Background: The foot is a complex body structure that plays an important role in static and dynamic situations. Previous studies have reported that altered foot posture might affect knee joint strength and postural stability, however their relationship still remains unclear.
Objects: The purpose of this study was to identify whether pronated foot posture has an influence on knee isokinetic strength and static and dynamic postural stability.
Methods: Forty healthy young males aged 18 to 26 years were included. Foot posture was evaluated using the Foot Posture Index-6 (FPI-6), and the subjects were divided into two groups according to their FPI-6 scores: a neutral foot group (n = 20, FPI-6 score 0 to +5) and a pronated foot group (n = 20, FPI-6 score +6 or more). Biodex Systems 3 isokinetic dynamometer was used to evaluate knee isokinetic strength and hamstring to quadriceps ratio at three angular velocities: 60°/sec, 90°/sec, and 180°/sec. The static and dynamic postural stability in a single-leg stance under the eyes-open and eyes-closed conditions were measured with a Biodex Balance System.
Results: There were no significant differences between the groups in knee isokinetic strength and static postural stability (p > 0.05), but there was a significant difference in the medial– lateral stability index (MLSI) for dynamic postural stability under the eyes-closed condition (p = 0.022). The FPI-6 scores correlated significantly only with the dynamic overall stability index (OSI) and the MLSI (OSI: R = 0.344, p = 0.030; MLSI: R = 0.409, p = 0.009) under the eyesclosed condition.
Conclusion: Participants with pronated foot had poorer medial–lateral dynamic stability under an eyes-closed condition than those without, and FPI-6 scores were moderately positively correlated with dynamic OSI and dynamic MLSI under the eyes-closed condition. These results suggest that pronated foot posture could induce a change in postural stability, but not in knee isokinetic strength.
Background: Whole-body vibration (WBV) has been used to alleviate proprioceptive damage by musculoskeletal and neurological conditions. However, no study has determined whether wearing shoes while applying WBV can affect proprioception precision of the knee joint.
Objects: This study aimed to determine the differences in the proprioceptive precision of the knee joint before and after WBV and to compare the proprioceptive precision of the knee joint between barefoot and shoe-wearing conditions.
Methods: This study recruited 33 healthy participants. A passive-to-active angle reproduction test was used to measure the proprioception precision of the knee joint using an electrogoniometer, and the target angle was set to a knee flexion of 30°. Proprioception precision was calculated using the error angle (angular difference from 30°). Proprioceptive precision was measured in weight-bearing and non-weight-bearing positions before and after applying WBV for 20 minutes at 12 Hz in barefoot and shoe-wearing conditions. Mixed repeated analysis of variance was used to determine the differences in changes in the proprioceptive precision of the knee joint according to foot conditions.
Results: There were significant improvements in the weight-bearing (p = 0.002) and nonweight- bearing (p < 0.001) proprioceptive precision of the knee joint after applying WBV. However, there was no significant difference in the change in proprioceptive precision of the knee joint after applying WBV between the barefoot and shoe-wearing conditions.
Conclusion: WBV stimulation had an immediate effect on improving the proprioceptive precision of the knee joint. However, foot conditions (barefoot or shoe-wearing) during WBV application did not influence the proprioceptive precision of the knee joint.
Background: The spinal nerves, which start at the lumbar level, are connected to the nerve innervation in the knees. Currently, there is a lack of research on the treatment of knee pain through lumbar mobilization.
Objectives: To investigate the effects of lumbar joint mobilization (LJM) and transcutaneous electronic nerve stimulation (TENS) on proprioception and muscular strength in volleyball players with chronic knee pain.
Design: Two group pre-posttest.
Methods: A total of 26 professional volleyball players with chronic knee pain were allocated to the LJM (n=13) and TENS (n=13) groups. In the LJM group, grade III - IV amplitude was applied 3 times for 1 minute (80 times per minute) at the affected lumbar (L2-3) facet joint in the prone position. In the TENS group, the TENS treatment device was used to directly apply or 15 minutes to the area of chronic knee pain (100 Hz, 150 ㎲). Proprioception was measured by knee flexion and extension angles, and muscle strength was evaluated using an isokinetic test. Measurements were taken before and after interventions.
