• Journal of the Korean Society of Physical Medicine
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• v.9 no.1
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• pp.1-10
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• 2014

PURPOSE: The purpose of this study was to investigate the effects of flexible derotator of femur orthosis (FDO) during treadmill gait training on the quadriceps-angle (Q-angle), lateral pelvic tilt, gait speed, and number of steps in children with cerebral palsy. METHODS: Seven children with cerebral palsy who had rotational deformity of the lower extremities participated in this study. We used single group repeated measure design. The procedure consisted of baseline phase, intervention phase, and post-intervention phase. The baseline phase consisted of stretching and strengthening exercise and treadmill gait training without FDO. The treatment phase not only included the same procedures as those for baseline, but also included FDO during treadmill gait training. Postural alignment of the lower extremities was assessed with the Q-angle, and lateral pelvic tilt using the Dartfish software program. A 10-m walk test was used to evaluate gait speed and number of steps. RESULTS: For postural alignment, there was significant differences after the application of FDO (p<.05). For gait ability, there was significant differences in all phases (p<.01). CONCLUSION: These finding suggest that the application of FDO during treadmill gait training had a positive effect on the improvement of postural alignment and gait ability in children with cerebral palsy having rotational deformity.

• Journal of Biomedical Engineering Research
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• v.28 no.5
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• pp.636-646
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• 2007

Adequate postural control depends on the spatial and temporal integration of vestibular, visual, and somatosensory information. Especially, the musculoskeletal function is essential to maintain the postural control. The experimental studies was performed on the muscular activities in the lower extremities during maintaining and moving exercises on an unstable platform with Magneto Rheological(MR) dampers. The unstable platform of the developed system was controlled by electric currents to the MR dampers. A subject executed the maintaining and moving exercises which are presented through the display monitor. The electromyographies of the eight muscles in lower extremities were recorded and analyzed in the time and the frequency domain: the muscles of interest were rectus femoris(RF), biceps femoris(BF), tensor fasciae latae(TFL), vastus lateralis(VL), vastus medialis(VM), gastrocnemius(Ga), tibialis anterior(TA), Soleus(So). The experimental results showed that the muscular activities differed in the four moving exercises and the nine maintaining exercises. For the anterior-posterior pattern, the TA showed highest activities; for the left-right pattern, the TFL; for the 45, $-45^{\circ}$ pattern, the TFL and TA. Also, the rate of the increase in the muscular activities were affected by the condition of the unstable platform with MR dampers for the maintaining and moving exercises. The experimental results suggest that the choice of different maintaining and moving exercises could selectively train different muscles in various intensity. Futhermore, the findings suggested that the training using this system can improve the ability of postural control.

• Physical Therapy Korea
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• v.14 no.1
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• pp.11-20
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• 2007

The objective of this study was to discern the effects of a balance training program on the performance of lower extremities in order to improve strength (muscle power, flexibility, walking power), balance control and walking ability in the elderly. The subjects selected were aged 65 years and over, with no known relevant medical history that may disturb their balance, and have also been visiting the Gimhae Senior Welfare Center. The variable group consisted of 30 subjects, of whom were people who had been participating in balance training programs (One Leg Standing; OLS, Functional Reach; FR, Timed Get Up and Go; TUG) as an intervention for 8 weeks 3 times per a week. They were examined in order to identify their balance control before and after. The control group consisted of thirty subjects who preferred to exercise without any intervention relating to balance training program. The subjects were measured before and after balance training in order to determine the effectiveness of exercise and the effectiveness of exercise combined with the aid of a Balance Performance Monitor. 1. Mean time on OLS test with left and right sided extremities in the experimental group was 35.44 sec, 42.10 sec longer than control group respectively. In FR tests applied to the left and right side, mean reaching distance was increased up to 5.56 cm, 6.73 cm in experimental group respectively. Mean time on TUG test from a chair in experimental group was decreased to 2.33 sec. 2. Mean value of decline in the level balance control, both left and right side, decreased to 2.24% as examined by the Balance Performance Monitor. Mean scores for sway level after balance training decrease to .98% and for balance control both anterior and posterior directions decreased to mean 1.07% and 1.44%, respectively.

