Journal of International Academy of Physical Therapy Research
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v.1
no.2
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pp.126-135
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2010
The purpose of this study is to investigate the effects of closed and open kinetic chain exercise for increasing knee joint function on the knee position sense in the normal adults. Thirty normal adults(male 15, female 15; mean age: $22.13{\pm}2.58$ years) were participated in this study into two groups, each with 15 people. The group I was trained that closed kinetic chain exercise on the knee joint and the group II was trained that open kinetic chain exercise on the knee joint. Exercise programs performed for 4 weeks, 3 times a week were using Shuttle 2000-1 closed kinetic chain exercise and Knee Extensor open kinetic chain exercise(HUR, Filand). The results of this study were as follows: 1) There were statistically significant decreasing of measuring error degree in $0-20^{\circ}$ were found between before and after training in closed kinetic chain exercise(p<.05). 2) There were statistically significant decreasing of measuring error degree in $21-40^{\circ}$ were found between before and after training in closed kinetic chain exercise(p<.05). 3) There were statistically significant decreasing of measuring error degree in $41-60^{\circ}$ were found between before and after training in closed kinetic chain exercise(p<.05). 4) There were statistically significant decreasing of measuring error degree in $0-20^{\circ}$ were found between before and after training in open kinetic chain exercise(p<.05). 5) There were statistically significant decreasing of measuring error degree in $21-40^{\circ}$ were found between before and after training in open kinetic chain exercise(p<.05). 6) There were statistically significant decreasing of measuring error degree in $41-60^{\circ}$ were found between before and after training in open kinetic chain exercise(p<.05). In conclusion, these results suggest that closed and open kinetic chain exercise has increased in the knee joint proprioception between before and after training. Especially, closed kinetic chain exercise could be more useful intervention than open kinetic chain exercise for increasing proprioceptive sense.
The density of ATP-sensitive potassium($K_{APT}$) channels, that open as intracellular ATP concentration falls below a critical level, is very high in skeletal muscle surface membrane and those high density may imply that $K_{ATP}$ channels have very important physiological roles. To elucidate a role of $K_{ATP}$ in relation to fatigue, the modulating effects of potassium channel openers and blockers on the fatigue velocity(FV) of mouse extensor hallucis longus muscle(EHL) were investigated in vitro. Twitch contraction was induced by an electrical field stimulation (EFS: 24-48V, 20ms, 0.2-4Hz) and resulting contraction force was isometrically recorded. The twitch forces were gradually decreased to 25% of initial contraction force(ICF) in $37.52{\pm}1.55sec$($mean{\pm}s.e.m.$, n=135), indicating the fatigue phenomena. The mean velocity for development of the fatigue was measured during the period that twitch force decreased to half($FV_{0/0.5}$) and during the period from half to 25%($FV_{0.5/0.25}$) of ICF. The fatigue was induced once every one hour and the tissue response was stable for up to 4 hours. In control condition, ICF was $5.8{\pm}0.12g$ (n=144) and decreased to 50% of ICF with the mean fatigue velocity of $0.182{\pm}0.006g/sec$($FV_{0/0.5}$, n=135) and from 50% to 25% of ICF with $0.084{\pm}0.004g/sec$($FV_{0.5/0.25}$, n=135). Cromakalim($50{\mu}M$) significantly increased $FV_{0.5/0.25}$(n=4). Glibenclamide($IC_{50}>50{\mu}M$), $Ba^{2+}$($IC_{50}=10{\mu}M$), 4-aminopyridine($FV_{0/0.5}$, $IC_{50}=0.5mM$; $FV_{0.5/0.25}$, $IC_{50}=2mM$) decreased both $FV_{0/0.5}$ and $FV_{0.5/0.25}$ concentration-dependently up to 75%. $TEA^+$(30mM), E-4031($10{\mu}M$), tolbutamide(1mM) decreased $FV_{0.5/0.25}$, but apamin(300nM) and $TEA^+$(10mM) showed no significant effects. Our results suggest that activation of the $K_{ATP}$ channels may be major cause of $K^+$ outflux during development of the fatigue and the isolated EHL muscle could be an useful experimental preparation in studying the fatigue phenomena in skeletal muscle. In addition, the possibility of activation of delayed rectifier during the fatigue development remains to be studied further.
