Background: The foot is a complex body structure that plays an important role in static and dynamic situations. Previous studies have reported that altered foot posture might affect knee joint strength and postural stability, however their relationship still remains unclear. Objects: The purpose of this study was to identify whether pronated foot posture has an influence on knee isokinetic strength and static and dynamic postural stability. Methods: Forty healthy young males aged 18 to 26 years were included. Foot posture was evaluated using the Foot Posture Index-6 (FPI-6), and the subjects were divided into two groups according to their FPI-6 scores: a neutral foot group (n = 20, FPI-6 score 0 to +5) and a pronated foot group (n = 20, FPI-6 score +6 or more). Biodex Systems 3 isokinetic dynamometer was used to evaluate knee isokinetic strength and hamstring to quadriceps ratio at three angular velocities: 60°/sec, 90°/sec, and 180°/sec. The static and dynamic postural stability in a single-leg stance under the eyes-open and eyes-closed conditions were measured with a Biodex Balance System. Results: There were no significant differences between the groups in knee isokinetic strength and static postural stability (p > 0.05), but there was a significant difference in the medial-lateral stability index (MLSI) for dynamic postural stability under the eyes-closed condition (p = 0.022). The FPI-6 scores correlated significantly only with the dynamic overall stability index (OSI) and the MLSI (OSI: R = 0.344, p = 0.030; MLSI: R = 0.409, p = 0.009) under the eyesclosed condition. Conclusion: Participants with pronated foot had poorer medial-lateral dynamic stability under an eyes-closed condition than those without, and FPI-6 scores were moderately positively correlated with dynamic OSI and dynamic MLSI under the eyes-closed condition. These results suggest that pronated foot posture could induce a change in postural stability, but not in knee isokinetic strength.
Several factors need to be considered for a successful anterior cruciate ligament (ACL) reconstruction, such as preoperative planning, operation technique, and postoperative rehabilitation. Graft choice, fixation, preparation method, maturation, incorporation to host bone, and graft tension should also be considered to achieve a good outcome after an ACL reconstruction. Factors to consider when selecting a graft are the graft strength, graft fixation, fixation site healing, and donor site morbidity, as well as the effects of initial strength, size, surface area, and origin of the graft on its potential for weakening during healing. There are two types of graft for an ACL reconstruction, autograft or allograft. Several autografts have been introduced, including the bone-patellar tendon-bone, hamstring tendon, and quadriceps tendon-bone. On the other hand, each has its advantages and disadvantages. The recent increased use of allografts for an ACL reconstruction is the lack of donor site morbidity, decreased surgical time, diminished postoperative pain, and good availability of source. Despite this, there are no reports suggesting that an allograft may have a better long-term outcome than an autograft. Allografts have inherent disadvantages, including a longer and less complete course of incorporation, remodeling, biomechanically inferiority to autograft, the potential risk of an immunogenic reaction and disease transmission. Higher long-term failure rates and poorer graft maturation scores were reported for allografts compared to autografts. An autograft in an ACL reconstruction should remain the gold standard, although the allograft is a reasonable alternative. If adequate length and diameter of autograft can be obtained for an ACL reconstruction, an autograft with adequate graft fixation and postoperative rehabilitation should be chosen instead of an allograft to achieve better results.
Journal of the Korean Applied Science and Technology
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v.38
no.2
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pp.608-617
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2021
The purpose of this study was to investigate the effects of 8 weeks of core training on the abdominal muscle strength, sargent lumps, Y-balance and equilibrium freestyle skiers'. Fourteen freestyle players were randomly assigned to the exercise group(Ex)(n=7) and control groups(Con)(n=7). Ex undertook a 8-week training program that included exercises for the Bench, Sideway bench, and Nordic hamstring whereas Con performed their usual activities. Muscular fitness were significant effect observed, but there was no difference between groups. The Y-balance test was effective in the front left, and the left and right left posteromedial showed significantly differences between the groups. In the total score, the Ex decreased to 7.5cm in the left and right difference and 1.66cm in the post, but the control group increased from 3.73cm in the pre-test to 7.01cm in the post-test. In the Equilibrium test, there was significant result in condition(C) in C2, C5, and C6. In conclusion, the 8-week core training was found to have a beneficial effect on the postural control in freestyle skiers'.
