• Physical Therapy Rehabilitation Science
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• 제13권1호
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• pp.53-70
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• 2024

Background: The conventional deadlift is a popular exercise for enhancing trunk, core, and lower extremity strength. However, its use in sports medicine is constrained by concerns of lumbar injuries, despite evidence supporting its safety and rehabilitative benefits. To optimize muscle activation using resistive bands in variable resistance therapy, we explored their feasibility in the deadlift. Design: Comparative experimental design Methods: Surface electromyography recorded muscle activity in the trunk and lower extremities during lifting, with normalization to the isometric Floor Lift using Maximal Voluntary Contraction. Kinematics were measured using inclinometer sensors to track hip and trunk sagittal plane angles. To prevent fatigue, each subject only used one of the three pairs of bands employed in the study. Results: Our study involved 45 healthy subjects (mean age: 30.4 ± 6.3 years) with similar baseline characteristics, except for years of lifting and strength-to-years-of-lifting ratio. Various resistance band groups exhibited significantly higher muscle activity than conventional deadlifts during different phases. The minimal resistance band group had notably higher muscle activity in the trunk, core, and lower extremity muscles, particularly in the end phase. The moderate resistance band group showed increased muscle activity in the mid-and end-phases. The maximum resistance band group demonstrated greater muscle activity in specific muscles during the early phase and overall higher activity in all trunk and lower extremity muscles in the mid and end phases of the deadlift (p<0.05). Conclusion: Our findings provide valuable insights into muscle activation with various resistance bands during deadlift exercise in clinical and gym settings. There appears to be a dose-response relationship between increased resistance bandwidth, external load, myoelectric activation, and range.

• Archives of Plastic Surgery
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• 제51권2호
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• pp.234-250
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• 2024

Background The impact of diabetes on complication rates following free flap (FF), pedicled flap (PF), and amputation (AMP) procedures on the lower extremity (LE) is examined. Methods Patients who underwent LE PF, FF, and AMP procedures were identified from the 2010 to 2020 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP®) database using Current Procedural Terminology and International Classification of Diseases-9/10 codes, excluding cases for non-LE pathologies. The cohort was divided into diabetics and nondiabetics. Univariate and adjusted multivariable logistic regression analyses were performed. Results Among 38,998 patients undergoing LE procedures, 58% were diabetic. Among diabetics, 95% underwent AMP, 5% underwent PF, and <1% underwent FF. Across all procedure types, noninsulin-dependent (NIDDM) and insulin-dependent diabetes mellitus (IDDM) were associated with significantly greater all-cause complication rates compared with absence of diabetes, and IDDM was generally higher risk than NIDDM. Among diabetics, complication rates were not significantly different across procedure types (IDDM: p = 0.5969; NIDDM: p = 0.1902). On adjusted subgroup analysis by diabetic status, flap procedures were not associated with higher odds of complications compared with amputation for IDDM and NIDDM patients. Length of stay > 30 days was statistically associated with IDDM, particularly those undergoing FF (AMP: 5%, PF: 7%, FF: 14%, p = 0.0004). Conclusion Our study highlights the importance of preoperative diabetic optimization prior to LE procedures. For diabetic patients, there were few significant differences in complication rates across procedure type, suggesting that diabetic patients are not at higher risk of complications when attempting limb salvage instead of amputation.

• 한국운동역학회지
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• 제26권2호
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• pp.167-174
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• 2016

Objective: The purpose of this study was to determine the interrelationship between ranges of motion of the knee and ankle joints on the sagittal plane and the attenuation magnitude of impact shock at high frequency (9~20 Hz) in the support phase during downhill running. Method: Fifteen male heel-toe runners with no history of lower extremity injuries were recruited for this study (age, $25.07{\pm}5.35years$; height, $175.4{\pm}4.6cm$; mass, $75.8{\pm}.70kg$). Two uniaxial accelerometers were mounted to the tuberosity of tibia and sacrum, respectively, to measure acceleration signals. The participants were asked to run at their preferred running speed on a treadmill set at $0^{\circ}$, $7^{\circ}$, and $15^{\circ}$ downhill. Six optical cameras were placed around the treadmill to capture the coordinates of the joints of the lower extremities. The power spectrum densities of the two acceleration signals were analyzed and used in the transfer function describing the gain and attenuation of impact shock between the tibia and the sacrum. Angles of the knee and ankle joints on the sagittal plane and their angle ranges were calculated. The Pearson correlation coefficient was used to test the relationship between two variables, the magnitude of impact shock, and the range of joint angle under three downhill conditions. The alpha level was set at .05. Results: Close correlations were observed between the knee joint range of motion and the attenuation magnitude of impact shock regardless of running slopes (p<.05), and positive correlations were found between the ranges of motion of the knee and ankle joints and the attenuation magnitude of impact shock in $15^{\circ}$ downhill running (p<.05). Conclusion: In conclusion, increased knee flexion might be required to attenuate impact shock during downhill and level running through change in stride or cadence while maintaining stability, and strong and flexible ankle joints are also needed in steeper downhill running.