Objective : The purpose of this study was to investigate the effects of landing height and knee joint muscle fatigue on the movement of the lower extremity during cutting after landing. Method : Subjects included 29 adults (age: $20.83{\pm}1.56years$, height: $172.42{\pm}9.51cm$, weight: $65.07{\pm}10.18kg$). The subjects were asked to stand on their dominant lower limb on jump stands that were 30 and 40 cm in height and jump from each stand to land with the dominant lower limb on a force plate making a side step cutting move at a $45^{\circ}$ angle with the non-dominant lower limb. The fatigue level at 30% of the knee extension peak torque using an isokinetic dynamometer. Results : The results showed that the difference of landing height increased maximum range of motion and angular velocity of hip, knee, and ankle joints in the sagittal plane, and in the angular velocity of motion of the hip joint in the sagittal plane. The maximum range of motion of the knee joint in the sagittal plane and the frontal plane decreased on landing from both heights after the fatigue exercise. The angular velocity of the hip joint in the sagittal plane, and the maximum range of motion of the hip joint in the transverse plane decreased for both landing heights after the fatigue exercise. The angular velocity of the hip joint in the frontal plane decreased for the 30 cm landing height after the fatigue exercise. On the other hand, the angular velocity and maximum range of motion of the ankle joint in the sagittal plane for both landing heights, and the angular velocity and maximum range of motion of the ankle joint in the frontal plane increased on landing from the 40 cm height after the fatigue exercise. Conclusion : Different landing heights of 30 and 40 cm and 30% fatigue of peak torque of knee extensor found a forefoot and stiff landing strategy, when cutting after landing. These results might be due to decline in the shock absorption capability of the knee joint and the movement capability related to cutting while increasing the contribution of the ankle joint, which may cause increased ankle joint injuries.
The Journal of the Korean bone and joint tumor society
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v.3
no.1
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pp.18-25
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1997
Prosthetic replacement is one of the most common methods of reconstruction after resection of malignant tumor around the knee. Gait analysis provides a relative objective data about the gait function of patients with prosthesis. The purpose of this study was to compare the gait pattern of the patients who underwent limb salvage surgery with prosthesis for distal femur and that of patients with prosthesis for proximal tibia. This study included ten patients (4 males, 6 females, mean age 22.7 years, range 14-36) who underwent a wide resection and Kotz hinged modular reconstruction prosthesis replacement and six normal adult(Control). The site of bone tumor was the distal femur (Group 1) in six patients and proximal tibia (Group 2) in 4 patients. The follow-up period ranged from 15 to 82 months (mean : 33 months). The evaluation consisted of clinical assessment, radiographic assessment, gait analysis using VICON 370 Motion Analysis System. The gait analysis included the linear parameters such as, walking velocity, cadence, step length, stride length, stance time, swing time, single support and double support time and the three-dimensional kinematics (joint rotation angle, velocity of joint rotation) of ankle, knee, hip and pelvis in sagittal, coronal and transverse plane. For the kinetic evaluation, the moment of force (unit: Nm/kg) and power (unit: Watt/kg) of ankle, knee and hip joint in sagittal, coronal and transverse plane. In the linear parameters, cadence, velocity, step time and single support were decreased in both group 1 and group 2 compared with control. Double support decreased in group 2 compared with control significantly(p<.05). In contrast to our hypothesis, there was no significant difference between group 1 and group 2. In Kinematics, we observed significant difference (p<.05) of decreased knee flexion in loading response (G2
Purpose: The biomechanics and kinematics of knee joint were reviewed in this article. And then the common sports injuries were presented. Anatomy and Kinetics: None of the pairs of bearing surfaces in the knee joint is exactly congruent This allows the knee six degrees of freedom of motion. Tibiofemoral Kinematics: In flexion and extension, the axis of motion is not perpendicular to the medial-lateral plane of the joint, nor is it perpendicular to the axis of longitudinal rotation. This results in coupled varus angulation and internal rotation with flexion and in valgus angulation and external rotation with extension. Patellofemoral Articulation: Loads across the patellofemoral joint are indirectly related to the angle of knee flexion and directly related to the force generated within the quadriceps mechanism. Fractures of the Patella: Nonoperative treatment is indicated if the extensor mechanism is intact and if displacement of fragment is minimal. The specific type of internal fixation depends on the fracture pattern. It is important to repair retinaculum. Acute and Recurrent Patellar Instability: The degree of dysplasia and the extent of the instability play a large part in determining the success of nonoperative treatment. Patients who experience recurrent dislocations and patients with major anatomic variations require surgery to minimize their instability. Sports Injuries in School-age Atheletes: Patellar pain in young athletes groups a number of conditions, including Idiopathic Adolescent Anterior Knee Pain, Osgood- Schlatter Disease, and Sinding-Larsen-Johansson Disease.
