• 대한관절경학회지
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• 제9권2호
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• pp.143-147
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• 2005

목적: 슬개 건을 이용한 전방 십자 인대 재건술 시, 이식 건을 경골 쪽에서 고정할 때 일반적으로 슬관절의 굴곡 각도는 신전 위치에서 시행한다. 저자들은 슬괵 건을 이용한 전방 십자 인대 재건술 시, 이식 건을 고정 할 때 슬관절의 굴곡 각도가 수술 후 슬관절 안정성과 운동 범위에 미치는 영향을 알아보고자 하였다. 대상 및 방법: 2002년 5월부터 2003년 1월까지 슬괵 건을 이용한 전방 십자 인대 재건술 시, Rigidfix system(Mitek Product, Johnson and Johnson, USA)와 intrafix를 이용하여 고정하였다. 전방 십자 인대 재건술을 시행 받은 39명 중 추시 관찰이 되지 않은 2명을 제외한 37명의 환자를 대상으로 하였다. 평균 추시 기간은 14개월(범위: $13{\sim}25$개월) 이었다. 완전 신전 위 또는 20도 굴곡 위의 슬관절 굴곡 각도의 결정은 수술 순서에 따라서 교대로 선택하였다. 내측 반월상 연골의 절제 2예, 내측 반월상 연골의 봉합 2예 외측 반월상 연골의 봉합 1예에서 시행하였다. 임상적 평가는 이학적 검사인 Lachman검사, Pivot shift검사와 재건술 후의 Lysholm점수, IKDC( international knee documentation committee)평가 기준, KT-1000관절 계측 결과를 이용하였다. 결과: 최종 추시 상 수술 후 Lysholm 점수는 93.1점(범위: $65{\sim}98$점), IKDC 평가 기준에 의한 최종 평가 상 정상(A) 26예, 거의 정상(B) 10예, 비정상(C) 1 예이었으며, 심한 비정상은 (D)은 없었다. 최종 추시 상 KT-1000 관절계를 이용한 최대 도수 부하 검사 상 건 측 과의 차이는 평균 2.5 mm 이였다. 술 후 시행한 Lachman 검사상 정상 32예, 1 등급 4예, 2 등급 II 1예 이었고, Pivot shift 검사 상 정상 34예, 1 등급 2예, 2 등급 1예 이었다. KT-1000 관절계를 이용한 최대 도수 부하 검사 상 건 측 과의 차이는 20도 고정을 한 경우는 평균 2.3 mm, 완전 신전 위에서 고정한 경우는 평균 2.7 mm이였다(P<0.05). 수술 후 1년 슬관절의 운동 범위는 20도 굴곡 위에서 고정한 경우에 1례 에서 5도의 굴곡 구축이 있었고, 신전 위에서 고정한 경우는 2례 에서 건측 보다 10도의 굴곡 제한이 있었다. 결론: 자가 슬괵 건을 이용한 전방 십자 재건술 시, 경골 부의 고정 시 슬관절의 굴곡 각도 따른 슬관절의 전방 안정성에 차이는 없었으나, 신전 위에서 고정하는 것이 과도한 이식 건의 장력으로 인한 슬관절 굴곡 구축을 예방하는데 도움이 될 것으로 사료된다.

• The Journal of Korean Physical Therapy
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• 제32권6호
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• pp.325-328
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• 2020

Purpose: This study examined the effects of the directions of neck rotation position on the muscle activity and strength of the elbow flexor and extensor muscle. Methods: Forty-one healthy adults participated in this study. The subjects were asked to their elbow 90° flexion in three different neck rotations (neutral, ipsilateral, and contralateral) in the sitting position. The muscle activities of the biceps and triceps brachii muscle were measured using surface electromyography. And the muscle strength of the elbow flexor was measured using dynamometer. One way repeated measures ANOVA was used to compare the muscle activity and strength of the elbow flexor and extensor depending on the different neck turning directions. Results: There were significant differences between contralateral neck rotation and ipsilateral neck rotation, contralateral neck rotation and neutral position. But, there was no significant difference in the triceps brachii muscle activity in comparison with the neck rotation. There were significant differences between contralateral neck rotation and ipsilateral neck rotation, contralateral neck rotation and neutral position. Conclusion: To summarize this study, the elbow flexor and extensor muscle activity and strength was highest in the contralateral neck rotation position. In other words, it was possible to confirm the effect of Asymmetrical Tonic Neck Reflex in healthy adults whose primitive reflexes were inhibition, and head and neck positions should be considered during clinical evaluation and treatment.