• Archives of Reconstructive Microsurgery
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• 제8권1호
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• pp.35-43
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• 1999

저자들은 1988년부터 1998년까지 시행한 252예의 유리피판술 중 9예에서 미세혈관 문합부의 혈전 등의 이유로 실패하였으며, 이들 중 두경부 및 하지의 7예에서는 첫 수술 4-16일 사이에 제 2의 유리피판술을 성공적으로 시행하여 환부를 치유시키고, 처음에 계획하였던 수술적 목표를 달성하였다. 수부의 2예는 환자 및 보호자와 충분한 상의하여 원거리 피판과 피부이식 등 고식적인 치료 방법을 선택하였다. 수부의 경우는 다른 부위보다 고식적 치료 방법이 덜 부담되었던 것으로 생각되었으며, 두경부와 하지는 환부의 특성상 제 2의 유리 피판술이 최선의 선택으로 생각되었다. 유리 피판술이 실패한 환부에서 계속된 제 2의 유리 피판술을 시행하는 것은, 처음의 수술보다 면밀한 술전 계획과 준비, 완벽한 수술, 수술후의 철저한 환자 관리가 요구되었으나, 이들 환부의 처치에 매우 효과적이고 환자의 기대에 부응할 수 있는 방법이라고 생각된다.

• Journal of Korean Neurosurgical Society
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• 제48권2호
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• pp.119-124
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• 2010

Objective : Disc herniations at the L1-L2 and L2-L3 levels are different from those at lower levels of the lumbar spine with regard to clinical characteristics and surgical outcome. Spinal canals are narrower than those of lower levels, which may compromise multiple spinal nerve roots or conus medullaris. The aim of this study was to evaluate the clinical features and surgical outcomes of upper lumbar disc herniations. Methods : We retrospectively reviewed the clinical features of 41 patients who had undergone surgery for single disc herniations at the L1-L2 and L2-3 levels from 1998 to 2007. The affected levels were L1-L2 in 14 patients and L2-L3 in 27 patients. Presenting symptoms and signs, patient characteristics, radiologic findings, operative methods, and surgical outcomes were investigated. Results : The mean age of patients with upper lumbar disc was 55.5 years (ranged 31 to 78). The mean follow-up period was 16.6 months. Most patients complained of back and buttock pain (38 patients, 92%), and radiating pain in areas such as the anterior or anterolateral aspect of the thigh (32 patients, 78%). Weakness of lower extremities was observed in 16 patients (39%) and sensory disturbance was presented in 19 patients (46%). Only 6 patients (14%) had undergone previous lumbar disc surgery. Discectomy was performed using three methods : unilateral laminectomy in 27 cases, bilateral laminectomy in 3 cases, and the transdural approach in 11 cases, which were performed through total laminectomy in 10 cases and unilateral laminectomy in 1 case. With regard to surgical outcomes, preoperative symptoms improved significantly in 33 patients (80.5%), partially in 7 patients (17%), and were aggravated in 1 patient (2.5%). Conclusion : Clinical features of disc herniations at the L1-L2 and L2-L3 levels were variable, and localized sensory change or pain was rarely demonstrated. In most cases, the discectomy was performed successfully by conventional posterior laminectomy. On the other hand, in large central broad based disc herniation, when the neural elements are severely compromised, the posterior transdural approach could be an alternative.

