• 한국방사선학회논문지
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• 제9권6호
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• pp.331-335
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• 2015

Glenohumeral joint's를 나타내는 단순방사선 촬영법으로 전후사방향 자세에서 촬영하는 Grashey법이 있다. 이 촬영법 자세는 선 자세에서 검사 측을 들어 올리고 촬영한다. 하지만 촬영 시 환자를 몸통을 들어 올리고 회전하는 정도에 따라 관찰범위가 변화한다. Glenohumeral joint's를 가장 잘 나타내기 위한 몸통 회전 각도를 알아보기 위하여 총 20명(남:13명, 여:7명)을 대상으로 촬영을 실시하였으며, 정확한 영상의 판단을 위하여 정형외과 전문의 2명, 방사선사 2명(경력 15년 이상자)이 관찰 평가하였다. 평가의 척도는 Glenohumeral joint's 분리 정도의 점수를 0점은 '분리 안 됨', 1점은 '불량', 2점은 '보통', 3점은 '양호'로 점수를 부여하였다. 몸통 회전 각도를 $30^{\circ}$ 인 영상은 Humerus head와 Glenoid fossa가 겹쳐서 나타났고, $35^{\circ}$ 인 영상에서는 Humerus head와 Glenoid fossa가 약간 겹쳐서 나타났고, $40^{\circ}$ 인 영상에서는 Humerus head와 Glenoid fossa의 관절강이 가장 겹침이 적게 나타났고, $45^{\circ}$ 인 영상에서도 겹침 정도가 많았다. 각 영상의 평가 점수는 $30^{\circ}$는 $0.40{\pm}0.499$, $35^{\circ}$는 $1.34{\pm}0.657$, $40^{\circ}$는 $1.84{\pm}0.573$, $45^{\circ}$는 $0.76{\pm}0.649$로 나타났고 통계적으로 유의한 차이를 나타냈다.(p < .05). 선 자세에서 Glenohumeral joint's를 나타내기 위한 자세에서 환자 몸통을 $40^{\circ}$ 검사 반대 측을 들어 올리고 촬영하였을 경우 우리는 가장 양호한 접시오목(Glenoid fossa)를 나타낼 수 있었다.

• 근관절건강학회지
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• 제1권1호
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• pp.1-30
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• 1994

Rheumatoid arthritis is a chronic systematic disease with unpredictable course of exacerbation and remission, characterized by pain, joint deformity and reduced activity by joint limitation. The growing public awareness of the need for health management of chronic illnesses, provides impetus for nursing to demonstrate social effectiveness by active nursing intervention in this vast area in general, and with rheumatoid condition in particular. However, nursing interventions to date have not demonstrated its active participation in the management of chronic conditions. Nursing intervention for the patients having rheumatoid arthritis is one such area that needs to be studied intensively and to demonstrate their effectiveness empirically. The purposes of this study were two fold : first, to develop a comprehensive program that was intensified with therapeutic joint exercises in water, self-help group activities and utilization of self-efficacy promoting strategies : and secondly, to determine the effect of aquatic exercise program on pain, physiological changes and quality of life in the rheumatoid arthritis patients. Thirty five female subjects participating in this study were selected from outpatients in the Rheumatism Center, Hanyang University hospital. The period of data collection was from December, 1992 to March, 1993 in seoul and Taejeon. Subjects in Taejeon were assigned to the experimental group. The comprehensive aquatic exercise program for the experimental group was carried out three times a week for 6 weeks in regular swimming pool. Subjects in Seoul did not participated in the program, and treated as the control group. Data were analyzed with repeated measure MANCOVA, t-test, ANCOVA, percentage of change, Kruskal-Wallis 1-Way ANOVA using SPSS $PC^+$ program. Results were obtained as follows : 1) Scores on Korean pain scale, Numeric pain score, and RAI score of the experimental group were significantly lower than those of the control group (t=2.11, p=0.022 ; F=4.40, p=0.044 : t=3.10, p=0.002). 2) There was significant improvement in the physiological parameters (higher joint movement parameters, F=15.64, p=0.024 ; higher lean body mass, percentage of change=+12.2, lower body weight, t=1.01, p=0.026 : lower ESR, t=1.69, p=0.001) in the experimental group compaired with subjects In the control group. 3) There was significant improvement in the specific self-efficacy score through the comprehensive aquatic exercise program(t=2.73, p=0.011), but not in the general self- efficacy score(t=0.62, p=0.113). 4) The quality of life failed to show significant improvement in the experimental group as compaired with the control group (F=3.69, p=0.064). 5) In the experimental group, findings from additional analysis showed no significant difference in the specific self-efficacy between those who continued to aquatic exercise after completing 6 week program and those who stopped (X2=0.086, p=0.690). Therefore, adherence to aquatic exercise program for 6 weeks seem to be affected mainly by self-help group activities. An indepth study to delve into articulation of mechanisms affecting the effect of aquatic exercise program be recommended. A further study is necessary to determine the difference in the effect of group and individual aquatic exercise program, to assess factors affecting adherence to exercise for an extended length of time.

