태권도 선수와 일반인의 등척성 무릎신전 토크-각도 관계 특성 비교 분석

조계훈 ( Gye Hun Jo ),오정훈 ( Jeong Hoon Oh ),이해동 ( Hae Dong Lee ) 한국운동역학회 2015 한국운동역학회지 Vol.25 No.3

Objective : In order for Taekwondo athletes to perform destructive kicking performance, they are expected to have Taekwondo-specific muscle properties such as high muscle strength and power. The purpose of this study was to investigate the joint angle-dependent force-producing property of Taekwondo athletes’ knee extensor muscles, which is one of the primary muscle groups involved in kicking performance. Method : Ten Taekwondo male athletes (age: 19.9±0.7 yrs, height: 180.6±6.2 cm, body mass: 75.9±8.9 kg, career: 9.2±2.9 yrs.) and 10 healthy male non-athletes (age: 26.3±2.6 yrs, height: 174.2±4.8 cm, body mass: 72.8±7.7 kg) participated in this study. Subjects performed maximum isometric knee extension at knee joint angles of 40°, 60°, 80°, and 100° (the full knee extension was set to 0°) with the hip joint angles of 0° and 80° (the full extension was set to 0°). During the contractions, knee extension torque using an isokinetic dynamometer simultaneously with muscle activities of the rectus femoris (RF), and the vastus lateralis (VL) and vastus medialis (VM) using surface electromyography were recorded. Based on the torque values at systematically different knee-hip joint angles, the joint torque-angle relationships were established and then the optimal joint angle for the knee extensor was estimated. Results : The results of this study showed that the isometric knee extension torque values were greater for the Taekwondo athletes compared with the non-athlete group at all hip-knee joint angle combinations (p<.05). When the hip joint was set at 80°, the peak isometric torque was greater for the Taekwondo athletes compared with the non-athlete group (313.61±36.79 Nm and 221.43±35.92 Nm, respectively; p <.05) but the estimated optimum knee joint angles were similar (62.33±5.71° and 62.30±4.67° for the Taekwondo athletes and non-athlete group, respectively). When the hip joint was set at 0°, the peak isometric torque was greater for the Taekwondo athletes compared with the non-athlete group (296.29±45.13 Nm and 199.58±25.23 Nm, respectively; p<.05) and the estimated optimum knee joint angle was larger for the Taekwondo athletes compared with the non-athlete group (78.47±5.14° and 67.54±5.77°, respectively; p<.05). Conclusion : The results of this study suggests that, compared with non-athletes, Taekwondo athletes have stronger knee extensor strength at all hip-knee joint angle combinations as well as longer optimum muscle length, which might be optimized for the event-specific required performance through prolonged training period.

Continuous flexion-extension test of the knee joint using motion simulator

Ho-Jung Cho(조호정),Eunah Hong(홍은아),In-Jun Koh(고인준),Dohyung Lim(임도형),Dai-Soon Kwak(곽대순) 대한기계학회 2021 대한기계학회 춘추학술대회 Vol.2021 No.4

Many devices were developed to simulate the movement of the knee joint. We designed the knee joint simulator which could move flexion to extension of the knee joint continuously based on the Oxford knee simulator, and investigated the knee joint kinematics using the designed knee simulator. This study introduced the methods and results of the biomechanical test of the knee joint through the evaluation of the designed knee simulator, the preparation process of the cadavers, motion analysis using motion capture cameras and optic markers, and measurement of the surface strain using the video extensometer. To obtain the results of the motion analysis, the medial and lateral rollback of the knee and patella movements were measured using 12 optic markers, also, the results showed high repeatability. The video extensometer could measure the strain of the ligamentous structures during flexion and extension of the knee joint in real-time, and, this showed high repeatability in the test.

