• Title/Summary/Keyword: Carpal Muscle

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Study on the Anatomical Pericardium Meridian Muscle in Human (수궐음 심포경근의 해부학적 고찰)

  • Park, Kyoung-Sik
    • Korean Journal of Acupuncture
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    • v.22 no.1
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    • pp.67-74
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    • 2005
  • Objectives : This study was carried to identify the component of the Pericardium Meridian Muscle in human. Methods : The regional muscle group was divided into outer, middle, and inner layer. The inner part of body surface were opened widely to demonstrate muscles, nerve, blood vessels and to expose the inner structure of the Pericardium Meridian Muscle in the order of layers. Results We obtained the results as follows; He Perfcardium Meridian Muscle composed of the muscles, nerves and blood vessels. In human anatomy, it is present the difference between terms (that is, nerves or blood vessels which control the muscle of the Pericardium Meridian Muscle and those which pass near by the Pericardium Meridian Muscle). The inner composition of the Pericardium Meridian Muscle in human is as follows ; 1) Muscle P-1 : pectoralis major and minor muscles, intercostalis muscle(m.) P-2 : space between biceps brachialis m. heads. P-3 : tendon of biceps brachialis and brachialis m. P-4 : space between flexor carpi radialis m. and palmaris longus m. tendon(tend.), flexor digitorum superficialis m., flexor digitorum profundus m. P-5 : space between flexor carpi radialis m. tend. and palmaris longus m. tend., flexor digitorum superficialis m., flexor digitorum profundus m. tend. P-6 : space between flexor carpi radialis m. tend. and palmaris longus m. tend., flexor digitorum profundus m. tend., pronator quadratus m. H-7 : palmar carpal ligament, flexor retinaculum, radiad of flexor digitorum superficialis m. tend., ulnad of flexor pollicis longus tend. radiad of flexor digitorum profundus m. tend. H-8 : palmar carpal ligament, space between flexor digitorum superficialis m. tends., adductor follicis n., palmar interosseous m. H-9 : radiad of extensor tend. insertion. 2) Blood vessel P-1 : lateral cutaneous branch of 4th. intercostal artery, pectoral br. of Ihoracoacrornial art., 4th. intercostal artery(art) P-3 : intermediate basilic vein(v.), brachial art. P4 : intermediate antebrachial v., anterior interosseous art. P-5 : intermediate antebrarhial v., anterior interosseous art. P-6 : intermediate antebrachial v., anterior interosseous art. P-7 : intermediate antebrachial v., palmar carpal br. of radial art., anterior interosseous art. P-8 : superficial palmar arterial arch, palmar metacarpal art. P-9 : dorsal br. of palmar digital art. 3) Nerve P-1 : lateral cutaneous branch of 4th. intercostal nerve, medial pectoral nerve, 4th. intercostal nerve(n.) P-2 : lateral antebrachial cutaneous n. P-3 : medial antebrachial cutaneous n., median n. musrulocutaneous n. P-4 : medial antebrachial cutaneous n., anterior interosseous n. median n. P-5 : median n., anterior interosseous n. P-6 : median n., anterior interosseous n. P-7 : palmar br. of median n., median n., anterior interosseous n. P-8 : palmar br. of median n., palmar digital br. of median n., br. of median n., deep br. of ulnar n. P-9 : dorsal br. of palmar digital branch of median n. Conclusions : This study shows some differences from already established study on meridian Muscle.

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Diagnostic Usefulness of Digital Infrared Thermal Image in Carpal Tunnel Syndrome (수근관 증후군에서 적외선 체열 검사의 진단적 유용성)

