moment and knee adduction moment, and center of pressure excursion were measured. In order to compare analyses among groups; repeated one-way ANOVA and $Scheff{\acute{e}}$ post hoc test were used. As a result, combined wedge group was significantly decreased compared to control wedge group in terms of knee varus angle in mid-stance(p<.05). Combined wedge group was significantly decreased compared to lateral wedge group in terms of ankle eversion moment in whole stance(p<.05). Combined wedge group was significantly decreased compared to lateral wedge group in terms of knee adduction moment in whole stance(p<.05). Combined wedge group was significantly decreased compared to lateral wedge in terms of center of pressure excursion in whole stance(p<.05). The results of this study suggest that combined wedge for genu varus decreased ankle eversion moment and knee adduction moment upon center of pressure excursion. We hypothesize that combined wedge may also be effective in the protection excessive ankle pronation.

• 동력기계공학회지
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• 제12권2호
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• pp.55-61
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• 2008

This paper discusses the advantages of using Fourier-based periodic excitation and of combining internal and external models in dynamic robot parameter identification. Internal models relate the joint torques or forces with the motion of the robot; external models relate the reaction forces and torques on the bedplate with the motion data. This combined model allows to combine joint torque/force and reaction torque/force measurements in one parameter estimation scheme. This combined model estimation will yield more accurate parameter estimates, and consequently better predictions of actuator torque, which is shown by means of a simulated experiment on a CRS A465 industrial robot.

• 제어로봇시스템학회논문지
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• 제14권9호
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• pp.886-892
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• 2008

In this paper, a closed-loop observer to extract the center of mass (CoM) of a bipedal robot is suggested. Comparing with the simple conversion method of just using joint angle measurements, it enables to get more reliable estimates by fusing both joint angle measurements and F/T sensor outputs at ankle joints. First, a nonlinear-type observer is constructed to estimate the flexible rotational motion of the biped in the extended Kalman filter framework. It adopts the flexible inverted pendulum model which is appropriate to address the flexible motion of bipeds, specifically in the single support phase. The predicted estimates of CoM in terms of the flexible motion observer are combined with measurements (that is, output of the CoM conversion equation with joint angles). Then, we have final CoM estimates depending on the weighting values which penalize the flexible motion model and the CoM conversion equation. Simulation results show the effectiveness of the proposed algorithm.

• 대한물리의학회지
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• 제13권2호
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• pp.11-19
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• 2018

PURPOSE: The aim of this study was to identify the effects of joint mobilization intervention combined with exercise on range of motion (ROM), pain intensity, and functional performance in adolescent baseball players with internal impingement syndrome of the shoulder. METHODS: The subjects were 30 adolescent baseball players diagnosed with internal impingement. Ten subjects were randomly assigned to each of 3 groups: Group 1 (exercise only), Group 2 (joint mobilization combined with exercise), and Group 3 (rest-only control group). Three weekly interventions were given for 4 weeks (the control group rested for 4 weeks). The main outcome measures were goniometer, visual analogue scale (VAS), and Korean Kerlan Jobe shoulder-elbow (K-KJOC) scores. The ROM (external and internal rotation), pain intensity (at the moment of throwing), and functional performance were compared among the groups. RESULTS: No significant difference was observed among the groups in the range of external rotation of the shoulder before and after the intervention, but the range of internal rotation was significantly increased in Group 2 compared to Groups 1 and 3. Pain intensity was significantly lower in Group 2 than in Group 1 and 3, and functional performance was significantly increased in Group 2 compared to Group 1 and 3. CONCLUSION: An intervention that combined joint mobilization with exercise was more effective than resting or exercise alone for rapid recovery from sports injury and improvement in athletic performance.

• Archives of Reconstructive Microsurgery
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• 제11권1호
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• pp.11-18
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• 2002

Large soft tissue defects around the knee joint are known to significantly diminish joint function. Severe soft tissue defects on the anterior aspect of the knee joint especially bring on significant joint motion limitation. Although simple split skin grafts can cover the skin defect, the progressing scar contracture of the grafted skin causes joint stiffness. One of the best solutions of large soft tissue defects around the knee joint is covering the defect with a good quality skin flap. Separated flaps with one vascular pedicle are good candidates for covering anterior and posterior aspects of the joint for example. Authors performed 12 cases of combined scapular and latissimus dorsi free flaps from 1984 to 2000. Among them, we experienced 5 cases of knee joint defect covering using the double free flap for coverage of the soft tissue defect with preservation of the knee joint function and satisfactory results. The system of flaps based on the subscapular artery and vein provides a variety of composite free flaps. The possible flaps that can be harvested based on this single vascular pedicle include the scapular and parascapular skin flap, the serratus anterior and latissimus dorsi muscular flap, the lateral scapular bone flap, the latissimus dorsi-rib flap, and the serratus anterior-rib flap. This combined flap is available for multiple tissue defects or complex defects because it can be incorporated with skin, muscle and bone flaps. A main advantage is the independent vascular pedicles of each component, which allow freedom in orientation of each components. Consequently it can be freely applied to any form of three dimensional defects on the upper and lower extremities. The combination of scapular cutaneous flap and latissimus dorsi musculocutaneous flap can be resurfaced for massive cutaneous defects on the extremities. We report the use of the combined scapular and latissimus dorsi free flap in five patients to reconstruct massive defects on the extremities with resultant improved joint function. There was no flap failure and minimal complications and disadvantages. The anatomy of this flap is reviewed and the indication and advantages are discussed. All of the five flaps survived and there was no scar contracture affecting the joint motion.