좌우무릎 신전근의 피로수준과 성별이 수직점프 높이 및 하지 관절의 움직임에 미치는 영향

박기현(KiHuynPark),염창홍(ChangHongYoum),김영준(YoungJunKim) 한국체육학회 2015 한국체육학회지 Vol.54 No.5

이 연구의 목적은 수직점프 동작 시 좌우무릎 신전근의 피로수준과 성별이 수직점프 높이와 하지관절의 움직임 특성에 미치는 영향을 분석하는 것이다. 연구대상은 20-30세의 건강한 성인 남성 21명과 여성 20명을 대상으로 하였으며, 좌우무릎 신전근의 피로유발 방법은 각속도 60°/s, 가동범위 90°로 설정하여 등속성 동력계를 이용하였다. 성별에 따른 결과, 수직점프 높이는 피로 전, 최대 좌우무릎관절 신전토크의 50% 피로 후, 30% 피로 후 모두 남성 그룹이 여성 그룹보다 유의하게 높게 나타났다. 또한 점프구간에서 남성 그룹이 여성 그룹보다 발목관절, 무릎관절, 엉덩관절 모두 굴곡각이 크게 나타났다. 점프 구간에서 무릎관절의 경우, 여성 그룹은 외전, 남성 그룹은 내전이 나타났으며, 발목관절은 여성 그룹이 남성 그룹보다 외회전이 크게 나타났다. 피로수준에 따른 결과, 수직점프 높이에서 남성 그룹은 50% 피로 후 약 8% 감소, 30% 피로 후 약 15% 감소, 여성 그룹은 50% 피로 후 약4% 감소, 30% 피로 후 약 5% 감소한 것으로 나타났다. 또한 여성 그룹과 남성 그룹 모두 점프 구간에서 피로수준이 증가함에 따라 발목관절, 무릎관절, 엉덩관절의 굴곡각이 작게 나타났으며, 특히 피로가 증가함에 따라 무릎관절은 외회전이 크게 나타났으며, 엉덩관절은 굴곡각, 외전, 외회전이 작게 나타났다. 결론적으로 성별과 최대 좌우무릎관절 신전토크의 50%와 30% 피로수준은 수직점프 시 높이의 감소에 영향을 미치며, 또한 발목관절과 엉덩관절의 시상면, 관상면, 수평면상에서의 움직임 특성에 영향을 미치는 것으로 나타났다. The purpose of this study was to analyze effects of extensor fatigue levels of both knee joints and genders on vertical jump height and joint motions of lower extremities. A group of 21 healthy men and 20 healthy women aged 20-30 years were selected as study subjects. The extensor fatigue induction method of both knee joint muscles was performed by the setting of the angular velocity and range of motion of an isokinetic dynamometer to 60°/s and 90°, respectively. The vertical jump height for the men in each of the three cases of pre-fatigue, after 50% fatigue, and after 30% fatigue of peak extension torque of both knee joints was significantly greater than that of the women. Furthermore, in the jumping phase, the men showed greater flexion angles of the ankle, knee, and hip joints than the women. The women and men showed abduction and adduction, respectively, of the knee joints during the jumping phase. In the jumping phase, the women showed greater degrees of external rotation of the ankle joints than the men. The results based on fatigue levels indicate that during the vertical jump according to fatigue levels, the men showed a decrease in the vertical jump height of 8% and 15% after 50% fatigue and 30% fatigue, respectively, whereas the women showed a decrease in the vertical jump height 4% and 5% after 50% fatigue and 30% fatigue, respectively. As the fatigue increased, both groups showed smaller flexion angles of the ankle, knee, and hip joints during the jumping phases as well as significant external rotation of the knee joints during the jumping phase. Furthermore, as the fatigue increased, both groups showed a small flexion angle as well as abduction and external rotation of the hip joints during the jumping phases. In conclusion, gender and the 50% and 30% fatigue levels of the knee extensors can decrease the vertical jump height. In addition, the 50% and 30% fatigue levels of the knee extensor affect the angular positions of the sagittal, frontal, and transverse planes of the ankle and hip joints.

