• Title, Summary, Keyword: Knee

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Proprioception After Total Knee Replacement (슬관절 전치환술 이후의 고유수용성 감각 변화)

  • Kim, Jae-Hun
    • PNF and Movement
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    • v.9 no.1
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    • pp.39-45
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    • 2011
  • Purpose : The purpose of this article was to review the literature on change of knee position sense after total knee replacement intervention in knee rehabilitation. Methods : This review outlines scientific findings regarding different literature data in knee rehabilitation, and discusses proprioceptive change of knee joints after total knee replacement intervention. Result : Severe pain and diminished joint sensation may precipitate degenerative changes of knees joint, and a strong association between decreased proprioception and function has been identified in elderly patients with knee osteoarthritis. Total knee replacement(TKR) of the knee joint are effective surgical procedures in osteoarthritis patients, resulting in decreased pain, and improved physical function and quality of life in patients. After total knee replacement, joint position sensation is partially recovered, which may improve functional stability of the knee, but aspects of physical functioning are not fully restored to preoperative status. Conclusions : Thus, recovery rate in proprioception after TKR also is considered to be important because it may be a significant risk factor in failure of total knee replacement and knee rehabilitation intervention.

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Evaluation of the Relationships Between Kellgren-Lawrence Radiographic Score and Knee Osteoarthritis-related Pain, Function, and Muscle Strength

  • Kim, Si-hyun;Park, Kyue-nam
    • Physical Therapy Korea
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    • v.26 no.2
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    • pp.69-75
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    • 2019
  • Background: Knee osteoarthritis (OA) diagnosis using Kellgren-Lawrence scores is commonly used to help decision-making during assessment of the severity of OA with assessment of pain, function and muscle strength. The association between Kellgren-Lawrence scores and functional/clinical outcomes remains controversial in patients with knee OA. Objects: The purpose of this study was to examine the relationships between Kellgren-Lawrence scores and knee pain associated with OA, function during daily living and sports activities, quality of life, and knee muscle strength in patients with knee OA. Methods: We recruited 66 patients with tibiofemoral knee OA and determined knee joint Kellgren-Lawrence scores using standing anteroposterior radiographs. Self-reported knee pain, daily living function, sports/recreation function, and quality of life were measured using the knee injury and OA outcome score (KOOS). Knee extensors and flexors were assessed using a handheld dynamometer. We performed Spearman's rank correlation analyses to evaluate the relationships between Kellgren-Lawrence and KOOS scores or muscle strength. Results: Kellgren-Lawrence scores were significantly negatively correlated with KOOS scores for knee pain, daily living function, sports/recreation function, and quality of life. Statistically significant negative correlations were found between Kellgren-Lawrence scores and knee extensor strength but not flexor strength. Conclusion: Higher Kellgren-Lawrence scores were associated with more severe knee pain and lower levels of function in daily living and sports/recreation, quality of life, and knee extensor strength in patients with knee OA. Therefore, we conclude that knee OA assessment via self-reported KOOS and knee extensor strength may be a cost-effective alternative to radiological exams.

Bilateral Differences of Knee Kinematics and Kinetics in Anterior Cruciate Ligament Reconstructed Females during Landing and Cutting

  • Chang, Eun Wook
    • Korean Journal of Sport Biomechanics
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    • v.28 no.3
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    • pp.175-180
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    • 2018
  • Objective: Anterior cruciate ligament reconstruction (ACLR) has been considered the primary treatment for anterior cruciate ligament (ACL) injured patient. However, there is little biomechanical evidence regarding bilateral knee joint biomechanics during landing and cutting task after ACLR. Method: Eighteen females with ACLR participated in this investigation. Double leg jump landing (DLJL) and single leg jump cut (SLJC) biomechanics were assessed. Results: During DLJL, the healthy knee showed greater knee valgus angle at initial contact ($^{\circ}$) compared to the injured knee (Injured: $2.93{\pm}2.59$, Healthy: $4.20{\pm}2.46$, t=2.957, p=0.009). There was a significant difference in anterior tibial shear force ($N{\times}N^{-1}$) with greater in the injured knee (Injured: $1.41{\pm}0.39$, Healthy: $1.30{\pm}0.35$, t=2.201, p=0.042). During SLJC, injured knee showed greater knee extension moment ($N^*m{\times}[N^*m]^{-1}$) compared to healthy knee (Injured: $0.51{\pm}0.19$, Healthy: $0.47{\pm}0.17$, t=2.761, p=0.013). However, there was no significant differences between the knees in the other variables. Conclusion: ACLRfemales exhibited a greater knee valgus angle at initial contact and lesser anterior tibial shear force on the healthy knee during double leg jump landing. In addition, ACLR females showed a greater knee extension moment on the injured knee during single leg jump cut.

