• Title/Summary/Keyword: lower extremity

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A Musculoskeletal Model of a Human Lower Extremity and Estimation of Muscle Forces while Rising from a Seated Position (인체 하지부 근골격계 모델 및 의자에서 일어서는 동작 시 근력 예측)

  • Jo, Young-Nam;Yoo, Hong-Hee
    • Transactions of the Korean Society for Noise and Vibration Engineering
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    • v.22 no.6
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    • pp.502-508
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    • 2012
  • An analytical model for a human body is important to predict muscle and joint forces. Because it is difficult to estimate muscle or joint forces from a human body, the objective of this study is the development of a reliable analytical model for a human body to evaluate the lower extremity muscle and joint forces. The musculoskeletal system of the human lower extremity is modeled as a multibody system employing the Hill-type muscle model. Muscle forces are determined to minimize energy consumption, and we assume that motion is constrained in the sagittal plane. Muscle forces are calculated through an equilibrium analysis while rising from a seated position. The musculoskeletal model consists of four segments. Each segment is a rigid body and connected by frictionless revolute joints. Muscles of the lower extremity are simplified to seven muscles with those that are not related to the sagittal plane motion are ignored. Muscles that play a similar role are combined together. The results of the present study are compared with experimental results to validate the lower extremity model and the assumptions of the present study.

Effect of a Lower Extremity Strengthening Exercise Using Proprioceptive Neuromuscular Facilitation on the Gait and Balance Ability of a Stroke Patient -A Single Case Study- (PNF를 이용한 하지근력 강화운동이 뇌졸중 환자의 보행 및 균형 능력에 미치는 영향 -단일사례연구-)

  • Lee, Soon-Hyun;Lee, Yong-Ju
    • PNF and Movement
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    • v.15 no.1
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    • pp.97-104
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    • 2017
  • Purpose: This study seeks to determine the effect of a lower extremity strengthening exercise that uses proprioceptive neuromuscular facilitation (PNF) on the gait and balance ability of a stroke patient. Methods: In this case study, a lower extremity strengthening exercise that used PNF was performed by the subject for 30 minutes 4 times per week for a 4-week period alongside typical rehabilitation therapy. The lower extremity pattern used flexion-abduction-internal rotation with knee flexion, extension-abduction-internal rotation, bilateral leg extension pattern. The 10 m walk test and 6 minute walk test were used to assess gait ability. The Berg balance scale was used to assess balance ability. Results: After the intervention, the time for the 10 m walk test decreased by 5.72 sec, the distance for the 6 minute walk test decreased by 20 meters, and the score on the Berg balance scale improved by 7 points, which indicates the effectiveness of this therapy for stroke patients. Conclusion: The results of this study indicate that a lower extremity strengthening exercise using PNF can improve the gait ability and balance ability of stroke patients.

The Effects of Proprioceptive Neuromuscular Facilitation on Lower Extremity Functions of Chronic Stroke Patients (고유수용성신경근촉진법이 만성 뇌졸중환자의 하지기능에 미치는 효과)

  • Song, Hyun-Seung;Kim, Seok-Hwan
    • PNF and Movement
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    • v.12 no.4
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    • pp.225-232
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    • 2014
  • Purpose: The purpose of this study is to determine the effects of proprioceptive neuromuscular facilitation on the lower extremity function of chronic stroke patients. Methods: The participants consist of 26 chronic stroke patients. They were randomly assigned to either an experimental group (n=13) or a control group (n=13) and engaged in exercise three times per week for eight weeks. The experimental group engaged in proprioceptive neuromuscular facilitation exercises and the control group engaged in general mat exercises. To measure lower extremity strength, the sit to stand test and the static balance test (standing on one leg) were used. To measure the stability index (SI) and weight distribution index (WDI), a Tetrax Portable Multiple System (Tetrax Ltd, Israel) was used in addition to a static balance test (standing on one leg). Results: : Lower extremity strength and static balance showed a significant improvement in the experimental group (p<.05). The SI and WDI were significantly improved in the experimental group (p<.05) for tests of standing with their eyes open, standing with their eyes closed, and standing on a sponge with their eyes open. Conclusion: Proprioceptive neuromuscular facilitation exercises have confirmed that lower extremity function improves after exercise interventions in chronic stroke patients.

