This study was undertaken to explore the antecedent factors and process of the treatment-seeking behaviors of medical and alternative treatments in patients with arthritis using methodological triangulation. The data were collected from 995 arthritic patients who were registered either in a center of rheumatology for medical treatment or residents of community having no treatment to classify different treatment patterns. Sixteen patients with various types of treatment only, alternative treatment only, and no treatment were selected among the total samples to identify the antecedent factors through in-depth interview. The quantitative data were analyzed by percentile, t-test, chi-square test and discrimant analysis using SAS PC program, while the qualitative data were analyzed by means of grounded theory methodology. Treatment-seeking behaviors of patients change from the early stage to the sick-role stage. At the early stage, initial characteristics of pain and acculturation of medical professionalism affect the choice of treatment patterns. The acculturation of medical professionalism is affected by health care accessibility, level of education, duration of sickness and lay referral system. At the sick-role stage, lay referral system and acculturation of medical professionalism affect the choice of treatment patterns. The acculturation of medical professionalism is affected by characteristics of symtoms, perceived treatment effects, perceived causes of diseases and socio-economic status as well as health care accessibility, level of education and lay referral system. In conclusion, different factors as well as common factors are influencing the treatment-seeking behaviors depending on the disease and treatment stages. More detailed further studies are required to explore the value system or medical acculturation of patients which is one of the most important factors in decision-making about treatment modalities.
This paper proposes a serious game for rehabilitation training targeting old persons and patients for rehabilitation. The serious game suggested for rehabilitation training provides the whole body movement recognition-based interface using the 3D depth camera. When the user stands before the camera, it distinguishes the user from the background and then recognizes the user's whole body with 15 joints. By analyzing the changes of location and direction of each joint, it recognizes gestures needed for the game. The game contents consist of the games for upper limb training, lower limb training, whole body training, and balance training, and it was realized in both 2D and 3D games. The system suggested in this article works robustly even with the environmental changes using the 3D depth camera. Even with no separate device, the game recognizes the gestures only using the whole body movement, and this enhances the effect of rehabilitation.
Lee, Byung Chan;Kim, Ah Ran;Kim, Eun Kyung;Kim, Sun Jeong;Kim, Sang Jun
Clinical Pain
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v.19
no.1
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pp.8-15
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2020
Objective: To compare the therapeutic efficacy of the bone marrow aspirate concentrate (BMAC)- platelet-rich plasma (PRP) complex with hyaluronic acid in patients with knee osteoarthritis. Method: Thirty-four patients with knee osteoarthritis participated in this study. Seventeen patients in the study group underwent BMAC and PRP extraction followed by intra-articular injection of BMAC-PRP complex within affected knee. Seventeen patients in the control group underwent intra-articular injection of hyaluronic acid. Knee injury, osteoarthritic outcome score (KOOS), and EuroQol-5D (EQ-5D) questionnaire were evaluated before, one month, three months, and six months after the injection. Results: There were statistically significant temporal differences in total KOOS scores in both BMAC-PRP and HA groups. However, there were no significant group difference in the study period. In the Sports and Recreational Function Scale, there was statistically significant improvement in the BMAC-PRP group compared to the HA group at three months (p=0.041). There were no side effects or complications in both groups. Conclusion: Intra-articular injection of BMAC-PRP showed better functional recovery in the OA at three months and this can be an alternative treatment in terms of functional recovery in the OA in addition to the decrease of pain.