• 한국산학기술학회논문지
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• 제16권3호
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• pp.1904-1919
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• 2015

본 연구는 낙상예방운동 프로그램을 적용 후 효과를 검증하고자 수행되었다. J시 A읍 두 보건진료소의 65세 이상 노인 52명 노인을 대상으로 2014년 6월1일부터 7월14일까지 시행되었다. 대상자는 실험군 31명, 대조군 21명으로 무작위로 분류하였다. 실험군은 주 2회, 6주간 낙상예방운동 프로그램을 실시하였고, 대조군 21명은 교육만 실시하였다. 연구결과 신체적 기능의 TUG에서 두 그룹 간에 유의한 차이를 보였다(p=.032). 정신적 기능의 낙상두려움, 낙상효능감에서는 통계적으로 유의하지 않았다. 하지근육의 초음파 측정은 7항목(RF CSA Contraction, RF DIS Resting, TA Thickness Contraction, TA P-angle Contraction, GCM Thickness Resting, GCM Thickness Contraction, GCM P-angle Contraction)에서 그룹 간 통계적으로 유의한 차이가 있었다(P<.05). 결론적으로 본 프로그램은 낙상예방에 매우 효과적이다.

• 한국운동역학회지
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• 제16권3호
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• pp.105-115
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• 2006

The purpose of this study is to elucidate the mechanical characteristics of lower extremity joint movements at different walking speeds in obese people and suggest the very suitable exercise for obese person's own body weight and basic data for clinical application leading to medical treatment of obesity. This experimental subjects are all males between the ages of 20 and 30, who are classified into two groups according to Body Mass Index(BMI): one group is 15 people with normal body weight and the other 15 obese people. Walking speed is analysed at 3 different speeds ($1.5^m/s$, $1.8^m/s$, $2.1^m/s$) which is increased by $0.3^m/s$ from the standard speed of $1.5^m/s$. We calculated joint moments of lower extremity during stance phase through video recording and platform force measurement.Two-way ANOVA(Analysis of Variance, Mix) is applied to get the difference of moments according to walking speeds between normal and obese groups. Pearson's Correlation Analysis is applied to look into correlation between walking speeds and joint moments in both groups. Significance level of each experiment is set as ${\alpha}=.05$. As walking speed increases maximum ankle plantar flexion moment in the stance phase is smaller in obese group than in normal group, which is suggestive of weak toe push-off during terminal stance in obese group, and the highest maximum ankle plantar flexion moment in obese group during the middle speed walking($1.8^m/s.$). Maximum ankle dorsal flexion moment in obese group is relatively higher than in normal group and this is regarded as a kind of compensatory mechanism to decrease the impact on ankle when heel contacts the floor. Maximum knee flexion and extension moments are both higher in normal group with an increase tendency proportional to walking speed and maximum hip flexion and extension moments higher in obese group. In summary, maximum ankle plantar flexion moment between groups(p<.025), maximum knee moment not in flexion but in extension(p<.001) within each group according to increasing walking speed, and maximum hip flexion and extension moment(p<.001 and p<.004, respectively according to increasing walking speed are statistically significant but knee and hip moments between groups are not. Pearson correlation are different: high correlation coefficients in maximum knee flexion and extension moments, in maximum hip extension moment but not hip flexion, and in maximum ankle dorsal flexion moment but not ankle plantar flexion, in each group. We suspect that equilibrium imbalance develops when the subject increases walking speed and the time is around which he takes his foot off the floor.

• Journal of Platform Technology
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• 제9권2호
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• pp.38-45
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• 2021