Results: In the eye opened conditiond, proprioception significantly increased during both knee extension and flexion after LJM, while only knee extension was significantly increased in the TENS group. There was also a significant difference in knee extension between the two groups. In the eye close conditiond, proprioception was significantly improved only during knee extension in the LJM group, and the difference in knee extension between the groups was also significant (P<.05). The maximum torque of the affected knee joint was significantly improved at 60°/sec in both groups (P<.05); however, there was no difference between the two groups. There was no significant difference in the maximum flexion torque within or between the groups.
Conclusion: This study suggests that LJM improved proprioception and muscular strength in volleyball players with chronic knee pain.
Background: A hip fracture may occur spontaneously prior to the hip impact, due to the muscle pulling force exceeding the strength of the femur.
Objects: We conducted falling experiments with humans to measure the activity of the hip muscles, and to examine how this was affected by the fall type.
Methods: Eighteen individuals fell and landed sideways on a mat, by mimicking video-captured real-life older adults’ falls. Falling trials were acquired with three fall directions: forward, backward, or sideways, and with three knee positions at the time of hip impact, where the landing side knee was free of constraint, or contacted the mat or the contralateral knee. During falls, the activities of the iliopsoas (Ilio), gluteus medius (Gmed), gluteus maximus (Gmax) and adductor longus (ADDL) muscles were recorded. Outcome variables included the time to onset, activity at the time of hip impact, and timing of the peak activity with respect to the time of hip impact.
Results: For Ilio, Gmed, Gmax, and ADDL, respectively, EMG onset averaged 292, 304, 350, and 248 ms after fall initiation. Timing of the peak activity averaged 106, 96, 84, and 180 ms prior to the hip impact, and activity at the time of hip impact averaged 72.3, 45.2, 64.3, and 63.4% of the peak activity. Furthermore, the outcome variables were associated with fall direction and/or knee position in all but the iliopsoas muscle.
Conclusion: Our results provide insights on the hip muscle activation during a fall, which may help to understand the potential injury mechanism of the spontaneous hip fracture.
Background: Although symmetry of spatio-temporal parameter and center of pressure (COP) shift during walking is associated with knee adduction moment, research on clinical association with knee osteoarthritis (OA)-related knee pain and functional scores is lacking.
Objects: The aims were 1) to compare symmetry of gait parameters and COP-shift in patients with unilateral knee OA and pain and matched controls, and 2) to investigate the relationship between symmetry of gait parameters and COP-shift, and clinical measures.
Methods: Female subjects (n = 16) had with unilateral radiological knee OA and pain. Healthy controls (n = 15) were age-matched to OA group. Symmetry of foot rotation, step length, stance and swing phase, lateral symmetry of COP and anterior/posterior symmetry of COP during walking was assessed. To assess the clinical variables, pain intensity, pain duration and function using Knee Osteoarthritis Outcome Survey (KOOS) subscales were collected. We compared symmetry between groups using Mann–Whitney U-test or independent t-test. Relationships between clinical measures and symmetry index measured using Spearman’s correlation test. Statistical significance was set at α = 0.05.
Results: Knee OA group showed significantly greater values of only lateral symmetry of COP (p < 0.01) than healthy group. Values of lateral symmetry of COP had moderate or strong correlation significantly with the intensity of knee pain, pain duration, and scores of all KOOS subscales (p < 0.01).
Conclusion: Patients with unilateral knee OA and pain showed more asymmetry of lateral COP-shift during walking compared with matched healthy controls. In addition, larger asymmetry of lateral COP-shift has the moderate or strong association with worse of knee pain, worse in KOOS scores and longer duration of knee pain. Asymmetry of lateral COP-shift during walking may be one of the characteristics of unilateral knee OA as the compensatory strategy response to unilateral OA of the knee.
Background: Prolonged standing during work causes a lower extremity pain and disorders. Patellofemoral pain syndrome (PFPS) is one of the common diagnoses of the knee pain. Although the etiology of PFPS is not completely understood, it is considered to be multifactorial.
Objects: The purpose of this study was to investigate difference in strength of knee muscles, quadriceps:hamstring muscles strength ratio (Q:H ratio), asymmetry ratio of knee muscles strength and dorsiflexion range of motion (ROM) between standing workers with and without PFPS.
