• Archives of Plastic Surgery
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• v.35 no.3
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• pp.295-302
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• 2008

Purpose: The lower leg often has poor vascularity, proximity to bone, and insufficient soft tissue. The island flaps offer a feasible one stage reconstruction and has a remarkable vascularization and high quality results for soft tissue defect with or without bony problems to occur on regions below the knee. So we reported our experience of island flaps with review of the literatures. Methods: We reconstructed 29 cases of soft tissue and 2 cases of bony defect on regions below the knee by using various island flaps at our hospital from December, 1991 to January, 2006. We used 2 fibular osteocutaneous island flaps, 15 reverse sural island flaps, 6 extensor digitorum brevis muscular island flaps, 2 medial plantar island flaps, 5 saphenous island flaps, and a dorsalis pedis island flap. Results: Partial necrosis was developed in 4 out of 15 reverse sural island flaps and 1 out of 5 saphenous island flaps, but they were healed with secondary skin graft. There was partial loss of skin graft on the donor sites in 2 cases. Conclusion: Island flaps are very useful for reconstruction of regions below the knee because island flaps have good vascularity and less risk of infection. Generous flap size, easy operative technique, lower cost, shorter operative time, and minimal morbidity at the donor site are other advantages. We attained satisfactory results.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.1
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• pp.125-132
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• 2014

PURPOSE: This study aims to determine the optimal knee joint angle and hip joint angle for minimizing the cervical muscle tension and maximizing the muscle activity of the trunk during the bridging exercise for trunk stabilization. METHODS: The bridging exercise in this study included seven forms of exercise: having a knee joint flexion angle of $120^{\circ}$, $90^{\circ}$, $60^{\circ}$, $45^{\circ}$ and hip joint abduction angle of $15^{\circ}$, $10^{\circ}$, $5^{\circ}$. The posture of the bridging exercise was as follows. To prevent the increase of hyper lumbar lordosis during the bridging exercise, the exercise was practiced after maintaining the lumbar neutral position through the pelvic posterior tilting exercise. RESULTS: The abduction angles did not result in statistically significant effects on the cervical erector, external oblique, rectus abdominis and erector spinae muscles. However, in relation to the knee joint angles, during the bridging exercise, statistically significant results were exhibited. CONCLUSION: The knee joint angle affected the muscle activity of the neck muscle. The greater the knee joint angle, the lower the load placed on the neck muscle. In contrast, the load increased as the knee joint angle decreased. In addition, the muscle activity of the neck muscle and trunk muscle increased as the knee joint angle decreased.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.3
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• pp.55-58
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• 2016

PURPOSE: This study was measured the differences in the flexor and extensor muscle activities of the elbow joints based on the tire pressure of wheelchairs during propulsion, investigating the optimal tire pressure for improving occupants' propulsion and avoiding related injury. METHODS: Ten healthy volunteers (10 men aged $23.1{\pm}1.9years$, weight: $67.9{\pm}3.4kg$, height: $175.1{\pm}2.7cm$) took part in the study. The mean values used in the statistical process were obtained from values measured while a subject sitting on a wheelchair propelled himself forward for 10 meters on a flat floor at maximum speed. The tire pressure of the wheelchairs was set at 100 psi, 50 psi, and 25 psi. All of the subjects performed wheelchair propulsion for each pressure. This study was measured the activation of the biceps brachii and triceps brachii muscles on the dominant side during wheelchair propulsion. The measured data was analyzed using one-way analysis of variance (ANOVA) via the statistical package for the social sciences (SPSS) version 12.0 for Windows to compare the muscle activity. RESULTS: The muscle activities of the biceps brachii and triceps brachii were significant differences between each pressure group. The post hoc test found statistically significant differences between 100 psi and 50 psi and 100 psi and 25 psi for the biceps brachii and triceps brachii muscles, respectively. CONCLUSION: The maintaining proper tire pressure in a wheelchair may help to prevent overuse syndrome in the occupant's elbow joints.

