• Title/Summary/Keyword: muscle and ligament

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Chronic Lateral Ankle Instability (만성 외측 발목 불안정)

  • Kim, Dae-Wook;Sung, Ki-Sun
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.2
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    • pp.55-61
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    • 2018
  • Chronic lateral ankle instability is a major complication of acute ankle sprains, which can cause discomfort in both daily and sports activity. In addition, it may result in degenerative changes to the ankle joint in the long term. An accurate diagnostic approach and successful treatment plan can be established based on a comprehensive understanding of the concept of functional and mechanical instability. The patients' history and correct physical examination would be the first and most important step. The hindfoot alignment, competence of the lateral ligaments, and proprioceptive function should be evaluated. Additional information can be gathered using standard and stress radiographs. In addition, concomitant pathologic conditions can be investigated by magnetic resonance imaging. Conservative rehabilitation composed of the range of motion, muscle strengthening, and proprioceptive exercise is the main treatment for functional instability and mechanical instability. Regarding the mechanical instability, surgical treatment can be considered for irresponsible patients after a sufficient period of rehabilitation. Anatomic repair (modified $Brostr{\ddot{o}}m$ operation) is regarded as the gold standard procedure. In cases with poor prognostic factors, an anatomical reconstruction or additional procedures can be chosen. For combined intra-articular pathologies, arthroscopic procedures should be conducted, and arthroscopic lateral ligament repair has recently been introduced. Regarding the postoperative management, early functional rehabilitation with short term immobilization is recommended.

Effect of 12-week Exercise Programs for Posture Correction on Standing Postural Alignment in Elderly Women

  • Han, Ki Hoon;Shin, Jin Hyung;Lee, Joong Sook
    • Korean Journal of Applied Biomechanics
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    • v.28 no.2
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    • pp.119-125
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    • 2018
  • Objective: The purpose of this study was to compare the effect of different 12-week exercise programs for posture correction on postural alignment in elderly women. Method: The study included 36 elderly women who were randomly divided into 3 groups: Group A (core exercise, n=12), Group B (combined exercise, n=12), and Group C (Pilates exercise, n=12). Postural alignment was measured using 6 variables in frontal and sagittal planes. Two-way mixed analysis of variance was used to compare the effect of exercise program types on postural alignment and a paired t-test was used to compare differences in postural alignment after exercise. Results: The core exercise group showed statistically significant improvement (p<.05) in multiple upper and lower body postural alignment measurements. The combined exercise and Pilates exercise groups showed statistically significant improvement (p<.05) in upper body measurements alone. Conclusion: Core exercise, combined exercise, and Pilates exercise improved postural alignment in elderly woman through improvement in muscle strength and ligament flexibility around the spine and pelvis.

Study of Ossification of posterior longitudinal ligament(OPLL) (후종인대 골화증(OPLL)에 관한 고찰 - "동의보감(東醫寶鑑)"을 중심으로 -)

  • Lee, Yuo-Ryul;Shin, Hyun-Kyu;Oh, Min-Seok
    • Journal of Haehwa Medicine
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    • v.16 no.1
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    • pp.147-156
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    • 2007
  • This study was performed to investigate the cause, symptom, treatment of OPLL through Western medicine and Dong-Eui-Bo-Kham(東醫寶鑑) Results & conclusins 1. Ossification of the posterior hgament(OPLL) have radiculopathy, myelopathy or both of them such as neck pain, numbness, myatonia 2. Neck pain of OPLL seems to be simular with pain in the neck(頸項痛), neck stiffness(項强), stiffness and pain of head and neck(頭項彈痛). The causes were usually Dampness and Cold, Wind. The treatments were classified according to pathoigenic factor(病因) and muscle along the regular meridian(經筋) 3. Radiculopathy of OPLL seems to be similar with numbness(痺證). The causes were usually, pathogenic Wind, Cold, Dampness. The treatments were classified according to diagnosis of three kinds of BI syndrome(三痺), five kind of Bi synrome(五痺), five jang Bi(五臟痺), six Bu Bi(六腑痺) 4. Myelopathy of OPLL seems to be simular with myatonia(痿證) The cause of myatoma was Lung scorched by Heat(肺熱葉無). And the treatment was purping the south and reinforcing the north(寫南方 補北方). We considered that more study to find various and effective methods oriental medicine for OPLL should be made.

