• Title/Summary/Keyword: muscle and ligament

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Scoring System for Factors Affecting Aggravation of Lumbar Disc Herniation

  • Lee, Sung Wook;Kim, Sang Yoon;Lee, Jee Young
    • Investigative Magnetic Resonance Imaging
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    • v.22 no.1
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    • pp.18-25
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    • 2018
  • Purpose: To investigate the various imaging factors associated with aggravation of lumbar disc herniation (LDH) and develop a scoring system for prediction of LDH aggravation. Materials and Methods: From 2015 to 2017, we retrospectively reviewed the magnetic resonance imaging (MRI) findings of 60 patients (30 patients with aggravated LDH and 30 patients without any altered LDH). Imaging factors for MRI evaluation included the level of LDH, disc degeneration, back muscle atrophy, facet joint degeneration, ligamentum flavum thickness and interspinous ligament degeneration. Flexion-extension difference was measured with simple radiography. The scoring system was analyzed using receiver operating characteristic (ROC) analysis. Results: The aggravated group manifested a higher grade of disc degeneration, back muscle atrophy and facet degeneration than the control group. The ligamentum flavum thickness in the aggravated group was thicker than in the group with unaltered LDH. The summation score was defined as the sum of the grade of disc degeneration, back muscle atrophy and facet joint degeneration. The area under the ROC curve showing the threshold value of the summation score for prediction of aggravation of LDH was 0.832 and the threshold value corresponded to 6.5. Conclusion: Disc degeneration, facet degeneration, back muscle atrophy and ligamentum flavum thickness are important factors in predicting aggravation of LDH and may facilitate the determination of treatment strategy in patients with LDH. The summation score is available as supplemental data.

The Effects of Vibration Exercise after Modified Bröstrom Operation in Soccer Players with Ankle Instability

  • Kim, Sanghoon;Kim, Yangrae;Kim, Yongyoun
    • Journal of International Academy of Physical Therapy Research
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    • v.10 no.2
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    • pp.1791-1796
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    • 2019
  • Background: Vibration exercise after ankle surgery improves proprioception and ankle muscle strength through vibration stimulation. Objective: To examine the effects of vibration exercise on the ankle stability. Design: Randomized controlled clinical trial (single blind) Methods: Twenty soccer players were randomly divided into experimental group and control group. The Vibration exercise program was conducted 12 weeks and 3 times a week. Ankle joint proprioceptive sensory test and Isokinetic muscle strength test were performed using Biodex system pro III to measure plantar flexion / dorsiflexion and eversion / inversion motion. Results: The result of isokinetic test of ankle joint is showed significant improvement in all measurement items, such as leg flexion, lateral flexion, external and internal muscle forces, compared to previous ones by performing vibration movements for 12 weeks. However, in the comparison group, plantar flexor ($30^{\circ}$), eversion muscle ($120^{\circ}$), inversion ($30^{\circ}$) of limb muscle strength were significantly improved compared with the previous phase; was no significant difference in dorsi-flexion. There was no significant difference between groups in all the items. Conclusions: In this study, we analyzed the effects of rehabilitation exercise on soccer players who had reconstructed with an ankle joint ligament injury through vibration exercise device. As a result, we could propose an effective exercise method to improve the ability, and confirmed the applicability as an appropriate exercise program to prevent ankle injuries and help quick return.

An Analysis of Human Knee Joint Motion for Anterior Cruciate Ligament reconstruction (전십자 인대 재건을 위한 인체 슬관절의 굴신 운동 해석)

  • Moon, Byung-Young;Son, Kwon;Park, Jung-Hong;Suh, Jeung-Tak
    • Proceedings of the KSME Conference
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    • 2003.04a
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    • pp.929-934
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    • 2003
  • Three dimensional joint motion data were obtained using precise magnetic sensors and X-ray. Six metal markers were inserted on the femur and the tibia to set the coordinate system. Two magnetic position sensors were used to record motion data and these positions were transformed into the knee motion. The quadriceps muscle was extended in an automatic manner by an extraction machine. Results of the knee motion were the same as the clinical data. The proposed method is found to be reasonable in describing the knee motion so that these motion data can be used to simulate the normal knee joint.

