• Physical Therapy Korea
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• v.19 no.1
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• pp.66-75
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• 2012

The purpose of this study was to identify the effects of two types of stretching extensor carpi radialis on the visual analog scale (VAS), pressure-pain thresholds (PPTs), grip strength (GS), and strength of wrist extensor (SWE) in patients with lateral epicondylalgia. Sixteen patients with lateral epicondylalgia were recruited for this study and randomly assigned to two groups; the conventional stretching group (CS) and the stretching of proximal functional massage group (PFM); the VAS, PPTs, GS, and SWE were measured before and after the intervention. Over a period of stretching exercises were performed for five minutes per day, five days per week. The paired t-test and Wilcoxon signed-rank test were used to determine the statistical differences in the VAS, PPTs, GS, and SWE (pre- and post-test). The Independent t-test and Mann-Whitney U test were used to compare the effects of stretching exercises between the CS and PFM groups. The results of this study demonstrated that in the PFM group, the PPTs, GS, and SWE significantly increased, and the VAS decreased (p<.05). In the CS group, the VAS and GS increased significantly after the three-week intervention (p<.05). Pain was decreased and strength (GS and SWE) was increased in the PFM group, compared to the CS group (p<.05). The findings of this study indicate that PFM technique can be applied for decreasing pain and increasing the GS and SWE in patients with lateral epicondylalgia.

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.140-146
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• 2012

Purpose: The objective of this study was to assess the clinical outcome of arthroscopic release of the extensor carpi radialis brevis (ECRB) tendon in chronic recalcitrant lateral epicondylitis and tried to determine any prognostic factors. Materials and Methods: A retrospective review of 24 patients with lateral epicondylitis treated by arthroscopic ECRB release was performed. Outcome measures included a patient self rating and visual analog scale (VAS). Functional evaluation was made with Quick-disabilities of the arm, shoulder and hand (DASH) score system to identify preoperative factors that might be associated with the outcomes. Results: Twenty one (88%) elbows received benefit from the procedure. A mean preoperative VAS pain score and the mean Quick-DASH were significantly improved at final follow up. Age, sex, dominant arm and duration of symptom, presence of capsular tear or calcification did not correlate significantly with the clinical outcome. Three of four patients without T2-weighted high signal focus of the ECRB origin on preoperative magnetic resonance imaging (MRI) showed higher Quick-DASH score. Conclusion: Arthroscopic release of the ECRB is an effective option for chronic recalcitrant lateral epicondylitis. Lack of high signal focus on preoperative MRI is significantly associated with a poor surgical outcome and a considerable factor for the proper surgical indication.

• Archives of Plastic Surgery
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• v.50 no.2
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• pp.177-181
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• 2023

Digital extensor hypoplasia (DEH) is a rare malformation that presents with loss of active finger extension at the metacarpophalangeal (MCP) joints. Descriptions of optimal treatment and outcomes in this population are sparse. We describe successful operative treatment of a child with DEH involving the extensor digitorum communis, extensor digiti minimi, and the extensor indicis proprius tendons. The 5-year-old male patient was referred for severe limitation on bilateral finger extension since birth. He had been previously diagnosed with arthrogryposis and managed conservatively. Due to lack of improvement, magnetic resonance imaging was done evidencing hypoplasia/aplasia of the extensor tendons. The patient underwent successful tendon transfers using extensor carpi radialis longus to the common extensor tendons, and one hand required an additional tenolysis procedure. 2 years postoperatively, his MCP position and finger extension are markedly improved, and he is able to grip objects without limitation or difficulty. The patient returned to full activity without restriction.