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The Effects of Strength Training on Knee Joint Torque During Walking in an Adolescent With Down Syndrome: A Single Case Study (근력훈련이 다운증후군 청년의 무릎 관절 토크에 미치는 영향)

  • Lim, Bee-Oh
    • Korean Journal of Applied Biomechanics
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    • v.16 no.4
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    • pp.73-81
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    • 2006
  • The purpose of this study was to investigate the effects of strength training on knee joint torque during walking in an adolescent with trisomy-21 Down syndrome. One adolescent with Down syndrome and one normal child participated in this study. Strength training consisted of eight exercises: squat, hamstring curl, hip adduction, hip abduction, knee extension, toe raise, sit-ups, and hyperextension of the waist. The participant with Down syndrome was participated in strength training for 12 weeks, three times a week, three sets, 10-15 RM; resistance was adjusted according to the principle of progressive overload. To measure the effect of strength training, isokinetic strength variables and knee joint torques were measured before training and after 12 weeks of training. The participant with Down syndrome had some abnormalities in controlling knee motion during walking due to muscle hypotonia, ligament laxity, and weakness of muscles. Post-training isokinetic strength increased compared to pre-training measurements. Knee range of motion were increased after strength training. Strength training did not affect ad/adduction and in/exteranl moments but did have an effect on flexor/extensor moment and timing.

Clinical observations on treatment of ankle-sprain (족관절 염좌의 치료에 대한 임상적 고찰)

  • You, Tae-seop;Park, Dong-suk;Kang, Sung-keel
    • Journal of Acupuncture Research
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    • v.21 no.1
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    • pp.168-175
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    • 2004
  • Objective: This report was designed to investigate characteristic of ankle sprain due to cause, degree of injury, treatment process, sex, age etc Methods: We selected 36 patients who visited our clinic at last over two times complaining of ankle-sprain since 8th, March, 2002. Results: The results were summarized as follows. 1. The major cause of ankle-sprain was injury of lateral collateral ligament. 2. Ankle-sprain was distinguished three degree, and generally presented pain, regional tenderness, swelling, limited movement, muscle spasm, redness, deformity. 3. In early stage of ankle-sprain, ice massage, compression, elevation, rest were very important. 4. In oriental medicine, the principle of treatment were promoting blood circulation to remove blood stasis, relaxing muscles and tendons and activating the flow of Gi and blood in the channels and collaterals, reducing edema or swelling, and alleviating pain. 5. There were more effective result to using three-edged needle with acupuncture. Conclusions: Ankle-sprain were treated successfully using acupuncture and three-edged needle.

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The Effect of Strength Training Targeting Medial Quadriceps and Hamstrings on Dynamic Balance (내측 사두거근 및 햄스트링근 강화 훈련이 동적 균형 능력에 미치는 영향 )

  • Jiyoung Jeong;Choongsoo S. Shin
    • Korean Journal of Applied Biomechanics
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    • v.33 no.2
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    • pp.45-51
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    • 2023
  • Objective: The aim of this study was to examine the effect of strength training targeting medial quadriceps/hamstrings and non-targeting strength training on dynamic balance. Method: A total of 51 healthy subjects were randomly assigned to control, targeting strength training, or non-targeting training groups. To measure the dynamic balance, the star excursion balance test (SEBT) was performed before and after training. The SEBT parameters were compared using repeated measures ANOVA, and post-hoc paired t test at a significance level of 0.05. Results: Greater anterior (p= .011), anteromedial (p= .001), medial (p< .001), lateral (p< .001), and anterolateral (p= .001) reach distances were found between pre- and post-training in the strength training targeting medial thigh muscles group. Only greater lateral reach distance was found after non-targeting strength training (p= .029). In addition, no differences were found for any SEBT scores in the control group. Conclusion: Strength training targeting medial quadriceps and hamstrings can improve the dynamic balance, thereby it positively affected in lower extremity injury risk, whereas non-targeting strength training rarely changes the dynamic balance.