• 한국전문물리치료학회지
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• 제13권2호
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• pp.16-25
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• 2006

The aim of this study was to investigate the kinematics of young adults during descent ramp climbing at different inclinations. Twenty-three subjects descended four steps at four different inclinations (level, $-8^{\circ}$, $-16^{\circ}$, $-24^{\circ}$). The 3-D kinematics were measured by a camera-based Falcon System. The data were analyzed using one-way ANOVA and the Student-Newman-Keuls test. The kinematics of descent ramp walking could be clearly distinguished from the kinematics of level walking. On a sagittal plane, the ankle joint was more plantar flexed at initial contact with $-16^{\circ}/-24^{\circ}$ inclination, was decreased in the toe off position with all inclinations (p<.001),and was decreased at maximum plantar flexion during the swing phase (p<.001). The knee joint was more flexed at initial contact with the $-24^{\circ}$ inclination (p<.001), was more flexed in the toe off position with all inclinations (p<.001), and was more flexed at minimum flexion during stance phase and at maximum flexion during swing phase with $-16^{\circ}$, $-24^{\circ}$ inclination (p<.001). The hip joint was more flexed in the toe off position with $-16^{\circ}$, $-24^{\circ}$ inclination and was deceased at maximum extension during stance phase with $-16^{\circ}$, $-24^{\circ}$ inclination (p<.05). In the frontal plane, the ankle joint was more everted at maximum eversion during stance phase with $-16^{\circ}/-24^{\circ}$ inclination (p<.01) and was decreased at maximum inversion during swing phase with $-16^{\circ}$, $-24^{\circ}$ inclination (p<.01). The knee joint was more increased at maximum varus during stance phase with $-16^{\circ}/-24^{\circ}$ inclination (p<.001). The hip joint was deceased at maximum adduction during stance phase with $-24^{\circ}$ inclination (p<.05). In a horizontal plane, only the knee joint was increased at maximum internal rotation during stance phase with $-24^{\circ}$ inclination (p<.05). In descent ramp walking, the different gait patterns occurred at an inclination of over $16^{\circ}$ on the descending ramp in the sagittal and frontal planes. These results suggest that there is a certain inclination angle or angular range where subjects do switch between level walking and descent ramp walking gait patterns.

• Journal of Trauma and Injury
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• 제19권2호
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• pp.126-134
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• 2006

Purpose: The aim of this study was to determine the kinematical characteristics of the pendular and the translational movements of each cervical vertebra at flexion and extension for understanding the mechanism of injury to the cervical spine. Methods: Twenty volunteers, young men (24~37 years), with clinically and radiographically normal cervical spines were studied. We induced two directional passive movements and then took X-ray pictures. The range of pendular movement could be measured by measuring the variation of the distance between the center point of two contiguous cervical vertebrae, and the range of translational movement could be measured by measuring the variation of the shortest distance between the center point of a vertebra and an imaginary line connecting the center points of two lower contiguous cervical vertebrae. The measurements were done by using a picture archiving and communicating system (PACS). Results: The total length of all cervical vertebrae in the neutral position was, on average, 133.66 mm, but in both flexion and extension, the lengths were widened to 134.83 mm and 134.79 mm, respectively. The directions of both the pendular and the translational movements changed at the $2^{nd}$ cervical vertebra, and the ranges of both movements were significantly larger from the $5^{th}$ cervical vertebra to the $7^{th}$ cervical vertebra for flexion and combined flexion and extension motion (p<0.05). Conclusion: The kinematical characteristics for flexion and extension motions were variable at each level of cervical vertebrae. The $1^{st}$ and the $2^{nd}$ cervical vertebrae and from the $5^{th}$ to the $7^{th}$ cervical vertebrae were the main areas of cervical spinal injury. This shows, according to "Hook's law," that the tissues supporting this area could be weak, and that this area is sensitive to injury.