Methods: Twenty-eight standing workers with PFPS and 26 age-, height-, and weightmatched standing workers without PFPS participated in this study. A tension sensor measured knee muscle strength, and motion sensor measured dorsiflexion ROM. The asymmetry ratio of knee muscles was calculated by a specific formula using the knee muscles strength of the dominant side and the sound side. An independent t-test was used to identify significant differences in the strength, ROM, Q:H ratio, and asymmetry ratio between the PFPS and normal groups.
Results: The standing worker with PFPS have significantly lower dorsiflexion ROM (p < 0.000) and higher asymmetry ratio of the hamstring muscles strength (p < 0.000) compare to the standing worker without PFPS. No significant differences were seen in the strength of quadriceps muscle and hamstring muscles, Q:H ratio, and asymmetry ratio of quadriceps muscle strength.
Conclusion: There was a significant difference in the asymmetry ratio of the isometric hamstring muscle strength. This finding suggests that the asymmetry ratio of isometric hamstring muscle strength may be more important than measuring only the hamstring muscle strength of the PFPS side. Furthermore, the results of this study showed a significant difference in dorsiflexion ROM between the standing industrial workers with and without PFPS. Dorsiflexion ROM and isometric hamstring muscle strength should be considered when evaluating the subjects with PFPS.
Background: With the increasing elderly population, the need for gait analysis of these elderly individuals is also increasing. Most devices are costly and not portable; however, smartphones using built-in sensors capable of measuring motion and are easily available.
Objectives: To examine the reliability and validity of knee joint angles of the elderly using smartphone measurements during walking.
Design: Quasi-experimental research. Methods: Sixteen elderly people, aged 65+ and living in Daejeon and Chungbuk, South Korea, participated in the study. Electrogoniometers and smartphones were attached to the thigh and the side and front of the shank of each subject, respectively, using double-sided tape, an arm band, and an elastic band. Each subject completed two sets of at least seven gait cycles (14 steps).
Results: Both the smartphones and electrogoniometers exhibited high agreement in terms of their primary and secondary measurements (ICC>.75). The agreement between the smartphones and electrogoniometers was also high in terms of both the primary and secondary measurements (ICC<.60).
Conclusion: These results indicate that smartphones can be costly equipment cannot, even though they cannot completely replace existing clinical-grade devices. Their utility is emphasized herein for measuring knee joint angles of the elderly during walking.
본 연구의 목적은 딥 스쿼트 동작 시 발목 관절 유연성이 무릎 관절의 운동역학적 요인들간의 관련성을 분석하는데 있었다. 본 연구는 최근 1년간 하지 근골격계 병력이 없는 성인 남성 19명과 여성 8명이 연구대상자로 참여하였다. 딥 스쿼드 시 발목 관절 유연성과 하지 관절의 운동역학적 요인들과 상관관계를 검증하기 위해 pearson의 적률상관계수(pearson’s correlation coefficient)를 이용하였고(SPSS 24.0, Armonk, NY, USA), 통계적으로 유의미한 상관성을 나타낸 변인들은 단순회기분석(simple regression analysis)을 실시하였으며, 유의 수준은 .05로 설정하였다. 본 연구를 통해 발목 관절 유연성과 무릎 관절의 압력을 결정하는 최대 관절모멘트와 관절반발력 요인들 간의 관련성을 확인할 수 있었다. 그러므로 근력 트레이닝 시 딥 스쿼트와 같은 무릎 관절에 많은 부하를 발생시킬 수 있는 운동을 적용할 때 개인에 신체적 특성 중 발목 관절의 유연성의 정도를 확인하는 것은 신체의 안정성과 무릎 관절의 상해 위험성을 감소시킬 수 있는 운동 강도를 설정하는데 도움이 될 수 있을 것으로 기대한다.
The purpose of this study was to assess knee joint loading in the target knee during a golf swing compared to loading rates of high impact activities such as cutting and drop landings. Nine healthy competitive golfers completed golf swings with the target foot both straight and externally rotated 30 degrees, as well as drop landings and cutting maneuvers. Motion capture data was collected at 240 Hz and ground reaction force data was collected at 2400 Hz. The frontal and transverse knee moments were examined using repeated measures ANOVA through SPSS. The abduction moments were higher in golf swings as compared to the other high impact activities (p=.010), while the external rotation moments were lower (p=.003). There were no significant differences between externally rotated and neutral golf swings. These results suggest moments applied to the knee during a golf swing are similar to those applied during a high impact activity.
