• Title/Summary/Keyword: lower extremities

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Indications and Prognostic Factors of Groin Flap for Reconstruction of the Extremities (사지 재건에 있어 서혜부 유리 피판술의 적응증 및 예후 인자)

  • Kim, Bo-Ram;Hahn, Soo-Bong;Kang, Ho-Chung;Choi, Yun-Rak;Kim, Sun-Yong
    • Archives of Reconstructive Microsurgery
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    • v.18 no.2
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    • pp.41-48
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    • 2009
  • There are several advantages for groin flap, but its small and unpredictable vessels of pedicle have made it to lose its initial popularity. Although it would be ideal flap when it is focused on its useful advantages such as relative larger size, low donor site morbidity and possible bone graft, there have been few studies for prognostic factors for successful groin flap. Authors intended to determine prognostic factors which are relative with success of free groin flap. From January 1985 to December 2007, 107 patients who underwent groin flap for reconstruction of extremities were selected consecutively. Univariate and multivariate analysis were performed to determine prognostic factors which were related with success of groin flap. Eighty of 107 (74.8%) flaps survived. There was significant difference in success rate according to the recipient site. Nineteen of 20 cases (95%) survived in upper extremities, but 61 of 87 cases (70.1%) survived in lower extremities, which was statistically significant (p=0.022). Univariate analysis showed that mean diameter of donor veins was significantly larger in success group (p=0.021). Groin flap is recommended for reconstruction of upper extremities than lower extremities. It is thought to be critical that surgeons try to match vessel diameters between donor and recipient site.

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Effect of Both Lower Extremities Proprioceptive Neuromuscular Facilitation Training with Functional Electrical Stimulation on the Balance and Gait of Stroke Patient: A Randomized controlled trial (기능적 전기자극치료를 동반한 양측 하지의 고유수용성 신경근 촉진운동이 뇌졸중 환자의 균형과 보행에 미치는 영향)

  • Kim, Sang-Mo;Kim, Young-Min
    • Journal of the Korean Society of Physical Medicine
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    • v.15 no.1
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    • pp.123-132
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    • 2020
  • PURPOSE: This study examined the effects of both lower extremities proprioceptive neuromuscular facilitation training with functional electrical stimulation on the balance and gait of stroke patients. METHODS: Ten patients with stroke were divided randomly into two groups of five patients each who met the selection criteria. The training was conducted five times a week, for 60 minutes. The experimental group received both lower extremities proprioceptive neuromuscular facilitation training with functional electrical stimulation while the control group received general physical therapy with functional electrical stimulation. RESULTS: The timed Up-and-Go (TUG) test result was statistically significant after the intervention in the experimental group (p<.041). Berg Balance Scale (BBS) assessment was statistically significant after the intervention in the experimental group (p<.047) and between the experimental and control groups (p<.012). The cadence assessment was statistically significant after intervention in the experimental group (p<.031) and between the experimental and control groups (p<.015). The stride length assessment was not statistically significant after intervention in the experimental group and between the experimental and control groups. Gait velocity assessment was statistically significant after the intervention in the experimental group (p<.031) and between the experimental and control groups (p<.015). CONCLUSION: Both lower extremities proprioceptive neuromuscular facilitation training with functional electrical stimulation had positive effects on the balance and gait of stroke patients.

Effects of a Tilting Training Program on Lower Extremities Function, Depression, and Self-efficacy among Stroke Inpatients (기대기 훈련프로그램이 뇌졸중 입원환자의 하지 기능, 우울 및 자기효능감에 미치는 효과)

  • Seo Nam-Sook;Han Mi-Sook;Lee Jeong-Soon
    • Journal of Korean Academy of Nursing
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    • v.36 no.3
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    • pp.514-522
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    • 2006
  • Purpose: The purpose of this study was to identify effects of a tilting training program on lower extremities function, depression, and self-efficacy among stroke inpatients. Method: The subjects were 60'stroke patients hospitalized in an oriental medical hospital; 31 in the experimental group and 29 in the control group. A nonequivalent control group pretest-posttest design was used. The tilting training program consisted of 3 sessions and was implemented for 30 minutes daily during 3 weeks. Data was collected from Feb to July 2003, and analyzed by percentage, Fisher's exact probability, $\chi^2-test$, and t-test using the SPSS/Win 10.0 computerized program. Result: After treatment with the tilting training program, the experimental group was significantly increased in the mean score for function of lower extremities (t=2.72, p=.009) compared to the control group, especially for keeping standing balance (t=2.78, p=.007) and standing by oneself (t=3.32, p=.002). However, in the mean scores of depression and self-efficacy, there were no significant differences between the two groups. Conclusion: The tilting training program was effective for increasing the function of lower extremities and to improve walking ability earlier among stroke inpatients. Therefore, the tilting training program is applicable to increase the balance level in standing and walking ability at the early rehabilitation stage for stroke patients.

