아킬레스 건염 환자의 보행 시 고관절, 슬관절 및 족관절 모멘트의 변화에 대한 연구

유재호(Yu, Jae-Ho),이규창(Lee, Gyu-Chang),이동엽(Lee, Dong-Yeop) 한국산학기술학회 2011 한국산학기술학회논문지 Vol.12 No.12

본 연구는 아킬레스 건염 환자들과 정상인들을 대상으로 보행 선형지표와 고관절, 슬관절, 그리고 족관절의 모멘트 변화를 조사하여 아킬레스 건염에 의한 보행의 역학적 변화를 구명하고 아킬레스 건염을 예방하기 위한 예측 인자들을 찾고자 실시되었다. 연구의 대상자는 아킬레스 건염 환자 20명과 비슷한 신체조건을 가진 건강한 정상인 20 명이며, 대상자가 맨발 상태에서 힘판의 중앙 부분을 밟고 지나가도록 13 m의 거리를 편안한 속도로 5회 왕복하도록 하였다. 또한 대상자가 보행하는 동안 3차원 동작분석 장비를 이용하여 고관절, 슬관절, 그리고 족관절 모멘트를 산출 하였다. 수집된 자료들을 SPSS 12.0 소프트웨어를 사용하여 분석하였다. 연구의 결과 아킬레스 건염 환자들의 고관절 은 입각기 초기에 신전 모멘트가 감소하였고, 중후반에는 굴곡 모멘트가 감소하였다. 또한 슬관절에서는 입각기 초기 부터 지속적인 굴곡 모멘트의 감소가 나타났으며 후기에는 신전 모멘트의 감소를 보였다. 그리고 족관절은 입각기 중 반에 저측굴곡 모멘트가 감소하였으며 말기에는 배측 굴곡 모멘트가 감소하였다. 정상인과 비교해 아킬레스 건염 환 자들에게서 보행의 역학적인 변화가 두드러지게 나타났으며, 임상에서는 아킬레스 건염 환자의 보행에 대한 변화를 세밀하게 파악하여 치료적 접근을 시도해야 할 것으로 보인다. 그리고 앞으로의 연구에서는 아킬레스 건염 환자에게 서 나타나는 역학적인 변화에 대한 조사가 더 이루어져야 할 것이다. This study was to investigate the change of gait temporal parameter and ankle joint moment between patients with achilles tendinitis and healthy people. Thus, the purpose of this study is to clarify biomechanical change of gait in patients with achilles tendinitis and to find risk factor for prevention of achilles tendinitis. We recruited 20 patients with an achilles tendinitis and 20 healthy people. While subjects shuttled 5 times on 13 m distance with comfortable pace, we examined gait function marker with three-dimensional gait analysis system. All subject outstepped center of forceplate during gait and calculated ankle joint moment using software. Obtained data was analyzed using SPSS 12.0 software. In results, we confirmed that patients with achilles tendinitis showed reduction of extension moment in early initial phase and reduction of flexion moment in mid-stance on hip joint. and reduction of flexion moment in early initial phase and reduction of extension moment in late phase on knee joint. And we identified that patients with achilles tendinitis showed reduction of dorsiflexion moment in early stance phase, maximal plantarflexion moment in mid stance phase, and dorsiflexion moment in late stance phase. Thus, there are biomechanical changes on gait in patients with achilles tendinitis compared to healthy people. And, in clinical settings, they should focus on changes of gait in patients with achilles tendinitis. Further study will be undertaken for the biomechanical changes of patietns with achilles tendinitis.