• 대한정형외과스포츠의학회지
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• 제10권2호
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• pp.47-53
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• 2011

목적: 전방십자인대 재건술의 수가 증가하면서, 재건술의 실패로 인한 재재건술의 빈도 또한 증가하고 있다. 따라서 저자는 전방십자인대 재건술 후 발생한 이식건 실패의 원인 및 전방십자인대 재재건술 후의 임상적 결과를 분석하였다. 대상 및 방법: 1998년 2월부터 2010년 7월까지 전방십자인대 재건술 실패에 대하여 전방십자인대 재재건술을 시술받은 후 최소 12개월 이상 추시가 가능하였던 36예를 대상으로 하였다. 재건술 후 재재건술까지의 평균기간은 60(5~334)개월이었으며, 처음 전방십자인대 재건술을 시술 시 23예(63.9%)에서 동종 이식건을, 13예(36.1%)에서 자가 이식건을 사용하였다. 전방십자인대 재건술 실패의 주증상으로 불안정성이 가장 많았으며, 전방십자인대 재건술을 한번 시행 받았던 경우가 35예(97.5%), 두 번 시행 받았던 경우가 1예(2.5%)였다. 임상적 결과는 Lysholm 슬관절 점수, Tegner activity 점수를 이용하여 평가하였으며, 안정성은 Lachman 및 pivot shift 검사와 Telos device를 이용하여 평가하였다. 결과: 환자의 평균 추시 기간은 21(12~40)개월이었으며, 전방십자인대 재건술의 실패원인으로는 외상이 19예(52.8%)로 가장 많았고, 대퇴 터널의 부정위치가 13예(36.1%), 경골부 터널의 부정위치가 1예(2.8%), 골융합의 실패 3예(8.4%)로 나타났다. 전방십자인대 재재건술을 시행할 시 34예(94%)에서 동종이식건을, 2예(6%)에서 자가 이식건을 사용하였으며, 21예에서 반월상 연골판 손상이 동반되었다(내측 반월상 연골판 손상 14예, 외측 반월상 연골판 손상 7예). Lysholm 슬관절 점수는 술전 66.5점에서 술후 최종 추시시 92점으로 호전되었다(p<0.01). 환자의 대부분은 수술 결과에 만족(92%)하고 있었다. Tegner activity 점수는 술전 2.0점에서 술후 6.2점으로 호전되었다(p<0.01). Lachman 및 pivot shift 검사에서 33예, 30예가 Gr I 이하로 호전되었으며, Telos device를 이용한 안정성 검사에서는 양측 차이 정도는 술전 평균 15.5 mm에서 술후 최종 추시시 4.5 mm로 의미있게 호전되었다(p<0.01). 환자의 대부분은 수술 결과에 만족(92%)하고 있었다. 결론: 전방십자인대 재 재건술은 1년 이상 추시 결과 약간의 전방 불안정성이 존재하였으나, 임상적 결과 및 환자의 주관적 만족도에 있어서는 우수한 결과를 보였다.