Gracilis Muscle Free Flap Transplantation in the Lower Extremities - 32 Cases Snalysis - (하지에 시행한 박근 유리 판 이식술 - 32예 분석 -)

  • Lee, Jun-Mo;Kim, Hak-Ji;Kim, Yong-Min;Park, Jae-Kyu
    • Archives of Reconstructive Microsurgery
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    • v.13 no.1
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    • pp.58-62
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    • 2004
  • Purpose: To cover the exposed tendons and bones after trauma and cure the concomitant osteomyelitis in the lower extremities, gracilis muscle free flaps are frequently preferred. 32 cases of gracilis muscle free flap we had done were analysed according to the indications, specification of flap length and width, pedicle length, vessels used in the anastomosis and final healing after at least over 1 year follow up. Materials and methods: From August 1995 through November 2002, we have performed 32 cases of gracilis muscle free flap transplantation with the general microsurgical procedures in the lower extremities. Open fracture of the middle and distal tibia were 12, exposed heel 6, crushing injury in the foot 5 cases, open fracture of the ankle 4, chronic osteomyelitis of the tibia 3 and osteomyelitis of the tarsal bones 2. Tailored flap length were ranged from 16 cm to 4 cm, width were from 5cm to 4cm. Pedicle length averaged around 4 cm. Anastomosis of one artery and two veins in both of donor and recipient were performed in 17 cases and one artery and one vein in 15 cases. Results: All flaps were survived, except 2 cases. Final flap healing was satisfactory to both of the patients and microsurgeon. Conclusion: Gracilis muscle free flaps are frequently chosen to cover the exposed components and cure the osteomyelitis in the lower extremities.

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Comparative Study of the Effect of Man Geum Tang and Bo Yang Whan O Tang as a General Prescription for the Treatment of Motor Disturbance in Sequelae of Cerebrovascular Disease (졸중풍(卒中風) 후유증(後遺症)에 의한 운동장애(運動障碍) 환자(患者)의 치료(治療)를 위한 통용방(通用方)으로서 만금탕(萬金湯)과 보양환오탕(補陽還五湯)의 효과(效果)에 관한 비교(比較) 연구(硏究))

  • Kim, Dong-Woung
    • The Journal of Korean Medicine
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    • v.15 no.2 s.28
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    • pp.233-240
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    • 1994
  • Cerebrovascular disease(CVD) is marked by loss of consciousness. facial palsy and hemiparesis. Although being treated properly in acute stage. CVD is accompanied by various sequelae. So treatment of sequelas is great importance as much as in acute stage. Man Geum Tang(MGT) and Bo Yang Whan O Tang(BYWOT) are representative general prescription for sequelae of CVD. This study is to clarify comparatively the efficiency of MGT and BYWOT. 110 Patients who were administrated with either MGT or BYWOT over 2 weeks for treatment of CVD divided into 2 groups:53 patients(27 males and 26 fomales. average $63.58{\pm}9.48$ years old) adminstated with MGT and 57 patients (32 males and 25 females. average $65.84{\pm}8.93$ years old) with BYWOT. In the patients administrated with MGT. 15 patients were with cerebral hemorrhage and 38 patients were with cerebral infarction. 57 BYWOT group consisted of 27 patients with cerebral hemorrhage and 30 patients with cerebral infarction. MGT with cerebral hemorrhage and 30 patients with cerebral infarction. MGT was administrated for $15.18{\pm}2.43$days and BYWOT for $14.24{\pm}1.24days$. Motor improved significantly(9〈0.005) from grade after administration in upper and lower extremities respectively. In view of comparative effeciency. the grade of motor disturbance after administration in upper extremities showed insignificant(p〉0.005) change to $1.19{\pm}1.18\;and\;0.89{\pm}1.13$ in MGT and BYWOT group respectively. In lower extremities. the grade changed insignificantly (p〉0.05) to $1.26{\pm}1.08\;and\;1.18{\pm}1.10$ respectively. In the patients group with cerebral infarction. the grade of motor disturbance in MGT and BYWOT administration groups respectively were $0.84{\pm}0.14\;and\;0.60{\pm}0.15$ in upper exemities and $0.89{\pm}0.14\;and\;0.90{\pm}0.17$ in lower extremities. The significant difference between two groups didn't appeared. In cerebral hemorrhage patients the grade of motor disturbance were in upper extremities $2.07{\pm}0.33$ in MGT group and $1.59{\pm}0.29$ in BOWOT group and $2.20{\pm}0.26\;and\;1.59{\pm}0.28$ in lower extremities respectively. The difference between two groups were insignificant(p〉0.05).