Exploring the In Vivo Anti-Inflammatory Actions of Simvastatin-Loaded Porous Microspheres on Inflamed Tenocytes in a Collagenase-Induced Animal Model of Achilles Tendinitis

Jeong, Chandong,Kim, Sung Eun,Shim, Kyu-Sik,Kim, Hak-Jun,Song, Mi Hyun,Park, Kyeongsoon,Song, Hae-Ryong MDPI AG 2018 INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES Vol.19 No.3

<P>Tendon rupture induces an inflammatory response characterized by release of pro-inflammatory cytokines and impaired tendon performance. This study sought to investigate the therapeutic effects of simvastatin-loaded porous microspheres (SIM/PMSs) on inflamed tenocytes in vitro and collagenase-induced Achilles tendinitis in vivo. The treatment of SIM/PMSs in lipopolysaccharide (LPS)-treated tenocytes reduced the <I>mRNA</I> expressions of pro-inflammatory cytokines (Matrix metalloproteinase-3 (<I>MMP-3</I>), cyclooxygenase-2 (<I>COX-2</I>), interleukin-6 (<I>IL-6</I>), and tumor necrosis factor-α (<I>TNF-α</I>)). In addition, the local injection of SIM/PMSs into the tendons of collagenase-induced Achilles tendinitis rat models suppressed pro-inflammatory cytokines (<I>MMP-3</I>, <I>COX-2</I>, <I>IL-6</I>, <I>TNF-α</I>, and <I>MMP-13</I>). This local treatment also upregulated anti-inflammatory cytokines (<I>IL-4</I>, <I>IL-10</I>, and <I>IL-13</I>). Furthermore, treatment with SIM/PMSs also improved the alignment of collagen fibrils and effectively prevented collagen disruption in a dose-dependent manner. Therefore, SIM/PMSs treatment resulted in an incremental increase in the collagen content, stiffness, and tensile strength in tendons. This study suggests that SIM/PMSs have great potential for tendon healing and restoration in Achilles tendinitis.</P>

Wrapping of tendon tissues with diclofenac-immobilized polycaprolactone fibrous sheet improves tendon healing in a rabbit model of collagenase-induced Achilles tendinitis

이태훈,김성은,이재용,김재균,박경순,김학준 한국공업화학회 2019 Journal of Industrial and Engineering Chemistry Vol.73 No.-

We fabricated diclofenac-immobilized polycaprolactone (DFN/PCL)fibrous sheets to improve tendonhealing of rabbits with collagenase-induced Achilles tendinitis. DFN/PCL have anti-inflammatory effectsrelated to suppression of mRNA levels of pro-inflammatory factors including COX-2, IL-6, TNF-α, andMMP-3 in inflamed tenocytes and tendon tissues of rabbits with Achilles tendinitis as well as those ofanti-inflammatory cytokines including IL-4, IL-10, and IL-13. In vivo studies, wrapping of tendon tissueswith DFN/PCLfibrous sheets may afford superior tendon healing, with decreased inflammatory cells,increased collagen content, restored collagenfiber organization, and improved mechanical strength. Thisapproach will be a promising treatment from Achilles tendinitis.

침도침술을 시행한 아킬레스건염 증례보고

장은하,임나라,나원민,김성철,Jang, Eun-Ha,Lim, Na-Ra,Na, Won-Min,Kim, Sung-Chul 대한약침학회 2008 Journal of pharmacopuncture Vol.11 No.4

Purpose In order to estimate clinical effects of Oriental Medicine Treatment with acupotomy therapy of Achilles Tendinitis Methods From 4th August, 2008 to 14th August, 2008, 1 female patient diagnosed as Chronic Achilles Tendinitis (clinical diagnosed) was treated with general oriental medicine therapy(acupuncture, moxibustion, cupping, physical therapy, herbal medication) and acupotomy. Results The patient's chief complaints- Lt. heel pain and stiffness, dorsi-flexion limitation, nodules in the achilles tendon- were notably improved. Conclusions This study demonstrates that oriental medical treatment with acuputomy therapy has significant effect in improving symptoms of achilles tendinitis. as though we had not wide experience in this treatment, more research is needed.

