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Despite the widespread use of postural correction in exercise interven-tions, limited experimental evidence exists for its effectiveness. The present study aimed to systematically review the literature on the effi-cacy of exercise interventions in improving postural malalignment in head, neck, and trunk. A systematic review was performed by screen-ing four scientific databases (MEDLINE, Web of Science, EBSCO, and Cochrane database) for published randomized controlled trials (RCTs) in English from 1996–2019. The review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement guidelines. Two researchers independently performed study screening, extracting data and assessing the risk of bias for each included study using the Cochrane Collaboration tool for evaluating the risk of bias. A total of 22 RCTs comprising 1,209 participants were identified for in-clusion in the review. There was a high risk of bias across most of the included studies (12 studies). Only two studies were classified as low risk of bias, and eight studies were classified as moderate risk of bias. The intervention duration ranged from 2 to 13 weeks, frequency from 2 to 4 days per week, and duration of each session between 15 to 60 min. The insufficiency and quality of included studies did not allow an inte-grated assessment of the efficacy of exercise interventions on postural malalignments; however, the positive effects noticed in most of the studies indicate some advantages but underscores the necessity of ad-equately designed RCTs in this field.

Purpose: This study was conducted in order to determine the effects of knee malalignment including genu varum, valgum, and recurvatum on static and dynamic postural stability. Methods: A total of 80 subjects were enrolled in this study. Subjects who showed over 3 cm in the distance between the knees were classified as the genu varum group, and subjects who showed over 3 cm in the distance between the ankles were classified as the genu valgum group. Subjects who showed over 1 cm in the distance between the patella and a table in prone position were classified as the genu recurvatum group. Static and dynamic stability were measured as overall, anterioposterior, and mediolateral balance index using a Biodex Balance System. Results: This study showed that knee alignment affected static and dynamic postural stability. In particular, there were significant differences in the mediolateral stability index among genu varum, valgum group, and the other groups, but no differences in overall and anteriolateral stability index. Significant differences in the anterioposterior stability index were observed between genu recurvatum and the other groups, however, there were no differences in overall and mediolateral stability index. Conclusion: The findings were that knee malalignment affects postural stability toward a specific direction. Treatment to improve postural stability for treatment of knee malalignment or to prevent falling or injuries is needed and postural stability toward a specific direction according to the knee alignment conditions should be considered.

본 연구는 부정렬증후군을 이해하기 위해 10가지 항목을 자가진단 테스트로 작성해 일반인들의 이해를 돕고, 의 식적으로 바른 자세를 인식시키기 위해서 진행되었으며 실험 대상자는 자가진단 테스트 항목 중 3가지 이상을 가지고 있고, 다리 길이 차가 10mm 이상 나는 대상자를 선정하여 실험하였다. 골반의 변위가 신체의 각 부분에 변화를 줄 수 있기에 골반 교정의 효과를 알아보기 위해 실험 측정 마지막 12주 후 대조군을 대상으로 골반 교정을 통해 일시적으로 신체의 변화를 줄 수 있는지를 살펴보았으며 부정렬증후군을 대상자로 12주간 골반 교정 후 웨이트트레이닝을 실시하는 데 운동 방법을 다르게 하였을 때 효과가 달라질 수 있는지 편측 운동군과 양측 운동군으로 나누어 프로그램을 진행하여 다음과 같은 결과를 보였다. 웨이트트레이닝 프로그램 간에는 측만 각도의 차이는 없었지만, 대조군과 편측 운동군에서 측만 각도의 차이를 보였고, 웨이트트레이닝 프로그램 간에는 골반 변위의 차이는 없었지만, 대조군과 편측 운동군에서 골반 변위의 차이를 보였고, 대조군과 양측 운동군에서 골반 변위의 차이를 보였다.

This study was conducted to help the general public understand and consciously recognize the correct posture by writing 10 items as self-diagnosis tests to understand Malalignment Syndrome. The subjects were selected and tested with at least 3 items of self-diagnosis test with a leg length difference of 10mm or more. Since pelvic displacement can change each part of the body, we examined whether pelvic correction could temporarily changed the body through pelvic correction in the control group after the last 12 weeks of the experimental measurement, weight training after pelvic correction 12 weeks was conducted for patients with Malalignment Syndrom, and the program was divided into one-sided and two-sided exercise groups to see if the effect could be different if the exercise method was different. There was no difference in the scoliosis angle between the weight training programs, but there was difference in the scoliosis angle between the control group and the one-side exercise group, there was no difference in pelvic displacement between the weight training programs, but there was a difference in pelvic displacement in the control group and one-sided exercise group, and there was a difference in pelvic displacement in the control and both-sided exercise groups.

