외반슬 환자의 교정운동의 효과: 단일 피험자 A-B-A 실험 설계

이호성 ( Ho Seong Lee ),김아람 ( Ah Ram Kim ) 대한물리의학회 2016 대한물리의학회지 Vol.11 No.1

PURPOSE: The purpose of this study was to determine the effect of corrective exercise on hip joint range of motion, lower limb alignment, radiographs of hip and knee joints, and quadriceps muscle activity in a patient with knee joint valgus deformity. METHODS: A single-subject A-B-A experimental design was used to determine the effects of therapeutic exercise. The single-subject was a 27-year-old male, who presented with knee joint valgus deformity. Corrective exercise program was performed for 40 min/day twice a week for 12-week. Range of motion (hip flexion, extension, abduction, adduction, internal rotation, and external rotation), lower limb alignment test (Q-angle, rear foot alignment, and leg length), standing anterior-posterior radiographs (neck shaft angle and knee joint space), and quadriceps muscle activity of both lower limbs were measured before (A 1), after 6 weeks (B 1) and after 12-weeks (B 2) of corrective exercise and after 6 weeks of exercise completion (A 2). RESULTS: Hip range of motion increased in all directions of both sides at B 2 and A 2 compared to at A 1. Q-angle of both side and leg length discrepancy decreased at B 2 and A 2 compared to at A 1. Neck shaft angle and knee joint space of both sides improve at B 2 and A 2 compared to at A 1. Quadriceps of both side muscle activities improved at B 2 and A 2 compared to at A 1. CONCLUSION: We demonstrated that corrective exercise increases range of motion, and improves lower limb alignment and muscle activity in a patient with knee joint valgus deformity.

교정운동이 내반슬 하지 변형자의 고관절각, Q각, 무릎 사이 간격에 미치는 영향

한상민,이기광,하성,손지훈 대한운동사협회 2011 아시아 운동학 학술지 Vol.13 No.1

[INTRODUCTION] The purpose of this study is to investigate the effect of correction exercise on genu varum patients' hip joint angle, Q angle and distance between the knees. [METHOD] 20 person who have a lower limbs' malalignment, genu varum, were participated in this research. Among them 8 were assigned in experimental group and the others were assigned in comparison group. Stretching exercise, bend exercise and sling exercise were applied to the experimental group for 12 weeks. For the statistical analysis 2-way ANOVA repeated measures was used. [RESULT] The correction exercise which were composed of bend exercise, sling exercise and stretching applied to the genu varum patients brings over significantly positive effects on hip joint angle, Q angle, and space between the knees. [CONCLUSION] The lower limbs' deformation caused by muscle imbalance, not by structural problem, can be recovered to the normal by continuous correction exercise. [서론] 본 연구는 내반슬 환자들에 대한 교정운동이 환자들의 고관절각과 Q각(angle), 그리고 무릎 사이 간격 등을 정상 범위로 되돌리는 데 효과가 있는지를 확인하는 것에 있다. [방법] 서울시 소재 S정형외과에서 내반슬(O형 다리)로 인해 체형 교정을 받는 회원들 중 20명을 대상으로 실험하였으며, 이들을 다시 실험군 12명과 대조군 8명으로 나눈 후, 12주간의 교정운동을 거쳐 사전·사후 검사를 하였다. 검사 실시 후, 집단의 동질성과 변인들에 대한 시기별 차이를 검증하기 위해 반복 측정 이원 분산 분석을 실시하였다. [결과] 분석 결과 스트레칭, 밴드 운동, 슬링 운동 등의 교정운동을 받은 집단의 고관절각과 Q각, 무릎 사이 간격 등이 정상에 가깝게 변형된 것을 알 수 있었다. [결론] 선천적인 골격의 문제가 아닌, 구조적인 근육의 불균형으로 인한 내반슬 증상은 꾸준한 교정운동을 통해 정상적인 범위로 되돌릴 수 있을 것이라 생각된다.

단기간의 교정운동이 골반전방경사 환자의 통증, 엉덩관절 가동범위 및 몸통근력에 미치는 영향: 증례보고

박상호,김아람,이호성 대한운동학회 2016 아시아 운동학 학술지 Vol.18 No.3

[PURPOSE] The purpose of this case report was to determine the effects of short-term corrective exercise on pain, hip Joint range of motion and trunk muscle strength of a patient with anterior pelvic tilt (APT). [METHODS] The single-subject was a 21-year-old female with APT and low back pain (LBP). Corrective exercise program was performed for 40 min/day twice a week for 4-week. LBP (VAS), lumbar disability (ODI), range of motion (hip flexion, extension, abduction, adduction, internal rotation, and external rotation) and trunk flexor and extensor strength were measured before and after 4 weeks of corrective exercise. [RESULTS] VAS and ODI decreased after corrective exercise. Hip joint range of motion increased at flexion, extension, abduction, adduction, internal rotation, and external rotation after corrective exercise. Trunk flexor and extensor strength improved after corrective exercise. [CONCLUSIONS] We demonstrated that short-term corrective exercise decreases pain and disability, increases range of motion, trunk flexor, and extensor strength of a patient with anterior pelvic tilt.