본 연구의 목적은 무릎 푸시업 플러스 동작 시 슬링과 진동기 적용이 체간 근육의 근활성도 변화에 미치는 영향에 대해 알아보는 것이었다. 본 연구의 대상자는 신체 건강한 20대 남성 10명을 대상으로 실시하였고(연령, 23.00±0.45 세; 신장, 176.60±1.64 cm; 체중, 67.50±1.22 kg; 신체질량지수, 21.65±0.34 kg/m2), 3가지의 기본 무릎 푸시업 플러스 동작, 슬링을 적용한 무릎 푸시업 플러스 동작, 및 진동기를 적용한 무릎 푸시업 플러스 동작을 수행하였으며, 표면전극 부착 부위는 체간 근육의 오른쪽 상부 승모근, 대흉근, 전거근, 복직근, 및 외복사근으로 설정하였다. 본 연구의 결과는 다음과 같다. 승모근, 대흉근, 전거근, 복직근, 및 외복사근의 근활성도는 진동기를 적용한 무릎 푸시업 플러스 동작 시 통계적으 로 가장 높게 나타났다(p<.001). 따라서 본 연구의 결과는 향후 무릎 푸시업 플러스 동작 적용 시 효과적인 체간 근육을 강화시키기 위한 트레이닝 프로그램의 기초자료가 될 것으로 기대된다.
본 연구는 퇴행성 무릎 관절염을 가진 노인여성을 대상으로 12주간의 노르딕 워킹을 통해 신체 기능과 관절염 통증 정도의 개선에 어떠한 효과를 미치는지 규명하는데 목적이 있다. 본 연구의 대상자는 퇴행성관절염으로 진단받은 노인여성 16명(나이: 73.00±3.70year, 신장: 154.30±4.07cm)을 대상으로 무선배정 된 노르딕 워킹 운동그룹(n=9)과 통제그룹(n=7)으로 나누었다. 운동 그룹은 노르딕 스틱을 이용하여 12주간 주 3회, 1회 30분 노르딕 워킹 운동을 실시하였고, 운동 강도는 HRR의 40-60%로 설정하였다. 통제그룹은 동일한 기간 동안 일상생활을 유지하도록 하였다. 종속변인으로 신체조성(체중, 체지방률, 근골격량)과 근력과 유연성(상·하지 근력, 상·하지 유연성), 균형능력(정적균 형, 동적균형) 및 통증정도를 측정하였다. 이러한 지표들의 측정은 운동프로그램을 진행하기 전과 후로 나누어 2번 측정하였다. 자료처리는 SPSS-PC version 25.0을 이용하여 실험집단과 통계집단간의 생리학적 특성 비교를 위해 독립표본 t-test를 사용하였으며, 노르딕 워킹 운동그룹과 통제그룹의 그룹 간, 시기간의 변화를 알아보기 위해 2x2 반복측정 이원배치분산분석을 사용하였다. 연구 결과는 첫째, 12주간의 노르딕 워킹을 통해 신체조성 기능에서 체지방률은 운동 처치 후에 감소하는 결과가 나타났으며(p=.004), 집단 간과 시기 간의 상호작용에서도 감소하는 결과가 나타났다(p=.003). 골격근량은 운동처치 후에 증가하는 결과가 나타났으며(p=.018), 집단 간과 시기 간의 상호작용에서도 증가하는 결과가 나타났다(p=.005). 둘째, 근력과 유연성은 상지근력과 하지유연성에서 집단 간과 시기 간 상호작용에서 증가하는 결과가 나타났으며(p=.009)(p=036), 하지근력에서는 운동집단과 통제집단 간 개선 효과가 나타났다(p=.006). 또한, 상지유연성은 운동처치 후에 증가하는 결과가 나타났다(p=.020). 셋째, 균형능력 요인은 정적균형에서 운동처치 후 개선 효과가 나타났으며(p=.016), 동적균형에서는 차이가 나타나지 않았다(p>.05). 넷째, 통증정도는 운동처치 후 개선 효과가 나타났으며(p=.022), 운동집단과 통제집단 간에 개선 효과도 나타났다(p=.013). 결론적으로 12주간의 노르딕 워킹은 퇴행성 무릎 관절염을 가진 노인여성의 신체조성과 근력과 유연성 에 긍정적인 영향을 미치는 것으로 나타났다. 따라서 노르딕 워킹은 퇴행성 무릎 관절염을 가진 노인여성 에게 신체조성과 안정성, 균형성을 높여 주였으며, 무릎 관절의 통증을 낮춰주어 재활 운동 기능 개선에 효과적인 운동방법이라고 사료된다.
