• 제목/요약/키워드: lower extremities

검색결과 789건 처리시간 0.027초

하지의 연부조직 결손에 있어 천공지 도서형 피판술을 이용한 재건 (Lower Extremity Reconstruction of Soft Tissue Defects with Perforator Island Flap)

  • 이태훈;최재원;이준호;김효헌
    • Archives of Plastic Surgery
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    • 제32권4호
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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.

세라밴드 운동프로그램이 농촌 여성의 하지근력과 균형에 미치는 효과 (The Effects of the Thera-band Exercise Program on Lower Extremities Muscle Strength and Balance in Rural Female Farmers)

  • 정미경
    • 한국농촌간호학회지
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    • 제1권1호
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    • pp.49-58
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    • 2006
  • Purpose: This study was done to investigate the effects of **the Thera-band exercise program on the lower extremities muscle strength and balance in rural female farmers. Method: The participants were 19 rural women age of 40 or over who were living in the area within the jurisdiction of a public health center in North Chung Province and who agreed to participate in the study. The Thera-band exercise program was implemented for 10 weeks from Jan 17. to Mar 31. 2005. Total time was 60 minutes, 5 times a week. Paired t-test was used to analyze the data using the SPSS program. Result: The results of study showed that thigh muscle strength(t= 6.718, p <.001) and the dynamic balance(t=4.934, p <.001) decreased significantly. Ankle muscle strength(t=-6.739, pp <.001) and static balance (t=-2.395, p=.025) increased significantly. Conclusion: The results suggest that the Thera-band exercise program could be effective in improving thigh muscle strength, ankle muscle strength, the static balance, and the dynamic balance of rural female farmers. Further study is needed to compare strength and balance before and after the exercise program and to use a control group for comparison. Also it is needed to do more study on the appropriate length of time that the intervention should be given in order to achieve maximum results.

MR 댐퍼 적용 불안정판을 이용한 재활 훈련시스템 개발 (Development of Rehabilitation Training System Using Unstable Flatform with Magneto-Rheological Damper)

  • 최윤정;박용군;허민;권대규;황지혜;김동욱;김남균
    • 제어로봇시스템학회논문지
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    • 제14권2호
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    • pp.197-204
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    • 2008
  • The purpose of this paper was to develop a rehabilitation training system which is controlled by electric currents to the Magneto-Rheological dampers system. This system provided the function for the training of the unbalance of the lower extremities. 10 subjects executed the tracing and moving exercises which are presented through the display monitor and confirmed own the capability of performance on the task. The electromyographies of the four muscles in lower extremities were recorded and analyzed in the time and frequency domain the muscles of interest were rectus femoris, biceps femoris, gastrocnemius, tibialis anterior. The experimental results showed that subjects had a task under feedback mode then subjects improve the capability of performance, increasing the in time, decreasing the out time and the distance of body shift. The moving average EMG, spectral energy of four muscle is lower the feedback mode than the constant mode. This could aid the hemiplegic patients to train more easily.

구두 굽의 형태가 인체의 근골격계에 미치는 영향에 관한 연구 (The Study on Musculoskeletal Effects of Heel Types)

  • 이창민;정은희
    • 대한인간공학회지
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    • 제23권1호
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    • pp.39-48
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    • 2004
  • In terms of women engaged in clerical job. working time of the workers who mainly keep standing with their high-heeled shoes on has been increasing. According]y. they are exposed to many kinds of foot deformation caused by loads of lower back and lower extremities due to high-heeled shoes. The type of heels they usually wear are diverse though the hight is same. In this study. we investigated most women's favorite styles of shoes concerned with heights. types and contact areas of the heels. Hence. we designed three kinds of shoes for an experiment: their contact areas with ground are 1 cm2. 2-4 cm2 and over 9 cm2 according to the heel heights. respectively. To investigate the biomechanical effects. analysis of motion and EMG were applied to the experiments. In addition. foot pressure distribution was measured for more detailed analysis. Six healthy young women were participated in this experiments. The result showed the heel becoming higher and narrower increased not only fluctuation of CBM(Center of Body Mass). but also the load of low back muscle and lower extremities. Accordingly. there was significant difference among types of the heel in terms of the role supporting load of the body. though the height is same. Especially. the difference among the pressures on a foot was most significant. In conclusion. we verified biomechanical effects are related with the contact area of a heel with ground as well as the hight.

