• Title/Summary/Keyword: Evidence- based physical therapy

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Comprehensive Approaches to Shoulder Impingement Syndrome: From Diagnosis to Rehabilitation

  • Jung-Ho Lee
    • International Journal of Advanced Culture Technology
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    • v.12 no.2
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    • pp.90-97
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    • 2024
  • Shoulder impingement syndrome (SIS) is a common musculoskeletal condition characterized by pain and functional limitation due to the impingement of subacromial structures. This comprehensive review elucidates the complex nature of SIS, covering its pathophysiology, diagnostic methodologies, treatment options, and preventive measures. Through an exhaustive examination of current literature and clinical practices, the review highlights the importance of a multifaceted approach to SIS management. Physical therapy plays a pivotal role, focusing on exercises to strengthen shoulder musculature, enhance scapular stability, and improve range of motion. The review also discusses the strategic use of medications such as NSAIDs and corticosteroid injections, emphasizing their effectiveness in pain and inflammation management. Additionally, it advocates for structured rehabilitation programs post-treatment to restore function and prevent recurrence, recommending preventive strategies like ergonomic adjustments, targeted exercises, and proper technique training. This paper underscores the need for personalized and evidence-based treatment strategies, integrating physical therapy and pharmacological management when necessary.

The Literature Review on the Effectiveness of Fall-related Hip Fracture Prevention Programs (노인의 넘어짐으로 인한 고관절 골절 예방프로그램의 효과: 문헌 고찰)

  • Lee, Se-young;Kim, Seung-su;Lim, Kitaek;Choi, Woochol Joseph
    • Physical Therapy Korea
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    • v.28 no.1
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    • pp.1-12
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    • 2021
  • While efforts have been made to address fall-related injuries in older adults, the problem is unsolved to date. The purpose of this review is to provide a guideline for fall and injury prevention programs in older adults, based on evidence generated over the past 30 years. Research articles published between 1990 and 2020 have been searched on PubMed, using keywords, including but not limited to, falls, hip fracture, injuries, intervention, older adults, prevention, hip protector, vitamin D, safe landing strategy, and exercise. Total of 98 articles have been found and categorized into five intervention areas: exercise program, hip protector, safe landing strategy, vitamin D intake, and compliant flooring. Furthermore, the articles have been rated based on their study design: class 1, randomized controlled trials; class 2, non-randomized controlled trials; class 3, experimental studies; class 4, all other studies. Exercise programs have shown to decrease the risk of fall, and associated injuries. Hip protectors, safe landing strategy, and vitamin D intake were effective in reducing a risk and incidence of hip fracture during a fall. Furthermore, compliant flooring has also decreased hip fracture risk without affecting balance. An integrated approach combining exercise program, wearing a hip protector, teaching safe landing strategies, scheduled vitamin D intake, and compliant flooring installation, is suggested to address fall-related injuries in older adults.

A Review of Motion Capture Systems: Focusing on Clinical Applications and Kinematic Variables (모션 캡처 시스템에 대한 고찰: 임상적 활용 및 운동형상학적 변인 측정 중심으로)

  • Lim, Wootaek
    • Physical Therapy Korea
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    • v.29 no.2
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    • pp.87-93
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    • 2022
  • To solve the pathological problems of the musculoskeletal system based on evidence, a sophisticated analysis of human motion is required. Traditional optical motion capture systems with high validity and reliability have been utilized in clinical practice for a long time. However, expensive equipment and professional technicians are required to construct optical motion capture systems, hence they are used at a limited capacity in clinical settings despite their advantages. The development of information technology has overcome the existing limit and paved the way for constructing a motion capture system that can be operated at a low cost. Recently, with the development of computer vision-based technology and optical markerless tracking technology, webcam-based 3D human motion analysis has become possible, in which the intuitive interface increases the user-friendliness to non-specialists. In addition, unlike conventional optical motion capture, with this approach, it is possible to analyze motions of multiple people at simultaneously. In a non-optical motion capture system, an inertial measurement unit is typically used, which is not significantly different from a conventional optical motion capture system in terms of its validity and reliability. With the development of markerless technology and advent of non-optical motion capture systems, it is a great advantage that human motion analysis is no longer limited to laboratories.

Effect of External Load on Shoulder Joint Active Relocation Using 3D Motion Capture System: A Pilot Study (외부 하중이 어깨관절의 능동적 재위치 검사 결과에 미치는 영향: 3차원 동작 분석 시스템을 이용한 예비연구)

  • Hwang, Jisun;Hwang, Seonhong
    • Physical Therapy Korea
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    • v.25 no.2
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    • pp.71-77
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    • 2018
  • Background: There are insufficient objective or quantitative evidence for the better intervention to improve proprioception particularly for the application of external load. There are conflicting opinions whether the external load is effective for proprioception improvement or not. Objects: The purpose of this study was to investigate effects of external load on proprioception of shoulder joint quantitatively using 3D motion capture system. Methods: Nine healthy adults joined for this study. They were asked to perform scapular plane abduction motion with attaching reflective markers on the trunk and upper limb. The 3D positions of finger marker, while they performed the same task with and without external load, were recorded and analyzed. Results: All participants showed decreased variable errors in the vertical direction when the external load was applied (p<.02). Even though other directions (y, z) and absolute errors increased, they did not have statistical significances. Conclusion: Based on this study results, the external load application would be effective for shoulder joint position sense improvement.