Background: Knee osteoarthritis (OA) causes not only pain during walking but also walking disorders. Therefore, intervention for older patients with OA is important.
Objective: To study investigated the effects of kinesio taping (KT) on pain and walking ability in elderly persons with knee OA. Design: One group, pre-post design
Methods: This study enrolled 12 community-dwelling elderly people with knee OA. KT was applied on the surrounding structures, including the patellar and bilateral lateral ligaments. Assessment was made using the visual analog scale and GAITRite system to measure pain and walking ability during KT and non- KT conditions.
Results: In this study, compared to the non-KT condition, the KT condition showed a significant improvement in walking ability and pain reduction during walking (velocity, cadence, step length, and stride length) (p < 0.05).
Conclusion: This study demonstrated that knee KT has a positive effect on pain reduction and walking ability of the elderly with OA.
Background: The bridge exercise targets the gluteus maximus (Gmax) and gluteus medius (Gmed). However, there is also a risk of dominant hamstring (HAM) and erector spinae (ES) muscles.
Objects: To analyze the muscle activity the of Gmax, Gmed, HAM and ES during the bridge exercise with and without hip external rotation in different degrees of knee flexion.
Methods: Twenty-three subjects were participated. The electormyography (EMG) activity of the Gmax, Gmed, HAM and ES muscles was recorded during the exercise. The subjects performed the bridge exercise under four different conditions: (a) with 90˚ knee flexion, without hip external rotation (b) with 90˚ knee flexion, with hip external rotation (c) with 135˚ knee flexion, without hip external rotation (d) with 135˚ knee flexion, with hip external rotation.
Results: There was no significant interaction effect between the degree of knee flexion and hip external rotation. There was a significant main effect for degree of knee flexion in Gmax, HAM muscles activity. Gmax muscle activity was significantly greater in the 135˚ knee flexion position than in the 90˚ knee flexion position (p<.001). While HAM muscle activity was significantly less in 135˚ knee flexion position than in the 90˚ knee flexion position (p<.001). ES muscle activity was significantly less in the 135˚ knee flexion position than in the 90˚ knee flexion position (p=.002). The activity of both the Gmax and Gmed muscles was significantly greater with hip external rotation (p<.001 and p=.005, respectively).
Conclusion: For patients performing the bridge exercise, positioning the knee in 135° of flexion with hip external rotation is effective for improving Gmax and Gmed muscle activity while decreasing HAM, and ES muscle activity.
Background: Measurement of passive ankle dorsiflexion range of motion (ADROM) is often part of a physical therapy assessment.
Objects: The objective of this study was to identify the effects of subtalar joint neutral position (SJNP) on passive ADROM according to knee position in young adults.
Methods: We recruited 14 young adult participants for this study. Two examiners used a universal goniometer to measure passive ADROM with and without SJNP. Dorsiflexion force was applied to the forefoot until maximum resistance was reached in two knee positions (extension and 90˚ flexion) in the prone position. Subtalar joint position was also recorded at maximum ADROM. Passive ADROM was measured three times at different knee and subtalar joint positions, in random order. Two-way repeated-measures analysis of variance was used to compare the effects of subtalar joint and knee position on passive ADROM.
Results: Passive ADROM was significantly lower with than without SJNP during both knee extension (mean difference: 7.4˚) and 90˚ flexion (mean difference: 16.9˚) (p<.01). Passive ADROM was significantly higher during 90˚ knee flexion than during knee extension both with (mean difference: 5.8˚) and without SJNP (mean difference: 15.2˚) (p<.01). The valgus position of the subtalar joint was significantly lower with than without SJNP during both knee extension (mean difference: 3.3˚) and 90˚ flexion (mean difference: 4.3˚) (p<.01).
Conclusion: Our results indicate that the gastrocnemius may limit ankle dorsiflexion more than the soleus does. Greater dorsiflexion at the subtalar and midtarsal joints was observed during passive ADROM measurement without than that with SJNP; therefore, SJNP should be maintained for accurate measurement of ADROM.