Knee joint line related to bony landmarks of the knee: a radiologic study in a Thai population

( S. Tantavisut ),( C. Amarase ),( S. Ngarmukos ),( C. Tanavalee ),( A. Tanavalee1 ) 대한슬관절학회 2022 대한슬관절학회지 Vol.34 No.-

Background: During revision total knee arthroplasty (TKA), knee joint line restoration may be difficult due to bone loss or structural changes. Although bony landmarks are consistent and can be used as references, there are limited data in Asian patients. We studied the knee joint line related to bony landmarks of the knee in a Thai population. Materials and methods: Magnetic resonance imaging (MRI) of 140 healthy knees of Thai patients (70 males, 70 females) were investigated. In all knees, a perpendicular line from knee joint line to the medial epicondyle (distance A) and the lateral epicondyle (distance B) in the coronal plane were measured. In the sagittal plane, a perpendicular line from the knee joint line to the fibular head (distance C), the tibial tubercle (distance D), and the inferior patellar pole (distance E) were measured. The femoral transepicondylar width (FW) was measured along the transepicondylar axis. The ratios of distances A, B, C, D, and E related to FW were evaluated (epicondylar ratio). Results: The mean and standard deviation (SD) of distances A, B, C, D, E, and FW were 27.1 ± 2.7 mm, 21.7 ± 2.5 mm, 12.6 ± 3 mm, 21.3 ± 3.6 mm, 7.6 ± 4.8 mm, and 76.7 ± 3.99, respectively. There was wide variation of measured values, with statistically significant differences between genders in distances A, B, C, and FW. The mean and SD of epicondylar ratios A/FW, B/FW, C/FW, D/FW, and E/FW were 0.35 ± 0.02, 0.29 ± 0.02, 0.16 ± 0.05, 0.28 ± 0.04, and 0.09 ± 0.04, respectively. All epicondylar ratios demonstrated less variation than all measured distances, with statistical differences between genders in the A/FW and D/FW ratios. However, the B/FW ratio had the highest consistent mean value. In addition, it had narrower SD than the rest (0.29 ± 0.02; range, 0.22-0.33). Conclusions: In Thai knees, the measured distances from bony landmarks to the knee joint line had higher variation than the epicondylar ratio. Among all studied epicondylar ratios, the ratio between lateral epicondyle to joint line distance (distance B)/FW demonstrated the narrowest range of mean and SD values; therefore, this could be the most reliable landmark for intraoperative knee joint line verification by multiplying the FW of the patient by 0.29 to get distance B in that patient.

Knee Trans-lateral 촬영 시 환자 Position에 관한 고찰

황인수(In-Su Hwang),김만규(Man-Gyu Kim),최용석(Yong-Seok Choi),박용훈(Yong-Hoon Park),이명기(Myeong-Ki Lee),이용대(Yong-Dae Lee),정호용(Ho-Yong Jeong) 대한영상의학기술학회 2012 대한영상의학기술학회 논문지 Vol.2012 No.-