분절다중주파수 생체전기임피던스분석법(Segmental Multi-frequency Bioelectrical Impedance)은 최근 체성분 검사를 위해 선호되는 검사법이다. 그러나 SMF-BIA 는 팔다리와 몸통의 임피던스를 추정하는 방법으로 정확한 사용을 위해서는 타당성에 대한 확인이 요구된다. 본 연구는 SMF-BIA 를 인체의 분절임피던스를 기준하여 분절별 임피던스의 추정값에 대한 정확도와 타당도를 검정하는데 목적하였다. 연구목적을 위해 노인 108 명을 대상으로 50kHz 주파수에서 얻어진 분절별 생체전기 임피던스값에 대하여 분절 생체임피던스 측정치 비교하였다. 실험 결과 오른쪽 팔의 저항 값은 준거값에 비해 유의한 수준으로 높았다(저항값: 35.5±6.2%, P < 0.001; 리액턴스: 2.7±7.6%, P < 0.01). 왼쪽팔, 오른쪽 다리와 왼쪽다리의 생체저항값은 준거값에 비해 모두 유의하게 높았다. 몸통의 추정값은 기준값에 비해 가장 큰 차이를 보였다(저항값: 65.4±3.2%, P < 0.001; 리액턴스: 89.2±1.8%, P < 0.001). 두 방법으로 측정한 임피던스 결과에서 사지와 전신의 생체저항값은 높은 상관관계(RA: R = 0.950 LA: R = 0.949 RL: R = 0.899, LL: R = 0.888)를 보였으며, 팔과 다리에서도 유의한 상관관계를 보였다. 따라서 분절다주파수 생체임피던스는 준거와 높은 상관도와 함께 유의한 오차를 보여, 향후 오차 수준을 줄이기 위한 연구가 필요하였다.c

• 한국응용과학기술학회지
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• 제38권2호
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• pp.532-542
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• 2021

본 연구의 목적은 골프 스윙 시 3가지 스탠스에서 클럽헤드 스피드와 볼의 정확성을 유지하기 위한 신체 전략을 하지의 운동학적 변인과 지면반력 변인을 통하여 알아보고자 하였다. 연구의 대상은 공식 핸디캡이 2인 남자골프선수 10명으로 하였다. 모든 대상자들은 스탠스 조건(스퀘어, 오픈, 클로즈드)에 따라 어드레스 자세를 유지한 후 스윙을 수행하였다. 3차원 동작분석 시스템과 지면반력기를 이용하여 각 스탠스에 따라 7번 아이언 풀스윙을 수행한 결과를 산출하였다. 연구결과로 신체중심의 변위, 고관절 각변위, 무릎관절 각변위는 차이가 나타나지 않았다. 발목관절 각변위는 어드레스부터 다운스윙까지 왼쪽에서 오픈 스탠스가 저측굴곡이 크게 수행되었고, 오른쪽에서 클로즈드 스탠스에서 저측굴곡이 크게 수행되었다. 지면반력에서 전후, 수직은 차이가 없었지만, 어드레스부터 테이크백까지 왼발은 오른쪽 방향, 오른발은 왼쪽 방향의 힘이 오픈이 클로즈드 스탠스보다 크게 나타났다. 결론적으로 다양한 스탠스에도 불구하고, 임팩트 시 동일한 자세를 유지하는 것이 클럽헤드 스피드와 볼의 방향에 긍정적으로 작용되는 것으로 판단된다.

• Archives of Plastic Surgery
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• 제34권5호
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• pp.557-561
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• 2007

Purpose: Malignant melanoma is a fatal tumor arising in the melanocytic systems of the skin. The incidence of malignant melanoma, formerly considered a rare tumor in Korea, is observed to increase. The aim of this study is to analyze the clinical and histopathological pattern of malignant melanoma in one institute. Methods: Thirty patients with ages ranging from 33 to 80 years, diagnosed as malignant melanoma at our skin tumor department, were enrolled in a retrospective study over a 6 year period(2000. 9-2006. 7). The analyzed data included age, sex, location, duration before diagnosis, clinical type, level of invasion, and stage. Results: The cases were identified and analyzed by clinical and histopathologic study. The male to female ratio was 1:1.7. Lower extremities(especially, feet) were favored sites. The majority of cases were acral lentiginous melanoma(40%), followed by nodular melanoma (36.7%), superficial spreading melanoma(20%) in this study. Clark level IV was predominant in histopathologic study. There was merely narrow gap among each stage by AJCC. Conclusion: The clinicopathological characteristic of melanoma in our patients is quite different with that in the West. In this retrospective study, primary lesions of the foot were predominant with melanoma, and a high percentage of these were classified pathologically as acral lentiginous melanomas. Patients had a more advanced stage of disease at first presentation and a more deeply invasive primary lesion than Western patients. These suggest that malignant melanoma has a worse prognosis in our patients than in the West. So, further organized prospective studies are needed to approach the prudent and accurate diagnosis and management of melanoma in Korea.