편평족 중학생의 고관절 교정 운동 프로그램과 발교정구 착용 유무가 안정시 종골기립 각도, 발목의 가동범위, 코어 근력에 미치는 영향

김남희 ( Nam Hee Kim ),이경옥 ( Kyung Ock Yi ) 한국운동역학회 2015 한국운동역학회지 Vol.25 No.4

Objective : The purpose of this study is to evaluate the effects of hip joint exercises and orthotics on RCSP, ankle``s range of motion, and core muscle strength of middle school students with pes planus. Method : Out of the original pool of 200 students, 60 students with pes planus (RCSP < -2) were selected for the study. The selected 60 students were then divided into four groups. The first group was a combined orthotics and exercise group (12 students), the second was the orthotics-only group (9 students), the third was the exercise-only group (8 students), and the last was the control group (10 students). Exercise groups worked out twice a week for 60 minutes per session over 8 weeks. The independent variables were corrective hip joint exercises and orthotics. The dependant variables consisted of kinematic and kinetic variables. The kinematic variables were RCSP, and ankle``s range of motion (dorsiflexion and plantarflexion). The kinetic variables were muscles forces that consist in core muscle strength, which are hip joint adduction, abduction, and flexion muscles forces. Statistical analysis was performed via SPSS 18.0 with multivariate analysis of covariance (MANCOVA) and a paired t-test was used. Results : The left foot was more responsive to the treatments, both exercise and orthotics, than the right foot. RCSP improved significantly in the left foot for the first and third groups. Only the first group significantly improved hip joint adduction, abduction, and flexion muscles`` strengths. As for the ankle``s range of motion of the left foot, plantarflexion showed improvement when treated with exercise, orthotics, or both. Conclusion : This study found that exercise is more effective in correcting RCSP and foot orthotics is more effective in reinforcing core muscle strength. Future studies should expand on these results to examine the relationship between the ankle, hip, and pelvis.

특발성 내반슬 여대생의 고관절 가동범위와 등속성 근력

김제영(Che-Young Kim),임승길(Seung-Kil Lim) 한국콘텐츠학회 2014 한국콘텐츠학회논문지 Vol.14 No.10

본 연구는 곧은 다리를 가지고 있는 여대생과 특발성 내반슬이 있는 여대생들의 고관절 ROM과 등속성 근력에 대해 비교·분석하여 내반슬의 교정을 위한 운동치료적 접근을 위한 객관적인 자료를 제시하고자 한다. 아울러 새롭게 개발된 운동장비 발로아(2013, Balloa/Adonia/Korea) 동작과정을 통해 휜다리 가진 실험자 내전근 대퇴부와 심층근의 상태를 실험하여 그의 효과와 적용성을 검토한 결과 내반슬이 있는 사람에게는 고관절 외회전 ROM을 증가시키기 위한 신장기법과 고관절 내회전근의 활동성을 억제시키고 외회전근을 단련시킬 수 있는 운동기법이 필요하다. 발로아 기구는 고관절 외회전 ROM을 증가시키며 둔근과 심층근, 내전근을 강화시키며 근력강화 기능으로 내반슬 환자의 교정운동에 효과적임을 나타내었다. This study is to present objective data for the approaches of therapeutic exercise for the correction of genu varum by making an analysis and a comparison of the hip joints’ ROM and isokinetic muscles of the female college students with straight legs with those of a female college student with idiopathic genu varum. Additionally, the state of the adductor muscle’s thighs and the deep muscles of the subjects with bowed legs were experimented and the equipment’s effect and applicability was reviewed through the process of the movement of newly developed exercise equipment, Balloa(2013, Balloa/Adonia/Korea). As a result, a person with genu varum needs the height increasing method for increasing external rotation ROM of a hip joint and requires the exercise techniques to strengthen external rotator muscles and to inhibit the activity of internal rotator muscles of a hip joint. Balloa increases the external rotation ROM of a hip joint and strengthens gluteal muscles, deep muscles, and adductor muscles, and the equipment’s function of muscle strengthening shows that the equipment is an effective corrective exercise for the patients of genu varum.