  • Park, Jihyun;Lee, Jang Woo;Lee, Sang Eok;Kim, Byung Hee;Park, Dougho
    • Clinical Pain
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    • v.18 no.2
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    • pp.70-75
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    • 2019
  • Objective: The purpose of this study is to evaluate the usefulness of infrared thermography in patients with carpal tunnel syndrome by comparing with electrodiagnostic and ultrasonographic findings. Method: From January 2014 to October 2017, electrodiagnosis, ultrasound, and digital infrared thermal image (DITI) of unilateral carpal tunnel syndrome diagnosed in a single hospital were retrospectively analyzed. The subjects with bilateral symptoms of carpal tunnel syndrome, peripheral vascular disease, diabetes, thyroid disease, fibromyalgia, rheumatic disease, systemic infection, inflammation, malignant tumor, and other musculoskeletal disorders such as finger osteoarthritis, peripheral neuropathy, cervical radiculopathy, and the previous history of surgery were excluded. Results: Of 53 patients diagnosed with carpal tunnel syndrome, 11 were male and 42 were female. The visual analogue scale was 4.9 ± 1.9, and the duration of symptom was 11.8 ± 12.5 months. There was no statistically significant difference in the body surface temperature between the unaffected and affected sides. The severity of symptoms, electrodiagnostic findings, and cross-sectional area of the median nerve significantly correlates to each other. The temperature difference between the second fingers of the affected and unaffected sides showed a weak correlation with the amplitude of sensory nerve action potential and onset latency of compound muscle action potential, when there was no significant correlation with the other parameters. Conclusion: The difference in temperature on the surface of the body, which can be confirmed by DITI, is little diagnostic value when DITI is performed in unilateral carpal tunnel syndrome patients, especially when compared with ultrasonography.

The Effect of Diabetes Mellitus on Postoperative Electrodiagnostic Outcomes of Carpal Tunnel Syndrome (손목터널증후군 환자에서 당뇨병이 수술 후 전기생리학적 결과에 미치는 영향)

  • Kwak, Jung Min;Jeong, Young Ha;Kang, Seok;Yoon, Joon Shik
    • Journal of Electrodiagnosis and Neuromuscular Diseases
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    • v.20 no.2
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    • pp.91-97
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    • 2018
  • Objective: The aim of this study was to compare the electrodiagnostic outcomes of carpal tunnel release in patients with and without diabetes with carpal tunnel syndrome (CTS), and to evaluate the effect of diabetes mellitus (DM) on electrodiagnostic outcomes. Method: We conducted a retrospective analysis of 67 patients with electro-diagnostic evidence of CTS. Patients were classified into two groups according to the presence of DM. Both groups were evaluated using nerve conduction studies preoperatively and 3 weeks and 3 months postoperatively. Results: There were no statistical differences in any of the electrodiagnostic parameters between groups 3 weeks postoperatively. However, there were statistical differences in the amplitude and the latency of compound muscle action potential, and sensory nerve conduction velocity 3 months postoperatively. Conclusion: Patients with DM did not show a significantly different outcome 3 weeks after surgery but showed a worse electrodiagnostic outcome 3 months after surgery than those without DM.

Clinical and Electrophysiological Changes after Open Carpal Tunnel Release: Preliminary Study of 25 Hands (수근관증후군 수술 전후 임상증상과 전기생리학적 검사소견의 변화: 25손을 대상으로 한 예비연구)

  • Yang, Ji Won;Sung, Young Hee;Park, Kee Hyung;Lee, Yeong Bae;Shin, Dong Jin;Park, Hyeon Mi
    • Annals of Clinical Neurophysiology
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    • v.16 no.1
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    • pp.21-26
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    • 2014
  • Background: Electrophysiological study has been known as a useful method to evaluate the therapeutic effect of operation in idiopathic carpal tunnel syndrome (CTS). The purpose of this study was to evaluate the clinical and electrophysiological changes after carpal tunnel release (CTR) compared to the preoperative results. Methods: We analyzed the changes of nerve conduction study (NCS) before and after minimal open carpal tunnel release in 18 patients (25 hands) with CTS. Follow-up study was performed over 6 months after operation. Results: Clinical improvement was seen in all cases after CTR. In contrast, electrophysiological improvement was various depending on the parameters; the mean median sensory latency and nerve conduction velocity (NCV) improved significantly (p = 0.001). The mean median motor latency also improved, but NCV and compound muscle action potential (CMAP) amplitude did not change. The extent of improvement was evident in moderate CTS, but not in severe CTS. Conclusions: In this preliminary study, all subjects who underwent CTR achieved a clinical relief along with a significant improvement of electrophysiological parameters such as median sensory latency, sensory NCV and median distal motor latency. After CTR, a number of cases with mild to moderate CTS showed a prominent improvement of clinical and electrophysiological parameters, while fewer improvements were seen in severe CTS, although it did not reach the statistical significance.