Journal of Korea Entertainment Industry Association
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v.14
no.1
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pp.17-25
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2020
The purpose of this study was to examine the effects of coordinative locomotor training (CLT) program on the balance for the promotion of life care of elderly obese women. Ten participants of elderly obese women who were able to walk independently without surgery experience of lumbar, hip or knee joint within the past year were recruited and under went the pretest, CLT (20 sessions), followed by the post-test. The test included BMI test using In-body, joint kinematics using myoVIDEO, muscle activation using surface EMG test (erector spinae (ER), external oblique abdominalis (EO), quadriceps femoris (Quad), hamstring muscle (Ham)) and balance tests including dynamic balance test using forced treadmill, Berg balance scale (BBS) and timed up go (TUG). The CLT program was conducted 60 minutes a day, 5 days a week, over 4 weeks period. As a result of this study, The the trunk and hip joints kinematics during the stance and swing phases of gait were a statistical significance levels were set at p <0.05. The ER and EO muscle activation were significantly improved after intervention (p <0.05). The length of gait line and single support line of change of center of pressure (COP) were significantly increased after intervention (p <0.05). The BBS and TUG were also significantly enhanced after intervention (p <0.05). The results of this study showed that CLT program for the improvement of life care had significant effects on improving postural instability, muscle weakness, reduced balance ability and falling risk of obese elderly women. Therefore, it is recommended to apply CLT program to improve life-care through improving balance ability and preventing fall of obese elderly women.
Journal of Korea Entertainment Industry Association
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v.15
no.8
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pp.363-377
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2021
The present study investigated the effects of dynamic tubing gait training(I and II) on the postural alignment, gait, and quality of life in chronic patients with Parkinson's disease. This study is based on the case study that recruited a total of 3 patients with chronic Parkinson's disease (Hoehn and Yahr Stage of 1 to 3 each one person). Dynamic tubing gait training (I and II) applied to chronic patients with Parkinson's disease for 25 sessions, 30 minutes a day, 5 days a week, over 5 weeks period. To investigate the effects of this study, evaluating using the postural alignment test, muscle activity tests, gait analysis, and quality of life scale for patient with Parkinson's disease. After the intervention of Dynamic tubing gait training (I and II), Trunk flexion was decreased. Also, during walking from initial contact (IC) to mid stance (Mst), muscle activity of Quadriceps, Hamstring, and Tibialis Anterior (TA) was increased and muscle activity of Gastrocnemius was decreased. The muscle activation of Erector Spinae (ES T12, L3) was increased in the H&Y I and III stages and decreased in the H&Y II stage. Length of gait line, single support line, ant/post position and lateral symmetry of center of pressure (COP) parameters improved. The spatio-temporal gait parameters including of step length, stride length, and velocity was increased, and cadence decreased. Further the quality of life of patients with Parkinson's disease was improved. Based on these findings, Dynamic tubing gait training (I and II) could be applied as a new approach to improve posture, gait, quality of life in chronic patients with Parkinson's disease for more than 5 years, whose drug resistance is halved.