• 한국전문물리치료학회지
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• 제24권2호
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• pp.1-8
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• 2017

Background: Individuals with spinal cord injury (SCI) rely on their upper limbs for body-lifting activity (BLA). While studies have examined the electromyography (EMG) and kinematics of the shoulder joints during BLA, no studies have considered foot position during BLA. Objects: This study compared the effects of different foot positions during BLA on the shoulder muscle activities, peak plantar pressure, knee flexion angle, and rating perceived exertion in individuals with SCI. Methods: The study enrolled 13 mens with motor-complete paraplegic SCI, ASIA (American Spinal Injury Association) A or B. All subjects performed BLA with the feet positioned on the wheelchair footrest and on the floor independently. Surface EMG was used to collect data from the latissimus dorsi, pectoralis major, serratus anterior, and triceps brachii. The peak plantar pressure was measured using pedar-X and the knee flexion angle with Image J. Borg's rating perceived exertion scale was used to measure the physical activity intensity level. The paired t-test was used to compare the shoulder muscle activities, peak plantar pressure, knee flexion angle, and rating perceived exertion between the two feet positions during BLA. Results: The activity of the latissimus dorsi, pectoralis major, serratus anterior, and triceps brachii and rating perceived exertion decreased significantly and the peak plantar pressure and knee flexion angle increased significantly when performing BLA with the feet positioned on the wheelchair footrest compared with on the floor (p<.05). Conclusion: These findings suggest that individuals with SCI may perform BLA with the feet positioned on the wheelchair footrest for weight-relief lifting to decrease the shoulder muscle activities and the rating perceived exertion and to increase the peak plantar pressure and the knee flexion angle.

• PNF and Movement
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• 제14권1호
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• pp.1-6
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• 2016

Purpose: The purpose of this study was to analyze the effects of proprioceptive neuromuscular facilitation (PNF) patterns on electromyography (EMG) activity in the rectus abdominis, internal abdominal oblique, external abdominal oblique, and erector spinae according to position changes. Methods: Ten healthy adults volunteered to participate in the study. The subjects were required to complete exercises that followed two PNF extremity patterns, namely, an upper extremity extension-adduction-internal rotation pattern and a lower extremity flexion-adduction-external rotation pattern. The exercises were applied in the supine, side-lying, and sitting positions. Repeated measure one-way ANOVA and post-hoc Bonferroni correction were used to determine the influence of the patterns on muscle activity for each muscle, and descriptive statistics were then used to determine the local/global muscle ratios. Results: The upper extremity pattern had a significant effect on the rectus abdominis and erector spinae in the supine position, and on the internal oblique and external oblique in the sitting position (p<0.05). The median value for the internal oblique/rectus abdominis showed a high ratio of 2.05, and a high ratio of 1.01 was shown for the internal oblique/external oblique in the sitting position. The lower extremity pattern had a significant effect on the rectus abdominis in the side-lying position and on the internal oblique, external oblique, and erector spinae in the sitting position (p<0.05). The median value for the internal oblique/rectus abdominis showed a high ratio of 2.83 in the sitting position and a high ratio of 1.30 for the internal oblique/external oblique in the side-lying position. Conclusion: The PNF pattern increases local muscle activation in an unstable position. Therefore, when the pattern is used for intervention purposes, trunk stability and varied position changes should be taken into account.

• 핵의학기술
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• 제12권1호
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• pp.33-38
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• 2008

Purpose: The Gated cardiac blood pool scan is non-invasive method that a quantitative evaluation of left ventricular function. Also this scan have shown the value of radionuclide ejection fraction measurements during the course of chemotherapy as a predictor of cardiac toxicity. Therefore a reliable method of monitoring its cardiotoxic effects is necessary. the purpose of this study is to minimize the overestimate of left ventricular ejection fraction (LVEF) by modified body position to reduce the influence of scattered rays from surrounding organs of the heart in the background region of interest. Materials and Methods: Gated cardiac blood pool scan using in vivo $^{99m}Tc$-red blood cell (RBC) was carried out in 20 patients (mean $44.8{\pm}8.6$ yr) with chemotherapy for a breast carcinoma. Data acquisition requires about 600 seconds and 24 frames of one heart cycle by the multigated acquisition mode, Synchronization deteriorates toward the end of the cycle and with the distance from the trigger signal (R-wave) by ECG gating. Gated cardiac blood pool scan was studied with conventional method (supine position and the detector head in $30-45^{\circ}$ left anterior oblique position and caudal $10-20^{\circ}$ tilt) and compared with modified method (left lateral flexion position with 360 mL of drinking water). LVEF analysis was performed by using the automatically computer mode. Results: The ROI counts of modified scan method were lower than LV conventional method ($1429{\pm}251$ versus $1853{\pm}243$, <0.01). And LVEF of modified method was also decrease compared with conventional method ($58.3{\pm}5.6%$ versus $65.3{\pm}6.1%$, <0.01). Imaging analysis indicated that stomach was expanded because of water and spleen position was changed to lateral inferior compared with conventional method. Conclusion: This study shows that the modified method in MUGA reduce the influence of scattered rays from surrounding organs. Because after change the body position to left lateral flexion and drinking water, the location of spleen, left lobe of liver and stomach had changed and they could escaped from background ROI. Therefore, modified method could help to minimize the overestimate LVEF (%).

