• Title, Summary, Keyword: Knee

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3-Dimensional Gait analysis and the relationship between lower limb alignment and knee adduction moment in elderly healthy women (3차원적 동작 분석기를 이용한 건강한 여자 노인의 하지 정렬 상태와 슬관절 내전 모멘트의 상관 관계에 관한 연구)

  • Cho, You-Mi;Lee, Wan-Hee
    • Journal of Korean Physical Therapy Science
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    • v.10 no.1
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    • pp.90-101
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    • 2003
  • Gait analysis can provide a better understanding of how the alignment of the lower limb and foot can contribute to force observed at the knee. Anatomic and mechanical factors that affect loading in the knee pint can contribute to pathologic change seen at the knee in degenerative pint disease and should be considered in treatment plan. The purpose of this study is to present the gait analysis data and to determine whether there is any relationships between alignment of the lower limb, foot progression angle and knee pint moments in elderly healthy women with 3-dimensional motion analyzer. The results were as follows; 1. Cadence showed 114.8 steps/min, gait speed showed 1.05 m/s, time per a stride showed 1.06 sec, time per a step showed 0.53 sec, single-supporting phase was 0.41 sec, double-supporting phase was 0.24 sec, stride length was 1.04 m, Step length was 0.56 m. 2. According to the parameters of kinematics, the maximal knee flexion angle through swing phase showed left $46.82^{\circ}$, right $40.19^{\circ}$ and the maximal knee extension angle showed left $-1.32^{\circ}$, right $2.01^{\circ}$. knee varus showed left $26.90^{\circ}$, right $30.93^{\circ}$. 3. Moment, one of kinetic parameters of knee pint the maximal flexion moment showed left 0.363. Nm/kg, right 0.464 Nm/kg and maximal extension moment showed left 0.389 Nm/kg, right 0.463 Nm/kg. The maximal. adduction moment showed left 0.332 Nm/kg, right 0.379 Nm/kg and the maximal internal rotatory moment showed left 0.13 Nm/kg, right 0.140 Nm/kg. 4. On sagittal plane, the maximal power of knee joint showed left 0.571 J/kg, right 0.629 J/kg. On coronal plane, the maximal power of knee joint showed left 0.11 J/kg, right 0.12 J/kg. On transverse plane, the maximal power of knee joint showed left 0.058 J/kg, right 0.072 J/kg. 5. The subject who had varus alignment of the lower extremity had statistically higher in knee adduction moment in mid stance phase. 6. The subject who had large foot progression angle had statistically lower in knee adduction moment in late stance phase. A relationship was observed between the alignment of the lower extremity and the adduction moment of the knee joint during stance phase. Hence, we need some research to figure, out the change of adduction moment according to the sort of knee joint osteoarthritis and the normal geriatrics as well. And we also require more effective, specific therapeutic program by making use of those background of researches.

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The Effects of Knee Sleeve with a Stimulation of Golgi Tendon Organ on One Leg Standing and Proprioception (무릎 슬리브 착용과 골지 건 기관 자극이 한 발 서기 동작과 고유수용성 감각에 미치는 영향)

  • Jeong, BoRa;Chang, YoonHee;Kim, GyuSeok;Ryu, JeiCheong;Ko, Chang-Yong
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.11 no.4
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    • pp.323-330
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    • 2017
  • Knee sleeve has been used for prevention of sport injuries as well as rehabilitation. To investigate prevention of sport injuries of knee sleeve, it is important to evaluate balance associated with proprioception. The aim of this study was to evaluate the effects of a knee sleeve with a pad that stimulate to golgi tendon organ (GTO_PAD) on proprioception and balance ability. Five healthy males were participated for the study. They were asked to reenact target angle with Biodex and perform one leg standing with knee sleeve and knee sleeve with GTO_PAD. There was no significant difference in %Target angle, but the value of %Target angle was higher in subjects wearing knee sleeve with GTO_PAD than only knee sleeve, except for one subject. During one leg standing, time duration was increased in subjects wearing knee sleeve with GTO_PAD. The length of center of pressure in x-axis (COPx) and COP in y-axis (COPy) were decreased when wearing knee sleeve with GTO_PAD (COPx : $162.06{\pm}58.99mm$ in knee sleeve vs. $149.03{\pm}45.30mm$ in knee sleeve with GTO_PAD, COPy : $310.79{\pm}115.89mm$ in knee sleeve, $291.57{\pm}76.53mm$ in knee sleeve with GTO_PAD). There was significant differences in INI_transition, steady, and LAT_transition phase (all, p < 0.05). These findings support that wearing knee sleeve with GTO_PAD might enhance proprioception and balance.