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An Introduction of IMS(Intramuscular Stimulation Therapy) with Theoretcial Basis and Clinical Applications (IMS(Intramuscular Stimulation Therapy)의 이론적 배경과 임상적 운용에 대한 고찰)

  • Kwon, Ki-Rok;Gok, Kyung-Seung;Kim, Sung-Wook
    • Journal of Pharmacopuncture
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    • v.6 no.2
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    • pp.159-164
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    • 2003
  • Results : 1. The most important concept of IMS is chronic pain illness that may develop into hypersensitivity of the nerves, i.e., neuropathy. 2. Muscle shortening may be triggered by stress, including emotional, physical, external, and internal factors. 3. Muscle shortening increases mechanical tension on the muscles as well as inducing abrasion of the tissues by stretching ligament, tendon, cartilage, bone, and etc. 4. Pain from neuropathy is normally manifested on musculoskeletal system and spasm or shortening play as the central axis of this pain. 5. Neuropathy often appears at the nerve root level and the most important decisive factor of radiculopathy is muscle shortening. 6. Spondylosis is the most common cause of radiculopathy. 7. The most significant treatment principle of IMS is to relieve muscle shortening and remove stimulating determinant from the vertebrae. 8. Dry needling is quite effective for treating various pain caused by muscle shortening.

A study on differentiation potency of adult stem cells from pulp, periodontal ligament, and dental follicle to osteoblast (치수, 치주인대 및 치낭에서 얻어진 성체줄기세포의 조골세포로의 분화능력 평가에 관한 연구)

  • Lee, Joong-Kyou;Lee, Jae-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.1
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    • pp.7-15
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    • 2010
  • Complex human tissues harbor stem cells and precursor cells, which are responsible for tissue development or repair. Recently, dental tissues such as dental pulp, periodontal ligament (PDL), dental follicle have been identified as easily accessible sources of undifferentiated cells. These tissues contain mesenchymal stem cells that can be differentiate into bone, cartilage, fat or muscle by exposing them to specific growth conditions. In this study, the authors procured the stem cell from pulp, PDL, and dental follicle and differentiate them into osteoblast and examine the bone induction capacity. Dental pulp stem cell (DPSC), periodontal ligament stem cell (PDLSC), and dental follicle precursor cell (DFPC) were obtained from human 3rd molar and cultured. Each cell was analyzed for presence of stem cell by fluorescence activated cell sorter (FACs) against CD44, CD105 and CD34, CD45. Each stem cell was cultured, expanded and grown in an osteogenic culture medium to allow formation of a layer of extracellular bone matrix. Osteogenic pathway was checked by alizarin red staining, alkaline phosphatase (ALP) activity test and RT-PCR for ALP and osteocalcin (OCN) gene expression. According to results from FACs, mesenchymal stem cell existed in pulp, PDL, and dental follicle. As culturing with bone differentiation medium, stem cells were differentiated to osteoblast like cell. Compare with stem cell from pulp, PDL and dental follicle-originated stem cell has more osteogenic effect and it was assumed that the character of donor cell was able to affect on differential potency of stem cell. From this article, we are able to verify the pulp, PDL, and dental follicle from extracted tooth, and these can be a source of osteoblast and stem cell for tissue engineering.

A Morphometric Study of the Obturator Nerve around the Obturator Foramen

  • Jo, Se Yeong;Chang, Jae Chil;Bae, Hack Gun;Oh, Jae-Sang;Heo, Juneyoung;Hwang, Jae Chan
    • Journal of Korean Neurosurgical Society
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    • v.59 no.3
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    • pp.282-286
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    • 2016
  • Objective : Obturator neuropathy is a rare condition. Many neurosurgeons are unfamiliar with the obturator nerve anatomy. The purpose of this study was to define obturator nerve landmarks around the obturator foramen. Methods : Fourteen cadavers were studied bilaterally to measure the distances from the nerve root to relevant anatomical landmarks near the obturator nerve, including the anterior superior iliac spine (ASIS), the pubic tubercle, the inguinal ligament, the femoral artery, and the adductor longus. Results : The obturator nerve exits the obturator foramen and travels infero-medially between the adductors longus and brevis. The median distances from the obturator nerve exit zone (ONEZ) to the ASIS and pubic tubercle were 114 mm and 30 mm, respectively. The median horizontal and vertical distances between the pubic tubercle and the ONEZ were 17 mm and 27 mm, respectively. The shortest median distance from the ONEZ to the inguinal ligament was 19 mm. The median inguinal ligament lengths from the ASIS and the median pubic tubercle to the shortest point were 103 mm and 24 mm, respectively. The median obturator nerve lengths between the ONEZ and the adductor longus and femoral artery were 41 mm and 28 mm, respectively. Conclusion : The obturator nerve exits the foramen 17 mm and 27 mm on the horizontal and sagittal planes, respectively, from the pubic tubercle below the pectineus muscle. The shallowest area is approximately one-fifth medially from the inguinal ligament. This study will help improve the accuracy of obturator nerve surgeries to better establish therapeutic plans and decrease complications.