• Journal of muscle and joint health
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• v.2 no.2
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• pp.131-146
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• 1995

Many arthritis patients experience weakness of muscles in extremities mainly due to disuse atrophy and weight gain because of the limited activities and exercises. This study examines the effects of the 6-week aquatic-exercise program on the body fat and the muscle of the rheumatoid arthritis patients. Seventeen patients in the experimental group and 18 in the control group were assigned depending on their preference and physical condition. These patients had more than 3 points of pain out of 10, deformities in knee, wrist and ankle joints. The amount of aquatic exercise increases from 35 minutes in the first week to 60 minutes in the 6th week. In the resting period they discussed their own experiences about exercise, personal and family affairs, and performed some recreation programs in order to increase the self-efficacy and promote the relationship with other patients by the group activities. Skinfold thickness and circumferences of both extremities were measured before and after experiment to compare the difference. For testing the body fat Saham Model was used. Prior to the experiment two group's body weight, skinfold thickness and skin circumferences were not significantly different which indicates the homogeneity of two groups. Body weight and most parts of skinfold thickness of the experimental group were significantly lower than the control group after 6-week aquatic exercise program. Circumference was not significantly lower than the control after the program. These findings indicate the in-crease of muscle sizes and the reduction of the body fat. Therefore a more active application of aquatic exercise into a variety of clients is strongly suggested.

• Journal of Chest Surgery
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• v.28 no.7
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• pp.678-683
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• 1995

Arterial bypass for the chronic ischemia of the lower extremities underlying atherosclerotic obliterans has been performed with a number of alternative conduits from 1941 by Kunlin. It is indicated for the limb salvage of patients with threatened limb loss despite of several controversies in surgical treatment of atherosclerotic obliterans. From March 1991 to January 1995, 26 arterial bypasses were performed in 23 patients with the chronic ischemia of the lower extremities in our hospital. Their mean follow up period is 18.9 months ranging from 4 months to 44 months. Mean age is 60.9 years ranging 47 years to 76 years and the most prevalent incidence is the 6th decade. 21 patients are male and 2 patients are female. 19 of 23 patients are smokers. Clinical classifications by Fontaine are class II[21.7% , class III[34.8% and class IV[43.5% .Diabetes mellitus[47.8% , hypertension[43.5% , hyperlipid-emia[26% , tuberculosis[21.7% , cerebrovascular accident[13.0% and cardiac diseases[8.7% are associated. Aorto-single femoral bypass in 4 cases, aorto-bifemoral bypass in 5 cases, aortofemoral & femoropopliteal bypass in 2 cases, femoropopliteal bypass in 10 cases, popliteotibial bypass in 3 cases, femoropedal bypass[composite graft bypass in 2 cases were surgically approached. There are complicated early thrombosis in 4 cases those are required immediately reoperation, wound infection in 3 cases, hematoma in 3 cases, and so on. Postoperative complication rate is 53.8%.Postoperative patency rates are 84.6% at 6 months, 75.0% at 1 year, 70.0% at 2 years and 66.7% at 3 years. We usually used 6 mm & 8 mm graft for bypass, and the rate of thrombosis formation is 28.6%[2/7 in 6 mm graft and 12.5%[2/16 in 8 mm separately. In according to the graft materials, the rate of thrombosis formation is higher in the group using artificial graft than in that using autologous saphenous vein[16.6% vs 12.5% . Limb salvage rate is 76.9%. Postoperative mortality rate is zero %.

• Korean Journal of Applied Biomechanics
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• v.19 no.3
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• pp.435-448
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• 2009

The purpose of this study was to investigate the kinemaitc gait parameter of lower extremities with different gait conditions(level walking, stairs, ramp) in old adults. Fourteen healthy older adults participated in this study and kinematic data were measured using 3D motion analysis system(Vicon, Oxford Metrics, England). Statistical analysis was used one-way ANOVA to know the difference of lower extremities angle at each gait phase with a different gait conditions. In sagittal plane, pelvic anterior tilt increased in stairs and ramp climbing and hip and knee flexion increased in stairs climbing but ankle dorsiflexion increased in ramp climbing. In frontal plane, pelvic was up in stairs and hip abduction and adduction more changed in stairs climbing than level walking. Knee varus and ankle inversion increased in stair climbing. In horizontal plane, pelvic internal rotation increased in stairs and ramp climbing and knee internal rotation increased in stairs climbing but ankle external rotation increased in stairs climbing. This results was shown that the stairs and ramp climbing changed the kinematic gait parameters of lower extremities in healthy old adults.