The effects of knee joint position sense following local and general load protocols (국소적 부하와 전신적 부하가 슬관절 위치 감각에 미치는 영향)

  • Hwang, Yoon-Tae;Park, Rae-Joon;Choi, Jin-Ho
    • The Journal of Korean Physical Therapy
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    • v.17 no.3
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    • pp.429-440
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    • 2005
  • The purpose of this study was to compare the effects of knee joint position sense following local and general load protocols in 25 healthy male subjects. Proprioception of the knee joint was evaluated by measuring absolute angular errors at matching angles before, after and between 2 different types of load protocols. Proprioception tests(on the dominant knee) were performed in which proprioception of the passivepassive reproduced and active-active reproduced knee position was measured. Local load was provided with maximum isokinetic knee extension-flexion on the isokinetic dynamometer(Cybex), and general load was 10 minutes running on a treadmill. Peak torque(knee extension and flexion) and heart rate(beats per minute) was evaluated as an indicator of local and general fatigue during load protocols. The results were as follows: 1. For pasive-pasive reproduced knee position test, significant difference in absolute angular errors after general load protocol was detected compared with that before general load protocol(P<.05), significant difference in absolute angular errors after local load protocol was detected compared with that before local load protocol(P<.05). However, no significant difference in absolute angular errors of general load protocol was detected compared with that of local load protocol (P>.05), no significant difference in absolute angular errors of local load protocol was detected compared with that of general load protocol(P>.05). 2. For active-active reproduced knee position test, significant difference in absolute angular errors after general load protocol was detected compared with that before general load protocol(P<.05), significant difference in absolute angular errors after local load protocol was detected compared with that before local load protocol (P<.05). Also, significant difference in absolute angular errors of general load protocol was detected compared with that of local load protocol(P<.05), significant difference in absolute angular errors of local load protocol was detected compared with that of general load protocol(P<.05). 3. A significant decrease of peak torque of knee extensors and flexors was seen after local load, although heart rate was significantly increased(P<.05). No significant change of peak torque of knee extensors and flexors was seen after general load(P>.05), although heart rate was also significantly increased(P<.05). The previous study revealed that knee proprioception is significantly altered when the muscle mechanoreceptors are dysfunctional due to muscle fatigue, although the joint mechanoreceptors have no significantly effect on knee proprioception when the presence of knee muscle fatigue. However, the results of this study are different from those of the previous study in that muscle weakness of the knee could not be seen after general load. This study shows that general load may diminish motor control by the central nervous system. Proprioceptional decline without muscle weakness of knee after general load suggests a change in the proprioceptional pathway without influence from muscle mechanoreceptors.

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The effects of muscle fatigue of knee muscles on balance ability in healthy adults (무릎 근육의 근피로가 정상 성인의 균형에 미치는 영향)

  • Lim, Garin;Chang, Jongsung
    • Journal of Korean Medicine Rehabilitation
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    • v.28 no.2
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    • pp.105-111
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    • 2018
  • Objectives The purpose of this study was to examine the effects muscle fatigue at the knee muscles on balance during standing in healthy adults. Methods Thirty healthy adults were recruited along with their written informed consent. Subjects were randomly assigned to knee extensor group (fatigue on knee extensor, KE), and knee flexor group (fatigue on knee flexor, KF). And subjects performed exercise with each muscle group until muscle fatigue was induced. They were assessed balance ability by functional reaching test (FRT), limit of stability (LOS), and postural sway (one leg standing, normal eye open (NO), normal eye close (NC), pillow with eye open (FO), and pillow with eye close (FC)) before and after fatigue. Results There were significant group differences balance performances in FRT, anterior of limit of stability, one leg standing, and the muscle fatigue of knee muscles were decreased balance performances. The balance performance was affected by visual sense and proprioception. Conclusions These results show that the muscle fatigue of knee muscles decreased balance performance. Therefore, balance exercise program should be trained without muscle fatigue.