The Clinical Study about Qualitative and Quantitative Characteristics of Acupuncture Sensation According to the Body Parts (인체 부위별 경혈에 따른 득기감의 질적, 양적 특성에 관한 연구)

  • Oh, Hyun Jin;Lee, Eun Sol;Lee, Yoon Joo;Lee, Seung Deok;Kim, Kap Sung;Kim, Eun Jung
    • Journal of Acupuncture Research
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    • v.30 no.5
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    • pp.65-76
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    • 2013
  • Objectives : This study was designed to find out the differences of the acupuncture sensation by body parts. Methods : Sixty-three subjects got acupuncture at five acupoints which represent five different body parts ; head($GV_{20}$), abdomen($ST_{25}$), back($BL_{24}$), upper extremity($LU_9$), lower extremity($GB_{40}$). All subjests were asked to complete questionnaire rating the intensity of 13 kinds of acupuncture sensation(acupuncture sensation scale, ASS). We compared the subjective acupuncture sensation between the body parts. Results : Intensity of acupuncture sensation of $GV_{20}$ was significantly lower than $LU_9$(p=0.001) and $GB_{40}$(p=0.000). Sum of acupuncture sensation of $GV_{20}$ was also significantly lower than $BL_{24}$(p=0.011), $LU_9$(p=0.004) and $GB_{40}$(p=0.033). Among the 13 types of acupuncture sensation scale, tingling and aching were well sensed at $GV_{20}$ and $ST_{25}$, aching, tingling and sharp pain were well sensed at $LU_9$, $GB_{40}$, dull pain, deep pressure and heaviness were well sensed at $BL_{24}$. Conclusions : Head showed significantly lower intensity of acupuncture sensation than upper extremity and lower extremity. Among the acupuncture sensation scales, tingling and aching were well sensed at head and abdomen, aching, tingling and sharp pain were well sensed at upper extremity and lower extremity, dull pain, deep pressure and heaviness were well sensed at back.

Evaluation of Usefulness of CT Angiography in the Lower Extremity using Heart Rate (심박동 수를 활용한 Lower Extremity CT Angiography 검사의 유용성 평가)

  • Sung-Sik, Kim;Ho-Sung, Park
    • Journal of the Korean Society of Radiology
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    • v.17 no.1
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    • pp.53-62
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    • 2023
  • The purpose of this study is to find an optimized imaging technique and evaluate its usefulness by comparing and analyzing the difference in contrast enhancement of lower extremity artery according to the patient's heart rate during lower extremity Computed Tomography Angiography examination. From January 2022 to August 22nd, 139 outpatients who visited Ajou University Hospital and underwent lower extremity angio CT examination were targeted. According to the heart rate, the groups were divided into four groups: A(HR ≤65), B(65 < HR < 80), C(80≤ HR). In addition, among patients with a heart rate of 65 or less, the heart rate was considered, and the scan was divided into D, E, F group with a delay time. The time of arrival of contrast medium and the average value of contrast enhancement were compared and analyzed. As a result of quantitative evaluation, B and C groups with a heart rate of more than 65 times had better HU values in the popliteal artery than A group (HR ≤ 65), and D group showed better HU improvement effects compared to A group (p<0.001). The comparative analysis with other groups was insignificant. The difference in heart rate affected the angiographic intensity of the lower extremities artery. Therefore, it is effective to apply the appropriate test timing for each patient by using the heart rate during the lower extremity angio CT Scan.

