• Physical Therapy Rehabilitation Science
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• v.13 no.1
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• pp.36-42
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• 2024

Objective: The aim of this study is to investigate the effect of hamstring eccentric exercise on pain and functional activity in patients with chronic low back pain. Design: Randomized controlled trial Methods: Participants comprised 27 subjects with back pain persisting for 3 months. They were randomly assigned to the experimental group (Eccentric exercise: n=13) and the control group (Stretching: n=14). The experimental group performed gastrocnemius, iliopsoas, and quadratus lumborum stretching along with hamstring eccentric exercise, while the control group engaged in the same stretches along with hamstring stretching. The eccentric exercise for the hamstrings was Nordic curl exercise. Each group practiced for 1 hour a day, 3 times a week, for 4 weeks. Pain, disability index, balance, and hamstring length were measured. Results: Significant differences were observed in the comparison of changes in back pain, back disability index, and hamstring length before and after exercise within each group (p<0.05). The balance ability of the experimental group showed a difference before and after exercise (p<0.05), whereas no significant difference in the control group. There were no significant differences in back pain and hamstring length between the groups. Changes in back disability index and balance ability significantly increased in the experimental group compared to the control group (p<0.05). Conclusion: Hamstring eccentric exercise using Nordic curls has a positive effect on back pain, back disability index, balance ability, and hamstring length changes.

• Journal of Medicine and Life Science
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• v.20 no.4
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• pp.158-165
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• 2023

This study prospective randomized controlled trial aims to test the impact of adding health education, awareness of some contributing factors and clinical guidance to therapeutic cabergoline given to infertile women with unexplained resistant hyperprolactinemia. It comprised 120 infertile women with unexplained persistent hyperprolactinemia not responding to therapeutic doses of cabergoline 1.5-2 mg/week who were subjected to proper history taking to exclude concomitant drug intake or possible brain problems in all cases. They were classified into group A (60 cases) who received health education and clinical guidance to search for possible contributing factors and were instructed to avoid them in addition to proper therapeutic doses of cabergoline, while group B (60 cases) received proper therapeutic doses of cabergoline only without clinical guidance. After 1 month, serum prolactin (PRL) was measured for all cases. All cases had high PRL level at the start of the study (79.9±28.4 [39-195] and 78.2±19.9 [42-189] in group A and B, respectively) without any significant difference. Pretreatment counselling revealed that lifestyle factors, sexual behaviors or feeding habits may contribute to resistant hyperprolactinemia in all cases without a significant difference between both groups. Serum PRL dropped significantly more in group A (20.14±10.31 [11-45] vs. 49.32±37.03 [12-100]) after combined health education, clinical guidance of the couple and proper treatment. It is concluded that lifestyle factors, sexual behaviors, and feeding habits would affect the response of hyperprolactinemia to treatment. Health education and clinical guidance with some advice to avoid them, would concomitantly improve the response of resistant hyperprolactinemia to therapeutic doses of dopamine agonists.

• Clinics in Shoulder and Elbow
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• v.26 no.4
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• pp.390-396
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• 2023

Background: The subacromial (SA) space is a commonly used injection site for treatment of impingement syndrome. For shoulder stiffness, glenohumeral (GH) injections are commonly performed. However, in cases of impingement syndrome with mild shoulder stiffness, the optimal site of steroid injection has yet to be identified. Methods: This prospective, randomized study compared the short-term outcomes of ultrasound-guided GH and SA steroid injections in patients who were diagnosed with impingement syndrome and mild stiffness. Each group comprised 24 patients who received either a GH or SA injection of 40 mg of triamcinolone. Range of motion and clinical scores were assessed before and 3, 7, and 13 weeks after the injection. Results: GH and SA injections significantly improved the range of motion and clinical scores after 13 weeks of follow-up. Notably, targeting the GH joint resulted in an earlier gain of forward elevation, external rotation, and internal rotation in 3 weeks (P<0.001, P=0.012, and P=0.002, respectively) and of internal rotation and a Constant-Murley score in 7 weeks (P<0.001 and P=0.046). Subsequent measurements were similar between the groups and showed a steady improvement in all ranges of motion and clinical scores. Conclusions: GH injections may be more favorable than SA injections for treatment of impingement syndrome with mild stiffness, especially in improving the range of motion in the early period. However, the procedures showed similar outcomes after 3 months. Level of evidence: I.