Therapeutic Approach for Stroke Patients based on Central Pattern Generator (중추유형발생기에 근거한 뇌졸중 환자의 치료적 접근)

  • Kim Joong-Hwi;Kim Chung-Sun
    • The Journal of Korean Physical Therapy
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    • v.14 no.4
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    • pp.131-146
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    • 2002
  • In the last years, it has become possible to regain some locomotor activity in patients with incomplete spinal cord injury (SCI) through intense training on a treadmill. The ideas behind this approach owe much to insights derived from animal studies. Many studies showed that cats with complete spinal cord transection(spinalized animals) can recover locomotor function. These observations were at the basis of the concept of the central pattern generator located at spinal level. The neural system responsible for the locomotor restoration in both cats and humans is thought to be located at spinal level and is referred to as the central pattern generator(CPG). The evidence for such a spinal CPG in human is emphasis on some recent developments which support the view that there is a human spinal CPG for locomotion. An important element in afferent inputs for both spinal injured cats and humans is the provision of adequate sensory input related locomotor, which can possibly activate and/or regulate the spinal locomotor circuitry This review article deals with the afferent control of the central pattern generator. Furthermore, the application of adequate afferent inputs related locomotor for stroke patients will be able to facilitate locomotion ability, which is automatic, cyclic, rhythmic. These insights can possibly contribute to a better therapeutic approach for the rehabilitation of gait in patients with stroke.

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Effect of Biomechanical Intervention based on Custom Seating System on Activities of Mouse Click for Children with Cerebral Palsy (맞춤형 착석장치를 통한 생체역학적 중재가 뇌성마비 아동의 마우스 클릭 동작에 미치는 영향)

  • Jeong, Dong-Hoon
    • The Journal of Korean Physical Therapy
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    • v.24 no.2
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    • pp.57-65
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    • 2012
  • Purpose: This study was to investigate the effect of biomechanical intervention, based on the custom seating system on the activities of a mouse click for children with cerebral palsy. Methods: Thirteen children with cerebral palsy participated in this study. We compared reaction time and frequency for proper mouse click in the subject's typical position, in addition to an intervention position. The intervention position conformed to the principle and practice of research on promoting the upper-extremity movement and postural control. The intervention position was achieved through an external postural support, which was based on the custom seating system. Results: Reaction time and frequency for proper mouse click were moderately improved in the intervention position, compared with that of the typical position. There was a statistically significant difference between the typical position and that of the intervention position (p<0.05). Conclusion: Results provide evidence of the positive effects of functional seating on the activities of a mouse click for children with cerebral palsy.

Current Treatments for Breast Cancer-Related Lymphoedema: A Systematic Review

  • Li, Lun;Yuan, Liqin;Chen, Xianyu;Wang, Quan;Tian, Jinhui;Yang, Kehu;Zhou, Enxiang
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.11
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    • pp.4875-4883
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    • 2016
  • Background and objective: Breast cancer-related lymphoedema (BCRL) is a disabling complication with long term impact on quality on life after breast cancer treatment. Its management remains a major challenge for patients and health care professionals; the goal of this overview was to summarize effects of different treatment strategies for patients with BCRL. Methods: A thorough search was undertaken to allow a systematic review or meta-analysis of treatments for BCRL. Two investigators independently selected studies and abstracted the data. Results: Combined physical therapy (CPT) with different combinations of surgery, oral pharmaceuticals, low-level laser therapy, weight reduction, mesenchymal stem cell therapy, kinesio tex taping, and acupuncture might be effective in reducing lymphoedema, but exercise demonstrated no obvious benefit. The results of direct comparisons showed CPT might be more effective than standard physiotherapy (ST). Manual lymphatic drainage (MLD) may not offer additional benefits to ST for swelling reduction, but could facilitate compression bandaging. MLD seemed to have similar effects with self-administered simple lymphatic drainage (SLD) or using an intermittent pneumatic compression pump (IPC). IPC might also not be associated with additional effectiveness for CPT. Efficacy of stem cell therapy vs. compression sleeve or CPT, as well as the effects of daflon and coumarin could not be established. Conclusion: Although many treatments for BCRL might reduce lymphoedema volume, their effects were not well established. The quality of many of the original studies in the included reviews was not optimal, so that in future randomized control trials are a high priority.

