• 재활복지공학회논문지
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• 제10권4호
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• pp.287-294
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• 2016

본 연구는 가변형 핸드바이크를 개발하기 위해서 손으로 구동하는 핸드바이크 사용자들이 싸이벡스를 이용하여 등받이각도별 상지회전력 값, 크랭크축과 가슴명치와의 거리에 대한 상지회전력 값, 그리고 핸드바이크의 손잡이 각도별 상지회전력 값을 토대로 핸드바이크 설계 가이드라인을 제시하기 위함이다. 본 연구를 위해 일반인 남자 3명을 대상으로 상지 회전력 값을 실험측정하였다. 본 연구 결과를 보면 다음과 같다. 첫째, 핸드바이크 등받이 각도 중 상지회전력에서 최대근력이 등받이 50도일때가 가장 높았고, 근지구력은 등받이 80도 일때가 가장 높았다. 이는 엎드린 자세 즉 K-Tybe 핸드바이크가 가장 속도가 높을거라고 주관적으로 생각되었지만 바람의 저항이 등받이가 낮을수록 속도와 효율성이 영향을 미치는 것으로 나타났다. 둘째, 핸드바이크 손잡이 타입 중 수평(0도)손잡이, 수직(90도)손잡이, 45도 손잡이 중 45도 손잡이가 가장 회전력 값이 높았다. 이는 수관절, 주관절, 견관절 등이 골고루 힘이 분배되어 회전력이 발생하는 것으로 나타났다. 셋째, 핸드바이크 크랭크축과 가슴명치와의 거리(35cm, 45cm, 55cm)중 45cm가 회전력이 가장 효율적으로 발생되는 것으로 나타났다. 이는 핸드바이크 핸들링 시에 나타나는 중력에 영향과 피로감이 영향을 받는 것으로 나타났다.

• Archives of Plastic Surgery
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• 제46권6호
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• pp.589-593
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• 2019

Post-traumatic defects of the distal third of the leg often require skipping a few steps of the well-established reconstructive ladder, due to the limited local reliable reconstructive options. In rare cases, the reconstructive plan and flap choice may encounter challenges when the patient has psychiatric illness affecting compliance with postoperative care. We describe a case of a patient with severe intellectual disability and an open fracture of the distal lower limb. After fracture management and debridement of devitalized tissues, the resultant soft tissue defect was covered with a free gracilis flap. On postoperative day 7, the patient ripped out the newly transplanted flap. The flap was too traumatized for salvage, so a contralateral free gracilis muscle flap was used. The patient showed good aesthetic and functional outcomes at a 1-year follow-up. When planning the postoperative management of patients with psychiatric illness, less complex and more robust procedures may be preferred over a long and complex surgical reconstruction requiring good compliance with postoperative care. The medical team should be aware of the risk of postoperative collapse, focus on the prevention of pain, and be wary of drug interactions. Whenever necessary, free tissue transfer should be performed despite potential compliance issues.

• 대한의용생체공학회:의공학회지
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• 제38권4호
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• pp.143-152
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• 2017

The main purpose of this research was to examine the EMG characteristics of driver's upper limb and driving performance for operating accelerator and brake pedal by using four types of left hand control devices(Push/Pull, Push/Right angle, Push/Rock, Push/Twist) during simulated driving. The persons with disabilities in the lower extremity have problems in operation of the vehicle because of functional impairments for controlling accelerator and brake pedal. Therefore, if hand control device is used for adaptive driving controls in persons with lower extremity loss, the disabled people could improve their quality of mobility life by driving a car. Twenty subjects were involved in this research to assess driving performance and EMG activities for operating accelerator and brake pedal by using four types of left hand controls in driving simulator. We measured EMG responses of six muscles(posterior deltoid, middle deltoid, biceps, triceps, extensor carpi radialis, and flexor carpi radialis) during pulling and pushing movement with four types of left hand controls for acceleration and braking. STISim Drive 3 program was used for evaluation test of four types of left hand control devices in straight lane course for time to reach target speed and brake reaction time. While operating the four types of left hand controls for acceleration, EMG activities of posterior deltoid in normal subjects were significantly increased(p < 0.05) compared to the disabled subjects. It was also found that EMG responses of triceps and posterior deltoid were significantly increased(p < 0.05) when using the Push/Right angle type than Push/Pull type. While operating the four types of left hand controls for braking, EMG activities of flexor carpi radialis and triceps in subjects with disability were significantly increased(p < 0.05) compared to the normal subjects. It was shown that muscle responses of posterior deltoid, middle deltoid and triceps were significantly increased when using the Push/Right angle type than Push/Rock type. Time to reach target speed and brake reaction time in subjects with disability was increased by 2.5% and 4.6% on average compared to normal subjects. The person with disabilities showed a tendency to relatively slow performance in acceleration at the straight lane course.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2004년도 추계학술대회 논문집
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• pp.1207-1210
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• 2004