• Journal of Chest Surgery
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• v.37 no.11
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• pp.911-917
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• 2004

Background: There are limited number of reports on May-Thurner syndrome (Iliac vein compression syndrome) in Korea, We analysed the clinical features, diagnostic modalities and endovascular treatment of May-Thurner syndrome. Material and Method: We reviewed 12 cases of May-Thurner syndrome between March 2001 and June 2003. Mean age was $57.6\pm2$ years. We were used in venography, color doppler and computed tomographic angiography as diagnostic modalities and in thrombolysis, thrombectomy, angioplasty and stent insertion as endovascular treatment. Result: Clinical features showed edema of lower extremities in 4 patients, pain of lower extremities in 1 patient, edema with pain in 5 patients, and all in 1 patient. In one patient, he did not have any pain and any edema of lower extremities but was diagnosed as May-Thurner syndrome using venography due to varicose veins on lower extremities. Diagnostic modalities included venography, computed tomographic angiography in all patients with clinical presentation except in one patient and color doppler was only performed only in 4 patients. Four kinds of endovascular treatment were performed for May-Thurner syndrome, angioplasty in 11 patients, stent insertion in 10 patients, thrombectomy in 9 patients and thrombolysis for 7 patients. Nine patients were followed up and we can show good blood flow in Left iliac vein for 7 of 9 patients. Conclusion: it is necessary to recognize the possibility of May-Thurner syndrome in Deep vein thrombosis patients and we should use a variety of modalities to diagnose May-Thurner syndrome. Finally, endovascular treatment is a safe and effective therapy for May-Thurner syndrome.

• Physical Therapy Korea
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• v.18 no.2
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• pp.1-8
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• 2011

The purpose of this study was to investigate the effect of high heeled shoes with the total contact insert (TCI) on the frontal plane of the joints for the lower extremity during the gait. Ten healthy females voluntarily participated in this study and the height of the high heeled shoes was 7 cm. A three-dimensional motion analysis system (VICON) and force plates were used to analyze the movements of the joints for the lower extremities. The results were as follows: There were no significant differences for the angle value on the event of the gait cycle in the maximum eversion and inversion of the ankle joint, the varus and valgus of the knee joint, and the adduction and abduction of the hip joint (p>.05). But, there was a significant difference or the range of motion in the ankle joint (p<.05). The value of ankle and knee moment with a TCI was less than the value for no TCI. And there were significant differences for the moment value of the maximum inversion and eversion on the ankle joint and for the maximum varus and valgus on the knee joint (p<.05). Therefore, a TCI would be effective in stabilizing the joints of the lower extremities and increasing the balance of a body to reduce the injure from a fall during the gait.

• Biomedical Science Letters
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• v.17 no.4
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• pp.313-319
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• 2011

Diabetes mellitus (DM) leads to a variety of complications and thus we have retrospectively studied to investigate problems of nerve conduction velocity (NCV) study and the heart in the patients with type-II DM. Blood glucose and blood pressure levels were higher in DM group than in Non-DM group. We found that several latencies were delayed in motor conduction study of upper (median and ulnar nerve) and lower extremities (peroneal and tibial nerve), whereas amplitudes and NCVs were decreased in DM group compared with Non-DM group. Latencies of sensory conduction study in upper and lower extremities (sural nerve) were delayed, while amplitudes and NCVs were lower in DM group than in Non-DM group. Abnormal percent of the electrocardiogram was higher in DM group than in Non-DM group. This retrospective study suggests that type-II DM can cause a damage effect on the peripheral nerve and the heart function.

• Archives of Plastic Surgery
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• v.32 no.4
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• pp.435-440
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• 2005

The reconstruction of deep soft tissue defects of lower extremities combined with bone exposure has been difficult problems. When it is impossible to raise local skin flap, we have been usually used the gastrocnemius musculocutaneous flap, cross leg flap or free flaps. However, In musculocutaneous flap, aesthetical appearance of the calf is not appropriate because of too bulky flap. Although the success rate of the free flap has improved, still failure of flap occurs in cases of the chronic ischemic state. As the concepts of perforator flap has recently developed and widely used due to its thin flap thickness. Between January 2002 to December 2004, we treated 7 patients with soft tissue defect in leg with chronic ischemic limbs with perforator island flap. Preoperative angiography were done in all case and we used 2 medial sural perforator flaps, 1 anterior tibial artery perforator flap, 1 posterior tibial artery perforator flap, 3 anterolateral thigh perforator flap. Partial necrosis of flap was seen in one patient but no further surgical procedure was required for wound healed spontaneously. Perforator island flaps are thin, reduce donor site morbidity, conceal donor site with primary closure and it is useful for resurfacing soft tissue defect of lower extremities.