• 한국전문물리치료학회지
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• 제20권2호
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• pp.20-27
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• 2013

The purpose of this study was to compare the slouched and upright sitting positions on lumbar joint reposition error (LJRE). Twenty subjects without low back pain were recruited for this study and, using a random number table, were randomly assigned to two groups; the upright sitting position group (UP group) and the slouched sitting position group (SP group). UP group was first asked to sit in an upright position and the SP group to sit in a slouched position as an intervention, and then the LJRE of both groups was measured at the neutral sitting position (lumbar flexion $0^{\circ}$). The measurement of the LJRE was repeated after one day. The sitting positions were performed for five minutes each and the LJRE was measured using an electronic goniometer. An independent t-test was used to compare the LJRE of both groups after each sitting position and after one day. The results of this study showed that the LJRE after an intervention in the UP group was lower than in the SP group (p<.05) and the LJRE after one day in the UP group was lower than in the SP group (p<.05). The findings of this study indicate that the upright sitting position can be applied to decrease LJRE, compared with the slouched sitting position. These findings also support that the upright sitting position reduces the potential for proprioceptive loss.

• 대한물리의학회지
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• 제9권3호
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• pp.249-253
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• 2014

PURPOSE: This study intends to examine the effects of change of anatomical position of the ankle joint in open kinematic chain, an appropriate position for selective muscle training, on vastus lateralis obliques, rectus femoris, vastus medilais obliques, and rectus abdominalis muscle activation and to present an effective method of muscle training for patients and normal people. METHODS: The participants of this study were Korean healthy adult in their 20s. The 8 channel surface electromyography was used to measure muscle activation while the subjects raised their legs under each condition. Under each condition, while the subjects raised the leg to hip joint flexion at $60^{\circ}$ along the arch. RESULTS: The analysis result of muscle activation by each section and position during leg rising. There were significant differences. CONCLUSION: For independent strengthening of each muscle, muscle activation was measured according to leg raising angles and the result differed according to each section and position. If this study result is applied to muscle training for patients who need selective muscle training, more effective muscle strengthening will be made possible.

• The Journal of Korean Physical Therapy
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• 제31권5호
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• pp.298-303
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• 2019

Purpose: This study examined the effects of slashpipe exercise on reducing the thickness of the left and right external oblique, internal oblique, transverse abdominis, erector spinae, and multifidus muscles. Methods: A total of 29 healthy adult men and women were included in the study. They performed trunk flexion in the supine position and trunk extension in the prone position with a slashpipe and weight bar. The external oblique, internal oblique, and transverse abdominis muscles were measured in the supine position, while the erector spinae and multifidus muscles were measured in the prone position. The data were analyzed using the SPSS ver 21.0 statistical program. The difference in thickness between the right and left sides of the trunk muscle was analyzed by repeated measures analysis. The statistical significance level was set to p<0.05. Results: The results showed that the slashpipe exercise reduced significantly the difference in thickness of the oblique internus and erector spinae muscles compared to the weight bar exercise. Conclusion: The chaotic fluidity of the fluid filled inside the slashpipe could be used as sensory feedback information on body mal-alignment, which would have positively affected the symmetrical contraction of the trunk muscles as a trigger for self-correction. Therefore, it will have a useful effect not only on the health of the general public, but also on low back patients and athletes with muscle asymmetry.