Effects of the Median Nerve Mobilization on Change of Grip Strength and Pain in Patients with Carpal Tunnel Syndrome (정중신경가동기법이 수근관증후군 환자의 악력과 통증에 미치는 영향)

  • Yoon, Young-Dae;Shim, Je-Myung;Park, Min-Chull;Kim, Hyoung-Su
    • Journal of the Korean Society of Physical Medicine
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    • v.4 no.2
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    • pp.107-115
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    • 2009
  • Purpose:This study was to determine whether median nerve mobilization has any effect on the recovery of muscle power and the reduction of pain for the patients with carpal tunnel syndrome. Methods:20 patients suffering from carpal tunnel syndrome were randomly divided into two groups: 10 subjects treated both with electrical therapy and median nerve mobilization(experimental group) and the other 10 subjects treated only with electrical therapy(control group). The therapy was taken three times a week for 3 weeks. Results:The grip strength increased in both groups. However, the experimental group showed more significant treatment effect than the control group, and the significant changes appeared every week during the experiment period. In terms of pain, both groups showed significant effects. But the experimental group showed but more significant treatment effect than the control group, and the significant changes appeared every week during the experiment period. Conclusions:It was significantly more effective for the patients with carpal tunnel syndrome to apply median nerve mobilization during the electrical therapy in order to reduce pain and to increase grip strength, compared with the method only using electrical therapy. Further research should be conducted to generalize these results in terms of the clinical effectiveness of the nerve mobilization.

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The Effectiveness of Mechanical Traction Therapy for Patients with Carpal Tunnel Syndrome (손목굴 증후군 환자를 위한 기계적 견인 치료의 효과)

  • Kyoung Sim Jung;Geum Sang Jeon;Sang Kun Sung;Bong Chun Noh;Tae Sung In
    • Journal of Korean Physical Therapy Science
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    • v.31 no.3
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    • pp.100-108
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    • 2024
  • Background: This study was conducted to investigate the effects of mechanical traction therapy on pain, symptom severity, and functional status in patients with carpal tunnel syndrome. Design: Randomized controlled trial study. Methods: The 24 participants in this study were randomly assigned to either the Mechanical traction therapy (MTT) group (n=12) or the placebo group (n=12). Both groups performed tendon and neural gliding exercise. Both groups underwent mechanical traction therapy with their forearms placed on a traction device. However, in the placebo group, the device was turned off, and a placebo treatment was administered without any mechanical stimulation. All the participants underwent 18 sessions of intervention (10 minutes, 3 days per week for 6 weeks). Both groups were assessed for pain using the numerical pain rating scale and for symptom severity and functional status using the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ), which includes two additional scales: the Boston Symptom Severity Scale (BSSS) and the Boston Functional Status Scale (BFSS). Results: The muscle activation, pain, symptom severity, and functional status in the MTT group were significantly improved compared to the placebo group (p<0.05). Conclusion: The results of this study indicate that traction therapy combined with tendon and neural gliding exercise. are a beneficial method for improving pain, symptom severity, and functional status in patients with carpal tunnel syndrome.

Study on the Skin of Hand Lesser Yang from the Viewpoint of Human Anatomy

  • Park, Kyoung-Sik
    • The Journal of Korean Medicine
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    • v.36 no.4
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    • pp.69-73
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    • 2015
  • Objectives: This study was carried out to analyse the skin of the Hand lesser yang in human. Methods: The Hand lesser yang meridian was labeled with latex in the body surface of the cadaver, subsequently dissecting a body among superficial fascia and muscular layer in order to observe internal structures. Results: This study has come to the conclusion that a depth of the skin has encompassed a common integument and a immediately below superficial fascia, and this study established the skin boundary with adjacent structures such as relative muscle, tendon as compass. The skin area of the Hand lesser yang in human is as follows: The skin close to the ulnar root angle of 4th finger nail, above between 4th and 5th metacarpal bone, between extensor digit. minimi tendon(t.) and extensor digit. t., extensor digit. m(muscle). at 2, 4, 7 cun above dorsal carpal striation, triceps brachii m. t., deltoid m., trapezius m., just around the ear, upper orbicularis oculi m. Conclusions: The skin area of the Hand lesser yang from anatomical viewpoint seems to be the skin area outside the superficial fascia or the muscle involved in the pathway of the Hand lesser yang meridian, the collateral meridian, the meridian muscle, with the condition that we consider adjacent skins.