• 대한정형외과학회지
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• 제54권1호
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• pp.37-44
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• 2019

목적: 슬관절 주위 악성 골연부 종양 치료 시 종양의 도약전이나 슬관절 내 침범, 종양인공관절 치환술 후 반복적 감염 치료를 위한 인접골 절제, 국소재발 및 기계적 파괴가 발생한 경우 슬관절 상하부 전치환술은 하지와 슬관절 기능을 보존하는 한 방법이다. 이 중 반복된 감염 치료를 위해 슬관절면 반대측 골까지 절제 후 한시적 슬관절 고정술을 한 환자에서 가동관절로 재치환술 시 적응증, 합병증, 치환물의 생존율에 대하여 알아보고자 하였다. 대상 및 방법: 본 연구는 슬관절 상하부 전치환술 환자 34예 중 슬관절 주위 종양인공관절 치환술 후 반복적인 감염으로 슬관절면 반대측 골까지 절제한 후 한시적 슬관절 고정술이 불가피했던 13예를 대상으로 하였다. 진단, 원발병소의 위치, 슬관절 상하부 전치 환술을 받기 전까지 수술 횟수 및 기간, 재 재건술 후 치환물의 생존율, 합병증, 기능적 결과를 분석하였다. 결과: 슬관절 상하부 종양인공관절 치환물의 Kaplan-Meier 법에 의한 5, 10년 생존율은 각각 69.0%±12.8%, 46.0%±20.7%였다. 총 13예 중 6예(46.2%)에서 주 합병증이 발생하여 3예는 내고정물을 제거 후 슬관절 고정술을, 2예는 내고정물의 부분교체를, 나머지 1예는 감염된 육아조직만 제거하였다. 최종 추시상 가동관절을 유지한 10예의 Musculoskeletal Tumor Society 기능평가 점수는 평균 24.6점(21-27점)이었다. 슬관절 상하부 종양인공관절 치환술이 실패하여 슬관절 고정술로 재치환 한 3예의 기능평가 평균 점수는 12.3점(12-13점)이었다. 가동관절을 유지한 10예의 슬관절 가동 범위는 평균 67°였다(0°-100°). 슬관절 능동적 신전제한은 평균 48° (20°-80°)였다. 결론: 슬관절 주위 종양인공 치환술 후 반복적인 감염으로 슬관절면 반대측 골까지 절제 후 한시적 슬관절 고정술이 불가피했던 환자에서 슬관절 상하부 종양인공관절 치환술은 합병증의 위험성은 높으나 슬관절 고정술에 비해 기능적 결과가 월등하므로 시도할 가치가 있는 술식이다. 고정된 슬관절을 가동관절로 치환 시 반흔 조직을 철저히 제거하고 연부조직을 확보하여 종양인공관절을 삽입 후 굴곡 및 신전이 가능할 정도의 공간을 확보하는 것이 술식의 성공에 중요하다고 생각된다.

• 한국전문물리치료학회지
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• 제11권1호
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• pp.1-17
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• 2004

The purposes of this study were to find correlations among Fugl-Meyer Assessment scale, gait speed, and Timed Up & Go test (TUG) and to predict gait ability from subscales of Fugl-Meyer Assessment scale. The study population consisted of 30 stroke patients referred to the Department of Rehabilitation Medicine in the Bundang Jaesang General Hospital. All subjects were ambulatory with or without an assistive device. All participants were assessed on Fugl-Meyer Assessment scale and gait speed (m/s), TUG (s). The data were analyzed using independent t-test, Pearson product moment correlation analysis and stepwise multiple regression. The results revealed that all items of Fugl-Meyer Assessment scale, except passive joint range of motion were significantly correlated with gait speed and TUG. In particular, sensation score, lower extremity motor and coordination score have a significant correlation with gait speed and TUG (p<.05). The sensation score and lower extremity motor score were important factors in comfortable gait and maximal gait speed. Their power of explanation regarding comfortable gait and maximal gait speed were 63.0% and 65.0%, respectively. The sensation score and lower extremity coordination score were important factors in TUG. Their power of explanation regarding TUG was 55.0%. These results showed that Fugl-Meyer Assessment scale is significantly correlated with gait speed and TUG. Therefore Fugl-Meyer Assessment scale is an appropriate assessment tool to predict gait ability of patients with stroke. Further study about gait speed and TUG by change of Fugl-Meyer Assessment score is needed using a longitudinal study design.