• Journal of Dental Anesthesia and Pain Medicine
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• v.24 no.2
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• pp.101-108
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• 2024

Background: Administering anesthesia in dentistry can be distressing for patients, especially those with dental fear and anxiety. Needle pain during local anesthesia is a common concern in intraoral procedures. This study aimed to compare pain perception in 4-6-year-old children following intraoral dental injections with 26- and 31-gauge needles. Methods: Fifty healthy children were divided according to age into Group I (N = 25; 4-5 years) and Group II (N = 25; 5-6 years). Each group was further subdivided according to the needle gauge as follows: Group IA (26 gauge), Group IB (31 gauge), Group IIA (26 gauge), and Group IIB (31 gauge). Using a lottery method, the gauge of the needle to be used at the first visit for local anesthesia administration was selected. Children's reactions to pain were evaluated using a Modified Behavioral Pain Scale. Immediately after administration of local anesthesia, pain perception was evaluated using the Faces pain rating scale. In the subsequent visit, another needle gauge was used to administer local anesthesia, and the previously described evaluations were performed. At the third appointment, the child was shown both syringes and asked to choose one of the syringes they preferred, and the choice was noted. Results: When local anesthesia was administered using a 31-gauge needle, pain perception was similar between the two groups. In group II, the children demonstrated significantly higher arm and leg movements (P = 0.001). However, the difference was significant in group I alone (P < 0.001). Conclusion: Irrespective of age, anesthesia with a 31-gauge needle resulted in significantly lower pain perception than anesthesia with a 26-gauge needle.

• Journal of Korean Physical Therapy Science
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• v.31 no.2
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• pp.1-14
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• 2024

Background: Many patients with chronic low back pain have reduced movement due to pain. For that reason, muscle strength weakens, which leads to pain again. The pain caused by such a vicious circle is not only caused by structural problems, but also by physical function, activity disorder, or psychological depression due to biopsychosocial approaches and pain neuroscience education was applied as an intervention to find out its effect. Therefore, this study was experimented with to find out the effects of pain neuroscience education on pain, physical function, activity disorder, and depression in patients with chronic low back pain. Design: Randomized control trial Method: The study subjects were 39 patients with chronic low back pain, and the study subjects were randomized through computers to the experimental group applying pain neuroscience education and the control group applying only general physical therapy and myofascial release techniques, and the experiment was conducted for 4 weeks. Pressure Pain Threshold , Schober test, Korean Roland-Morris Disability Questionnaire, Korean Oswestry Disability Index, and Korean Depression Screening Assessment were measured. Results: As a result of the study, there was no significant difference in pain neuroscience education compared to the group that applied only general physical therapy and myofascial release techniques in both lumbar pressure pain thresholds, Schober test, Korean Roland-Morris disability questionnaire, and Korean Oswestry disability questionnaire. However, the Korean Depression Screening Assessment which is the result of measuring depression, showed significant results(p<0.05). Conclusion: Therefore, it is believed that it can be a way to mediate the psychological part through pain neuroscience education for patients with chronic low back pain in the future.

• Journal of Korean Physical Therapy Science
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• v.31 no.2
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• pp.52-62
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• 2024

Background: This study was to investigate effects of narrow squat exercise according to ankle angle of Toe in 10° and Toe out 10° on women with genu varum. Design: Randomized Controlled Trial or Cross-sectional Study. Methods: 30 adult women with genu varum participated in this study. All subjects were randomly assigned to 15 people of narrow squat exercise in ankle angle of Toe in 10° group (TI) and 15 people of narrow squat exercise in ankle angle of Toe out 10° group (TO). The narrow squat exercise program was conducted three times a week for six weeks. The distance between the knees was measured by using Digital Vernier Caliper. The quadriceps angle (Q-angle) was measured by using Goniometer. The stride length and propulsion were measured through G-Walk Results: Both TI and TO groups showed effective significant differences in distance between the knees, Q-angle, and propulsion (p<.05). There was no significant difference in stride length (p>.05). Left leg propulsion was found to be significantly more effective in TI group than in TO group (p<.05). Conclusion: These results suggested that narrow squat exercise according to ankle angle of toe in 10° and toe out 10° was effective for genu varum. However, compared to TO group, TI group was more effective in gait propulsion. It is considered that narrow squat exercise in ankle angle of Toe in 10° can be suggested as an effective intervention method for women with genu varum.

• Clinical Endoscopy
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• v.57 no.3
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• pp.335-341
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• 2024

Background/Aims: The coronavirus disease 2019 pandemic has affected the worldwide practice of upper gastrointestinal endoscopy. Here we designed a modified N95 respirator with a channel for endoscope insertion and evaluated its efficacy in upper gastrointestinal endoscopy. Methods: Thirty patients scheduled for upper gastrointestinal endoscopy were randomized into the modified N95 (n=15) or control (n=15) group. The mask was placed on the patient after anesthesia administration and particles were counted every minute before (baseline) and during the procedure by a TSI AeroTrak particle counter (9306-04; TSI Inc.) and categorized by size (0.3, 0.5, 1, 3, 5, and 10 ㎛). Differences in particle counts between time points were recorded. Results: During the procedure, the modified N95 group displayed significantly smaller overall particle sizes than the control group (median [interquartile range], 231 [54-385] vs. 579 [213-1,379]×10³/m³; p=0.056). However, the intervention group had a significant decrease in 0.3-㎛ particles (68 [-25 to 185] vs. 242 [72-588] ×10³/m³; p=0.045). No adverse events occurred in either group. The device did not cause any inconvenience to the endoscopists or patients. Conclusions: This modified N95 respirator reduced the number of particles, especially 0.3-㎛ particles, generated during upper gastrointestinal endoscopy.