Song Eun Kyoo;Shim Sang Don;Kim Hyung Jong;Kim Hyung Won
Journal of the Korean Arthroscopy Society
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v.6
no.2
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pp.101-108
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2002
Purpose: To evaluate the clinical results of anterior cruciate ligament (ACL) reconstruction and to know the results of physeal injury by transphyseal tunnel in adolescents who had remaining growth potential. Materials and Methods : This study involved 12 patients under 19 years old out of 445 patients, who underwent ACL reconstruction between 1993 and 2001. The mean age at the time of operation was 15.9 $(13.1\~16.9)$ years and fellow-up period was 45.1 $(24\~120.6)$ months in avrarge. Autologous quadrupled hamstring tendon was used as graft in 11 cases and bone-patellar tendon-bone in 1 case. Clinical results were evaluated by Lysholm Knee Scoring Scale, range of motion and return to preinjury sports activities. Radiologic results were evaluated by $Telos^{\circledR}$ device. Bone maturity were analyzed by chronological age, standing height and the width of growth plate in AP and lateral view of knee joint at preoperatively. The growth disturbances were evaluated by measuring femorotibial angle, anatomical and mechanical lateral distal femoral angle, mechanical medial proximal tibial angle and leg length and by comparing those of uninjured site in last follow-up teleoroentgenogram. Results : The mean Lysholm Knee score was 51 $(25\~63)$points preoperatively and 98 $(94\~100)$ points at last follow up. The mean anterior displacement of the tibia by using $Telos^{\circledR}$ device was improved from 13.5 $(6\~27)$ mm to 2.9 $(1\~4)$ mm and there were no significant instabilities of the knee in all cases. There were no leg length discrepancies over 1 cm and no statistically significant abnormal alignment of the knee joint in all cases. Conclusion: ACL reconstruction using transphyseal tunnel for restoring stability and knee function is assumed as a good mettled of treatment without significant leg length discrepancy and abnormal alignment of the knee joint.
Purpose: To evaluate the long term outcomes of the ACL reconstruction from the standpoint of osteoarthritis. Materials and Methods: We evaluated 31 patients who underwent ACL reconstruction from April 1986 to April 1999 and could be followed-up more than 7 years. Mean follow-up period was 10.1 years (7~22 years). In terms of the graft, 11 cases were treated with the ACL reconstruction using a autologous hamstring tendon graft, 20 cases were treated with using a autologous bone patellar tendon bone graft. For femoral tunnel, 11 cases were placed through transtibial tunnel, 20 cases were placed through anteromedial portal using mini-open arthrotomy. Functional and radiographic evaluation was performed. Results: Mean Lysholm score was $89.2{\pm}11.7$ points. Patients had KT-2000 side-to-side differences were $2.1{\pm}1.9\;mm$. IKDC ligament evaluation showed 38.7% type A, 48.3% type B, 6.5% type C and 6.5% type D. Femoral tunnel were placed at 11 or 1 o'clock position in transtibial technique and placed 10 to 10:30 or 2 to 2:30 o'clock position in technique using anteromedial portal. Radiographic analysis for degenerative arthritis revealed that in group using anteromedial tunnel, 50.0% were excellent, 25.0% were good. In group using transtibial tunnel 18.2% were excellent, 18.2% were good. Conclusion: More than 87.1% of cases, long term result of the ACL reconstruction showed good and excellent result in IKDC score. Especially, the group using tunnel through anteromedial portal showed good results for degenerative arthritis.
Ahn, Gil Yeong;Nam, Il Hyun;Moon, Gi Hyuk;Lee, Yeong Hyun;Choi, Seong Pil;Yoo, Jong Yeon
Journal of the Korean Arthroscopy Society
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v.17
no.1
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pp.11-17
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2013
Purpose: The purpose of this study is to evaluate the effect of preservation of the tibial remnant on the synovialization of graft tendon after the reconstruction of anterior cruciate ligament (ACL) based on the second look arthroscopic findings. Materials and Methods: From May 2005 to May 2012, among sixty three patients having ACL reconstruction with the four-strand hamstring using a bioabsorbable cross pin (RigidFix$^{(R)}$) for the femoral tunnel, nineteen patients who had second look arthroscopy were analyzed. We classified them into three groups according to the tibial remnant of the torn ACL for arthroscopic findings. Group 1 had less than 5 mm of a remnant tissue, Group 2 had from 6 mm to 10 mm of it, and Group 3 had more than 11 mm. We estimated the percentage of synovial coverage on the graft tendon during second look arthroscopy. We evaluated Lysholm score and Tegner activity score preoperatively and in the last follow-up. Results: At the time of ACL reconstruction, the mean length of preserved tibial remnant of torn ACL was 2.3 mm in Group 1, 7.4 mm in Group 2, and 13.7 mm in Group 3. In the second look arthroscopy, the average percentage of synovial coverage was 55.4% in Group 1, and 77.9% in Group 2, and 89.7% in Group 3. Lysholm score and Tegner activity score improved from 74.2 and 7.3 preoperatively to 94.1 and 8.5 in the last follow-up. Conclusion: The preservation of tibial remnant of torn ACL influenced the synovial coverage of the graft tendon and the volume of preserved remnant in accordance with the surface of synovial coverage. It would have a good effect on graft healing and preservation of proprioceptive function.