• 대한간호학회지
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• 제29권2호
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• pp.328-335
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• 1999

This study was designed to investigate the effects of exercise therapy on joint mobility, daily activity. pain and depression of patients with ankylosing spondylitis. 25 persons with the experimental group and 25 persons with the control group were conveniently sampled among out-patients diagnosed with ankylosing spondylitis at the rheumatism center of H University Medical Center. The control patients were matched to the experimental group and they were selected considering sex and age. The exercise therapy was developed by the author with the assistance of exercise specialists. The program includes muscle relaxation, flexibility, muscle strengths, breathing strengths and straight posture exercises. The 20-minute exercise therapy was carried out to the experimental group once a day for eight weeks from October. 1997 to February, 1998. Before and after the experiments, joint mobility, daily activity, pain and depression were measured respectively. Data were analyzed by $\chi$$^2$-test. t-test, paired t-test and unpaired t-test. The results were as follows : Joint mobility(cervical flexion, extension, shoulder flexion, abduction, hip abduction, knee flexion and fingertip to floor distance) and daily activity in the experimental group after the exercise were significantly increased than that in the control group. The pain and depression score in the experimental group after the exercise were significantly decreased than that in the control group. These findings may indicate that the exercise therapy is effective in increasing the joint mobility and daily activity, and also effective in decreasing pain and depression in patients with ankylosing spondylitis, Accordingly, the exercise therapy can be adopted as an effective nursing intervention for ankylosing spondylitis.

• Clinics in Shoulder and Elbow
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• 제21권2호
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• pp.95-100
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• 2018

Background: The purpose of this study was to evaluate the clinical outcomes and complications of hook plate fixation in acromioclavicular (AC) joint dislocations and distal clavicle fractures. Methods: We retrospectively reviewed a series of 60 consecutive patients with hook plate fixation for AC joint dislocation (group I) and distal clavicle fracture (group II). Groups I and II had 39 and 21 patients, respectively. Clinical results were evaluated using the pain visual analogue scale (VAS), simple shoulder test, and Constant-Murley scores. In addition, subacromial erosion and stiffness were evaluated as complications. Results: At the removal, the pain VAS was $2.69{\pm}1.30$ and $4.10{\pm}2.14$ in groups I and II, respectively, which were significantly different (p=0.003). The simple shoulder test score was $9.59{\pm}1.60$ and $7.81{\pm}2.67$ in groups I and II, respectively, which were also significantly different (p=0.002). Subacromial erosion was significantly more frequent in group II (14/21 patients, 66.7%) than in group I (15/39 patients, 38.5%) (p=0.037), and stiffness was also higher in group II (17/21 patients, 81.0%) than in group I (22/39 patients, 56.4%), but it was not significant. Conclusions: Hook plate fixation showed good clinical and functional results for the treatment of acute unstable AC joint dislocation and distal clavicle fracture. But, in distal clavicle fractures, there are more subacromial erosion and stiffness compare with acute unstable AC joint dislocation.