Purpose: The lateral epicondylitis is very common around elbow joint. We investigated the effectiveness of arthroscopic treatment. Materials and Methods: From Oct. 2002 to Feb. 2006, a total of 14 patients who were diagnosed with lateral epicondylitis and treated with arthroscopy were used in this study. The average symptom durations before receiving treatment was 27.3 months (9 to 47 months) and the average follow-up periods was 13.6 months (8 to 22 months). Results: The mean preoperative VAS scores was 8.3 (7 to 10 points) and the mean postoperative scores was 1.6 (0 to 4 points). The lesions of extensor carpi radialis brevis were classified using Baker's classification system. Type 1 lesion was found in 7 cases, type 2 in 4 cases, type 3 in 1 case Patients were able to return to their normal life style by 12.3 days (6 to 27 day). Conclusion: The Clinical outcomes of patients who received arthroscopic treatment were found to be good. Patients experienced lesser pain, and shorter recovery time. Therefore, when conservative treatment is ineffective in treating the lateral epicondylitis, arthroscopic treatment is considered af another option available for patients.
In 2026, in ten years from now, Korea is expected to enter into a super aged society. By facing this social phenomenon, analyzing the elderlies and preparing measures are needed among society. In the transportation field, the traffic accidents which are related to the elderly pedestrians have drastically increased so that R&D projects and policy supplementations are introduced. However very few base studies on which focused on the behavior, capability, impact factors analysis of for elderly pedestrians are conducted. To determine the walking capability, this study divided the walking capability into 3 three categories - general, health and exercise. It carries out the comprehensive survey targeting 52 elderlies with the average age of 72.6 years and this survey is made up of total 12 factors in the 3 three categories. This survey also is conducted with various measuring devices and methods such as interview, National Fitness Award, SPBB, Cybex and the like for. From the 12 detailed factors, the general factors such as age, physical shape and so forth have little impact on the walking speed. However the factors that have the greatest impact on the walking speed are extensor muscle on lower limbs in the health factors and balance, coordination, and SPPB in the exercise factors. With these results, this study develops the independent walking model which can measure the walking capability of the elderly people. The developed model is expected to be utilized as the base study for elderly's walking patterns in the transportation field by examining the walking capability of the older people.
Objective : This study aimed to investigate the effect of simultaneous application of peripheral nerve sensory stimulation and task-oriented training on the improvement of upper extremity motor function after stroke. Methods : This study included 29 patients with hemiplegia. The 14 subjects were in the peripheral nerve sensory stimulation and task-oriented training group for 4 weeks (30 min/d, 5 d/wk), while the 15 control group subjects underwent only task-oriented training for the same duration. The outcome measures were the percentage of voluntary baseline muscle contractions of the wrist and shoulder and Box and Block Test, grip and pinch strength, and Action Research Arm Test. Results : After 4 weeks, muscle activity of extensor carpi radialis, flexor carpi radialis and grip strength and Action Research Arm Test were significantly higher in the experimental group. Conclusion : Simultaneous application of the peripheral nerve sensory stimulation and task-oriented training was found to be superior to task-oriented training for improving upper extremity motor function of adults with stroke.
We report a case of simultaneous anterior and posterior interosseous nerve syndrome in association with shoulder arthroscopy. Shoulder arthroscopy was performed in a 45-year-old male patient with left shoulder instability. In the right lateral decubitus position, under general anesthesia, traction was applied with elbow extension for 2 hours. One week after surgery, the patient revisited the clinic for weakness of the flexor of the thumb, index finger, and extensor of the fingers. Recovery was not achieved after four months of observation. Therefore, nerve exploration was performed in the anterior and posterior interosseous nerve and hourglass-like fascicular constriction was detected in the posterior interosseous nerve. The area of constriction was removed and epineural neurorrhaphy was performed. Three months after exploration, the extension function of the fingers was recovered. Recovery was achieved gradually, and, five months after nerve exploration, the symptoms were completely recovered. Simultaneous anterior and posterior interosseous nerve syndrome following shoulder arthroscopy is rare. However, it could occur due to the traction and position of the patient. Thus, the operator should be careful of traction and position of the patient.
During the electromyographic evaluation for the diagnosis of neuropathy, presence for site of lesion could be predicted by a detection of denervation potentials such as fibrillation potentials or positive sharp waves in a group of muscles. Unfortunately, since denervation potentials are distinguished by examiner's experience, it is possible to make mistake identifying endplate spikes as a denervation potential. The aim of the study was to extract parameters to make an algorithm for quantitative distinction between denervation potentials and endplate spikes. It will help to minimize the examiner's bias and to localize the site of lesion thus increase the reliability on EMG diagnosis. There types of signals, endplate spike, fibrillation potential and positive sharp wave were obtained from the EDB(extensor digitorum brevis) muscle using then neuropathic patients. Eight parameters such as duration, area, slope, peak-to-peak amplitude, positive peak negative peak amplitude, ratio of positive to negative peak amplitude, and number of phase were extracted and compared. As a results, peak-to-peak amplitude, positive peak amplitude, ratio of positive to negative peak amplitude showed statistically significant differences between endplate spikes and denervation potentials. It was concluded that those parameters could be used to establish an algorithm which will improve the accuracies in automated quantitative EMG diagnosis.
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