The purpose of this study was to investigate the effect of different arthroplasty designs on knee kinematic and lower limb muscular activation for up-stair and down-stair movement. 3-D video analysis of whole body and joint kinematics and EMG analysis of quadriceps and hamstrings were conducted. One-way ANOVAs were used for statistical analyses (p=0.05). The single-radius group exhibited more arthroplasty limb quadriceps EMG and hamstring coactivation EMG than the multi-radius group. Single-radius demonstrated more abduction angular displacement and reached peak abduction earlier than the multi-radius arthroplasty limb. The single- radius the percent body fat showed similar values in the Elderly, Single and Multi-radius group among the periods, however Control group was Lowered among the periods. Single-radius group limb also increased the quadriceps muscle activation level to produce more knee extension moment to compensate for the short quadriceps moment arm. Resting metabolic rate was significantly increased in control group in the period of LI. Energy expenditure was extremely increased in all groups except control group among the periods. We can say this is the exercise effects.
Park, Jin;Kim, Young Sin;Lee, Ju Hong;Wang, Seong Il;Park, Chan Ill
Journal of the Korean Arthroscopy Society
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v.16
no.1
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pp.26-33
/
2012
Purpose: The purpose of this study was to evaluate the clinical outcomes and stability of anatomical single bundle anterior cruciate ligament reconstruction (SBACLR) with quadriceps tendon comparable to double bundle anterior cruciate ligament reconstruction (DBACLR). Materials and Methods: We retrospectively reviewed 28 consecutive patients (16 male, 12 female) who underwent SBACLR using quadriceps tendon from March 2009 (Group 1) and compared its clinical results to whom DBACLR with semitendinosus tendon for 53 patients (51 male, 2 female) from August. 2006 (Group 2). Mean age were 34.9 (range, 16-52) in Group 1 and 21.6 (range, 17-55) in Group 2. Mean follow up periods were 13.9 months (range, 12-20) in Group 1 and 36.2 months (range, 20-52) in Group 2. Lysholm score, International Knee Documentation Committee (IKDC) evaluation form and Tegner score were performed for evaluating the clinical outcome. Lachman test, pivot shift test and KT-1000 arthrometer (MEDmetric Corp., San Diego, CA, USA) were performed for stability. Results: There was no statistical significant difference between the two groups in terms of Lysholm score (Group 1: $85.9{\pm}2.6$, Group 2: $90.9{\pm}1.0$, P=0.226), IKDC score (P=0.345) and Tegner score (Group 1: $6.9{\pm}1.4$, Group 2: $7.1{\pm}1.3$, P=0.523). Nor was there statistical significance between the two groups in terms of KT-1000 arthrometer (Group 1: $1.5{\pm}1.1\;mm$, Group 2: $1.5{\pm}1.6\;mm$, P=0.457), Lachman test (P=0.547) and pivot shift test (P=0.073). Conclusion: Anatomical SBACLR with quadriceps tendon shows similar clinical outcomes and stability comparable to anatomical DBACLR with hamstring tendon.
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