• PNF and Movement
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• v.16 no.3
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• pp.415-424
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• 2018

Purpose: This study aimed to determine the effects of various wheelchair handling directions on the upper limb muscle activities of wheelchair attendants while climbing a ramp. Methods: For the study participants, healthy males over 20 years of age were chosen, and the order of the direction of wheelchair handle grip was determined using a randomized method. The handling directions for pushing the wheelchair up a ramp included a general grip with ulnar deviation, a medial grip with wrist pronation, and a neutral grip with a neutral wrist. The muscle activities in the participants' upper limbs were measured using surface electromyography. For statistical data processing, SPSS 18.0 was used to perform repeated measures ANOVA in order to compare the muscle activity among the intervention groups. A contrast test was also conducted among the participants. The significance level (${\alpha}$) was set to 0.05. Results: There was a significant difference between groups using a general grip and a medial grip in the biceps brachii, triceps brachii, and flexor carpi radialis muscles (p<0.05). There was also a significant difference between using a general grip and a neutral grip in the biceps brachii and flexor carpi radialis muscles (p<0.05), and there was a significant difference between using a medial grip and a neutral grip in the biceps brachii and extensor carpi radialis brevis muscles (p<0.05). Conclusion: In this study, the wheelchair assistants' wrist muscle activity was the lowest with a neutral grip while ascending a ramp. Accordingly, this study proposes that wheelchair assistants push wheelchairs up ramps with a neutral grip.

• Journal of International Academy of Physical Therapy Research
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• v.9 no.2
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• pp.1447-1454
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• 2018

The objective of this study was to investigate the dynamic neural mobilization program on the changes in muscle activity and nerve conduction velocity (NVC) in stroke patients. The participants were sampled and randomly divided into experimental group I (n=12) who underwent arm neural mobilization and experimental group II (n=13) who underwent arm dynamic neural mobilization. As the pretest, peripheral NVC of the radial, median, and ulnar nerves were measured using the Viking Quest; the biceps brachii, brachioradialis, flexor carpi radialis, and extensor carpi radialis activities were measured with sEMG. Each intervention program consisted of 10 trials per set and three sets per session. The intervention programs were performed once daily for four weeks (four days/week). Posttest measurements were taken equally as the pretest measurements. Significant differences in peripheral NVC in all sections of the radial and median nerves and wristbelow elbow and below elbow-above elbow areas of the ulnar nerve, as well as in muscle activity of all muscles except the biceps brachii. These findings indicate that dynamic neural mobilization was effective in increasing peripheral NVC and altering the muscle activity.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.2
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• pp.39-48
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• 2023

Background: The position of pitcher requires a lot of repetitive motion, and because of this, it is known that not only professional baseball players, but also middle and high school players are frequently exposed to injuries in baseball. The purpose of this study is to examine the differences in upper extremity muscle activity during repeated pitching and the activity of each muscle during repeated pitching by analyzing middle and high school pitchers, divided into groups by age. Methods: Twenty participants (10 middle school male students and 10 high school male students) were recruited for this research. The outcome measures included neuromuscular motor control, including the upper trapezius (UT), triceps brachii (TB), deltoid (DT), latissimus dorsi (LD), biceps brachii (BB), pectoralis major(PM), extensor carpi radialis(ER), and flexor carpi radialis (FR). Results: The two-way analysis of varaince (ANOVA) was used to compare the muscle activity variables between the middle school and high school students. The one-way ANOVA was used to compare the muscle activity variables within time differences each groups. Conclusion: Our results provided promising clinical evidence that guide for upper extremity muscles to increase pitching efficiency in middle and high school base ball players.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.7 no.1
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• pp.103-112
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• 2012

Objectives : This study was performed to report the effect of oriental medical treatments on the 4 patients with lateral epicondylitis of the elbow. Methods : The 4 patients were treated by Bee Venom acupuncture, Dong-Qi acupuncture, acupuncture on tender points of the origin of the extensor carpi radialis and taping on the extensor carpi radialis. The state of patients was measured by visual analog scale(VAS), elbow range of motion(ROM) and patient's subjective symptom grade(PSSG). Results : After mean 9.5 times of treatments, the recovery of elbow ROM was measured and significant pain relief was seen as the average of VAS changed from 10 to 1.25 and average of PSSG changed from 2.75 to 0.5 grade. Conclusions : These results suggest that oriental medical treatments including Bee Venom acupuncture, Dong-Qi acupuncture, acupuncture, taping are effective to improve the lateral epicondylitis of the elbow.