The Influence of Local Anesthesia of Canine Periodontal Ligament on Electromyographic Activity of Jaw Elevator Muscles during Canine Guidance (견치유도군에서 견치치주인대의 국소마취가 저작근활성도에 미치는 영향)

  • Yang-Soo Jung;Jin-Soo Kim;Jae-Kap Choi
    • Journal of Oral Medicine and Pain
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    • v.13 no.1
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    • pp.85-93
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    • 1988
  • The author studied maximum clenching EMG activities of temporalis anterior and masseter muscle during canine guidance and centric occlusion. It was performed before and after anesthesia of maxillary and mandibular canines. The 22 normal subjects (15 males and 7 females) who had healthy maxillary and mandibular canines were selected. Their occlusal contact scheme was canine guidance during movement and they did not have temporomandibular disorder. The results were as follows : 1. The maximum clenching EMG activities of temporalis anterior and masseter muscle during guidance were less than those during centric occlusion. 2. After left maxillary and mandibular canines were anesthetized with 2% lidocanine with 1:100,000 epinephrine, the maximum clenching EMG acivities of temporalis anterior and masseter muscle during left canine guidance were greater than those before anesthesia of left maxillary and mandibular canines(p<0.01) 3. The maximum clenching EMG activities of temporalis anterior and masseter muscle during right guidance were not significantly different between before and after anesthesia of left maxillary and mandibular canines(p>0.05).

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Effect of Backward Versus Forward Lunge Exercises on Trunk Muscle Activities in Healthy Participants

  • Song, Jae-Keun;Yoo, Won-Gyu
    • Physical Therapy Korea
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    • v.28 no.4
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    • pp.273-279
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    • 2021
  • Background: Lunge exercises are lower extremity rehabilitation and strengthening exercises for patients and athletes. Most studies have shown the effectiveness of the forward and backward lunge exercises for treating patellofemoral pain and anterior cruciate ligament injuries (by increasing lower extremity muscle activity) and improving kinematics. Objects: However, it is not known how the two different lunge movements affect trunk muscle activities in healthy individuals. The purpose of this study was to investigate the electromyographic activity of the rectus abdominis and erector spinae muscles during forward and backward lunge exercises in healthy participants. Methods: Twelve healthy participants were recruited. Electromyographic activity of the rectus abdominis and erector spinae was recorded using surface electrodes during forward and backward lunges, and subsequently normalized to the respective reference voluntary isometric contractions of each muscle. Results: Activity of the erector spinae was significantly higher than that of the rectus abdominis during all stages of the backward lunge (p < 0.05). The activity of the erector spinae was significantly greater during the backward than forward lunge at all stages (p < 0.05). Conclusion: Backward lunging is better able to enhance trunk motor control and activate the erector spinae muscles.

