Title Page
Abstract
Contents
1. Introduction 12
1.1. Background and Necessity 12
1.2. Purpose 16
1.3. Hypothesis 16
2. Theoretical Background 17
2.1. Evjenth-Hamberg stretching 17
2.2. Joint mobilization in the Kaltenborn-Evjenth concept 21
2.3. Total knee replacement (TKR) 25
3. Methods 27
3.1. Subjects 27
3.2. Study procedures 28
3.3. Study methods(interventions) 30
3.3.1. EHSHVG 31
3.3.2. EHSKF 33
3.3.3. Conventional physical therapy (CPT) 35
3.3.4. CPM 36
3.4. Assessments 37
3.4.1. Pain 37
3.4.2. ROM 38
3.4.3. Knee volume 40
3.4.4. Balance ability 41
3.4.5. Function evaluation 42
3.5. Statistical analysis 43
4. Results 44
4.1. General characteristics of subjects and homogeneity tests 44
4.2. Comparison of the pain 45
4.3. Comparison of ROM 47
4.3.1. Comparison of the knee flexion 47
4.3.2. Comparison of the knee extension 49
4.3.3. Comparison of the hip flexion 51
4.3.4. Comparison of the Hip extension 53
4.3.5. Comparison of the Hip Abduction 55
4.3.6. Comparison of the Hip Adduction 57
4.3.7. Comparison of the hip internal rotation 59
4.3.8. Comparison of the hip external rotation 61
4.4. Comparison of Knee volume 63
4.4.1. Comparison of knee superior volume 63
4.4.2. Comparison of inferior knee volume 65
4.5. Comparison of balance 67
4.6. Comparison of the Function 69
4.6.1. Comparison of the KWOMAC Pain 69
4.6.2. Comparison of the KWOMAC tightness 71
4.6.3. Comparison of the KWOMAC function 73
5. Discussion 75
5.1. Quadriceps stretching and pain. 76
5.2. Quadriceps stretching and ROM 77
5.3. Quadriceps stretching and knee volume 78
5.4. Quadriceps stretching and balance 79
5.5. Quadriceps stretching and leg function 80
5.6. Limitations 82
6. Conclusion 83
II. List of references 85
III. List of abbreviations 96
VI. Appendix 99
7.1. Korea Western Ontario McMaster 99
7.2. Abstract (Korean) 101
7.3. Agreement to participate in research(연구 참여 동의서) 103
7.4. Explanation for the subject agreement(대상자 동의를 위한 설명문) 103
Table 1. Intervention 30
Table 2. General characteristics of subjects and homogeneity tests 44
Table 3. Comparison of VAS between the experimental and control groups 45
Table 4. Comparison of Knee flexion ROM between the experimental and control group 47
Table 5. Comparison of Knee extension ROM between the experimental and control groups 49
Table 6. Comparison of hip flexion ROM between the experimental and control groups 51
Table 7. Comparison of Hip extension ROM between the experimental and control groups 53
Table 8. Comparison of hip Abduction ROM between the experimental and control groups 55
Table 9. Comparison of hip adduction ROM between the experimental and control groups 57
Table 10. Comparison of hip Internal rotation ROM between the experimental and control groups 59
Table 11. Comparison of hip external rotation ROM between the experimental and control groups 61
Table 12. Comparison of superior knee volume between the experimental and control groups 63
Table 13. Comparison of inferior knee volume between the experimental and control groups 65
Table 14. Comparison of TUG between the experimental and control groups 67
Table 15. Comparison of KWOMAC pain between the experimental and control groups 69
Table 16. Comparison of KWOMAC tightness between the experimental and control groups 71
Table 17. Comparison of KWOMAC function between the experimental and control groups 73
Figure 1. Flow chart 29
Figure 2. Evjenth-Hamberg stretching using hip ventral gliding 32
Figure 3. Evjenth-Hamberg stretching using knee flexion 34
Figure 4. Interference current type low-frequency stimulator 35
Figure 5. Cold pack 35
Figure 6. Continuous passive motion 36
Figure 7. Visual analog scale 37
Figure 8. Goniometer 39
Figure 9. Range of motion 39
Figure 10. Komelon KMC-220, Korea 40
Figure 11. Tape measurement 40
Figure 12. Timed up and go 41
Figure 13. Comparison of pain score (VAS) between the experimental and control groups 46
Figure 14. Comparison of the knee flexion ROM score between the experimental and control groups 48
Figure 15. Comparison of the knee extension ROM score between the experimental and control groups 50
Figure 16. Comparison of the hip flexion ROM score between the experimental and control groups 52
Figure 17. Comparison of hip xtension score between the experimental and control groups 54
Figure 18. Comparison of the hip abduction ROM score between the experimental and control groups 56
Figure 19. Comparison of the hip adduction ROM score between the experimental and control groups 58
Figure 20. Comparison of the hip internal rotation ROM score between the experimental and... 60
Figure 21. Comparison of the hip external rotation ROM score between the experimental and... 62
Figure 22. Comparison of superior knee volume between the experimental and control groups 64
Figure 23. Comparison of knee inferior part volume between the experimental and control groups 66
Figure 24. Comparison of balance score (TUG) between the experimental and control groups 68
Figure 25. Comparison of KWOMAC pain part the between the experimental and control groups 70
Figure 26. Comparison of KWOMAC tightness part the between the experimental and control groups 72
Figure 27. Comparison of KWOMAC function part the between the experimental and control groups 74