• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.137-143
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• 2022

Purpose : The purpose of this study was to evaluate the reliability analysis of the deep tendon reflex by using electromyography (EMG). Methods : The study was tested on 30 volunteers who are women in their 20s. Using an electronic reflective hammer of EMG, deep tendon reflex was measured on all subjects with the participation of three trained physical therapists as raters. First, the subjects were comfortably seated on a table with their knees bent at 90 °. The three raters tapped the electric hammer at intervals of 10 seconds to avoid habituation until a total of 10 compound muscle action potential records were collected. Intraclass correlation coefficients (ICCs) were calculated to assess the inter-rater reliability of the deep tendon reflex with the use of EMG. The items of analysis included amplitude (mV), latency (ms), duration (ms), and area (mV × ms) of the compound evoked potentials. Results : Based on the average records of 10 compound muscle action potential, excellent reliability (ICC: .912) was achieved in terms of area, and there was good reliability in terms of latency (ICC: .795) and duration (ICC: .800). In the shortest latency of the compound muscle action potential, good reliability was achieved in terms of amplitude (ICC: .865), duration (ICC: .781), and area (ICC: .832). In the amplitude of peak-to-peak of compound muscle action potential, excellent reliability was recorded in terms of amplitude (ICC: .924), and good reliability was recorded in terms of duration (ICC: .801) and area (ICC: .874). Conclusion : The findings in this study indicate that electromyography via an electric hammer is a reliable method of assessing and measuring deep tendon reflexes. Especially, it may be an excellent gauge in the area of average values of the compound muscle action potentials and the amplitude of peak-to-peak of compound muscle action potentials.

• Physical Therapy Korea
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• v.14 no.3
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• pp.57-63
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• 2007

The purpose of this study was to evaluate inter-rater reliability of the amplitude and first knee extension angles in deep tendon reflex test by using an electrical hammer. Twenty-five healthy adults participated in the study. Compound muscle action potential is elicited by tapping the knee tendon with an electrical hammer in deep tendon reflex tests. The amplitude and knee extension angle were simultaneously measured. The mean value of the amplitude and the knee extension angles through three time trials for each tester, are used for determining the inter-rater and Intra-class Correlation Coefficients (ICCs) reliabilities. According to the results, the ICCs of the amplitude is .280 and that of the knee extension angle is .789. Pearson correlation coefficients of the amplitude of the action potential and the knee extension angles are .685, showing significant statistically moderate correlation. Inter-rater reliability in the amplitude was not significant. More objective and quantitative deep tendon reflex tests should be done to obtain higher reliability in further studies.

• Kosin Medical Journal
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• v.33 no.2
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• pp.257-262
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• 2018

Guillain-$Barr{\acute{e}}$ syndrome (GBS) and acute disseminated encephalomyelitis (ADEM) are demyelinating neurologic disorders with different target organs. Although they share similar pathogenetic mechanism, reports of simultaneous occurrence of the 2 disorders are rare. A 2 year 6 month old girl visited our hospital for fever, cough, and general weakness. Although the muscle power of extremities showed mild weakness and voiding difficulty, initial deep tendon reflex of both knees and ankles was normal. A nerve conduction study to evaluate the weakness revealed the absence of F waves. Cerebrospinal fluid analysis demonstrated pleocytosis with lymphocyte predominance and elevated protein levels. Magnetic resonance imaging showed abnormal T2 hyperintensity in pons, medulla and spinal cord. Serum anti-GD1b antibody was positive. Based on clinical findings, laboratory findings, nerve conduction study, and neuroimaging, the diagnosis of GBS and ADEM was made. This is the first case of GBS accompanied by ADEM in Korea.

• Journal of Sasang Constitutional Medicine
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• v.35 no.4
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• pp.55-64
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• 2023

Objectives This study was aimed to report improvement of Soeumin patient diagnosed with Alcoholic Polyneuropathy using Hyangbujapalmul-tang. Method The 41-year-old man had severe foot pain, sensory slow down and ataxic gait. The patient was diagnosed Soeumin and medicated with Hyangbujapalmul-tang three times a day. Clinical improvement was evaluated with blood test, ataxic gait evaluation, deep tendon reflex and visual analogue scale (VAS). Results The symptoms of foot pain, sensory slow down and ataxic gait were dramatically improved after treatment. Conclusions Constitutional treatment for foot pain, sensory slow down and ataxic gait diagnosed with Alcoholic Polyneuropathy are potentially effective.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.2
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• pp.1785-1790
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• 2019

Background: Lumbar disc herniation (LDH) causes neurological symptoms by compression of the dura mater and nerve roots. Due to the changed in proprioception inputs that can result in abnormal postural pattern, delayed reaction time, and changed in deep tendon reflex. Objective: To investigate the effects of lumbar stabilization exercises on motor neuron excitability and neurological symptoms in patients with LDH. Design: Randomized Controlled Trial (single blind) Methods: Thirty patients with LDH were recruited; they were randomly divided into the balance center stabilization resistance exercise group (n=15) and the Nordic walking group (n=15). Each group underwent their corresponding 20-minute intervention once a day, four times a week, for four weeks. Participants' motor neuron excitability and low back pain were assessed before and after the four-week intervention. Results: There were significant differences in all variables within each group (p<.05). There were significant differences between the experimental and control groups in the changes of upper motor neuron excitability and pain (p<.05), but not in the changes of lower motor neuron excitability and Korean Oswestry Disability Index. Conclusion: Lumbar stabilization exercises utilizing concurrent contraction of deep and superficial muscles improved low back function in patients with LDH by lowering upper motor neuron excitability than compared to exercises actively moving the limbs. Lumbar stabilization exercises without pain have a positive impact on improving motor neuron excitability.