본 연구는 부정렬증후군 대상자로 성별에 따라 골반 견인과 웨이트트레이닝을 실시했을 때 골반 각도와 LLD에 미치는 영향이 다른가를 알아보고, 대조군과 실험군을 비교해 골반 견인과 웨이트트레이닝의 방법이 골반 각도와 LLD에 미치는 영향을 보고, 운동 방법을 다르게 한 편측 운동군과 양측 운동군으로 구분해 4주마다 운동강도를 높여 주3회씩 12주간 동안 실시해 방법의 차이가 골반 각도와 LLD에 영향을 미치는지 알아보았다. 실험 참가자 대상자는 부정렬증후군 자가진단 테스트 항목 10가지 중 3가지 이상을 지니고, 다리 길이 차가 10mm 이상인 남·여 37명(남:22명, 여:15명)으 로 하여 대조군은 운동을 하지않고 일상생활을 하였고, 실험군은 기능적 운동과 전통 방식의 운동을 구룹으로 나누어 12주간 진행하여 다음과 같은 결과를 얻었다. 골반 견인과 웨이트트레이닝이 남성의 골반 각도에 대한 효과는 편측 운동 군(OG)과 양측 운동군(BG)에 차이가 있었고, 여성의 골반 각도에 대한 효과는 없었다. 골반 견인과 웨이트트레이닝이 부정렬증후군 성별의 LLD에 대한 효과는 남성의 양측 운동군(BG)이고, 여성의 LLD에 대한 효과는 편측 운동군(OG)과 양측 운동군(BG)이었다.

This study examined whether pelvic traction and weight training differ on pelvic angle and LLD by gender, compared with control and experimental groups, and divided the pelvic traction and weight training method into one-sided and both-sided weight training groups. Participants of the experiment had at least 3 out of 10 items of self-diagnosis test for Malalignment Syndrome, 37 men and women(men: 22, women: 15) with a leg length difference of 10mm or more, and the experiment group divided functional and conventional exercise into groups for 12 weeks to obtain the following results. The effect of pelvic traction and weight training on pelvic angles in men was different in one-sided weight training groups(OG) and both-sided weight training groups(BG), and there was no effect on pelvic angles in women. The effect of pelvic traction and weight training on LLD in gender of Malalignment Syndrome was both-sided weight training groups(BG) in men, and the effect on LLD in women was one-sides weight training groups(OG) and both-sided weight training groups(BG).

Purpose: We investigated the effect of isometric resistance exercise on the vastus medialis oblique muscle with inelastic tape and EMG biofeedback training applied to the patello-femoral joints of patients with patella malalignment. Methods: The 39 elderly subjects that had patella malalignment but no neuromuscular disorders were divided into a control group, taping group, and EMG biofeedback training group. Evaluations of function improvement performed before and after the treatment, as well as 4 weeks after treatment. Results: Change in pain in the knee joint were significantly different among groups (p<0.05). Maximum voluntary isometric contractility in the quadriceps muscle was significantly in the EMG biofeedback group (p<0.001). The WOMAC (Western Ontairo & McMaster Questionnaire) index showed a significant change (p<0.05) in pain, function, and total score. Taping and EMG biofeedback training showed a lasting effect until measurement 4 weeks after treatment. SF-36 (Medical outcome short form-36), which assesses the quality of life, did not significantly change. Conclusion: In osteoarthritis patients with a loss of patello-femoral joint function, isometric resistance exercise of the vastus medialis oblique muscle with taping seems effective.

운동학 학술지, 2011, 13(1): 83-90. 교정운동이 내반슬 하지 변형자의 고관절각, Q각, 무릎 사이 간격에 미치는 영향. [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 받는회원들 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 사이간격 등이 정상에 가깝게 변형된 것을 알 수 있었다. [결론] 선천적인 골격의 문제가 아닌, 구조적인 근육의 불균형으로 인한내반슬 증상은 꾸준한 교정운동을 통해 정상적인 범위로 되돌릴 수 있을 것이라 생각된다.