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Comparison Analysis of Lower Extremities Activity while Walking Downhill according to the Height of Heel for Women in 20's

  • Kim, Hyeun-Ae;Kim, Hee-Tak
    • Journal of International Academy of Physical Therapy Research
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    • v.2 no.2
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    • pp.324-328
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    • 2011
  • The purpose of this study is to measure the effect of change in heel height on lower extremities activity of young women on high-heeled shoes that young women prefer from more kinetic and realistic perspective as this study changes the degree of slope on a treadmill. The study subjects are 15 young and healthy women who do not have any external injuries or problem with walking and understand the purpose of this study clearly. They wore three different height of heels(1cm, 7cm, 12cm) and walked on a treadmill at a constant speed of 3km/h. EMG value of four muscles (anterior tibial muscle, gastrocnemius muscle, straight muscle of thigh, and biceps muscle of thigh) were collected when walking and the change according to the height of heels were analyzed using one-way ANOVA. Multiple comparison analysis on anterior tibial muscle and heel height showed that the group with 12cm heel showed significantly high muscle activation compared to the groups with 1cm and 7cm heels. The result of this study can be used for various perspectives from inferring and mediating problems caused by wearing high heels on different ground slopes for a long time.

Differences in Electric Potential of Meridian System(6) -Comparing electrical potentials of patients with waist lesions- (요각통 환자의 12 경맥 전위측정 연구(6))

  • Nam, Bong-Hyun;Choi, Hwan-Soo
    • Korean Journal of Oriental Medicine
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    • v.8 no.2 s.9
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    • pp.85-93
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    • 2002
  • Objectives:Assuming that the characteristic of meridian system has been similar to that of electric potentials in human body and that measurements of electric potential at well(井穴) and sea(合穴) points in branches of the twelve meridians(WSBTM) will be representative of measurements of the twelve meridians, to measure the electric potentials of 17 patients with loin lesions, and pain of loin and lower extremities (腰脚痛, LWLE), to find out the characteristic of meridian system in patients with loin lesions. Methods:Electric potentials of well and sea points in the meridians in 17 patients with LWLE diagnosed by both CT or MRI and self view on pain at loin and lower extremities were repeatedly measured by physiograph(PowerLab). Measurements of those electrical potentials were analyzed by factor analysis. Results The electric potentials of WSBTM at the left side were divided into four factors. On the other hand those at the right side wert divided into three factors.

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The Effect of Functional Strengthening Exercise of Standing Balance in a Child With Cerebral Palsy (기능적 근력강화 운동이 뇌성마비 아동의 기립균형에 미치는 영향)

  • Shin, Hwa-Kyung;Chung, Bo-In
    • Physical Therapy Korea
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    • v.8 no.3
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    • pp.97-105
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    • 2001
  • The purpose of this study was to investigate the effect of functional strengthening exercise on static and dynamic standing balance in a child with cerebral palsy. The subject was a 7 year old boy with diplegia whose Gross Motor Function Measure (GMFM) score was 80% along with G1 of the lower extremities in Modified Ashworth Scale. The subject was ambulatory with some degree of limitation and demonstrated muscle weakness and strength asymmetry in the lower extremities. A changing criterion design for a single-subject research was used for this study. The functional strengthening exercise consisted of lower extremity ergometer exercise and knee exercise with grading movement in standing position, each for 20 minutes, which lasted 18 sessions for 6 weeks. A knee extensor strength test on both extremities and standing balance test were conducted after each functional strengthening exercise. Two types of standing balance were tested: one leg stance test and functional reach test. One leg stance test was to evaluate static standing balance, and functional reach test was to evaluate dynamic standing balance. The results showed that the functional strengthening exercise had some positive effects on improvement of both static and dynamic standing balance, and there was a positive correlation between the knee strength and standing balance.

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Effects of Repetitive Transcranial Magnetic Stimulation on Motor Recovery in Lower Extremities of Subacute Stage Incomplete Spinal Cord Injury Patients: A Randomized Controlled Trial

  • Ji, Sang-Goo;Cha, Hyun-Gyu;Kim, Myoung-Kwon
    • Journal of Magnetics
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    • v.20 no.4
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    • pp.427-431
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    • 2015
  • The aim of this study was to investigate whether repetitive transcranial magnetic stimulation (rTMS) can improve motor recovery in the lower extremities of the patients with subacute stage spinal cord injury (SCI). This study was conducted with 19 subjects diagnosed with paraplegia because of SCI. The experimental group included 10 subjects who underwent active rTMS, and the control group included 9 subjects who underwent sham rTMS. The SCI patients in the experimental group underwent conventional rehabilitation therapy, and active rTMS was applied daily to the hotspot of the lesional hemisphere. The SCI patients in the control group underwent sham rTMS and conventional rehabilitation therapy. The participants in both the groups received therapy five days per week for six weeks. Latency, amplitude, and velocity were assessed before and after the six-week therapy period. A significant difference in post-treatment gains for the latency and velocity was observed between the experimental and control groups (p < 0.05). However, no significant differences in the amplitude were observed between the two groups (p > 0.05). The results of this study indicate that rTMS may be beneficial in improving motor recovery in the lower extremities of subacute stage SCI patients.