The purpose of this study is to investigate the effect of loss of incisal function on the thickness, growth activities, ultrastructure of the condylar cartilage and on the muscle fibers of masseter superlicialis, anterior belly of digastric muscle in the growing rats. 37 day-old-rats of which incisors had been trimmed every day received soft diet from weaning and were studied by the autoradiography, electron microscopy and muscle histochemistry. The results obtained were as follows : The thickness of the fibrous, proliferative layer in superior, posterosuperior portion of the condylar cartilage was significantly(p<0.01) reduced in experimental groups and the decrease rate of fibrous layer thickness was greater in posterosuperior portion than in superior portion of cartilage and was greater than in proliferative layer. In normal group, more cells of posterosuperior portion moved more rapidly towards the medullary cavity. In experimental group, the labelling index of posterosuperior portion was decreased in proliferative layer at 2 hours, in transitional layer at 1, 2 days, in hypertrophic layer at 4 days after injection relative to posterosuperior portion of control group. But labelling index of superior portion was not different from that of control group at all time course after injection. From the muscle histochemistry, the diameter of type IIB fibers in masseter superficialis muscle, type IIA, type IIB fibers in anterior belly of digastric muscle decreased significantly(p<0.01) relative to controls in experimental group. From electron microscopic study, in the fibrous layer of the posterosuperior portion of condylar cartilage in normal group, many fibroblast like cells near the joint cavity showed extensive remodelling activities in ultrastructure. There was no morphological changes between experimental and control group in all cartilage cell layers of superior portion but cells near the joint cavity in fibrous layer of posterosuperior portion of experimental group showed morphologically inactive state relative to control group.
The Journal of Korean Orthopaedic Ultrasound Society
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v.6
no.1
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pp.1-9
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2013
Purpose: The purpose is to perform objective evaluation for rotator cuff using ultrasonography and validate factors influencing cuff integrity as well as efficacy of follow-up ultrasonography after unreamed antegrade intramedullary nailing for humerus fracture. Materials and Methods: Seventeen patients with an average age of $55.7{\pm}18.6$ years underwent antegrade intramedullary nailing for humerus fracture and follow-up ultrasonography of shoulder joint. Mean follow-up period was $43.5{\pm}32.2$ months. Intraoperative evaluation for preoperative cuff tear was performed, of which four cuffs were repaired by single row repair technique. Clinical evaluation included visual analogue scale (VAS), range of motion, Korean Shoulder Scoring System (KSS) and American Shoulder and Elbow Society (ASES) score. Ultrasonographic evaluation was performed on cuff integrity and protrusion of proximal nail tip as well. Radiographic evaluation included time to union, protrusion of proximal nail tip and migration of proximal interlocking screw which could affect shoulder joint function. Results: Mean VAS at last follow-up was $1.65{\pm}1.84$ points. Range of motion showed forward flexion of $137.0{\pm}33.5^{\circ}$, external rotation of $43.5{\pm}12.7^{\circ}$ and internal rotation of $16.4{\pm}2.0^{\circ}$ while KSS score and ASES score were $79.6{\pm}20.7$ and $83.7{\pm}17.0$ points, respectively. Bone union was demonstrated in all cases and average time to union was $3.4{\pm}1.3$ months. Migration of proximal interlocking screw was shown in 6 cases (35%). On ultrasonographic evaluation, there were normal in 8 (47%), weaving in 4 (24%), partial tear in 5 cases (29%), but no complete tear. Protrusion of proximal nail tip was demonstrated in 8 cases (47%) on plain radiographs whereas in 11 cases (65%) on ultrasonography and was associated with increasing age (p=0.038). Ultrasonographic weaving and partial tear was associated with protrusion of proximal nail tip (p=006), but not with repair of preoperative tear (p>0.05). Conclusion: Because weaving and partial tear on ultrasonography originated from protrusion of proximal nail tip, careful insertion of nail and meticulous repair of cuff during operation lead to stable fixation with satisfactory recovery of shoulder function follow-up ultrasonography can be a useful tool for evaluating protrusion of nail tip and rotator cuff tear, of which diagnosis is difficult on plain X-ray after antegrade intramedullary nailing for humerus fracture.