• Pediatric Infection and Vaccine
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• v.23 no.1
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• pp.67-71
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• 2016

Erythema nodosum (EN) is a painful skin disease characterized by erythematous tender nodules located predominantly over the extensor aspects of the legs. Various etiological factors, including infection, drug administration, and systemic illness have been implicated as causes of EN. Mycoplasma pneumoniae is one of rare infectious agents to cause EN in children. We report a case of a 7-year-old boy with context of respiratory illness and skin lesions with arthralgia. From stepwise approaches, IgM antibody against M. pneumoniae was positive with titers of 12.18, consistent with respiratory infection of M. pneumoniae and histopathology showed findings of septal and lobular inflammation without vasculitis consistent with EN. In addition, we reviewed the pathogenesis of this disease based on our case and the previous reports.

• Korean Journal of Applied Biomechanics
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• v.22 no.2
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• pp.201-208
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• 2012

The purpose of this study was to investigate the effect of leg extension exercises performed on outdoor resistance exercise machines on knee extension muscle strength and quadriceps muscle group cross sectional area (CSA) in elderly women. Two groups were recruited for this study, including an exercise group (EG: n=13, $71.38{\pm}2.79$ yrs) and a control group (CG: n=5, $73.4{\pm}5.94$), In all subjects, maximum isometric and isokinetic muscle strength of knee flexion and extension were measured using an isokinetic dynamometer (Cybex(R) Humac Norm Testing & Rehabilitation System, USA). Quadriceps muscle group CSA were measured using MRI (Philps, Intera 1.5 T, NE Netherlands). The results of this study showed that post-intervention isometric knee extension peak torque value were higher than pre-intervention measures in the EG. However, the EG did not show improvement in quadriceps muscle group CSA, Also, no differences in the shift of optimal knee joint angle were observed between pre and post-intervention exercise. Outdoor leg extension exercise showed small increases in muscle strength in comparison to other resistance training exercises. The results of this study suggest that because outdoor leg extension exercise machines lack a progressive loading mechanism, significant increases in muscle strength may not be obtained.

• Korean Journal of Applied Biomechanics
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• v.21 no.3
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• pp.297-308
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• 2011

The purpose of this study was to investigate the relationship among isometric and isokinetic muscle strength, lean body mass(LBM) and bone mineral density(BMD) in the elderly. Eleven males(age, 70.27${\pm}$5.78yr; height, 167.36${\pm}$6.68 cm; weight, 68.34${\pm}$8.23 kg) and thirteen female(age, 69.77${\pm}$4.13yr; height, 152.80${\pm}$4.45 cm; weight, 56.86${\pm}$7.40 kg) participated in this study. In all subjects, LBM and BMD segments was measured by using Dual-energy x-ray absorptiometry(DEXA, Lunar DPS-DM, U.S.A.). Maximum isometric and isokinetic muscle strength of flexion and extension at the knee and elbow, ankle, trunk joints were measured by using an isokinetic dynamometer(CON-TREX(R) Multi Joint Testing Module, Switzerland). The results of this study showed that isometric and isokinetic muscle strength was significantly higher in extension than flexion. In the male and female, hamstring to quadriceps strength ratio(H:Q ratio) was increased as contraction velocity increased. BMD was correlated significantly with trunk extension in the male, but not in the female. LBM was correlated significantly in the male and female with knee extension strength. This study suggests that in the elderly muscle strength training program should put more weight on extensor muscles of the body.

• Archives of Reconstructive Microsurgery
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• v.5 no.1
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• pp.112-120
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• 1996

We peformed tendon transfer with a microvascular free flap for recovery of handicapped function and reconstruction for the skin and soft tissue loss. We review the clinical data of 11 children who underwent these operation due to injured foot by pedestrian accident from January, 1986 to June, 1994. The mean age of patients was 5.6 years old(3-8). Five cases underwent tendon transfer and microvascular free flap simultaneously. Another 6 cases underwent operations separately. The time interval between tendon trasnfer and microvascular free flap was average 5.6 months(2-15 months). The duration between initial trauma and tendon transfer was average 9.6 months(2-21 months). The anterior tibial tendon was used in 6 cases. Among these, the technique of splitting the anterior tibial tendon was used in 5 cases. The posterior tibial tendon was used in 3 cases and the extenosr digitorum longus tendon of the foot in 2 cases. Insertion sites of tendon transfer were the cuboid bone in 3 cases, the 3rd cuneiform bone in 3 cases, the 2nd cuneiform bone in 1 case, the base of 4th metatarsal bone in 1 case, and the remnant of the extensor hallucis longus in 3 cases. The duration of follow-up was average 29.9 months(12-102 months). The clinical results were analysed by Srinivian criteria. Nine cases were excellent and 2 cases were good. The postoperative complications were loosening of the tranferred tendon in 2 cases, plantar flexion contracture in 1 case, mild flat foot deformity in 1 case and hypertrophic scar in 2 cases. So we recommend the tendon transfer with a microvascular free flap in the case of injured foot of children combined with nerve injury and extensive loss of skin, soft tissue and tendon.

• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.1
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• pp.51-55
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• 2009

Volar rotatory dislocation of the proximal interphalangeal joint(PIP) of the finger is rare. We report a female judo player who had volar rotatory dislocation of the PIP joint of the middle finger. She had dislocation of PIP joint total 4 times. At operation, the central tendon was identified as being distension, with the ulnar collateral ligament ruptured. The ruptured ulnar collateral ligament was interposed within the joint. The ruptured ulnar collateral ligament was repaired and extensor expansion was repaired. At last follow-up, she didn't have recurrent dislocation during judo. Accurate diagnosis, early intervention and progressive rehabilitation of this injury are very important as other dislocations.

• The Journal of Korean Physical Therapy
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• v.24 no.6
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• pp.409-413
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• 2012

Purpose: Rehabilitative devices are used to enhance sensorimotor training protocols, for improvement of motor function in the hemiplegic limb of patients who have suffered a stroke. Sensorimotor integration feedback systems, included with these devices, are very good therapeutic frameworks. We applied this approach using electrical stimulation in stroke patients and examined whether a functional electric stimulation-assisted biofeedback therapy system could improve function of the upper extremity in chronic hemiplegia. Methods: A prototype biofeedback system was used by six subjects to perform a set of tasks with their affected upper extremity during a 30-minute session for 20 consecutive working days. When needed for a grasping or releasing movement of objects, the functional electrical stimulation (FES) stimulated the wrist and finger flexor or extensor and assisted the patients in grasping or releasing the objects. Kinematic data provided by the biofeedback system were acquired. In addition, clinical performance scales and activity of daily living skills were evaluated before and after application of a prototype biofeedback system. Results: Our findings revealed statistically significant gradual improvement in patients with stroke, in terms of kinematic and clinical performance during the treatment sessions, in terms of manual function test and the Purdue pegboard. However, no significant difference of the motor activity log was found. Conclusion: Hemiplegic upper extremity function of a small group of patients with chronic hemiparesis was improved through two weeks of training using the FES-assisted biofeedback system. Further research into the use of biofeedback systems for long-term clinical improvement will be needed.

• Journal of Korean Clinical Health Science
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• v.3 no.2
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• pp.311-319
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• 2015

Purpose. This study of purpose was to compare and analyze the relationship among the isokinetic trunk muscular functions, flexibility and low back pain of elite weight lifter with regard of sex. Methods. we measured the level of low back pain, isokinetic muscular functions according to gender, then analyzed the relationship between isokinetic functions and the level of low back pain, between flexibility and the level of pain, between Athletic Career and the level. Results. In this study, the gender, the VAS point was $2.6{\pm}2.3$ and the VRS point was $2.3{\pm}1.3$ in males. The other side, in females the VAS points was $3.6{\pm}1.7$ and the VRS was $3.2{\pm}1.1$. There was significant negative correlation(r=-0.826) between the VAS point and the maximal flexion muscular strength per kilogram of $30^{\circ}/sec$ isokinetic exercise in female. also there was negative correlation between the muscular flexion strength per kilogram and the VRS point in female, but there was no significant relationship in male. Conclusions. In current study, these results suggested that the higher muscular flexion strength per kilogram is, the lower the level of low back pain is in female athletes. this is caused by the imbalance between Abdominal Muscles and Back Extensor in weight lifter. Therefore, there is the need to apply the program to improve the balance of trunk.