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NMES를 이용한 무릎폄근 강화가 무릎관절성형술 환자의 관절가동범위, 근력과 보행에 미치는 효과
이동화,백창윤,유정열,장우남 대한신경치료학회 2020 신경치료 Vol.24 No.2
Purpose The purpose of this study was to investigate the effects of knee reinforcement training using neuromuscular electrical stimulation(NMES) therapy on range of motion, strength and gait in patients with total knee arthroplasty. Methods Subjects (n=24) were recruited and randomly assigned to study group (n=12) and control group (n=12). The intervention of the study group was conducted with knee extensor active exercise program combined with NMES applied to knee muscles for 30minutes, 5 times a week, for 2 weeks. Control group conducted intervention with same time and frequency as the study group while applying pain control electrical stimulation. Outcome measures include Numerical Rating Scale(NRS), Range of motion(ROM) and muscle strength of knee joint, and gait ability. Results After intervention, the significant changes were seen in NRS(p<.01), knee flexion angle(p<.01), and muscle strength(p<.01) for both groups, but there were no significant differences in NRS and muscle strength outcome between groups other than flexion angle(p<.05). In outcome measure for gait ability, significant changes were seen in gait speed(p<.01), step length, stride length(p<.01) and cadence(p<.05) after intervention in both groups. Significant differences in outcome between two groups were found in speed(p<.01), step length(p<.05) and stride length(p<.05). Conclusion knee extensor strengthening combined with NMES could improve pain, knee joint function and gait ability in patient with total knee Arthroplasty.
재관류손상을 받은 가토의 이개 피판에서 레이저도플러에 의한 피판 생존의 예측
김석권,박정민,백창윤,정기환,이근철,정진숙,박주인,박병호 대한성형외과학회 2005 Archives of Plastic Surgery Vol.32 No.4
If we could predict the necrosis of the flap caused by reperfusion injury, we can minimize the necrosis of the flap by taking appropriate action before necrosis begins. In this study, we examined whether we can predict the survival of flap under reperfusion injury or not, by measuring laser doppler flow meter values. We divided the group into the control and experimental groups corresponding to 6, 8, 9, 10, and 12hours after reperfusion(hours after ligation of auricular central artery). In each group, we examined necrotic change, perfusion unit (PU), serum superoxide dismutase (SOD), glutathione peroxidase, angiography and pathologic findings. No necrosis was observed in the 6 and 8 hours group but 8, 18, 20 hours after ligation, necrosis was observed, Also in each of 9, 10 and 12 hours group (each group consisted of 20 flaps), necrosis were noted. According to the above data, the critical time of necrosis in the auricular skin flap model lies between about 8 to 9 hours. Comparing the PU between the necrosis and non-necrosis groups, the former group showed a mean 39.57 PU increase after 60 min of reperfusion, and the latter group showed a mean increase of 21.21 PU.We can conclude that better flow can dilute oxygen free radical into systemic circulation, and this means less injuries are caused on vessels. Our study implies that if blood flow increase is less than 30 PU, intensive care is needed to save the flap. Additionally, we found significant decrease of serum SOD and glutathione peroxidase in the necrotic group. Therefore, monitoring these serum markers will be helpful in predicting reperfusion injury and supplementing these enzymes could be helpful to save the flap. The laser doppler flow meter is thought to be helpful in clinical circumstances for evaluating the circulation of the flap after the operation. However, more accumulation of clinical studies should be necessary establishing useful clinical data.