Early versus Delayed Surgery for Spinal Epidural Abscess : Clinical Outcome and Health-Related Quality of Life

  • Behmanesh, Bedjan;Gessler, Florian;Quick-Weller, Johanna;Dubinski, Daniel;Konczalla, Juergen;Seifert, Volker;Setzer, Matthias;Weise, Lutz
    • Journal of Korean Neurosurgical Society
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    • v.63 no.6
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    • pp.757-766
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    • 2020
  • Objective : Spinal epidural abscess (SEA) is a severe and life-threatening disease. Although commonly performed, the effect of timing in surgical treatment on patient outcome is still unclear. With this study, we aim to provide evidence for early surgical treatment in patients with SEA. Methods : Patients treated for SEA in the authors' department between 2007 and 2016 were included for analysis and retrospectively analyzed for basic clinical parameters and outcome. Pre- and postoperative neurological status were assessed using the American Spinal Injury Association Impairment Scale (AIS). The self-reported quality of life (QOL) based on the Short-Form Health Survey 36 (SF-36) was assessed prospectively. Surgery was defined as "early", when performed within 12 hours after admission and "late" when performed thereafter. Conservative therapy was preferred and recommend in patients without neurological deficits and in patients denying surgical intervention. Results : One hundred and twenty-three patients were included in this study. Forty-nine patients (39.8%) underwent early, 47 patients (38.2%) delayed surgery and 27 (21.9%) conservative therapy. No significant differences were observed regarding mean age, sex, diabetes, prior history of spinal infection, and bony destruction. Patients undergoing early surgery revealed a significant better clinical outcome before discharge than patients undergoing late surgery (p=0.001) and conservative therapy. QOL based on SF-36 were significantly better in the early surgery cohort in two of four physical items (physical functioning and bodily pain) and in one of four psychological items (role limitation) after a mean follow-up period of 58 months. Readmission to the hospital and failure of conservative therapy were observed more often in patients undergoing conservative therapy. Conclusion : Our data on both clinical outcome and QOL provide evidence for early surgery within 12 hours after admission in patients with SEA.

The Effect of the Active Release Technique on Balance and Functional Movement in Youth Basketball Players

  • Kwang-Nam Kim;Byoung-Hee Lee
    • Journal of Korean Physical Therapy Science
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    • v.31 no.1
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    • pp.1-15
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    • 2024
  • Background: This study was conducted to apply active release techniques to male youth basketball players to help improve physical development and damage prevention and improve performance through improved balance and functional movement. Design: Randomized control trial. Methods: The subjects included 33 youth basketball players who were randomly assigned to the experimental group (n=17) and the control group (n=16). For the experimental group, the active release technique was applied to the hip muscles, calf muscles, posterior thigh muscles based on the distribution of injuries surveyed in youth basketball players in the Korean Basksetball League. The Y-balance test and the functional reach test (FRT) were used to assess balance and the Functional Movement Screen (FMS) was used to assess functional movement. Interventions were conducted twice a week for 4 weeks at 40 minutes per session. The experimental group was the active release technique group, and static stretching, a common exercise therapy technique, and self-myofascial release using a foam roller were applied for 20 minutes. The control group received general exercise therapy and placebo active release technique. The placebo active release technique applies pressure only. results:The experimental group showed a greater improvement in balance, as evidenced by the FRT, compared to the control group, which received general exercise treatment. However, there was no statistically significant difference in improvement between the 2 groups. In the case of the experimental group, the difference in the Y balance test before and after the intervention was larger than that of the control group, but there was no statistically significant difference. Significant improvement was found in functional movement, as evidence by the FMS, for the trunk stability test (p < 0.05), in-line lunge test (p < 0.05), rotational stability test (p < 0.05), total score (p < 0.05). Conclusion: In this study, the active release technique improved the balance and functional movement of young basketball players more than general exercise therapy. The application of the active release technique is therefore expected to assist in physical development, prevent damage, and improve the performance of youth basketball players.

The Utilization of Physical Therapies in the Korean Medicine Clinics : A Survey for National Health Insurance Planning (한의원의 한방물리요법 이용 현황과 건강보험 급여화에 대한 인식)

  • Shin, Mi-Sook;Shin, Byung-Cheul;Lee, Myeong-Jong;Kim, Ho-Jun;Song, Yoon-Kyung;Song, Mi-Yeon;Shin, Seung-Woo;Lim, Byungmook
    • Journal of Korean Medicine Rehabilitation
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    • v.19 no.3
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    • pp.101-109
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    • 2009
  • Objectives : This study aimed to investigate the present status of physical therapies provided in the Korean medicine clinics, and to find out the priorities among and the estimated fees of physical therapies for the National Health Insurance plan. Methods : We administered nationwide survey to Korean medicine doctors using the on-line survey system. 16 physical therapies were listed in the Web-based questionnaires, and responders were asked to mark the therapies they used for their patients, and, for each therapy they marked, to fill in the form including the frequencies of service, service fees, target diseases, and priorities for health insurance coverage, etc. Results : Of 488 respondents, 93.7% provide more than one physical therapy for their patients, and each responder uses 5.9 physical therapies on average. 60-90% of physical therapies are being given to patients for free because they are not covered by the National Health Insurance. There is little evidence that the specialties of Korean medicine doctors are related with the use of physical therapies, but, in some therapies, the doctors with longer career years use the physical therapy more frequently. Most physical therapies are applied to the patients with musculoskeletal diseases, cardiovascular diseases, and nervous diseases, etc. Conclusions : Physical therapies are widely used among Korean medicine doctors without proper compensation. This could be the one of the main factors distorting the profit structure of Korean medicine clinics, and it encourages the National Health Insurance to cover physical therapies provided in the Korean medicine clinics.