A Case of Aberrant Abducens Nerve in a Cadaver and Review of Its Clinical Significance

  • Choi, Chan-Young;Han, Seong-Rok;Yee, Gi-Taek;Lee, Chae-Heuck
    • Journal of Korean Neurosurgical Society
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    • v.47 no.5
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    • pp.377-380
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    • 2010
  • The abducens nerve usually travels from the brainstem to the lateral rectus muscle as a single trunk. However, it has been reported that this nerve could split into branches occasionally. We attempted to show the aberrant course of abducens nerve in a specimen with unilateral duplicated abducens nerve and review relevant literatures. The micro-dissections were performed in a head specimen injected with colored latex under the microscope. The abducens nerve was duplicated unilaterally. This nerve emerged from the pontomedullary sulcus as a single trunk and splitted into two branches in the prepontine cistern. These two separate branches were piercing the cerebral dura of the petroclival region respectively. The slender lower branch passed between the petroclinoid and petrosphenoid ligaments and the thick lower one passed under the petrosphenoid ligament. These two branches united just lateral to the ascending segment of internal carotid artery in the cavernous sinus. The fact that there are several types of aberrant abducens nerve is helpful to perform numerous neurosurgical procedures in the petroclival region and cavernous sinus without inadvertent neurovascular injuries.

Identification of Matrix Mineralization-Related Genes in Human Periodontal Ligament Cells Using cDNA Microarray (cDNA microarray에 의한 치주인대세포의 광물화 결절형성에 관여하는 유전자들의 분석)

  • Shin, Jae-Hee;Park, Jin-Woo;Yeo, Shin-Il;Noh, Woo-Chang;Kim, Moon-Kyu;Kim, Jung-Chul;Suh, Jo-Young
    • Journal of Periodontal and Implant Science
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    • v.37 no.sup2
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    • pp.447-463
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    • 2007
  • Periodontal ligament (PDL) cells have been known as multipotential cells, and as playing an important rolesin periodontal regeneration. The PDL cells are composed of heterogeneous cell populations which have the capacity to differentiate into either cementoblasts or osteoblasts, depending on needs and conditions. Therefore, PDL cells have the capacity to produce mineralized nodules in vitro in mineralization medium which include ascorbic acid, ${\beta}$-glycerophosphate and dexamethasone. In spite of these well-known osteoblast like properties of PDL cells, very little is known about the molecules involved in the formation of the mineralized nodules in the PDL cells. In the present study, we analysed gene-expression profiles during the mineralization process of cultured PDL cells by means of a cDNA microarray consisting of 3063 genes. Nodules of mineralized matrix were strongly stained with alizarin red S on the PDL cells cultured in the media with mineralization supplements. Among 3,063 genes analyzed, 35 were up-regulated more than two-fold at one or more time points in cells that developed matrix mineralization nodules, and 38 were down-regulated to less than half their normal level of expression. In accord with the morphological change we observed, several genes related to calcium-related or mineral metabolism were induced in PDL cells during osteogenesis, such as IGF-II and IGFBP-2. Proteogycan 1, fibulin-5, keratin 5, ,${\beta}$-actin, ${\alpha}$-smooth muscle actin and capping protein, and cytoskeleton and extracellular matrix proteins were up-regulated during mineralization. Several genes encoding proteins related to apoptosis weredifferentially expressed in PDL cells cultured in the medium containing mineralization supplements. Dkk-I and Nip3, which are apoptosis-inducing agents, were up-regulated, and Btf and TAXlBP1, which have an anti-apoptosis activity, were down-regulated during mineralization. Also periostin and S100 calciumbinding protein A4 were down-regulated during mineralization.