As many humans age, degenerative lumbar spinal stenosis (DLSS) becomes a major cause of lower limb discomfort and disability. By surgical treatment method of DLSS, the existing surgical treatment methods using internal fixation have showed degeneration changes of an adjacent vertebrae and loss of lumbar spine lordosis-kyphosis due to eliminating a motion. For solving the problems of internal fixation, a novel interspinous spacer has been developed to treat DLSS by surgical treatment method. In this study, we evaluated the biomechanical effects of the interspinous spacer on the kinematics of the porcine lumbar spine before and after insertion of the implant. For this purpose, a device that is capable of measuring 3-D motions were built based on direct linear transformation (DLT) algorithm written with MATLAB program. Results showed that in extension, a change of the mean angle between the intact and the implanted specimens at L4-L5 was 1.87 degree difference and the implant reduced the extension range of motion of the L4-L5 (p＆lt;0.05). But the range of motion in flexion, axial rotation and lateral bending at the adjacent segments was not statistically affected by the implant. In conclusion, we thought that interspinous spacer may have remedical value for DLSS by flexing human lumbar spine.

• Journal of Acupuncture Research
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• 제34권4호
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• pp.185-189
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• 2017

Background: The aim of this study was to assess the change in radiating leg pain after traffic accidents in patients with and without herniated intervertebral disc (HIVD) and improvement of radiating leg pain after traffic accidents. Methods: This was an retrospective study of 188 patients. Patients who had been admitted to the Hospital of Korean Medicine with the complaint of radiating leg pain after traffic accidents, and who had undergone lumbar spine magnetic resonance imaging to determine the presence or absence of HIVD were observed from April to June 2016. We analyzed sex, age, length of admission, direction (to a single leg or to both legs) and locations, (medial, anterior, lateral or posterior side of the lower limb) of radiating leg pain, presence or absence of HIVD, and number, grade and position of HIVD. The Numeric Rating Scale (NRS) and Oswestry Disability Index (ODI) were used to evaluate the impact of radiating leg pain on patients. Results: Radiating leg pain NRS score decreased significantly in both the HIVD group (from $6.12{\pm}2.39$ to $4.31{\pm}1.87$, p < 0.001) and the no HIVD group (from $5.76{\pm}1.64$ to $3.85{\pm}1.41$, p < 0.001). ODI score also decreased significantly in both groups (HIVD, from $44.67{\pm}17.38$ to $26.83{\pm}13.18$; no HIVD, from $39.24{\pm}15.58$ to $19.69{\pm}12$.; both p < 0.001). Conclusion: There was no significant change in radiating leg pain after traffic accidents in patients with and without HIVD and improvement of radiating leg pain after traffic accidents.

• 척추신경추나의학회지
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• 제6권2호
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• pp.71-78
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• 2011

Objectives : The purpose of this study was to evaluate the effect of Oriental medical treatment in patients with acute lumbar Herniated Intervertebral Disc(HIVD). Methods : This clinical study was carried out on 44 patients with acute lumbar HIVD, who had been admitted from Oct. 2011 to Nov. 2011. All of 44 patients were treated with acupuncture, Chuna treatment and herbal medicine during the whole admission period. Verbal numerical rating scale(VNRS) and Oswestry disability index(ODI) were used to evaluated the effectiveness of the Oriental medical treatment. Result : Siginificant improvement of the symptoms was seen when evaluated with VNRS and ODI. Conclusions : These results suggest that in the case of low back pain and lower limb numbness caused by acute HIVD, conservative treatments can be considered as one of the options of treating the symptoms beside surgical way.