상하지 등속성 운동시 나타나는 심혈관계의 반응 (Cardiovascular Responses to Isokinetic Exercise in Upper and Lower Extremities)

  • 김천경;박혜정;홍지아;권혁철
    • 한국전문물리치료학회지
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    • 제1권1호
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    • pp.10-16
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    • 1994
  • The purpose of this study was to establish a baseline in order that individuals may exercise safely. Sixty healthy students who were divided into two groups participated in the experiment. One group exercised both arms and legs at 60 rpm and the other at 90 rpm. There was a significant difference between arm and leg exercise in diastolic blood pressure (DBP) and time to target heart rate (tTHR). DBP decreased more in the upper (U//E) than the lower extremity (L/E), but tTHR increased more in the L/E than the U/E (p < 0.05). Systolic blood pressure (SBP) was similar for both arm and leg exercise (p > 0.05). There was also no significant difference between 60 rpm and 90 rpm in SBP, DBP or tTHR in either arm or leg exercise (p > 0.05). In conclusion, the slope of the linear increase in heart rate was steeper for U/E than L/E work. Therefore L/E exercise is safer than U/E exercise.

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경동맥 폐관류 신티그라피를 이용한 상하지 동정맥 혈관기형의 진단과 치료 평가 (Diagnosis and Post-Therapeutic Evaluation of Arteriovenous Malformations in Extremities Using Transarterial Lung Perfusion Scintigraphy)

  • 정현우;최준영;김영욱;김동익;도영수;이은정;이수진;조영석;현승협;이경한;김병태
    • Nuclear Medicine and Molecular Imaging
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    • 제40권6호
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    • pp.316-321
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    • 2006
  • 목적: 동정맥 혈관기형은 혈역학적 변화를 일으켜 생명에 위험을 줄 수 있으므로, 사지의 선천성 혈관기형 환자에서 동정맥 혈관기형과 비동정맥 혈관기형을 정확히 감별진단 하는 것이 중요하다. 이 연구에서는 혈관조영술과 비교하여 경동맥 폐관류 신티그라피(transarterial lung perfusion scintigraphy, TLPS)가 선천성 혈관기형 중 상하지에 위치하는 동정맥 혈관기형의 진단과 치료 효과 평가에 유용한 지를 알아보았다. 대상 및 방법: 색전술/경화요법 전에 처음 TLPS를 시행 받은 57명(나이: $21{\pm}13$세, 남:여 = 26:31)이 연구대상이 되었다. 병변의 위치는 상지가 9명이었고 하지가 48명이었다. TLPS에서 폐의 시간 방사능 곡선을 이용하여 혈액 단락량을 구하였다. 모든 환자들에서 혈관조영술을 시행하여 혈관기형의 해부학적 및 혈역학적 평가를 하였다. 혈관조영술로 동전맥 혈관기형이 진단된 환자들은 치료 후 TLPS를 추적 시행하였다. 결과: 혈관조영술상 16명은 동정맥 혈관기형(상지 8명, 하지 8명), 나머지 41명은 비동정맥 혈관기형(상지 1명, 하지 40명)으로 진단되었다. 동정맥 혈관기형 환자들의 치료 전 평균 혈액 단락량은 비동정맥혈관기형 환자들에 비하여 유의하게 높았다($66.4{\pm}25.8%\;vs.\;2.8{\pm}4.3%$, p<0.0001). TLPS의 치료 전 상하지 동정맥 혈관기형을 진단하는 예민도와 특이도, 정확도는 각각 93.8% (15/16), 100% (41/41), 98.2% (56/57)이었다(혈액 단락량 기준 역치 = 20%). 동정맥 혈관기형 환자 16명은 추적 TLPS를 시행하였고 이 중 13명은 치료 평가에서 혈관조영술과 일치하는 결과를 보여주었다(81.3%). 색전술/경화요법 시행 후 TLPS 혈액 단락량은 유의하게 감소하였다($69.5{\pm}24.0%\;vs.\;41.0{\pm}34.7%$, p = 0.01). 결론: TLPS는 상하지동정맥 혈관기형에서 혈액 단락량의 반정량적인 정보를 제공해주며 혈관 조영술과 높은 검사결과 일치도를 보여주었다. 그러므로, TLPS는 상하지 동정맥 혈관기형의 진단과 치료 평가에 유용하다.

Effects of Manual Intervention and Self-Corrective Exercise Models of the General Coordinative Manipulation on Balance Restoration of Spine and Extremities Joints

