• 제목/요약/키워드: lower extremities

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대퇴골 회전방지보조기를 착용한 트레드밀 보행훈련이 뇌성마비 아동의 하지배열 및 보행에 미치는 영향: 단일그룹 반복측정 연구 (The Effects of Treadmill Gait Training with Flexible Derotator of Femur Orthosis on Postural Alignment of Lower Extremities and Gait in Children with Cerebral Palsy: Single Group Rpeated Measure Design)

  • 유현영;김선엽;장현정
    • 대한물리의학회지
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    • 제9권1호
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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.

MR 댐퍼를 적용한 불안정판에서 하지 근력 훈련이 근 활성도에 미치는 영향 분석 (Analysis on the Effects of the Lower Extremities Muscle Activation during Muscular Strength Training on an Unstable Platform with Magneto-Rheological Dampers)

  • 최윤정;박용군;권대규;김동욱;김정자;김남균
    • 대한의용생체공학회:의공학회지
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    • 제28권5호
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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.

노인의 단기집중 균형훈련이 하지수행능력에 미치는 영향 (Effects of Short-Term Intensive Balance Training for the Performance Ability of Lower Extremities in the Elderly)

  • 정순미;안덕현
    • 한국전문물리치료학회지
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    • 제14권1호
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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.

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수중운동 프로그램이 류마티스 관절염 환자의 사지 피부두겹 두께와 둘레에 미치는 영향 (Effects of Aquatic Exercise on Skinfold Thickness and Circumference of Upper and Lower Extremities in Patients with Rheumatoid Arthritis)

  • 김종임;김인자;이은옥
    • 근관절건강학회지
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    • 제2권2호
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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.

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하지 만성 허혈에 대한 동맥 우회술의 임상적 고찰 (Clinical Analysis of the Arterial Bypass Surgery for Chronic Ischemia of the Lower Extremities)

  • 안정태
    • Journal of Chest Surgery
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    • 제28권7호
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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 %.

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노인의 계단과 경사로 오르기 동안 하지의 운동학적 분석 (Kinematic Analysis of Lower Extremities during Stairs and Ramp Climbing with Older Adults)

  • 한진태;황보각
    • 한국운동역학회지
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    • 제19권3호
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    • pp.435-448
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    • 2009
  • 본 연구는 노인의 계단과 경사로 오르기와 평지보행 동안 하지의 운동학적 변화를 분석하는 것이었다. 건강한 노인 14명(남:10, 녀:4)이 실험에 참여하였으며 측정도구는 삼차원동작분석기인 Vicon system(Vicon, Oxford Metrics, England)을 사용하였다. 보행주기 각 시점에서 하지 관절의 각도 변화를 보행 조건(평지, 계단, 경사로)에 따라 알아보기 위해 일요인 반복측정 분산분석(one-way repeated measure of ANOVA)을 사용하였다. 전후면상에서 골반은 평지 보행에서 보행 주기 동안 전방굴곡이 나타났으며 계단과 경사로 오르기에서 전방굴곡이 증가하였다. 고관절과 슬관절는 모두 평지보행과 비교해 계단 오르기에서 굴곡이 더 증가하였다. 족관절은 평지보행과 비교해 경사로 오르기에서 굴곡이 더 증가하였다. 좌우면상에서 보행 주기 동안 평지보행과 비교해 계단 오르기에서 골반이 크게 올라갔으며 고관절도 계단 오르기에서 내전과 외전의 변화가 크게 나타났다. 또한 슬관절도 계단 오르기에서 내반이 증가하였고 족관절 역시 계단 오르기에서 내번이 증가하였다. 수평면상에서 보행 주기 동안 골반은 평지 보행과 비교해 계단과 경사로 오르기에서는 내회전이 대체로 증가하였고 고관절은 계단과 경사로 오르기에서 내회전이 증가하였으나 통계적으로 유의한 차이는 없었다. 슬관절은 계단 오르기에서 대체적으로 내회전이 증가하였고 족관절은 계단 오르기에서 대체적으로 외회전이 증가하였다. 이러한 결과는 노인의 계단과 경사로 오르기는 평지 보행과 비교해 하지의 운동학적 보행 변수들을 크게 변화시키는 것을 알 수 있었다.

May-Thurner 증후군의 진단과 혈관내 치료 (Diagnosis and Endovascular Treatment of May-Thurner Syndrome)

  • 허균;이재욱;신화균;원용순
    • Journal of Chest Surgery
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    • 제37권11호
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    • pp.911-917
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    • 2004
  • 배경: 하지심부정맥 혈전증의 원인으로 알려져 있는 May-Thurner증후군(혹은 장골정맥 눌림증후군)의 임상 증상, 진단 및 혈관내 치료에 대해 분석하고자 하였다. 대상 및 방법: 2001년 3월부터 2003년 7월까지 May-Thurner증후군으로 진단 받은 12명의 환자들을 대상으로 하였으며 진단방법으로는 정맥조영술, 정맥초음파, 혈관조영 컴퓨터 단층촬영을 이용하였고 혈관내 시술은 혈전용해술, 혈전제거술, 혈관성형술, 혈관내 스텐트삽입 등을 시행하였다. 결과: 임상양상으로는 하지부종이 4예, 하지의 통증이 1예에서 보였으며 5예에서는 하지부종과 통증이 동반되었고 하지부종과 통증과 압통이 동반된 경우도 1예였다. 1예에서는 부종이나 통증은 없었으며 하지정맥류로 인해 시행한 정맥조영술에서 May-Thurner증후군이 발견되었다 진단방법으로는 임상양상과 더불어 1예를 제외하고는 모든 환자들이 정맥 조영술과 혈관조영 컴퓨터 단층촬영을 시행하였고 이중 4예에서는 정맥 초음파를 시행하였다. 혈관성형술을 11예에서 시행하였고, 혈관내 스텐트 삽입은 10예, 혈전 제거술은 9예, 혈전용해술은 7예에서 시행되었다. 9예에서 추적관찰을 하였고 이중 7예에서 혈관내 원활한 혈류의 흐름을 관찰할 수 있었다. 결론: 하지의 심부정맥 혈전증 환자에 있어서 May-Thurner증후군의 가능성을 충분히 인식하여야 하며 이의 진단을 위하여 다양한 방법이 필요하며 치료 방법으로는 혈관내 시술이 안전하면서 효과적이라고 생각된다.

높은 굽 신발 보행 시 전면 접촉인솔이 보행 변수에 미치는 영향 (The Effect of Total Contact Inserts on the Gait Parameters During High-Heeled Shoes Walking)

  • 문곤성;김택훈
    • 한국전문물리치료학회지
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    • 제18권2호
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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.

Diabetes affects Peripheral Nerve and Heart Function

  • Ku, Jeong-Min;Choi, Hwa-Sik;Hyun, Kyung-Yae;Moon, Seong-Min;Kim, Dae-Sik;Choi, Seok-Cheol
    • 대한의생명과학회지
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    • 제17권4호
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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.