Knee-wearable Robot System Using EMG signals (근전도 신호를 이용한 무릎 착용 로봇시스템)

  • Cha, Kyung-Ho;Kang, Soo-Jung;Choi, Young-Jin
    • Journal of Institute of Control, Robotics and Systems
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    • v.15 no.3
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    • pp.286-292
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    • 2009
  • This paper proposes a knee-wearable robot system for assisting the muscle power of human knee by processing EMG (Electromyogram) signals. Although there are many muscles affecting the knee joint motion, the rectus femoris and biceps femoris among them play a core role in the extension and flexion motion, respectively, of the knee joint. The proposed knee-wearable robot system consists of three parts; the sensor for measuring and processing EMG signals, controller for estimating and applying the required knee torque, and actuator for driving the knee-wearable mechanism. Ultimately, we suggest the motion control method for knee-wearable robot system by processing the EMG signals of corresponding two muscles in this paper. Also, we show the effectiveness of the proposed knee-wearable robot system through the experimental results.

The Effects of Knee Brace on the Knee Muscular Neuro-Biomechanical Variables during the Rebound in Female Highschool Basketball Players (여자 고등학교 농구 선수들이 리바운드 점프 후 착지할 때 무릎보호대가 무릎의 근신경 생체역학적 변인에 미치는 효과)

  • Han, Ki-Hoon;Lim, Bee-Oh
    • Korean Journal of Sport Biomechanics
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    • v.17 no.4
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    • pp.107-113
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    • 2007
  • The purpose of this study were to investigate the effects of knee brace on the knee muscular neuro-biomechanical variables during the rebound in female highschool basketball players. Twelve high school female ($17.9{\pm}0.8years$) basketball players rebound jumped for maximal vertical height to sufficiently stress the anterior cruciate ligament with and without knee brace. Kinematic data were collected to estimate the knee flexion, abduction angles and jump height. The EMG data from the biceps femoris and rectus femoris was used to estimate the ratio of quadriceps muscle activity. Female athletes with knee brace showed more reduced the knee abduction angle and the ratio of quadriceps muscle activity at foot contact phase than without knee brace. In conclusion, Female athletes with brace reduced knee anterior cruciate ligament loads.

Validity and Reliability of Ultrasound Measurement of Knee Joint Space Width in Individuals With Knee Osteoarthritis

  • Kim, Geon;Cha, Young-joo;Shin, Ji-won;You, Sung-hyun
    • Physical Therapy Korea
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    • v.26 no.1
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    • pp.60-66
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    • 2019
  • Background: Knee osteoarthritis (OA) is a single most arthritic disease. Knee joint space width (JSW) is commonly used for grading severity of knee OA. However, previous studies did not established criterion validity and test-retest reliability of ultrasound (US) image for measuring JSW. Objects: The aim of this study was to establish criterion validity and test-retest reliability of US measurement of medial and lateral knee JSW. Methods: Twenty-nine subjects with knee OA were participated. The US and X-ray were used to measure knee JSW. One sample Kolmogorov-Smirnov test was used to confirm the data normal distribution. Pearson correlation coefficient and ICC were used to calculated and establish criterion validity and test-retest reliability, respectively. Results: US measurement of medial and lateral knee JSW was highly correlated with radiographic imaging measure (r=.714 and .704, respectively). Test-retest reliabilities of medial and lateral knee JSW were excellent correlated (ICC=.959 for medial side and .988 for lateral side, respectively). Conclusion: US may be valid tool to measure knee JSW.

The Influence of High-heeled Shoes on Kinematics and Kinetics of the Knee Joint during Sit-to-stand task

  • Park, Ji-Won;Kim, Yun-Jin
    • The Journal of Korean Physical Therapy
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    • v.27 no.5
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    • pp.304-310
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    • 2015
  • Purpose: The purpose of this study was to examine the change in the kinematics and kinetics of the knee joint depending on high-heeled shoes during sit-to-stand (SitTS) task. Methods: Nineteen healthy females participated in this study. The subjects performed the SitTS task wearing high-heeled shoes and barefoot. The experiment was repeated three times for each task with foot conditions. The kinematics and kinetics of the knee joint were measured and analyzed using a 3D motion analysis system. Results: The result of this study showed kinematic and kinetics differences in knee joints during the SitTS task based on high-heeled shoes. Significant differences in knee flexion angle were observed during SitTS. The knee extensor force showed statistically significant differences during SitTS tasks. At the initial of SitTS, the knee flexor and extensor moment showed significant differences. The knee extensor moment showed statistically significant differences at the terminal of SitTS. At the maximum of SitTS, the knee extensor moment showed statistically significant differences. Conclusion: Therefore, wearing high-heeled shoes during SitTS movements in daily life is considered to influence knee joint kinematics and kinetics due to the HH, suggesting the possibility of increased risk of patellofemoral pain, and knee osteoarthritis caused by changes in loading of the knee joint.