Prospective Study of Central versus Peripheral Obesity in Total Knee Arthroplasty

  • Armstrong, John G.;Morris, Tyler R.;Sebro, Ronnie;Israelite, Craig L.;Kamath, Atul F.
    • Knee surgery & related research
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    • v.30 no.4
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    • pp.319-325
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    • 2018
  • Purpose: Body mass index (BMI) is often used to predict surgical difficulty in patients receiving total knee arthroplasty (TKA); however, BMI neglects variation in the central versus peripheral distribution of adipose tissue. We sought to examine whether anthropometric factors, rather than BMI alone, may serve as a more effective indication of surgical difficulty in TKA. Materials and Methods: We prospectively enrolled 67 patients undergoing primary TKA. Correlation coefficients were used to evaluate the associations of tourniquet time, a surrogate of surgical difficulty, with BMI, pre- and intraoperative anthropometric measurements, and radiographic knee alignment. Similarly, Knee Injury and Osteoarthritis Outcome Score (KOOS) was compared to BMI. Results: Tourniquet time was significantly associated with preoperative inferior knee circumference (p=0.025) and ankle circumference (p=0.003) as well as the intraoperative depth of incision at the quadriceps (p=0.014). BMI was not significantly associated with tourniquet time or any of the radiographic parameters or KOOS scores. Conclusions: Inferior knee circumference, ankle circumference, and depth of incision at the quadriceps (measures of peripheral obesity) are likely better predictors of surgical difficulty than BMI. Further study of alternative surgical indicators should investigate patients that may be deterred from TKA for high BMI, despite relatively low peripheral obesity.

Gait Study on the Normal and ACL Deficient Patients After Ligament Reconstruction Surgery Using Chaos Analysis Method (전방십자인대 재건수술 환자와 정상인의 보행 연구)

  • Ko Jae-Hun;Moon Byung-Young;Suh Jeung-Tak;Son Kwon
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.30 no.4
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    • pp.435-441
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    • 2006
  • The anterior cruciate ligament(ACL) is an important stabilizer of knee joint. The ACL injury of knee is common and a serious ACL injury leads to ligament reconstruction surgery. Gait analysis is essential to identify knee condition of patients who display abnormal gait. The purpose of this study is to evaluate and classify knee condition of ACL deficient patients using a nonlinear dynamic method. The nonlinear method focuses on understanding how variations in the gait pattern change over time. The experiments were carried out for 17 subjects(l2 healthy subjects and five subjects with unilateral deficiency) walking on a motorized treadmill for 100 seconds. Three dimensional kinematics of the lower extremity were collected by using four cameras and KWON 3D motion analysis system. The largest Lyapunov exponent calculated from knee joint flexion-extension time series was used to quantify knee stability. The results revealed the difference between healthy subjects and patients. The deficient knee was significantly unstable compared with the contralateral knee. This study suggests an evaluation scheme of the severity of injury and the level of recovery. The proposed Lyapunov exponent can be used in rehabilitation and diagnosis of recoverable patients.

The Effects of Landing Height and Distance on Knee Injury Mechanism (착지의 높이와 거리가 무릎 부상 메카니즘에 미치는 영향)