  • Moon, Sang Eun;Kim, Mi Hwa
    • 국제물리치료학회지
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    • 제4권2호
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    • pp.573-587
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    • 2013
  • The purpose of this study was conducted in order to analyze the effects of the manual intervention and self-corrective exercise models of general coordinative manipulation(GCM) on the balance restoration of spine & extremities joints with distortions and mal-alignment areas. The subjects were the members who visited GCM Musculoskeletal Prevent Exercise Center from March 1 2012 to December 31 2013 because of spine & extremities joints distortion and mal-alignments, poor posture, and body type correction. All subjects were diagnosed with the four types of the GBT diagnosis. And according to the standards of the mobility vs stability types of the upper & lower body, they were classified into Group 1(40 persons) and Group 2(24 persons). For every other day for three times a week, GCM intervention models were applied to all subjects for four weeks, adding up to 12 times in total. Then the balance restoration effects were re-evaluated with the same methods. The results are as follows. 1) Balance restoration effects of VASdp(Visual analysis scale pain & discomfort) and ER(Equilibrium reaction: ER) came out higher in GCM body type(GBT) II III IV of Group 1. 2) In case of balance restoration effects in Moire and postural evaluation areas, Group 1 was higher and cervical and scapular girdle were higher in Group 2. The balance restoration of the four GBT types was significant in all regions(p<.05), and the scapular girdle came out as high in the order of GBTII IV I. 3) In case of thoracic-lumbar scoliosis and head rotation facial asymmetric cervical scoliosis ribcage forward, the balance restoration effects of the upper body postural evaluation areas came out the highest in Group 1 and Group 2, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in lumbar scoliosis GBTIII I, ribcage forward and thoracic scoliosis GBTII IV. 4) The balance restoration effects of the lower body postural evaluation areas came out higher in Group 1 and Group 2 for pelvis girdle deviation patella high umbilicus tilt and hallux valgus foot longitudinal arch: FLA patella direction, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in pelvis girdle deviation GBTIII I and patella high-direction GBTIV II I. 5) The balance restoration effects between the same GBT came out significant (p<.05) in all evaluation areas and items. The conclusions of this study was the manual intervention and self-corrective exercise models of the GCM about the mal-alignment of the spine & extremities joints across the whole body indicated high balance restoration effects(p<.05) in spine & extremities joints in all evaluation areas.

족지에 발생한 조갑하 편평 상피 세포암 (1예 보고) (Subungual Squamous Cell Carcinoma of the Toe (A Case Report))

  • 강호정;정성훈;곽윤해;한수봉;신규호
    • 대한족부족관절학회지
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    • 제11권1호
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    • pp.97-99
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    • 2007
  • Nail bed malignancies are rare entities. Most nail bed malignancies are squamous cell carcinoma (SCC)s. Less than 10% of subungual SCCs occur in the foot. Fifty percent occurred on the hallux and approximately 25% on both the fourth and fifth digits. The correct diagnosis is often delayed because nail bed malignancies are frequently mistaken for benign or infectious processes. SCC on extremities is hard to distinguish from the benign lesion like chronic ulcer, fistula caused by chronic osteomyelitis, and abscess fistula. Attention should especially be paid in diagnosing the subungual lesion because paronychia is a common disease. SCC is the most common carcinoma second to malignant melanoma as a soft tissue malignant tumor in the West, and it involves mainly the head, neck and upper extremities but rarely involves lower extremities, particularly the toes. The authors emphasize the importance of a biopsy for chronic nonhealing lesions by presenting this case.

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사지에 발생한 편평상피 세포암 (Squamous Cell Carcinoma in the Extremities)

  • 최일용;김태승;조원민;최충규
    • 대한골관절종양학회지
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    • 제1권1호
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    • pp.98-104
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    • 1995
  • 장기간 피부에 존재하는 궤양성 반흔이나, 만성골 수염의 누루 등에서 편평상피 세포암이 잘 발생하며 이들은 동통이 더욱 심해지거나 종괴의 크기가 갑자기 증가할때 그리고 분비물(discharge)이 늘어 날때는 악성 변화를 의심하여야 하며 조기에 생검을 하여 진단 후 적절한 수술적 치료가 필요하다. 또한 이들은 국소 림프절로의 전이가 빈발하므로 Grade II와 III에서는 예방적으로 국소 림프절에 방사선 조사(irradiation)를 고려해야 된다.

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상지 재활을 위한 3-D 로봇 시스템의 혼합 위치/힘 제어 (Hybrid Position/Force Control of a 3-D Rehabilitation Robot System for Upper Extremities)

  • 이수한;신규현
    • 한국정밀공학회지
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    • 제28권5호
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    • pp.599-605
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    • 2011
  • A 3-D rehabilitation robot system is developed. The robot system is for the rehabilitation of upper extremities, especially the shoulder and elbow joints, and has 3-D workspace for occupational therapy to recover physical functions in activities of daily living(ADL). The rehabilitation robot system has 1 DOF in horizontal rotational motion and 2 DOF in vertical rotational motion, where all actuators are set on the ground. Parallelogram linkage mechanisms lower the equivalent inertia of the control elements as well as control forces. Also the mechanisms have high mechanical rigidity for the end effector and the handle. In this paper, a hybrid position/force controller is used for controlling positions and forces simultaneously The controller is tuned according to the robot posture. The active motion modes for rehabilitation program consist of active-resisted motion mode and active-free motion mode. The results of the experiments show that the proposed motion modes provide the intended forces effectively.