만성 아킬레스건염 환자에게 고유수용성 걷기운동이 발목 근기능과 통증정도에 미치는 영향

김상수 한국스포츠학회 2018 한국스포츠학회지 Vol.16 No.3

본 연구는 만성 아킬레스건염 환자에게 고유수용성 걷기운동이 발목 근기능과 통증정도에 미치는 영향을 살펴보 는 것이다. 이를 위하여 20-30대 남성 6명에게 8주간 고유수용성 기구인 점퍼를 이용한 걷기운동을 적용하였다. 측정 항목으로는 발목 근기능을 확인하기 위해 Calf raise 1RM과 Calf raise RM을 측정하였으며, 통증정도를 확인하기 위 해 VAS 설문지를 이용하였다. 이에 다음과 같은 결과를 얻었다. 발목 근기능의 변화에서 Calf raise 1RM(최대근력)과 Calf raise RM(최대반복회수)이 고유수용성 걷기 적용에 따라 유의하게 증가하였으며(p<.05), 통증정도의 변화에서 는 고유수용성 걷기운동의 적용에 따라 유의하게 감소하였다(p<.05). 이에 따라, 만성 아킬레스건염 환자에게 고유수 용성 걷기운동의 적용은 발목 근기능 향상 및 통증정도 감소에 도움이 되는 것을 확인할 수 있었다. The purpose of this study was to investigate the effects of proprioceptive walking exercise on muscle function of ankle and pain level in patient with chronic achilles tendinitis. The subjects for the study were 6 male patient with chronic achilles tendinitis composed of the experimental group. The experimental group participated in the proprioceptive walking exercise for 8 weeks and the effects on calf raise 1RM(1 Repeated Maximum), calf raise RM(Repeated Maximum) and pain level were evaluated. The proprioceptive walking exercise group significantly increased calf raise 1RM and calf raise RM. The proprioceptive walking exercise group also significantly decreased pain level. Consequently, Applying of proprioceptive walking exercise for patient with chronic achilles tendinitis will be effectively appeared to improvement of muscle function of ankle and decreasing of pain level.

아킬레스 건염에서 스테로이드 주입 후 아킬레스 건 파열 (5예 보고)

김전교,곽희철,백종민,Kim, Jeon-Gyo,Gwak, Heui-Chul,Baik, Jong-Min 대한족부족관절학회 2013 대한족부족관절학회지 Vol.17 No.4

Purpose: The purpose of the study was to investigate five cases with chronic Achilles tendon rupture that occurred after steroid injections. Materials and Methods: In our hospital, we experienced five cases of chronic Achilles tendon rupture from September 2010 to March 2012. All patients had got steroid injection for Achilles tendinitis at the other hospitals, and their heel pain was aggravated when they visited our outpatient department. After treatment, signs and symptoms of Achilles tendon rupture were developed and the diagnosis was confirmed by ultrasonography or magnetic resonance imaging (MRI). Surgical treatment was done for Achilles tendon rupture. Results: There was difference between intra-operative findings of Achilles tendon rupture and usual chronic Achilles tendon rupture. Unlike usual findings of chronic Achilles tendon rupture whose scar tissue or tissue attenuation are found around the defect area of Achilles tendon, there were partial necrosis of tendon severe adhesion with surrounding tissue, extensive defect and longitudinal rupture on ruptured area. Also, severe inflammation of paratenon, granulation and fibrinoid deposit were found on biopsy findings in four cases. Conclusion: Based on review of data about relative risk and benefit of local corticosteroid injection to inflammatory lesion in Achilles tendon, it requires more attention to Achilles tendon rupture following local corticosteroid injection.

Levofloxacin-Induced Achilles Tendinitis in a Young Adult in the Absence of Predisposing Conditions

Areum Durey,백용수,박진석,이광수,유정선,정문현,이진수 연세대학교의과대학 2010 Yonsei medical journal Vol.51 No.3

Fluoroquinolones (FQs) represent a major class of antimicrobials that have a high potential as therapeutic agents. Although FQs are generally safe for the use as antimicrobials, they may induce tendinopathic complications such as tendinitis and tendon rupture. A number of factors have been suggested to further predispose a patient to such injuries. Hitherto, a few published cases on tendon disorders have implicated levofloxacin, a more recently introduced FQ. Here, we report a patient with levofloxacin-induced Achilles tendinitis, who exhibited no known predisposing factors. A 20-year-old man without any history of disease or medication presented with community-acquired pneumonia. Levofloxacin was administered and 3 days later, he complained of pain in the left Achilles tendon and revealed redness and swelling in the area. On suspecting Achilles tendinitis, levofloxacin treatment was discontinued, and the tendinitis subsequently improved. To our knowledge, this is the first case report on FQ-induced Achilles tendinitis in Korea.