KINESIOLOGY, 2011, 13(1): 83-90. The Effects of Correction Exercise on Hip joint angle, Q angle, and the Distance between Knees of Genu Varum Patients. [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.

Purpose： The aim of this study was to identify of bilateral trunk rotation(BTR) exercise and PNF exercise on gait in the individuals with malalignment syndrome. Methods： Subjects were 32 that were divided 2 groups in 20's generation. Interventions were trunk ratation exercise and PNF exercise. We used Medex for trunk rotation exercise. BTR group received exercise for three-sets (10min/set) along with stretching exercise ten-minutes, 3 times per week. PNF group took turns the D1 pattern in upper extremity and the D1 pattern in the opposite side of lower extremity for three-sets (10min/set). The measurement were force metatarsal 1 (FM 1), impulse metatarsal 1 (IM 1), force heel lat (FHL), impulse heel lat (IHL) by using footscan (RS scan). Statistical method was repeated measurement of ANOVA and p value was 0.05. Results： BTR and PNF group were significantly different in time(FM 1, IM 1, FHL, IHL). As different of right/left, BTR and PNF exercise were significantly different in FM 1, IM 1, FHL. Conclusion： BTR exercise was good exercise for malalignment but needs expensive equipment, for example, Medex. PNF exercise doesn't need expensive equipment but good method in malalignment syndrome person for gait ability. If PNF exercise is more experiment, PNF exercise could use variety for more patients.

Purpose : The purpose of this study was to verify effects of trunk inclination, side deviation using combined PNF patterns of upper and lower extremities on 20's generation with malalignment syndrome. Methods : 15 subjects with malalignment syndrome participated this study. We measured 2 factors(trunk inclination, side deviation). combined PNF patterns of upper and lower extremities were used intervention method for malalignment syndrome subjects. Experience during was 6 weeks. Results : The trunk inclination was significantly decreased. The value was from 0.87 to 0.43(p=0.27). The side deviation was too. The value was decreased 1.62(p=0.044). Conclusion : The results of this study indicate that the use of combined PNF patterns of upper and lower extremities for malalignment syndrome people was positive effect.

없음

Patellar maltracking after total knee arthroplasty (TKA) can lead to significant patellofemoral complications such as anterior knee pain, increased component wear, and a higher risk of component loosening, patellar fracture, and instability. This study was to investigate the preoperative and operative variables that significantly affect patellar tracking after cruciate-retaining TKA.We studied 142 knee joints in patients who had undergone TKA: the knees were dichotomized based on postoperative patellar tracking, which was evaluated on patellar skyline, axial-projection radiographs: group 1, normal patellar tracking (lateral tilt ≤?10° and displacement ≤?3?mm) and group 2, patellar maltracking (lateral tilt >?10° or displacement >?3?mm). The patients’ demographic data and clinical and radiographic measurements obtained before and after surgery were compared between the two groups. Preoperative lateral patellar displacement was greater (4.1?±?2.6?mm vs. 6.0?±?3.5?mm), as was the frequency of medial collateral ligament (MCL) release (3/67 vs. 24/75) in group 2 than in group 1 ( p <?0.001 and p <?0.001, respectively). The distal femur was cut in a greater degree of valgus in group 1 than in group 2. (6.3?±?0.8° vs. 6.0?±?0.8°) ( p =?0.034). Complete release of the MCL during surgery was associated with patellar maltracking (logistic regression: p =?0.005, odds ratio?=?20.592). Surgeons should attend to patellar tracking during surgery in medially tight knees. Retrospective comparative study, level III.