The Journal of the Korean bone and joint tumor society
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v.7
no.4
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pp.139-143
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2001
Purpose : Limb salvage for osteosarcoma of proximal tibia is challenging problem due to difficulties in mobilizing or retracting the main neurovascular structure, inadequate soft tissue coverage, and unsolved problem of patellar tendon reattachment to endoprosthesis. The authors analyzed the functional result of limb salvage using tumor prosthesis with medial gastrocnemius rotation plasty for osteosarcama of the proximal tibia. Materials and Methods : Eleven patients with histologically proven osteosarcoma of the proximal tibia, treated with adjuvant and neoadjuvant chemotherapy and limb salvage operation with tumor prosthesis between January 1992 and December 1998 at our Medical Center, were selected. There were 6 male and 5 female. Age ranged from 15 years to 23.7 years with an average of 23.7 years. Follow-up period ranged from 1 year to 4.5 years with an average of 2.5 years. The final functional result was evaluated using the method by ISOLS, 1993. The factors include pain, functional activities, emotional acceptance, use of external supports, walking ability and gait. Each of the factors has been scored from 0 to 5 depending on the appropriate description or data. The rating score is determined by dividing the individual factor scores into the total score and indicates percentage of normal function. Results : The overall functional result ranged from 53,3% to 86.7% with an average of 68.3% of normal function. In details, the averages were 82.5% for pain, 62.5% for functional activities, 67.5% for emotional acceptance, 77.5% for use of external supports, 62.5% for walking ability, and 57.5% for gait. The average range of motion of the knee joint was $5^{\circ}$ extension and $85^{\circ}$ flexion. Five patients have extension lag ranged from $5^{\circ}$ to $15^{\circ}$ with an average of $10^{\circ}$. Two patients suffered postoperative infection. One was treated with antibiotics injection only, but the other needed removal of the prosthesis and knee fusion. Both of them showed unsatisfactory result. C o n c l u s i o n : The overall functional result after limb salvage using tumor prosthesis with medial gastrocnemius rotational flap for osteosarcoma of the proximal tibia was relatively satisfactory in case of no postoperative infection. The patients were less satisfactory in functional activities, emotional acceptance and gait than pain, use of external supports due to limitation of motion and extension lag. More aggressive postoperative physical therapy and protection with brace for 6~9 months as well as surgical technique is mandatory for more satisfactory result.
Journal of the Korean Applied Science and Technology
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v.37
no.6
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pp.1556-1566
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2020
The purpose of this study was to investigate the effect of Nurida-Ball exercise on isokinetic muscle function, spinal alignment, and dynamic balance capacity in middle-aged men. All middle-aged men(n=16) were divided into 2 groups: Ball exercise(BE, n=8) and control(CON, n=8) group. BE group performed the Nurida-Ball exercise(30 min/day, 3 days/week, 8 weeks) and isokinetic knee and trunk muscle function, spinal alignment, and dynamic balance capacity were measured. All of the measured variables calculated the mean and standard deviation and verified normality using the Shapiro-Wilk test. The independent t-test method and the Paired t-test method were then analyzed to identify differences between groups. This study found that isokinetic knee and trunk muscle function was significantly strengthened in the BE compared with CON group by increasing peak torque(PT) of right and left knee extension(60°/sec, p<0.01, respectively), average power(AP) of right and left knee extension(60°/sec, p<0.05, p<0.01, respectively), and PT of right knee flexion(180°/sec, p<0.05) and AP of right knee extension(180°/sec, p<0.05). In the change of isokinetic trunk muscle function, only PT of trunk extension(180°/sec) was increased in the BE compared with the CON group(p<0.05). In addition, Nurida-ball exercise can improve the spinal alignment by reducing the trunk inclination(p<0.05) in the BE compared with the CON group. Finally, dynamic balance capacity was also enhanced in the BE compared with the CON group by decreasing the score of overall balance index(OBI, p<0.01) and Antero-posterior balance index(p<0.05) in the Stage-6, and OBI(p<0.05) in the Stage-1. This result demonstrated that Nurida-ball exercise may improve spinal alignment, dynamic balance capacity, and isokinetic muscle function, which might be an effective way for the improvement of health-related fitness in middle-aged men.