• Clinical and Experimental Pediatrics
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• v.59 no.6
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• pp.271-275
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• 2016

Purpose: A limited number of studies have examined the link between F-wave abnormalities and clinical presentation in pediatric Guillain-$Barr{\acute{e}}$ syndrome (GBS). Therefore, this study examined the importance of F-wave abnormalities as a prognostic factor in pediatric GBS patients. Methods: The records and electrodiagnostic studies (EDS) of 70 GBS patients were retrospectively evaluated, and divided into 2 groups according to the results of EDS. Group A (n=33) presented with F-wave abnormalities, and group B (n=26) exhibited normal findings. We compared laboratory reports, clinical features, response to treatment, and prognosis between the 2 groups. Results: Motor weakness was the most frequently observed symptom for either group. Clinically, the incidence of fever and upper respiratory symptoms differed between the 2 groups, while the prevalence of abnormal deep tendon reflex (DTR) was significantly higher in group A than B (P<0.05). Patients diagnosed with GBS had received intravenous immunoglobulin treatment: 94% in group A and 58% in group B. Furthermore, significantly greater numbers of patients in group A showed H-reflex abnormalities and poor prognosis compared with group B (P<0.05). Conclusion: This study demonstrated that F-waves are a clinically important prognostic factor in GBS. F-wave abnormalities were associated with abnormal DTR and poor prognosis in patients. Limited studies have examined the link between F-wave abnormalities and clinical results; therefore, further randomized controlled studies are needed to confirm the clinical characteristics and efficacy of treatments.

• Annals of Clinical Neurophysiology
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• v.3 no.1
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• pp.37-39
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• 2001

Although the etiology and pathogenesis of amyotrophic lateral sclerosis(ALS) is unknown, increasing evidence supports a role for autoimmune mechanisms in motor neuron degeneration. The coexistence of immune disease in ALS supports that an altered immune system may contribute to disease pathogenesis. A 55-year-old woman was admitted to our department due to dysarthria and gait disturbance. On physical and neurologic examination, she showed thyroid enlargement, tongue atrophy, muscle weakness, fasciculation, and increased deep tendon reflex. The electrophysiological studies are compatible with motor neuron disease. Cytological findings of thyroid were compatible with Hashimoto's thyroiditis. Thus, we report a case of ALS combined with Hashimoto's thyroiditis. And the simultaneous presentation with ALS and Hashimoto's thyroiditis led us to consider whether this was simply a chance association or not.

• Journal of Korean Neurosurgical Society
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• v.29 no.10
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• pp.1377-1382
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• 2000

Ossification of ligamentum flavum(OLF) is a type of ectopic bone formation developed within the spinal ligament. Thoracic myelopathy is common symptom of OLF but radiculopathy is uncommon. We present 3 operated cases of OLF. Two showed myelopathy and one radiculomyelopathy. Main symptoms were motor weakness, sensory disturbance, incoordination of both legs, and back pain. One patient complained of left girdle pain in T4 dermatome. Deep tendon reflex(DTR) was increased in all cases. The diagnosis was made from myelogram, CT and MRI. Sufficient posterior decompressive laminectomy and medial facetectomy were performed. Postoperative diagnosis was comfirmed by histopathological examination. One patient could return to work 3 months after operation and two patients showed satisfactory improvement 2-3 months after operation. Early diagnosis and appropriate surgical treatment were prerequisite of good outcome.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.2
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• pp.209-217
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• 2013

PURPOSE: The purpose of this study was to investigate the clinical availability of the pendulum test (through reliability and validity) using a NK table attached electrogoniometer for spasticity measurement in patients with brain lesions. METHODS: Thirty-one stroke and traumatic brain injury subjects participated in the study. Intraclass correlation coefficient (ICC) was used to verify the test-retest reliability of spasticity measures of the pendulum test. Pearson's product correlation coefficient was used to examine the validity of the pendulum test through the amplitude of the deep tendon reflex (DTR) test known for objective and quantitative measure of spasticity. RESULTS: In these results, the test-retest reliability was showed significantly high correlation between pendulum tests (ICCs=.95~.97, p<.01). There were significant negative correlations between the amplitude of the DTR test and all measures of spasticity of the pendulum test(r=-.77~-.85, p<.01). CONCLUSION: Thus, it is possible to use the pendulum test using a NK table as an objective measure of spasticity, rather than other expensive equipment, which is more complicated to use. Further studies are needed to explore the therapeutic effects of spasticity using a newly designed pendulum test equipment in this study.

• Korean Journal of Acupuncture
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• v.21 no.3
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• pp.137-146
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• 2004

Objective : The purpose of this study is to report the patient with peripheral neuropathy, who improved by Oriental medical treatment. Methods : The patient was managed by acupuncture, moxibustion, physical treatment and herbal medicine. We checked digital infrared thermographic imaging(D.I.T.I.), electromyography(E.M.G.), nerve conduction velocity(N.C.V.), deep tendon reflex(D.T.R.), sensory recover area and range of motion(R.O.M.) of knee & ankle. Results : After 6 week treatment, clinical sign(the movement and sense of leg) of improvement was appeared. Also E.M.G., N.C.V., D.T.R. and D.I.T.I. was recovered to nearly normal range. Conclusion : The results suggest that combination of acupunture, moxibustion and herbal medicine is good method for treatment of peripheral neuropathy. But further studies may be required to concretely prove the effectiveness of this methods for treating peripheral neuropathy.