• 한국전문물리치료학회지
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• 제20권3호
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• pp.45-53
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• 2013

The purpose of this study was to examine the differentiation of proprioception, invertor and evertor muscle strength, and time to peak torque at a velocity of $300^{\circ}/sec$ of the ankle joint in people with or without functional ankle instability (FAI). Nineteen subjects with a history of ankle sprain participated. All subjects were divided into FAI group ($n_1=9$, Cumberland ankle instability tool (CAIT)${\leq}24$) and a control group ($n_2=10$) based on their CAIT scores. Isokinetic dynamometer was used to measure the sense of active joint position of the ankle at mid-range and end-range of an inversion motion and invertor as well as the evertor muscle strength and time to peak torque at $300^{\circ}/s$. The FAI group showed a statistically reduction in invertor and evertor muscle strength and time to peak torque when compared to the control group (p<.05). Muscle strength and time to peak torque of the invertor and evertor, as well as the sense of active joint position at end-range were also lower in the FAI group than in the control (p<.05). Correlations between CAIT score and position sense at end-range (r=-.577) and invertor muscle strength (r=.554) were statistically significant (p<.05). Individuals with FAI showed reduction in invertor and evertor muscle strength and recruitment time as well as in proprioception of the ankle joint. Thus, proprioception and invertor and evertor muscle strength of the ankle joint at fast angular velocity may be investigated when examining and planning care for individuals with FAI.

• Clinics in Shoulder and Elbow
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• 제20권2호
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• pp.59-67
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• 2017

Background: The purpose of this study was to examine the clinical and radiological results of the all-arthroscopic, suture-button fixation technique to treat acute acromioclavicular (AC) joint separations. Methods: All patients with acute AC joint separations received all-arthroscopic, single suture-button (TightRope) procedure without a special guide. Postoperative Constant score (CS), pain level according to visual analogue scale, and range of motion (ROM) were evaluated. For radiological evaluation, coracoclavicular distances were measured bilaterally. Results: Between December 2010 and June 2012, 18 consecutive patients (4 women and 14 men; mean age, 29.3 years) with acute AC joint separations underwent surgical treatment after 6.4 days (range, 2-20 days) following the initial trauma. The average postoperative follow-up was 16.9 months. The mean CS was 92.4 (range, 84-96). The mean external rotation, forward flexion, and abduction were $75.8^{\circ}$ (range, $50^{\circ}-90^{\circ}$), $170^{\circ}$ (range, $150^{\circ}-180^{\circ}$), and $163.8^{\circ}$ (range, $140^{\circ}-180^{\circ}$), respectively. Five patients exhibited coracoclavicular ossifications. In two patients, superficial wound infections were successfully treated with antibiotic therapy. In one patient, a coracoid fracture was observed. No significant differences were found regarding pain, ROM, or strength parameters between both sides. The coracoclavicular distance was discovered to be approximately 2.8 mm greater on the affected side; however, this minimal reduction loss did not affect the functional results. Conclusions: The findings of this study suggests that all-arthroscopic treatment of AC joint separations using the single suture-button technique without a drill guide is safe, yielding good to excellent clinical results.

• 한국응용과학기술학회지
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• 제38권4호
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• pp.1107-1116
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• 2021

이 연구의 목적은 8주간의 플라이오메트릭 훈련이 대학 태권도 시범단의 순발력, 동적 평형성 및 관절 위치감각에 미치는 영향을 분석하고자 하였다. 태권도 시범 전공 대학생 20명을 훈련군 10명, 통제군 10명으로 분류한 후 운동군은 주 3회, 60분, 8주간 플라이오메트릭 훈련을 하였다. 측정 변인은 제자리높이뛰기, 제자리멀리뛰기, 배근력, 동적 평형성 및 관절 위치감각으로 사전 사후 측정하였다. 연구 결과, 제자리높이뛰기와 멀리뛰기 및 배근력에서 유의한 운동의 효과가 있었다(p<.05). 동적 평형성은 후방 바깥쪽과(p<.01) 후방 안쪽에서(p<.05) 유의한 운동의 효과가 있었다. 관절 위치감각은 왼발 15°와(p<.01) 45°에서는(p<.05) 운동군에서 유의한 효과가 있었다. 이상의 결과 8주간의 플라이오메트릭 훈련은 태권도 시범선수의 순발력과 동적 평형성 및 관절 위치감각에 긍정적인 영향을 미치는 것으로 나타났다.