Femoral Nerve Injury after Rectus Abdominis Muscle Slap Harvesting: A Case Report (복직근 유리피판 거상 후 합병된 대퇴 신경손상 1례)

  • Kim, Jino;Lew, Dae Hyun;Tark, Kwan Chul
    • Archives of Plastic Surgery
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    • v.33 no.4
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    • pp.510-513
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    • 2006
  • Purpose: The Rectus abdominis muscle free flap is utilized in various reconstruction surgeries due to easiness in harvesting, consistency of vascular pedicle and reduced donor site morbidity. But rarely, femoral nerve injury during rectus abdominis harvesting can be resulted. We report a case of femoral nerve injury after rectus muscle harvesting and discuss the injury mechanism with the follow-up process of this injury. Methods: To reconstruct the defect of middle cranial base after wide excision of cystic adenocarcinoma of the external ear, rectus muscle free flap was havested in usual manner. To achieve a long vessel, inferior epigastric artery was dissected to the dividing portion of femoral artery and cut. Results: One week after the surgery, the patient noted sensory decrease in the lower leg, weakness in muscle strength, and disabilities in extension of the knee joint resulting in immobilization. EMG and NCV results showed no response on stimulation of the femoral nerve of the left leg, due to the defects in femoral nerve superior to the inguinal ligament. With routine neurologic evaluations and physical therapy, on the 75th day after the operation, the patient showed improvement in pain, sensation and muscle strength, and was able to move with walking frame. In 6 months after the operation, recovery of the muscle strength of the knee joint was observed with normal flexion and extension movements. Conclusion: Rarely, during dissection of the inferior epigastric artery, injuries to the femoral nerve can be resulted, probably due to excessive traction or pressure from the blade of the traction device. Therefore, femoral nerve injury can be prevented by avoiding excessive traction during surgery.

The Benefit of KT-2000 Knee Ligament Arthrometer in Diagnosis of Anterior Cruciate Ligament Injury (슬관절 전방 십자 인대 파열의 진단에 있어서 KT-2000 기기의 유용성)

  • Park, Jai-Hyung;Kim, Hyoung-Soo;Jung, Kwang-Gyu;Yoo, Jeong-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.2
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    • pp.82-88
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    • 2004
  • Purpose: In this study, we intended to ascertain the benefit of KT-2000 Knee arthrometer(KT-2000) in the diagnosis of ACL(Anterior cruciate ligament) injury by comparing the anterior displacement of normal knee with that of ACL deficient knee. Materials and Methods: We designated two examiners to measure the anterior displacement of the knee joint of 30 healthy individuals, using KT-2000, at 30$^{\circ}$ flexion setting of muscle full relaxation, contraction, 25$^{\circ}$ internal rotation and 25$^{\circ}$ external rotation and analyzed these results according to the variables and measured the preoperative anterior displacement of the ACL injured knee in the 30 patients who have gone through an arthroscopic ACL reconstruction later. Results: The results of examiner 1 are 6.5${\pm}$1.5 mm, 2.5${\pm}$0.9 mm, 4.8${\pm}$1.2 mm, 6.4${\pm}$1.3 mm in right knee and 5.6${\pm}$1.3 mm, 2.1${\pm}$0.8 mm, 4.5${\pm}$1.2 mm, 5.2${\pm}$1.3 mm in left knee, in order of muscle full relaxation, contraction, 25$^{\circ}$ internal rotation and 25$^{\circ}$ external rotation. The results of examiner 2 are 6.9${\pm}$1.2mm, 2.9${\pm}$1.1mm, 5.6${\pm}$1.6mm, 6.9${\pm}$1.5mm in right, 5.5${\pm}$1.7 mm,1.9${\pm}$0.9 mm, 5.1${\pm}$1.9 mm, 5.7${\pm}$1.6 mm in left knee, The side to side difference of examiner 1 in the setting of muscle relaxation is 0.9${\pm}$1.0 mm. The anterior displaement of ACL injured knee is average 11${\pm}$2.93 mm and difference of average 6.5${\pm}$2.31 mm form that of normal. In comparison between the right and left knees of healthy individuals, the both results of two examiners showed the statistical difference in the setting of muscle full relaxation but, the results showed the side to side difference below 2 mm in 25case(83%), 21case(70%) respectively and above 3 mm in just 1 case. In the comparison between the normal and ACL injured knees, the results show the statistical difference of the side to side difference in the setting of muscle relaxation(p<0.05). Conclusion: The KT-2000 result is affected by relaxation of muscles around knee, flexion angle of knee joint, rotation of tibia, the strength of displacing force, time of the test and physical factors as height and weight. However, the Accuracy of diagnosis of ACL injury by KT-2000 will increase if the examiner is skillful and the tests are made on the exact position of knee joint.

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