• 국제물리치료학회지
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• 제9권4호
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• pp.1642-1650
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• 2018

The purpose of this study was to identify the effect of proprioceptive neuromuscular facilitation (PNF) stretching exercise and joint mobilization on ankle joint range of motion (ROM), plantar pressure, and balance in subjects with stroke. Thirty patients (n=30) were organized into three groups, each of which received different treatments: PNF stretching (n=10), joint mobilization (n=10), and joint mobilization and PNF stretching combined (n=10). Each group received three exercise sessions per week for four weeks. The ankle ROM was measured using a goniometer, and plantar pressure and balance ability were measured using BioResque static posturography. In comparison within each group, the joint mobilization group and the joint mobilization with PNF stretching group showed significant improvements in ankle ROM, plantar pressure, and balance ability (p<.05). In comparison between the groups, a statistically significant difference was found in SECS change between the PNF stretching group, joint mobilization group and the joint mobilization with PNF stretching group. This study found demonstrates that the joint mobilization and joint mobilization with the PNF stretching methods were effective in improving ankle ROM, plantar pressure, and balance ability in stroke patients.

• 대한정형도수물리치료학회지
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• 제30권1호
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• pp.51-60
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• 2024

Background: Ankle sprains are a common clinical ankle disorder and alternations in tibiofibular joint biomechanics along with the talus are thought to contribute to its occurrence. During ankle joint dorsi flexion, proper movement requires the talus to glide posteriorly. Due to the wider front of the talus head, achieving the end range of dorsi flexion necessitates both superior and posterior glide of the distal fibula and anterior glide of the proximal fibula. The purpose of this study was to investigate the effects of tibiofibular joint mobilization on pain, range of motion, and balance in patients with lateral ankle sprains. Methods: Participants were randomly assigned to a control group (n=33) or an experimental group (n=31). Both groups underwent ankle joint mobilization three times a week for two weeks. Additionally, the experimental group received proximal and distal tibiofibular joint mobilization three times a week for two weeks. Measurements were obtained pre-intervention and post-intervention (after 2 weeks). Results: Evaluation parameters included the visual analog scale score (VAS), range of motion (ROM), and one-leg standing test (OLS). Post-intervention, both groups demonstrated significantly improved results for all assessments (p<.01). A significant intergroup difference was observed only in the ROM (p<.01) and OLS (p<.05). Conclusion: Our findings suggest that tibiofibular joint mobilization, combined with ankle joint mobilization, may be beneficial in enhancing outcomes for individuals with lateral ankle sprains.

• 대한물리의학회지
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• 제13권3호
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• pp.91-97
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• 2018

PURPOSE: Stroke patients have reduced balance ability due to a lack of motion in the ankle joint. Elastic taping assists movement, and joint mobilization, a form of passive movement, enhances mobility. The purpose of this study was to determine the immediate effects on balance ability after anterior-to-posterior (A-P) talocrural joint mobilization combined with elastic taping in stroke patients. METHODS: Twenty stroke patients were divided into two groups: a joint mobilization with taping group (experimental group, n=10) and an elastic taping only group (control group, n=10). The experimental group underwent anteroposterior mobilization of the talus and elastic tape was applied to the calf and tibialis anterior muscles. The control group had elastic tape applied. Dynamic balanced abilities were assessed by using the BioRescue system. After 30 minutes of intervention, the forward, backward, left side, and right side sway areas ($mm^2$) were measured. RESULTS: Only the experimental group showed a significant increase in forward sway area after intervention. However, no significant differences were detected between the two groups. CONCLUSION: This study shows that A-P talocrural joint mobilization combined with elastic taping has a positive effect, producing an immediate increase in the forward balance ability of stroke patients. However, this study did not examine joint mobilization alone. In subsequent studies, it is necessary to examine the effect of joint mobilization only on balance in stroke patients.