목적: Femoral neck fracture 환자의 수술 전 traction을 하기 위한 post pinning이나 Knee joint의 ligament, 무릎관절전치환술 후 Knee lateral 촬영 시에는 환자의 position이 lateral recumbent position이 어려워 trans-lateral로 촬영하게 된다. 이때 true lateral이 되지 않는다면 올바른 traction의 설치 및 수술 평가를 제대로 할 수 없게 되며, 이는 재촬 영을 불러오게 되어 환자 피폭의 증가를 가져올 수 있다. 이에 trans lateral 시 foot을 얼마나 external rotation 시켰을 때 true lateral이 나오는지 알아보았다. 방법: 대조군 지원자는 남녀노소 구분 없이 10인, 임상실험 대상은 2011년 9월부터 12월 까지 본원 응급실 및 외래를 내원한 환자 중 Femoral neck fracture로 인해 수술 전 post pinning 환자와 knee joint 수술 후 환자 50인 이었다. 실험 장비는 각도를 잴 수 있는 촬영용 각도기와 post pinning 환자의 경우 detector의 이동이 가능한 SHIMADZU tube & Cannon DR장비를, 수술 후 환자의 경우 SHIMADZU사의 MUX-100 Portable CR 장비를 사용하였다. 대조군 실험은 detector와 cassette를 Knee joint에 평행하게 밀착시킨 후, knee joint를 30° flexion 시킨 후 calcaneous에서 2 nd toe를 이은 중앙선을 기점으로 foot 을 각도기를 이용해 5°, 10°, 15°로 external rotation 시킨 후 촬영을 하였으며, 이때 CR 은 수직입사가 아닌 lateral recumbent position처럼 cephalad 5°로 입사하였다. 이중 가장 많은 true lateral을 보인 각도를 임상실험 각도로 하였다. 결과: 기준각도 측정을 위한 대조군 실험결과 지원자 10인 중 5° 10%, 10° 70%, 15° 10%, 기타 10%가 나왔으며, 이를 토대로 10°를 기준으로 임상실험에 적용하여 촬영 한 결과 50인 중 condyle의 겹침이 2mm이내의 true lateral image를 보인 것은 74%이며, 3~5mm 16%, 5mm이상 10%의 결과를 나타내었다. 결론: Knee trans lateral 촬영 시 foot을 external rotation 10°로 하여 촬영 하는 것이 보다 정확한 Image를 얻을 수 있었으며, 이는 재촬영의 방지를 통해 환자 피폭선량 경감에도 Purpose: During lateral knee x-rays of the post pinning for traction before surgery of a femoral neck fracture and after the knee joint ligament and total knee replacement surgery, it is difficult for the patient to take an x-ray in the lateral recumbent position so a trans-lateral x-ray is taken. Thus, an attempt was made to discover the amount of external rotation that was needed to be given to the foot during the trans-lateral position for a true trans-lateral position to occur. Materials and Methods: The comparison group volunteers were composed of 10 volunteers without distinction based on sex or age and the clinical trial subjects were comprised of 50 post pinning patients before surgery for femoral neck fractures and post operation patients who had completed knee joint surgery that had visited the emergency room and outpatient. As a test method for the comparison group test, an x-ray is taken when the detector and cassette are placed closely parallel to the knee joint and, after the knee joint is moved to 30° flexion, the center line that is connected to the 2nd toe in the calcaneous the foot becomes the starting point and is given an external rotation at 5°, 10° and 15° angles using the protractor. At this time, the CR does not enter vertically but enters at cephalad 5°like the lateral recumbent position. The angle that revealed the greatest true lateral position among these tests was set as the clinical test angle for taking x-rays. Results: 1. The results of the comparative group test to assess the standard angle showed 10% at 5°, 70% at 10°, 10% at 15° and 10% at a miscellaneous angle. 2. Based on this, when the x-rays were taken with 10°being applied to the clinical test, 74% showed under 2mm of true lateral image condyle overlap and 16% 3 to 5mm and 10% more than 5mm respectively out of the 50 subjects. Conclusion: When taking a trans-lateral x-ray, a more exact image can be obtained than taking an x-ray with the external rotation of the foot at 10°. This also gives the benefit of providing an accurate diagnosis after surgery or a procedure since it prevents the retaking of x-rays which contributes to the reduction of exposure to radiation by the patient.

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

( Ji-won Park ),( Yun-jin Kim ) 대한물리치료학회 2015 대한물리치료학회지 Vol.27 No.5

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.

