슬관절 전치환술 초기의 대퇴사두근 운동 방법에 따른 슬관절과 족관절의 관상면 정렬 비교: 하지 등척성 동시수축과 대퇴사두근 단독 등척성 수축

• Published in: Han'guk Chŏnmun Mulli Ch'iryo Hakhoe chi = Journal of the Korean Academy of University Trained Physical Therapists Vol. 23; no. 1; pp. 20 - 30
• Main Authors: 김형수, Hyung Soo Kim, 정영희, Young Hee Jeong
• Format: Journal Article
• Language: Korean
• Published: 한국전문물리치료학회 28.02.2016; Korean Academy Of University Trained Physical Therapy
• Subjects: Hip-knee-ankle angle; Quadriceps exercise; Tibiotalar angle; Total knee arthroplasty; 물리치료학; Tibiotalar angle; Total knee arthroplasty; Quadriceps exercise; Hip-knee-ankle angle
• ISSN: 1225-8962; 2287-982X
• DOI: 10.12674/ptk.2016.23.1.020

Background: Total knee arthroplasty (TKA) recovers the alignment of the knee joint, but fails to automatically restore the alignment and function of the hip and ankle joints. It may affect the alignment and stability of the knee joint, therefore therapeutic intervention in hip and ankle joint is necessary for the rehabilitation process after TKA. Objects: The aim of this study was to comparison of the effects of the two exercise methods on the coronal plane alignment after TKA. This study conducted an experiment by dividing subjects into a lower extremity isometric co-contraction group (LEIC) and a quadriceps isolated isometric contraction (QIIC) group. Methods: A total of 37 subjects were randomly assigned to the LEIC (n1=19) or the QIIC (n2=18). Exercise was applied to five times per week for three weeks, starting on the eighth day after surgery. Range of motion exercises were performed as a common intervention and then each group performed quadriceps isometric contraction exercises with 10 sets of 5 repetitions. Radiological imaging was performed prior to surgery, one month and six months after surgery. In addition, the hip-knee-ankle angle (HKA) and tibiotalar angle (TTA) were measured. Results: The HKA was close to neutral in the LEIC rather than the QIIC (p<.05). The LEIC showed varus and the QIIC exhibited valgus TTA (p<.05). In a comparison of HKA and TTA over time, there was no significant change in either group (p>.05). According to the comparison of the TTA before surgery, the LEIC showed significant changes in the varus direction (p<.05), while there was no significant change in the QIIC (p>.05). Conclusion: The LEIC method triggered changes in the TTA and brought the HKA close to the neutral. Thus, LEIC is more effective than QIIC in creating stability in the coronal plane alignment of the knee and ankle joints after TKA.