Development of the Automatic Knee Joint Control System for a Knee-Ankle-Foot Orthosis Using an Electromechanical Clutch (전자-기계식 클러치를 이용한 장하지 보조기용 무릎관절 자동 제어 장치의 개발)

  • 이기원;강성재;김영호;조강희
    • Journal of Biomedical Engineering Research
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    • v.22 no.4
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    • pp.359-368
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    • 2001
  • A new knee-ankle-foot-orthosis(KAFO) which uses an automatically-controlled electromechanical wrap spring clutch for the knee joint was developed in the present study. It was found that the output voltage from the foot switches of the developed KAFO was proportionally increased with respect to the applied load. The output voltage from the infrared sensor also decreased as the knee flexion angle increased. The knee joint system for the new KAFO weighs only 780g lighter than any other commercially available developed system. In addition, the solenoid reduces the reaction time for the automatic control of the knee joint. The static torque of the clutch was measured for three persons, and it satisfied the normal knee extension moment during the pre-swing. Three-dimensional gait analyses for three different gait patterns (normal gait, locked-knee gait, controlled-knee gait) from five normal subjects were conducted. Controlled-knee gait showed the maximum knee flexion angle of 40.56$\pm9.55^{\circ}$ and the maximum knee flexion moment of 0.20$\pm$0.07Nm/kg at similar periods in the normal gait. Our KAFO system satisfies both stability during stance phase and free knee flexion during the swing phase at the proper period during the gait cycle. Therefore, our KAFO system would be very useful in various low extremity orthotic applications.

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Comparisons of the gait characteristics depended on amputation length of the Unilateral Trans-Tibial Prostheses (편측하퇴의지의 절단 길이에 따른 보행 특성 비교)

  • You Jae-eung;Jung Seok
    • The Journal of Korean Physical Therapy
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    • v.15 no.3
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    • pp.166-172
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    • 2003
  • The aim of this study is to present the basic reference data of age and specific gait parameters for comparisons of the gait characteristics depended on amputation length of the Unilateral Trans-Tibial Prostheses. The basic gait parameters were extracted from 10 Adult, and 20 below knee(B/K) patients, 50 to 60 years of age using VICON 512 Motion Analyzer. The results were as follows; 1. The mean Cadence of the above knee(A/K) patients and below knee(B/K) patients were $87.77{\pm}8.64$ steps/min, to $99.84{\pm}11.14$ steps/min.(p<0.05) 2. The mean Walking Speed of the above knee(A/K) patients and below knee(B/K) patients were $0.84{\pm}0.15$ m/s, to $0.96{\pm}0.25$ m/s.(p>0.05) 3. The mean Stride Length of the above knee(A/K) patients and below knee(B/K) patients were $1.14{\pm}0.14\;m$, to $1.14{\pm}0.22m$.(p>0.05) 4. The mean maximal angles of joint on the hip flexion motion for different above knee(A/K) patients and below knee(B/K) patients were $34.75{\pm}10.18_{\circ}$, to $32.32{\pm}6.34_{\circ}$.(p>0.05) 5. The mean maximal angles of joint on the knee flexion motion for different above knee(A/K) patients and below knee(B/K) patients were $66.97{\pm}15.08_{\circ}$, to $52.65{\pm}9.21_{\circ}$. (p<0.05) 6. The mean maximal angles of joint on the ankle dorsi-flexion motion for different above knee(A/K) patients and below knee(B/K) patients were $14.41{\pm}4.82_{\circ}$, to $10.04{\pm}3.49_{\circ}$.(p>0.05) 7. The mean maximal angles of joint on the ankle plantar-flexion motion for different above knee(A/K) patients and below knee(B/K) patients were $5.77{\pm}3.17_{\circ}$, to $2.75{\pm}4.49_{\circ}$.(p>0.05)

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Muscle Strength Ratio and Q-angle in Patients With Osteoarthritis of The Knee: A Comparative Study With Healthy Persons (슬관절 골관절염 환자의 슬관절 주위근의 근력비와 Q-각과의 관계)

  • Kim, Suhn-Yeop
    • Physical Therapy Korea
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    • v.12 no.1
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    • pp.45-54
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    • 2005
  • The quadriceps-angle (Q-angle) and the ratio of hamstring/quadriceps (H/Q) are important for the stability of the knee and for protection from excessive stress. The aim of this study was to examine the association between Q-angle and H/Q ratio with and without knee osteoarthritis. We compared knee osteoarthritis patients with symptom-free women. The mean age of the patients in the arthritis group (25 women, osteoarthritis) was 59.7 years. The non-arthritis group consisted of 25 women with a mean age of 55.2 years. Of the 25 women with osteoarthritis, 5 had the condition in their left knee, 5 had it in their right knee, and 15 had it on both sides. There was no significant difference in the knee Q-angle of the left and right knees of the arthritis group and the non-arthritis-group (p>.05). The strength of all the muscles around the involved right knee in the arthritis group was significantly weaker than that of the non-arthritis group (p<.05). However, in the left knee, only the strength of the knee extensors and internal rotators was significantly weaker than that of the non-arthritis group (p<.05). The Q-angle was not associated with the H/Q ratio and internal rotators/external rotators ratio of the involved knee in the arthritis group (p>.05). Neither was the Q-angle associated with the pain level of an involved knee in the arthritis group (p>.05). The knee pain was not associated with the H/Q ratio of the involved knee in the arthritis group (p>.05). The Q-angle was not associated with the ratio of H/Q and pain level of the involved knee in the osteoarthritis women.

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