Comparison of Knee Joint Loads during Floor Sit-to-Stand and Chair Sit-to-Stand: A Computer Simulation Study

조병찬,한재웅 국제물리치료연구학회 2023 Journal of International Academy of Physical Ther Vol.14 No.3

Background: Floor sit-to-stand (FSTS) places a higher load on the knees than chair sit-to-stand (CSTS). It is difficult to experimentally measure the maximum knee joint force during sit-to-stand motion. Objectives: This study's objectives were twofold: firstly, to quantify the differences in knee joint force between FSTS and CSTS, and secondly, to identify the angles at which the maximum knee joint force occurs during these motions. Design: Computer simulation study. Method: This study was conducted on 4 adult male subjects in their 20s. The FSTS and CSTS motion trajectories of the subjects were acquired using 3- dimensional motion analysis equipment. Using these, the human body mass model of the program was modified according to the subject, and the knee joint force was calculated. Also, the knee angle at which the maximum knee joint force occurs was found. Results: When the subjects performed the FSTS motion, a knee joint force that was up to about 160% higher than that of the CSTS motion occurred, and the angle at which the maximum knee joint force occurred was different between the sitting sequence(FSTS motion: 56~58 degree, CSTS motion: 78~82 degree) and the standing sequence(FSTS motion: 98~100 degree, CSTS motion: 70~74 degree). Conclusion: By comparing FSTS motion with CSTS motion, it is expected that it can be used as a quantitative guide for the effect of motion similar to FSTS motion on the knee when prescribing exercise for the elderly or patients with knee-related lesions

Kinematic Characteristics of the Knee Joint According to the Purpose of Elastic Taping

채성옥,박형순 대한기계학회 2021 대한기계학회 춘추학술대회 Vol.2021 No.4

When elastic taping that fits the direction of the muscles, it is generally effective in assisting muscles and realigning joints. However, the size of the taping effect may vary depending on which exercise is primarily supported. In this study, the kinematic effects were confirmed by elastic taping to assist knee flexion and knee extension, which are movements in the sagittal plane of the knee joint. Subjects consisted of 2 people. The subject repeatedly performed the motion of ascending and descending the 30cm step box in each of the three cases of non-taping, knee flexion taping, and knee extension taping. The subject performed one motion every two seconds for one minute and extracted data from the last three steps. analyze the change in motion of the knee joint, motion analysis was performed using a reflective marker. And the co-contraction of the major muscles that influence the movement of the knee joint was analyzed through the EMG of the muscles. In the range of motion of the knee joint angle in the sagittal plane, when knee extension taping (91.5±2.23°) is performed, the movement is more limited than when knee flexion taping (101.23±4.96°) and non-taping (99.00±4.81°) are performed. And the tibial anterior translation force increased in some sections. These results suggest that the risk of injury to structures constituting the knee joint, such as ACL injury, may increase when knee extension taping is performed. Therefore, it is necessary to consider these points to prevent injury in elastic taping.

Aspiration and Injection of the Knee Joint: Approach Portal

( Robert J Douglas ) 대한슬관절학회 2014 대한슬관절학회지 Vol.26 No.1

Aspiration and injection of the knee joint is a commonly performed medical procedure. Injection of corticosteroid for the treatment of osteoarthritis is the most common reason for knee joint injection, and is performed as an office procedure. Debate exists among practitioners as to the ‘best’ approach portal for knee injection. This paper examines the various approach portals for injection and/or aspiration of the knee joint, as well as the accuracy of each approach. Searches were made of electronic databases, and appropriate papers were identified and hand-searched. Although there is some evidence that particular approach portals may be more efficacious in the presence of specific knee joint pathologies, generally, in experienced hands, it is of no clinical consequence as to which approach portal is utilised for aspiration or injection of the knee joint. No approach portal is 100% accurate, and the accuracy of injection of the knee joint may be enhanced by the use of techniques such as ultrasound. Practitioners are reminded that they should continuously refine and practice their preferred technique. Knee joint aspiration and injection is a common, simple, and generally safe office procedure.

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

박지원,김윤진 대한물리치료학회 2015 대한물리치료학회지 Vol.27 No.5

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.