아킬레스 건염? 염증이라고 다 같은 염증이 아니야

김대유,이동연,Kim, Dae-Yoo,Lee, Dong Yeon 대한족부족관절학회 2021 대한족부족관절학회지 Vol.25 No.2

It is widely acknowledged that Achilles tendinopathy and resultant degeneration of the Achilles tendon could be either due to vigorous physical exertion or due to inflammation of the tendon associated with systemic disease. The overuse injuries are generally multifactorial in origin and are caused by repetitive strain of the affected tendon till the tendon can no longer endure the tensile stress. Various alignment and biomechanical faults are claimed to play a causative role. Only 2% of patients complaining of Achilles tendon pain are caused by systemic disease. However, to ensure the right approach to treatment, it is necessary to rule out inflammatory tendinitis caused by systemic diseases such as rheumatoid arthritis, gout, and seronegative spondyloarthrosis.

근막추나와 한방치료 및 그라스톤테크닉을 병행하여 호전된 아킬레스건염 증례보고 1례

박재홍 ( Jae Hong Park ),오은영 ( Eun Young Oh ),이흔주 ( Heun Ju Lee ),김영준 ( Young Jun Kim ),신유빈 ( You Bin Shin ) 한방재활의학과학회 2015 한방재활의학과학회지 Vol.25 No.1

The objective of this study is to report the improved case of Achilles tendinitis treated with Korean medicine, Gyeon-mak chuna and Graston Technique. The patient diagnosed with Achilles tendinitis is hospitalized at Department of Korean Rehabilitation Medicine, Samse Hospital of Korean Medicine. The subject is treated by herbal medicine, acupuncture, Gyeon-mak chuna and Graston technique. This study was measured by Visual Analogue Scale (VAS) score, walking time without pain per 6 minutes (6MWT) and American orthopaedic foot and ankle society Hind foot scale (AOFAS). The patient showed decreased VAS, AOFAS and improved 6MWT after treated with Korean medicine, Gyeon-mak chuna and Graston Technique. The patient showed reduced pain and positive effect on activities of daily living. (J Korean Med Rehab 2015;25(1):103-110)

수직점프 시 비탄력 테이핑이 발목 발등굽힘과 하퇴삼두근의 근활성도에 미치는 영향

김근수 ( Geun-su Kim ),원종혁 ( Jong-hyuck Weon ),정도영 ( Do-young Jung ) 대한물리의학회 2016 대한물리의학회지 Vol.11 No.4

PURPOSE: There are several standard interventions for managing Achilles tendinitis, including eccentric exercise and calf muscle stretches, orthoses, electrotherapy, and taping. However, no study has determined the effect of non-elastic taping on deloading the Achilles tendon while vertical jumping. Therefore, this study determined the effect of non-elastic taping on ankle dorsiflexion and the triceps surae muscle activity while vertical jumping in healthy subjects. METHODS: The study recruited 17 participants. A motion analysis system was used to measure the angle of ankle dorsiflexion and wireless surface electromyography was used to measure the soleus and gastrocnemius activities while vertical jumping. Non-elastic taping was applied on randomized leg side. All subjects performed maximal effort vertical jumps without and with non-elastic taping, with three trials for each condition. The mean peak dorsiflexion and muscle activities during the three trials were calculated and paired t-tests were used to compare the mean values without and with non-elastic taping. Significance was defined as (p<.05). RESULTS: The maximum angle of ankle dorsiflexion and activity of the gastrocnemius muscle decreased significantly when non-elastic tape was applied (p<.05), while there was no significant difference in the soleus activity between no-taping and taping (p>.05). CONCLUSION: We introduce non-elastic taping as a method to decrease maximum ankle dorsiflexion and gastrocnemius activity while vertical jumping.