Analysis of the Lower Extremity Reconstruction with Free Tissue Transfer in Recent 5 Years (최근 5년간 유리 피판술을 이용한 하지재건의 분석)

  • Baek, Seong-Jun;Heo, Chan-Yeong;Oh, Kap-Sung
    • Archives of Reconstructive Microsurgery
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    • v.8 no.2
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    • pp.130-138
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    • 1999
  • The lower extremity injuries are extremely increasing with the development of industrial & transportational technology. For the lower extremity injuries that result from high-energy forces, particularly those in which soft tissue and large segments of bone have been destroyed and there is some degree of vascular compromise, the problems in reconstruction are major and more complex. In such cases local muscle coverage is probably unsuccessful, because adjacent muscles are destroyed much more than one can initially expect. Reconstruction of the lower extremity has been planned by dividing the lower leg into three parts traditionally The flaps available in each of the three parts are gastrocnemius flap for proximal one third, soleus flap for middle one third and free flap transfer for lower one third. Microvascular surgery can provide the necessary soft tissue coverage from the remote donnor area by free flap transfer into the defect. Correct selection of the appropriate recipient vessels is difficult and remains the most important factor in successful free flap transfer. Vascular anastomosis to recipient vessels distal to the zone of injury has been advocated and retrograde flow flaps are well established in island flaps. Retrograde flow anastomosis could not interrupt the major blood vessels which were essential for survival of the distal limb, the compromise of fracture or wound healing might be prevented. During 5 years, from March 1993 to Feb. 1998, we have done 68 free flap transfers in 61 patients to reconstruct the lower extremity. From analysis of the cases, we concluded that for the reconstruction of the lower extremity, free flap transfer yields a more esthetic and functional results.

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Movement Patterns for Rising from Supine to Erect Stance of Children and Adolescent (아동기와 청년기의 똑바로 누운 자세에서 일어서기 운동형태)

  • Bae Sung-Soo;Park Sang-Ock;Kwon Mi-Ji
    • The Journal of Korean Physical Therapy
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    • v.7 no.1
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    • pp.21-31
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    • 1995
  • This study was described the movement patterns when rising from supine to erect stance. Two hundred eighty seven subjects, ranging in age from 6 year to 28 were filmed while rising from a supine position. Movement Patterns were classified using categorical descriptions of the action of three body regions-the upper and lower extremity, head-trunk region. This study was designed to determine whether within the rising task the movement patterns of different regions of the body vary with age level and sex. The incidence of each movement pattern was calculated and graphed with respect to age level and sex. The most common form of rising for subject in the 6, 7 year mate group usually involved push and reach pattern with upper extremity, half kneel pattern with lower extremity, partial rotation pattern with head-trunk. In the 6, 7 year female group usually involved symmetrical push pattern with upper extremity, symmetrical squat with balance step pattern with lower extremity, symmetrical interrupted by rotation pattern with head - trunk. In the teenage and twenties both sex group usually involved symmetrical push pattern with upper extremity, symmetrical squat pattern with lower extremity, partial rotation pattern with head-trunk.

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A Correction Effect of Multiaxial Lower Extremity Orthosis in Patients with Genu Valgum (다 축면 하지 보조기가 외반슬 교정에 미주는 효과)

  • Chang In-Su;Bae Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.14 no.3
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    • pp.355-372
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    • 2002
  • The purpose of this study was to evaluate the effect of multiaxial lower extremity orthosis on correction of genu valgum. 20 volunteers among people visited department of Rehabilitation Medicine, chungnam national university hospital, who had been diagnosed as genu valgum without other musculoskeletal problems were included. 10 individuals(mean age: 9.gyrs) who had been taken multiaxial lower extremity orthosis at least 12month were included in experimental group and the other 10 individuals(mean age: 11.7yrs) refused taking this orthosis in the control group. We measured the Q-angle & femorotibial angle using plain roentgenogram images at visiting day and repeat same test after 1year follow up. Multiaxial lower extremity orthosis consist of proximal horizontal bar with both thigh cuff, central vertical bar and distal horizontal bar with both shoes. we narrowed inter-shoes distance from start to 6th month and inter-thigh cuff distance together with above correction for next 6month in the frontal plane and from 10th month, dorsiflexed both shoes in sagittal plane. Also, we rotate the both shoes externally and retract the proximal vertical bar every month. This orthosis have to be taken at least 4 hours during sleep. The result were as follows 1. There were no statistical significant difference in each parameter between the right and left Q-angle before multiaxial lower extremity orthosis. 2. The left Q angle reduced $-11^{\circ}$ between 1st day and after 1year follow up showed statistical significant difference between multiaxial lower extremity orthosis taking group and non-taking(p<0.001). 3. The right Q angle reduced $-13^{\circ}$ between 1st day and after 1year follow up showed statistical significant difference between multiaxial lower extremity orthosis taking group and non-taking(p<0.001). 4. There were no statistical significant difference in each parameter between the right and left femorotibial angle before multiaxial lower extremity orthosis. 5. The left femorotibial angle reduced $-10.1^{\circ}$ between 1st day and after lyear follow up showed statistical significant difference between multiaxial lower extremity orthosis taking group and non-taking(p<0.001). 6. The right femorotibial angle reduced $-11.2^{\circ}$ between 1st day and after 1year follow up showed statistical significant difference between multiaxial lower extremity orthosis taking group and non-taking(p<0.001).