Clinical Evaluation of TightRope Cranial Cruciate Ligament Technique for Treatment of Cranial Cruciate Ligament Deficiency in Dogs (전방 십자인대 결손을 보이는 개에서 TightRope을 이용한 치료방법 평가)

  • Yoon, Hun-Young;Kim, Kyung-Hee;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.29 no.6
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    • pp.455-459
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    • 2012
  • Nine dogs presented to the Veterinary Medical Teaching Hospital of Konkuk University and Woosung Animal Hospital with a history of pelvic limb lameness. On physical examination, 9 dogs all showed a consistent weight bearing lameness and mild muscle atrophy. There was cranial drawer sign with pain in 9 dogs. Mediolateral radiographic projection revealed cranial subluxation of the tibial tuberosity in a tibial compression view. The right and left stifle joints were affected in 7 dogs and 2 dogs respectively. TightRope cranial cruciate ligament (CCL) technique for treatment of CCL deficiency was performed. Polyester and nylon were used to stabilize the stifle in 3 dogs and 6 dogs respectively. Suture sizes were 0.8 mm (n = 2), 0.9 mm (n = 4), 1.1 mm (n = 2), and $1.1mm{\times}2$ strands (n = 1) in diameter. Mean (${\pm}SD$) surgical duration was $48.3{\pm}8.5$ minutes (range 35 to 60 minutes). Preoperative and postoperative mean (${\pm}SD$) cranial drawer signs were $8.6{\pm}1.6$ mm (rage 7 to 12 mm) and $1.2{\pm}1.0$ mm (rage 0 to 3 mm) respectively. Immediate postoperative radiographs of the affected limb revealed no evidence of cranial subluxation of the tibial tuberosity in a tibial compression view of 9 dogs. Normal limb function was regained in 8 dogs within 8 weeks postoperatively. A consistent weight bearing lameness resolved in all dogs after TightRope CCL technique, but reoccurred in one dog (case No. 6) 2 weeks after surgery. Cranial subluxation of the tibial tuberosity was identified in a tibial compression test. During the second surgery, breakage of surgical button was identified and a tibial wedge osteotomy was performed. Based on surgical time, complication, stifle stability, and functional recovery, the present study indicated that TightRope CCL technique is effective treatment for the dogs with CCL deficiency.

ACL Reconstruction with Hamstring Tendon and LA (Ligament anchor) Screw (슬괵건과 LA나사를 이용한 관절경적 전방 십자 인대 재건술)

  • Song Eun-Kyoo;Seon Jong-Keun;Cho Sang-Gwon
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.189-195
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    • 2003
  • Purpose : To evaluate the clinical results after anterior cruciate ligament (ACL) reconstruction with hamstring tendon and Ligament Anchor (LA) screw Materials and Methods : 103 patients (104 cases) who were followed up at least more than 2 years after ACL reconstruction were included in this study. The average period of follow-up was 36 months. The clinical results such as physical examination and Lysholm knee score and instrumented anterior laxity test with Telos were evaluated. Results : The Lysholm knee score was 57.9 in average preoeratively and improved to 95.2 in average at follow up. On the Lachman test, there were mild (+) instability in 46 cases $(45\%)$, moderate (++) in 33 $(31\%)$, severe (+++) in 25 $(24\%)$ preoperatively. 90 cases $(87\%)$ were converted to negative and 14 $(13\%)$ to mild at follow up. On Pivot-shift test, there were negative (-) instability in 22 cases $(22\%)$, mild (+) in 62 $(59\%)$, moderate (++) in 12 $(11\%)$ and severe in 8 $(8\%)$ preoperatively. 87 cases $(84\%)$ were converted to negative and 17 $(16\%)$ to mild at follow up. On instrumented anterior laxity test with $Telos^{\circledR}$, side to side difference on 20 lb was $13.4{\pm}5.6$ (7-25) mm in average preoperatively, and was decreased to $3.6{\pm}1.5$ (1-6) mm in average at follow-up. Complications were quadriceps muscle atrophy in 27 $(30.0\%)$, saphenous nerve paresthesia in 19 $(18.3\%)$, anterior knee crepitus in 13 $(12.5\%)$ and over-penetration of screw through lateral femoral cortex in 5 cases $(4.8\%)$. Conclusion : ACL reconstruction with hamstring tendon and LA screw was one of the choice of graft and fixatives in restoring knee stability and in improving clinical results with little complications such as anterior knee pain.

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