Background: Knee osteoarthritis (OA) diagnosis using Kellgren-Lawrence scores is commonly used to help decision-making during assessment of the severity of OA with assessment of pain, function and muscle strength. The association between Kellgren-Lawrence scores and functional/clinical outcomes remains controversial in patients with knee OA.
Objects: The purpose of this study was to examine the relationships between Kellgren-Lawrence scores and knee pain associated with OA, function during daily living and sports activities, quality of life, and knee muscle strength in patients with knee OA.
Methods: We recruited 66 patients with tibiofemoral knee OA and determined knee joint Kellgren-Lawrence scores using standing anteroposterior radiographs. Self-reported knee pain, daily living function, sports/recreation function, and quality of life were measured using the knee injury and OA outcome score (KOOS). Knee extensors and flexors were assessed using a handheld dynamometer. We performed Spearman’s rank correlation analyses to evaluate the relationships between Kellgren-Lawrence and KOOS scores or muscle strength.
Results: Kellgren-Lawrence scores were significantly negatively correlated with KOOS scores for knee pain, daily living function, sports/recreation function, and quality of life. Statistically significant negative correlations were found between Kellgren-Lawrence scores and knee extensor strength but not flexor strength.
Conclusion: Higher Kellgren-Lawrence scores were associated with more severe knee pain and lower levels of function in daily living and sports/recreation, quality of life, and knee extensor strength in patients with knee OA. Therefore, we conclude that knee OA assessment via self-reported KOOS and knee extensor strength may be a cost-effective alternative to radiological exams.
Background: After stroke, in order to improve gait function, it is necessary to increase the muscle strength and to enhance the propriocetive function of the lower extremity.
Objects: This study aimed to compare the effects of open kinetic chain (OKC) versus closed kinetic chain (CKC) isokinetic exercise of the hemiparetic knee using the isokinetic equipment on lower extremity sensorimotor function and gait ability in patients with chronic stroke.
Methods: Thirty participants with chronic hemiplegia (> 6 months post-stroke) were randomly divided into 2 equal groups: CKC group and OKC group. Patients from both groups attended conventional physiotherapy sessions 3 times a week for 6 weeks. Additionally, subjects from the CKC group performed isokinetic exercise using the CKC attachment, while those from the OKC group performed isokinetic exercise using the OKC attachment. The isokinetic knee and ankle muscles strength, position sense of the knee joint, and spatiotemporal gait parameters were measured before and after interventions.
Results: The knee muscles peak torque/body weight (PT/BW) and hamstring/quadriceps (H/Q) ratio significantly increased in both groups (p<.01). In particular, ankle plantarflexors PT/BW, position sense of the knee, gait velocity, and spatial gait symmetry significantly improved in the CKC group (p<.01, p<.05, p<.01, and p<.01, respectively).
Conclusion: CKC isokinetic exercise can be an effective therapeutic intervention for the improvement of sensorimotor function of the lower extremity and gait functions, such as gait velocity and symmetry. CKC position in isokinetic strength training is effective to improve functional ability in patients with chronic stroke.
목 적:Knee 자기공명영상에서 TSE 시퀀스에 SMS(Simultaneous MultiSlice)를 적용하여 유용성을 평가하고자 한다.
대상 및 방법:2019년 1월 10일부터 2019년 1월 31일까지 무릎 관절의 이상으로 본원에 내원 하여 진료중인 환자 30명(남 17명, 여 13명, 평균 50.25세)을 대상으로 conventional turbo spin echo(이하 cTSE)와 SMS turbo spin echo(이하 sTSE) 기법으로 T2WI와 PDWI sagittal 영상을 획득하였다. 전신용 3.0T MRI에 15 channel knee coil을 사용하였고, interpolation은 cTSE에만 적용하였다. 또한, 유용성 평가를 위하여 서울시 소재 임의의 5개 병원에서 cTSE의 검사시간을 조사하여 sTSE와 비교 평가하였다. 정량적 평가를 위해 획득한 영상을 viewing system으로 전송하여, ACL과 PCL이 가장 크게 보이는 부분에 ROI를 그려서 SNR을 측정하였고, infrapatellar fat pad(이하 IPFP)와의 CNR을 구하였다. 정성적 평가는 PACS로 전송된 영상을 영상의학과 전문의 2명이 각 시퀀스 간의 진단능과 영상품질에 대해 5점 척도로 평가하였다. 통계적 검증은 t-test를 이용하여 유의성을 검증하였다(p<0.05).