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Incidences of Lower Extremity Injuries in Korea (국내 하지손상의 발생현황에 대한 분석)

  • Kim, Chang Sun;Choi, Hyuk Joong;Kim, Jai Yong;Shin, Sang Do;Koh, Sang Baek;Lee, Kug Jong;Im, Tai Ho
    • Journal of Trauma and Injury
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    • v.21 no.1
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    • pp.36-45
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    • 2008
  • Purpose: We conducted this retrospective epidemiological study to assess the incidence and severity of lower extremity injuries in Korea Methods: For this study, we retrospectively reviewed nationwide lower-extremity injury data compiled from 2001 to 2003 based on the National Injury Database, what included National Health Insurance Corporation (NHIC), Car Insurance, and Industry Insurance data. Data were standardized in terms of demographic characteristics, region, and socioeconomic status by using NHIC data. To assess the degree of the injuries, we used the Modified Abbreviated Injury Scale (MoAIS), what has been changed from the International Classification of Disease-10 (ICD-10) code. By using the Excess Mortality Ratio-adjusted Injury Severity Score (EMR-ISS), we classified the degree of severity into four categories: mild, moderate, severe and critical. Results: From 2001 to 2003, lower extremity injuries increased slightly, with a yearly average of 2,437,335. Insurance data should that lower-extremity injuries were the most common, followed by upper-extremity injuries. Significant difference were seen in the numbers of lower extremity injuries based on gender and age. As for provinces, Seoul and Gyeongi provinces had the highest numbers of cases. Junlabukdo had the highest rate of 55,282 cases per 1 million people for standardized gender and population. The annual incidence of the insured patients with lower extrimity injuries was higher than the employer's medical insurance contributions to the medical insurance program. Daily cases occur most often in May and June, with the lowest occurrences being in January and February. Conclusion: The result of this study shows that lower extremity injuries comprised common cause of all injuries. In addition, differences associated with gender, location and socioeconomic status were observed. Further studies are needed to find reasons and then this knowledge will allow strategies to prevent the lower extremity injuries.

Free Flaps in Reconstruction of the Lower Extremity (유리 피판을 이용한 다양한 하지 연부 조직 결손의 재건)

  • Hwang, Jee-Hoon;Lee, Kun-Chang;Yoo, Won-Min;Tark, Kwan-Chul;Roh, Tai-Suk
    • Archives of Reconstructive Microsurgery
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    • v.13 no.2
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    • pp.123-129
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    • 2004
  • Lower extremity injuries are frequently accompanied with large soft-tissue defects. Such Injuries are difficult to manage for its poor vascularity, rigid tissue distensibility, easy infectability and a relatively long healing period. Also, osteomyelitis, and/or non-union of the fractured bones are relatively common in lower extremity injuries and its weight-bearing role should be considered. Therefore, it is important to select appropriate reconstruction method of the lower extremities, which is applicable to a variety of surgical techniques according to these considerations. The goal of flap coverage in the lower extremity should not only be satisfactory wound coverage, but also acceptable appearance and minimal donor site morbidity. In this article, we have tried to establish a reconstruction method in the lower extremity based on our experiences and clinical analysis of soft tissue reconstruction using free muscle flap transfer in 27 cases from Jan. 2000 to Dec. 2002. The results showed 96% flap survival, and flap failure noted in one of the cases due to vascular insufficiency. In conclusion, we believe that in cases of lower extremity soft-tissue defects especially with open comminuted fractures and infections, muscle free flaps should be considered as the first line of treatment.

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