This study is intended to provide a basic clinical data useful for preventing shoulder injuries related to occupation and curing them, by measuring the shoulder muscle activity of normal adults in an arm posture type of a wide shoulder joint angle, according to several differences of hand grip force. In order to examine the shoulder muscle activity during hand grips at a variety of intensity, according to the arm posture type, MVCs of all subjects were measured, and %MVCs of anterior deltoid, supraspinatus, the upper trapezius and infraspinatus at 0 degree, 90 degrees and 160 degrees of shoulder angle were yielded according to the grip force in an arm posture type, changing the maximum grip force into 30%, 50% and 90%, randomly. When measuring the hand grip at 30%, 50% and 70% of the maximum grip force to compare %MVC of each group depending on the arm posture type, there were no significant differences of muscle activity at 0 degree of shoulder angle among anterior deltoid, supraspinatus, the upper trapezius and infraspinatus, but there were significant differences of it among them at 90 degrees and 160 degrees of should angle(p<.001). According to the results of post-hoc test, also, anterior deltoid had the highest muscle activity, whereas the upper trapezius had the lowest muscle activity.
The purpose of the study was to evaluation of the knee lateral collateral ligament (LCL) stability of normal males and females in twenties by using digital telometer. The volunteer subjects agreed the research goal and were 31 normal adults(16 male: $21.1{\pm}1.5$ years, 15 female: $21.2{\pm}1.2$ years) who have not got any illness regarding their knee. X-ray images were taken varus stress on medial femorotibial joint space using by digital telometer, and grade of pain was surveyed. We measured the joint space width (JSW) in the digital radiology. As a result, the JSW of male group were $5.60{\pm}0.76$ mm and JSW of female group were $5.05{\pm}0.55$ mm (p=0.022) on the neutral state of the knee. Based on the result of varus stress on the knee, female group showed much widen than male group but it was not significant difference (p>0.05). When increased varus stress on the knee, all groups were felt pain from 17 daN to 19 daN. The result could be valuable when the varus stress on the LCL by using the digital telometer.
The tarsometatarsal joint complex is formed by articulation of the five metatarsal bases with the three cuneiform bones and the cuboid bone. Fracture-dislocation of tarsometatarsal area are difficult to recognize on standard radiographs. The exact diagnosis is occasionally delayed. As a result, improper treatment and late sequelae remains. We decided to make a study of patients with normal foot radiographs on 200 cases. Standard radiographic evaluation was used to study the normal variants of the foot and to evaluate the coincided alignment of the lisfranc joint. Accurate accessment on AP & lateral & $30^{\circ}$ oblique projection of radiographs are very adventageous & important, and next final outcome was detected. : 1. Coincided alignment below 1mm and unfolded lisfranc joint on AP projection was well visalized on 1st cuneiform-metatarsal lateral border and 2nd cuneiform-metatarsal medial border. 2. Coincided alignment below 1mm and unfolded lisfranc joint on oblique projection was well visualized on 2nd cuneiform-metatarsal lateral border and 3rd cuneiform-metatarsal medial border and 3rd cuneform-metatarsal lateral border. 3. More proximal location of 2nd lisfranc joint compared to another joint was 196 cases (98%). It is due to inceleration of 2nd metatarsal base between 3rd & 1st cuneiform. 4. 3rd lisfranc joint was volarward position compared to 2nd listranc on lateral projection at 191 cases (95.5%). It's due to anterior covexity of lisfranc joint. 5. Wide dorsal sided 2nd lisfranc is investigated at 189 cases (94.5%). Because of it. 2nd & 3rd lisfrances are mainly volar dislocated usually. 6. Notching on 5th metatarsal base is visible on 171 cases (85.5%). 7. 4th lisfranc joint had offset normally within $2\sim3mm$ at 98 cases (49%). 8. 5th Lisfranc joint had normally offset within $2\sim3mm$ at 99 cases (49.5%). 9. On lateral projection, slight dorsal location of cuneiform to metatarsal base is investigated at 82 cases (41%).
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