  • Cho, Joon-Haeng;Kim, Ro-Bin
    • Korean Journal of Sport Biomechanics
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    • v.21 no.2
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    • pp.197-205
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    • 2011
  • Various jumping and landing motions are shown during sports event. But most previous studies have not considered landing height and distance simultaneously. The purpose of this study was to identify the effects of landing height and distance on knee injury mechanism. Fourteen male(age: $28.86{\pm}1.99$ yrs, height: $177.00{\pm}4.69$ cm, weight: $76.50{\pm}6.41$ kg) participated in this study. The subjects attempted drop landing task onto the ground from 30 cm to 45 cm heights and to 20 cm to 40 cm distances. The results were as follows. First, higher drop landing height and longer distance showed greater degree of maximal knee flexion and valgus. Second, higher drop landing height and longer distance showed greater maximal knee extension moment and varus moment. Third, higher drop landing height and longer distance showed larger maximal knee absorption power. Lastly, higher drop landing height showed increased Peak GRF. Landing height was more related to the cause of injury, which was indicated by increased maximal knee extension moment, peak GRF and maximal knee absorption power. Landing distance was also associated with increased knee valgus moment and absorption power during landing. These results suggest that landing height and distance may be the cause of injury.

Automated 2D/3D Image Matching Technique with Dual X-ray Images for Estimation of 3D In Vivo Knee Kinematics

  • Kim, Yoon-Hyuk;Phong, Le Dinh;Kim, Kyung-Soo;Kim, Tae-Seong
    • Journal of Biomedical Engineering Research
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    • v.29 no.6
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    • pp.431-435
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    • 2008
  • Quantitative information of a three dimensional(3D) kinematics of joint is very useful in knee joint surgery, understanding how knee kinematics related to joint injury, impairment, surgical treatment, and rehabilitation. In this paper, an automated 2D/3D image matching technique was developed to estimate the 3D in vivo knee kinematics using dual X-ray images. First, a 3D geometric model of the knee was reconstructed from CT scan data. The 3D in vivo position and orientation of femoral and tibial components of the knee joint could be estimated by minimizing the pixel by pixel difference between the projection images from the developed 3D model and the given X-ray images. The accuracy of the developed technique was validated by an experiment with a cubic phantom. The present 2D/3D image matching technique for the estimation of in vivo joint kinematics could be useful for pre-operative planning as well as post-operative evaluation of knee surgery.

Determination of Total Knee Replacement Parameter by Simulation (시뮬레이션을 이용한 슬관절 수술 변수 결정)

  • Yoon Y.S.;Park S.H.;Lee S.H.;Choi K.W.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • pp.881-887
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    • 2005
  • A total knee replacement is an extremely 'position-sensitive' operation; a malposition or a malalignment of the components will lead to a breakage of the component, a fracture around the knee prosthesis, and the limitation of range of the motion, etc. In a conventional total knee replacement, surgeons have to select an appropriate prosthesis according to the shape of the surgical region. A wrong selection may give rise to side effects or to need re-operation. Nevertheless, it is so difficult to choose the most proper prosthesis out of various kinds of prosthesis. This paper presents a surgical planning system for the total knee replacement with an operation simulating method in order to determine the parameters for the total knee replacement operation. We select an alignment axis and a resection angle as major operation parameters in the total knee replacement operation, and introduce the method to determine the major operation parameters with the operation simulator we developed. The simulator is used to determine operation parameters for optimized operations, to select the most appropriate prosthesis, and to analyze the prospective problems of the operation.

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Construction and Measurement of Three-Dimensional Knee Joint Model of Koreans (한국인의 3차원 무릎관절 구축 및 형상 측정)

  • Park, Ki-Bong;Kim, Ki-Bum;Son, Kwon;Suh, Jeung-Tak;Moon, Byung-Young
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.28 no.11
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    • pp.1664-1671
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    • 2004
  • It is necessary to have a model that describes the feature of the knee Joint with a sufficient accuracy. Koreans, however, do not have their own knee joint model to be used in the total knee replacement arthroplasty. They have to use European or American models which do not match Koreans. Three-dimensional visualization techniques are found to be useful in a wide range of medical applications. Three-dimensional imaging studies such as CT(computed tomography) and MRI(magnetic resonance image) provide the primary source of patient-specific data. Three-dimensional knee joint models were constructed by image processing of the CT data of 10 subjects. Using the constructed model, the dimensions of Korean knee joint were measured. And this study proposed a three-dimensional model and data, which can be helpful to develop Korean knee implants and to analyze knee joint movements.