• Physical Therapy Rehabilitation Science
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• v.13 no.2
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• pp.231-239
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• 2024

Objective: This study was conducted to investigate the effect of high-intensity laser therapy(HILT), transcutaneous electrical nerve stimulation(TENS), and ultrasound(US) treatment on pain, grip strength, and hand function in patients who had undergone carpal tunnel syndrome surgery. Design: A randomized controlled trial. Methods: Thirty patients who had undergone carpal tunnel syndrome surgery were randomly assigned to receive either TENS combined with HILT, US combined with HILT, or only HILT as the control group. Treatments were applied around the surgical site, and pre- and post-treatment changes were evaluated. Pain was assessed using NPRS, hand symptoms using CTS-6 and BCTQ-SSS, grip strength with an electronic dynamometer, and hand function using BCTQ-FSS. Treatments were administered seven times over two weeks. Results: The pain and symptoms were significantly reduced(p<0.05) and grip strength and hand function were significantly increased(p<0.05) after treatment compared to before treatment for all subjects. Pain was significantly reduced(p<0.05) and grip strength was significantly increased(p<0.05) in the TESN+HILT group and US+HILT group compared to the Control group. Hand symptoms were significantly reduced(p<0.05) and hand function significantly increased(p<0.05) in the TENS+HILT group compared to the Control group. Conclusions: TENS combined with HILT was found to be more effective than US combined with HILT in reducing pain and symptoms and improving grip strength and hand function in patients following carpal tunnel syndrome surgery. These findings suggest that these treatment modalities can be beneficially applied in clinical practice.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.5
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• pp.298-312
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• 2024

Purpose: Cytomegalovirus (CMV) infection affects the hepatic, neurologic, hematopoietic, respiratory, gastrointestinal, and other organs, resulting in a high mortality rate and longterm sequelae. It may cause acute or chronic hepatitis, or even lead to hepatic cirrhosis. Valganciclovir (VGCV) is an effective, safe, and well-tolerated treatment for congenital CMV infection, without any serious adverse effects. This study was conducted to evaluate the clinical, biochemical, and virological profiles of infants with CMV with intrahepatic cholestasis and to determine the outcomes with or without treatment with VGCV. Methods: Twenty infants aged <6 months diagnosed with congenital CMV infection with evidence of intrahepatic cholestasis were included in this study. Randomization was used to divide the study participants into 2 groups. The control group (n=10) was treated with only supportive management, and the intervention group (n=10) was treated with oral VGCV at 16 mg/kg/dose 12 hours a day for 6 weeks plus supportive treatments. Physical examinations and biochemical, serological, and virological tests were performed at the time of diagnosis and at the end of 6 weeks and 6 months. Results: The control and intervention groups were compared in terms of clinical and laboratory parameters such as jaundice, dark urine, pale stool, hepatomegaly, total bilirubin, aminotransferases, gamma-glutamyl transferase, alkaline phosphatase, and CMV polymerase chain reaction load, which showed a significant reduction after treatment in the intervention group (p<0.05) with oral VGCV, with very few side effects, whereas the control group showed no significant changes. Conclusion: Oral VGCV can be used to effectively treat CMV infection with intrahepatic cholestasis without notable side effects.

• Korean Circulation Journal
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• v.52 no.4
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• pp.280-287
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• 2022

Several studies have shown the benefit of complete revascularization (CR) over culprit-only percutaneous coronary intervention (PCI) in patients with ST-segment elevated myocardial infarction (STEMI) and multivessel disease (MVD). Nevertheless, optimal strategy to select targets for non-culprit PCI has not been clarified. In this paper, we critically discuss and compare the safety and efficacy of different strategies for CR in patients with STEMI and MVD using a Bayesian network meta-analysis including all previous randomized controlled trials (RCTs). In Bayesian network meta-analysis of 13 RCTs, culprit-only PCI was associated with higher risk of major adverse cardiac events (MACE), compared with angiography-guided or fractional flow reserve (FFR)-guided CR strategies. However, there was no significant difference between angiography-guided and FFR-guided CR strategies in the risk of MACE and its individual components including all-cause death, cardiac death, myocardial infarction (MI), and revascularization. These evidence support that both angiography-guided and FFR-guided complete revascularization strategies would be reasonable treatment option in patients with STEMI and MVD. If the non-culprit lesion is severe on visual assessment, angiography-guided PCI can be considered. If the non-culprit lesion is intermediate in severity or unclear based on visual assessment, FFR-guided strategy can be used as a reliable and objective tool, providing similar benefits with less stents compared with an angiography-guided strategy. Further RCT is needed to evaluate direct comparison between angiography-guided and FFR-guided CR strategies in patients with STEMI and MVD. Ongoing FRAME-AMI trial (NCT02715518) will provide more evidence regarding this issue.