결 과:cTSE와 sTSE 두 시퀀스에서 T2WI로 촬영한 ACL의 SNR은 각각 10.68±2.6, 9.49±2.38, PCL의 SNR은 7.80±3.02, 6.93±1.73이었고, PDWI로 촬영한 ACL의 SNR은 21.39±6.09, 16.54±6.49, PCL의 SNR은 12.27±5.63, 8.51±2.86이었 다. cTSE와 sTSE 두 시퀀스의 T2WI에서 IPFP의 SNR은 각각 101.96±22.99, 97.59±15.96, PDWI에서는 135.51±32.97, 116.66±25.97이었다. cTSE와 sTSE 두 시퀀스에서 T2WI로 촬영한 ACL과 IPFP와의 CNR(이하 CNRACL-IPFP)은 각각 91.19±23.01, 79.10±14.91, PCL과 IPFP와의 CNR(이하 CNRPCL-IPFP)은 94.07±21.56, 90.66±14.7이었고, PDWI 에서 CNRACL-IPFP은 114.12±30.73, 100.12±24.18, CNRPCL-IPFP은 123.24±30.29, 109.1±24.56이었다. cTSE와 sTSE 의 T2WI로 촬영한 영상의 진단능을 정성적으로 평가한 결과 각각 4.49±0.49, 4.62±0.35이었고, PDWI에 서는 4.45±0.49, 4.55±0.35였다. 영상 획득 시간은 cTSE T2WI에서 3분 32초 이었고, sTSE T2WI에서는 1분 49초였으 며, cTSE PDWI에서는 3분 20초, sTSE PDWI에서는 1분 48초로, SMS를 사용하는 시퀀스에서 각각 50.9%, 54% 감소하 였다. cTSE와 sTSE 두 시퀀스의 SNR과 CNR에 대한 통계적 유의성 검정(t-test) 결과 T2WI와 PDWI 모두에서 p-value 가 0.05 이상으로 나타나 두 영상 간의 화질의 차이는 없는 것으로 나타났다.
결 론:sTSE 기법은 cTSE에 비해 화질의 변화 없이 검사시간을 약 50% 감소시킬 수 있어 소아나 넓은 검사 부위에 임상적으로 유용할 것으로 사료된다.
Background: Knee osteoarthritis (OA) is a single most arthritic disease. Knee joint space width (JSW) is commonly used for grading severity of knee OA. However, previous studies did not established criterion validity and test-retest reliability of ultrasound (US) image for measuring JSW.
Objects: The aim of this study was to establish criterion validity and test-retest reliability of US measurement of medial and lateral knee JSW.
Methods: Twenty-nine subjects with knee OA were participated. The US and X-ray were used to measure knee JSW. One sample Kolmogorov-Smirnov test was used to confirm the data normal distribution. Pearson correlation coefficient and ICC were used to calculated and establish criterion validity and test-retest reliability, respectively.
Results: US measurement of medial and lateral knee JSW was highly correlated with radiographic imaging measure (r=.714 and .704, respectively). Test-retest reliabilities of medial and lateral knee JSW were excellent correlated (ICC=.959 for medial side and .988 for lateral side, respectively).
Conclusion: US may be valid tool to measure knee JSW.
This study examined the correlation between power error (PE) and velocity error (VE) according to the condition and frequency of self-controlled feedback (SCF) during knee extension. One hundred participants were randomly assigned to 30% SCF, 70% SCF, 30% yoked feedback (YF), 70% YF and control group, respectively. The SCF group was provided with feedback when they requested it, whereas the YF group did not influence the feedback schedule. Participants in the control group were not given any visual feedback during the experiment. The isotonic, isometric, and isokinetic dynamometer (PRIMUS RS, BTE, USA) was used to measure the power and velocity error during knee extension. The collected data was analyzed using a Pearson test and SPSS 21.0. The correlation between PE and VE according to the condition and frequency of feedback on each phase during knee extension was significant. Both PE and VE were significantly higher when the feedback was provided with high frequency, passive, and no feedback. Our study suggests that application of SCF can help to improve the proprioception of the healthy person while reducing errors through low frequency and active feedback.