• 한방재활의학과학회지
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• 제32권1호
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• pp.125-131
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• 2022

This study was to investigate the effectiveness of combined Korean medicine treatment on a patient who was diagnosed on lumbosacral transitional vertebra (LSTV) with localized bone marrow edema. The patient was treated with acupuncture, pharmacopucture, cupping and herbal medicine. We evaluated patient's progress using range of motion (ROM), EuroQol-5 dimensions (EQ-5D), Oswestry disability index (ODI), numerical rating scale (NRS), patient global impression of change, self-walkable distance. NRS of back pain decreased from 7 to 5, at the same time NRS of lower limb decreased from 4 to 3. EQ-5D score increased from 0.24 to 0.646. ODI score improved 80 to 62. Self-walkable distance and lumbar spine ROM also increased. As a result, clinical improvements were found in a patient. In conclusion, this study shows that Korean medicine treatment can be considered as effective conservative care for LSTV with localized bone marrow edema.

• 척추신경추나의학회지
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• 제7권2호
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• pp.63-74
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• 2012

Objectives : The purpose of this study was to evaluate the effect of Oriental medical treatment in patients with Spondylolisthesis and lumbar Herniated Intervertebral Disc(HIVD). Methods : This clinical study was carried out on 39 patients with Spondylolisthesis and lumbar Herniated Intervertebral Disc(HIVD), who had been admitted from Jan. 2012 to Nov. 2012. All of 39 patients were treated with acupuncture, Chuna treatment and herbal medicine during the whole admission period. Verbal numerical rating scale(VNRS) and Oswestry disability index(ODI) were used to evaluated the effectiveness of the Oriental medical treatment. Results : 1. Significant improvement of the symptoms of low back pain and leg pain on 39 patients with Spondylolisthesis and lumbar Herniated Intervertebral Disc(HIVD) was seen when evaluated with VNRS and ODI. 2. There was no significant difference of improvement by herniated type when evaluated with VNRS and ODI.. 3. There was no significant difference of improvement by spondylolisthesis type(degenerative and spondylolytic) when evaluated with VNRS and ODI. Conclusions : These results suggest that in the case of low back pain and lower limb numbness caused by Spondylolisthesis and HIVD, conservative treatments can be considered as one of the options of treating the symptoms beside surgical way.

• 대한의용생체공학회:의공학회지
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• 제32권2호
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• pp.165-176
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• 2011

The femoral nerve innervates the quadriceps muscles and its dermatome supplies anteromedial thigh and medial foot. Paralysis of the quadriceps muscles due to the injury of the femoral nerve results in disability of the knee joint extension and loss of sensory of the thigh. A child could walk independently even though he had injured his femoral nerve severely due to the penetrating wound in the medial thigh. We measured and analyzed his gait performance in order to find the mechanisms that enabled him to walk independently. The child was eleven-year-old boy and he could not extend his knee voluntarily at all during a month after the injury. His gait analysis was performed five times (GA1~GA5) for sixteen months. His temporal-spatial parameters were not significantly different after the GA2 or GA3 test, and significant asymmetry was not observed except the single support time in GA1 results. The Lower limb joint angles in affected side had large differences in GA1 compared with the normal normative patterns. There were little knee joint flexion and extension motion during the stance phase in GA1 The maximum ankle plantar/dorsi flexion angles and the maximum knee extension angles were different from the normal values in the sound side. Asymmetries of the joint angles were analyzed by using the peak values. Significant asymmetries were found in GA1with seven parameters (ankle: peak planter flexion angle in stance phase, range of motion; ROM, knee: peak flexion angles during both stance and swing phase, ROM, hip: peak extension angle, ROM) while only two parameters (maximum hip extension angle and ROM of hip joint) had significant differences in GA5. The mid-stance valleys were not observed in both right and left sides of vertical ground reaction force (GRF) in the GA1, GA2. The loading response peak was far larger than the terminal stance peak of vertical ground reaction curve in the affected side of the GA3, GA4, GA5. The measured joint moment curves of the GA1, GA2, GA3 had large deviations and all of kinetic results had differences with the normal patterns. EMG signals described an absence of the rectus femoris muscle activity in the GA1 and GA2 (affected side). The EMG signals were detected in the GA3 and GA4 but their patterns were not normal yet, then their normal patterns were detected in the GA5. Through these following gait analysis of a child who had selective injuries on the knee extensor muscles, we could verify the actual functions of the knee extensor muscles during gait, and we also could observe his recovery and asymmetry with quantitative data during his rehabilitation.