• Clinics in Shoulder and Elbow
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• v.8 no.1
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• pp.49-56
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• 2005

Purpose: To review the surgical results of stiff elbow using the posterior extensile approach which provides a wide surgical view with a single posterior skin incision. Materials and Methods: From February 1999 to May 2002, we performed 6 surgical correction of stiff elbow using posterior extensile approach and followed the patients more than 1 year. In order to get better result, we performed cadaver study (four elbows of two fresh cadavers). Average duration of follow up was 15.7 months $(14{\sim}21)$. Functional results was analyzed using Brobery and Morrey analysis scale. Results: The approach through the plane between the extensor carpi radialis longus and the extensor carpi radialis brevis was ideal, because it preserves normal anatomy and provides a wide surgical view of the anterior joint. The posterior joint could be approached directly between the medial head of the triceps brachii and brachialis medially, the lateral head of triceps brachii and brachioradialis laterally. In all patients, an improved ROM was obtained with intra and extra-articular adhesiolysis: an average $61.7^{\circ}$ improvement $(50{\sim}75)$. Functional results were as follows: five excellent, one good. In addition, the patients' satisfaction was high since the scar from the operation was only a single line at the posterior surface of the elbow. Conclusion: In the treatment of stiff elbow, posterior extensile approach is thought to be useful because this method provides wide anterior and posterior surgical view.

• The Journal of Korean Physical Therapy
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• v.16 no.4
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• pp.202-217
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• 2004

Lateral epicondylitis is characterized by pain at the lateral aspect of the elbow, commonly associated with resisted wrist or finger extension and gripping activities. Lateral epicondylitis is also known such as lateral epicondylosis, tennis elbow, or tendonitis of the wrist extensor muscles, especially extensor carpi radialis brevis. Lateral epicondylitis is a common musculoskeletal lesion in the clinical states, so physical therapist usually meet a patients who has the lateral epicondylitis. But many of physical therapists are treating patients based on a self know-how, so I want to describe a systematically about lateral epicondylitis and give a objective information on the lateral epicondylitis. And now I want that they will be treat patients with lateral epicondylitis not a self-experience but based on a objective information.

• Physical Therapy Korea
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• v.15 no.4
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• pp.43-49
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• 2008

The objective of this study was to compare the differences on the activity and power of the wrist flexors and extensors in subjects before the use of a wrist extension splint, after nighttime wearing of the splint, and after daytime wearing of the splint. Ten healthy male and ten healthy female students (mean: $22.4{\pm}1.2$ years old) volunteered to wear custom-made wrist splints either during the night or during the day, The hand force of the wrist flexor and extensor, and grip force were measured by PowerTrack II and Dynatron, respectively. At the same time, the activities of the wrist flexor and extensor were recorded by' surface electromyography. The maximal hand force and motor unit recruitment of the flexor carpi ulnatis (FCU) increased significantly (p<.05) when tile subjects wore the wrist splints during the daytime, but the maximal hand power of the FCU decreased with nighttime use of the splints. The maximal hand power and motor unit recruitment of the extensor carpi radialis (ECR) and the ECR/FCU ratio decreased both during nighttime and daytime use. The decrement of the ECR/FCU ratio was significant (p<.05). Wearing a wrist extension splint during nighttime led to the maintenance of a lengthened position of the wrist flexor, resulting in the wrist flexor becoming weak. Wearing a wrist extension splint during the day induced the wrist flexors to be greater. In healthy people, the imbalance between the wrist flexors and extensors may be caused by the use of a wrist extension splint. This study indicates that therapists have to consider whether a splint will be effective, as well as the wearing time, when prescribing splints to people with problems of the musculoskeletal system.