The Effect of Wheelchair Propulsion on Carpal Tunnel Syndrome of Wrist Joint

  • Kong, Jin-Yong;Kwon, Hyuk-Cheol;Chang, Ki-Yeon;Jeong, Dong-Hoon
    • Physical Therapy Korea
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    • v.11 no.4
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    • pp.7-17
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    • 2004
  • Individuals who propel wheelchairs have a high prevalence of upper extremity injuries (i.e., carpal tunnel syndrome, elbow/shoulder tendonitis, impingement syndrome). Musculoskeletal injuries can result from overuse or incorrect use of manual wheelchairs, and can hinder rehabilitation efforts. To better understand the mechanisms of upper extremity injuries, this study investigates the motion of the wrist during wheelchair propulsion. This study also examines changes in the variables that occur with fatiguing wheelchair propulsion to determine how the time parameters of wheelchair propulsion and the state of fatigue influence the risk of injury. A two dimensional (2-D) analysis of wrist movement during the wheelchair stroke was performed. Twenty subjects propelled a wheelchair handrim on a motor-driven treadmill at two different velocities (50, 70 m/min). The results of this study were as follows; The difference in time parameters of wheelchair propulsion (cadence, cycle time, push time, recovery time, and PSP ratio) at two different velocities was statistically significant. The wrist kinematic characteristics had statistically significant differences at two different velocities, but wrist radial deviation and elbow flexion/extension had no statistically significant differences. There were statistically significant differences in relation to fatigue in the time parameter of wheelchair propulsion (70 m/min) between initial 1 minute and final 1 minute. The wrist kinematic characteristics between the initial 1 minute and final 1 minute in relation to fatigue had statistically significant differences but the wrist flexion-extension (50 m/min) had no statistically significant differences. According to the results, the risk of musculoskeletal injuries is increased by fatigue from wheelchair propulsion. To prevent musculoskeletal injuries, wheelchair users should train in a muscle endurance program and consider wearing a splinting/grove. Moreover, wheelchair users need education on propulsion posture, suitable joint position, and proper recovery patterns of propulsion.

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Quantitative Evaluation of Median Nerve Motor Function in Carpal Tunnel Syndrome Using Load Cell : Correlation with Clinical, Electrodiagnostic, and Ultrasonographic Findings

  • Kim, Dong Hwan;Park, Sung Bae;Lee, Sang Hyung;Son, Young-Je;Chung, Gih Sung;Yang, Hee-Jin
    • Journal of Korean Neurosurgical Society
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    • v.54 no.3
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    • pp.232-235
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    • 2013
  • Objective : Major complaints of carpal tunnel syndrome (CTS) are sensory components. However, motor deficit also impedes functional status of hand. Contrary to evaluation of sensory function, the objective, quantitative evaluation of median nerve motor function is not easy. The motor function of median was evaluated quantitatively using load cell and its correlation with findings of electrodiagnostic study (EDS) was evaluated. Methods : Objective motor function of median nerve was evaluated by load cell and personal computer-based measurement system. All of the measurement was done in patients diagnosed as having idiopathic CTS by clinical features and EDS findings. The strength of thumb abduction and index finger flexion was measured in each hand three times, and the average value was used to calculate thumb index ratio (TIR). The correlation of TIR with clinical, EDS, and ultrasonographic findings were evaluated. Results : The TIR was evaluated in 67 patients (119 hands). There were 14 males and 53 females, mean age were 57.6 years (range 28 to 81). The higher preoperative nerve conductive studies grade of the patients, the lower TIR was observed [p<0.001, analysis of variance (ANOVA)]. TIR of cases with thenar atrophy were significantly lower than those without (p<0.001, t-test). TIR were significantly lower in patients with severe median nerve swelling in ultrasonography (p=0.042, ANOVA). Conclusion : Measurements of median nerve motor function using load cell is a valuable evaluation tool in CTS. It might be helpful in detecting subclinical motor dysfunction before muscle atrophy develops.