The purpose of this study was to analyze the effects of manual therapy on lower extremity alignment in pelvic malalignment. The subjects were 20 adults with pelvic malalignment. They were divided into two groups: manual therapy group (n=10) and stretching exercise group (n=10). Each group performed the intervention two times per week for 4 weeks. The lower extremity alignment was measured by pelvic deviation, functional leg length inequality, and plantar pressure distribution, which were measured between pre- and post-test. In the result of pelvic deviation, there was a significant difference between the pre- and post-test of the manual therapy group and stretching exercise group. In the result of the functional leg length inequality, there was a significant difference between the pre- and post-test of the manual therapy group. In the result of plantar pressure distribution, there was a significant difference between the pre- and post-test of the manual therapy group. These findings suggest manual therapy improves the pelvic deviation, functional leg length inequality, and plantar pressure distribution in the pelvic malalignment.

purpose: To evaluate the radiologic and functional outcomes of medial open wedge high tibial osteotomy (HTO) combined with arthroscopic procedure in patients with medial osteoarthritis. Materials and Methods: From June 1996 to March 2010, 26 patients (32 knees) who underwent medial open wedge osteotomy and arthroscopic operation for medial osteoarthritis were retrospectively reviewed. Measurements included hip-knee-ankle (HKA) angle, femorotibial angle, medial proximal tibial angle, posterior tibial slope angle, and Kellgren-Lawrence grade. Clinical evaluation was performed using Lysholm knee scoring scale and knee and function score of the American Knee Society.results: Differences between the mean preoperative and postoperative measurements were significant in all angles including the HKA angle (?5.7o and +5.5o), femorotibial angle (?1.9o and +9.8o), and medial proximal tibial angle (82.9o and 90.5o) (p<0.05). Mean Lysholm knee scoring scale was 63.6 preoperatively and 88.7 at the last follow-up, mean Knee Society knee score was 61.2 and 86.6, and mean function score was 59.3 and 87.2, respectively. All differences were significant (p<0.05).conclusions: Medial open wedge HTO in combination with arthroscopic procedure is an effective treatment method for medial osteoarthritis to treat varus deformity and an intra-articular lesion.

목적: 시멘트형 대퇴스템을 사용한 인공고관절 치환술을 시행 중 임시 대퇴삽입물(broach)을 삽입한 상태에서 c-arm 촬영을 통하여 대퇴스템 정렬 상태를 예측하여 부정정렬을 예방하였던 저자들의 방법의 유용성을 평가하고자 하였다. 대상 및 방법: 2011년 10월부터 2013년 2월까지 일차 인공 고관절 부분치환술이나 인공 고관절 전치환술을 시행 받은 103예를 대상으로 후향적으로 연구를 시행하였다. 수술 중 예측된 대퇴스템 정렬각 및 최종 대퇴스템 정렬각들을 세 군 분류하였고, 수술 중 예측된 대퇴스템 정렬각에 영향을 미칠 수 있다고 예상된 요인들(나이, 성별, 진단명, 체질량 지수, 대퇴스템 크기, 골다공증, 근위대퇴골 형태)에 대한 분석을 위해서 multinomial logistic regression analysis를 시행하였다. 결과: 수술 중 예측된 대퇴스템 정렬각은 중립위 군이 80예, 내반위 군이 18예, 외반위 군이 5예 등으로 분포하였다. 최종 대퇴스템 정렬각은 중립위 군이 100예, 내반위 군이 2예, 외반위 군이 1예 등으로 분포하였다. 수술 중 예측된 대퇴스템 정렬각에 통계적으로 유의하게 영향을 미치는 요인은 없었다. 결론: 저자들이 시행하였던 방법이 시멘트형 대퇴스템의 부정정렬을 예방하는데 있어서 유용하였다고 생각한다.

Purpose: The purpose of this study was to evaluate the usefulness of our method, which estimated femoral stem alignment using a c-arm when the broach was inserted, for prevention of femoral stem malalignment. Materials and Methods: A total of 103 hips were enrolled in this study. All patients underwentprimary hip arthroplasty from October 2011 to February 2013. The study was conductedretrospectively. Intraoperative estimated femoral stem alignments and final femoral stem alignments were classified into three groups. Multinomial logistic regression analysis was performed for analysis of factors (age, sex, diagnosis, body mass index, femoral stem size, osteoporosis, and proximal demur geometry) thatmight affect intraoperatively estimated femoral stem alignment. Results: The distribution of intraoperative estimated femoral stem alignment was 80(78%) in the neutral group, 18(17%) in the varus group, and 5(5%) in the valgus group. The distribution of final femoral stem alignment was 100(97%) in the neutral group, 2(2%) in the varus group, and 1(1%) in the valgus group. There was no statistically significant factor affecting the intraoperatively estimated femoral stem alignment. Conclusion: Intraoperative estimated femoral stem alignment using a c-arm is an effective method for prevention of femoral stem malalignment.