• The Journal of Korean Physical Therapy
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• 제25권2호
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• pp.88-95
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• 2013

Purpose: The purpose of this study was to conduct an analysis of kinematics of lower extremities and trunk in stance phase of walking according to turning direction. Methods: Ten university students (five male, five female) who were in their 20s (mean age was 20.6 years old) participated in this study. Participants did not have participants did not have any problem with skeletal muscular system. We used the "Qualisys motion capture system" for analysis of trunk and lower extremity movement in stance phase of walking according to turning direction. We collected data while subjects walked a distance of 10 m, and at the 6 m line, subjects were required to turn to the left side and the right leg was positioned in stance phase and the left leg was positioned in swing. For data analysis, the SPSS for Windows ver. 20.0 statistics program was used in performance of one way analysis of variance according to turning direction. Results: Significant difference of trunk and lower extremities was observed for turning direction according to walking cycle (p<0.05). Upper trunk movement showed a greater increase at three dimensions than lower trunk, and in heel off phase, pelvic movement showed a greater increase than lower trunk (p<0.05). In 45 degree and 90 degrees of turning direction, all movements of trunk and lower extremities were significantly different among three events of stance phase (p<0.05). Conclusion: We suggest that three-dimensional movement analysis of trunk and lower extremities during turning movement was very important in order to indicate increasing balance or walking ability for people with impaired movement or walking.

• 대한통합의학회지
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• 제8권2호
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• pp.211-220
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• 2020

Purpose : The purpose of the present study is to examine the effects of VR training with FES on improving the muscle strength, AROM, and function of the upper limb joints in patients with chronic stroke. Methods : The present study makes use of a pre-post control group design. Thirty patients with chronic stroke were randomly assigned to two groups according to treatment method - the VRFES group and the control group. The VRFES group received 15 minutes of VR training and 15 minutes of FES treatment. The control group received 15 minutes of conservative physical therapy and 15 minutes of VR training. All subjects received 30 minutes of treatment, three times a week, for eight weeks, which amounted to 24 sessions of training. The muscle strength, AROM, and function of the upper extremities were measured before the training and eight weeks after. Upper limb muscle strength was tested using the Digital Manual Muscle Tester while AROM was measured using the Digital Dual Inclinometer. The clinical assessment tools for upper extremity function included the use of the Manual Function Test and the Jebsen-Taylor Hand Function Test. Results : Both groups exhibited great improvements in muscle strength and upper extremity function during the intervention period. The VRFES group exhibited a significant difference in muscle strength, AROM, and function of the upper extremities in comparison with the control group(p<.05). Our results reveal that VRFES is more effective for the muscle strength, AROM, and function of the upper extremities in patients with chronic stroke. Conclusion : VRFES treatment will be used as an important intervention for improving the muscle strength, AROM, and function of the upper extremities in patients with chronic stroke and achieving the functional recovery of the upper extremities.

• Radiation Oncology Journal
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• 제37권1호
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• pp.51-59
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• 2019

Purpose: We evaluated failure pattern and treatment outcomes of observational approach on regional lymph node (LN) in cutaneous melanoma of extremities and sought to find clinico-pathologic factors related to LN metastases. Material and Methods: We retrospectively reviewed 73 patients with cutaneous melanoma of extremities between 2005 and 2016. If preoperative 18-F-fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) findings were non-specific for regional LNs, surgical resection of primary tumors with adequate margins was performed without sentinel lymph node biopsy (SLNB) and/or complete lymph node dissection (CLND), irrespective of tumor thickness or size. In patients with suspicious or positive findings on PET/CT or CT, SLNB followed by CLND or CLND was performed at the discretion of the surgeon. We defined LN dissection (LND) as SLNB and/or CLND. Results: With a median follow-up of 38 months (range, 6 to 138 months), the dominant pattern of failure was regional failure (17 of total 23 events, 74%) in the observation group (n = 56). Pathologic LN metastases were significant factor for poor regional failure-free survival (hazard ration [HR] = 3.21; 95% confidence interval [CI], 1.03-10.33; p = 0.044) and overall survival (HR = 3.62; 95% CI, 1.02-12.94; p = 0.047) in multivariate analysis. In subgroup analysis for cN0 patients according to the preoperative PET/CT findings, LND group showed the better trend of LRFFS (log rank test, p = 0.192) and RFFS (p = 0.310), although which is not statistically significant. Conclusion: Observational approach on regional LNs on the basis of the PET/CT in patients with cutaneous melanoma of extremities showed the dominant regional failure pattern compared to upfront LND approach. To reveal regional lymph node status, SLND for cN0 patients may of importance in managing cutaneous melanoma patients.

• Journal of Chest Surgery
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• 제19권1호
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• pp.58-67
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• 1986

Aggressive revascularization of the ischemic lower extremities in atherosclerotic, occlusive diseases or acute embolic arterial occlusion due to cardiac valvular disease by thromboembolectomy or an arterial bypass operation has been advocated by some authors. We have performed 68 first time vascular operations, including thromboembolectomies on RR patients with ischemic lower extremities, within an 11-year-and-6-month period, from January 1974 to June 1984. We have reviewed and analyzed our vascular operative procedures and post operative results. The patients upon whom thromboembolectomies were performed were 42 males and 13 females ranging from 5 to 72 years of age. The major arterial occlusive sites were common iliac artery in 20 cases, femoral artery in 21 cases, popliteal artery in 8 cases, common iliac artery and femoral artery in 4 cases, and femoral artery and popliteal artery in 3 cases. The underlying causes of arterial occlusive disease were atherosclerosis obliterans in 34 cases; Buerger`s disease in 3 cases; emboli due to cardiac valvular disease in 13 cases; and vascular trauma in 4 cases, including cardiac catheterization in I of those cases. Arterial bypass operations with autogenous or artificial vascular prosthesis were done in 31 cases. Amputations were done on 2 patients carrying out any more vascular operative procedures would have been of no benefit to them. Our bypass operations for ischemic lower extremities were classified as follows: those done between the abdominal aorta and the femoral artery in 17 cases, including those done between the aorta and the bifemoral arteries with a Y graft in four of those cases and long ones done from the axillary to the femoral artery in 4 cases. Five patients died in the hospital following vascular surgery for ischemic lower extremities, the causes of death were not directly related to the vascular reconstructive operative procedures. The leading causes of death were respiratory failure due to metastatic lung carcinoma: renal failure due to complications from atherosclerosis obliterans; sepsis from open, contaminated fractures of the tibia and fibula; and myocardial failures due to open heart surgery in one case and reconstructive surgery of the ascending aorta in another.

• Journal of Korean Neurosurgical Society
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• 제60권4호
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• pp.475-480
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• 2017

Objective : The main aim of the present study is to examine the electrode configurations used to record the muscle motor evoked potential (mMEP) in the upper extremities during surgery with the goal of producing a high and stable mMEP signal, in particular among the abductor pollicis brevis (APB), abductor digiti minimi (ADM), and across the APB-ADM muscles, which have been widely used for the mMEP in the upper extremities. Methods : Thirty right-handed patients were recruited in this prospective study. No patients showed any adverse events in their mMEP signals of the upper extremities during surgery. The mMEPs were recorded independently from the signals for the APB and ADM and for those across the APB-ADM. Results : The mMEP amplitude from across the APB-ADM was statistically higher than those recorded from the APB and ADM muscles. Moreover, the coefficient of variation of the mMEP amplitude from across the APB-ADM was smaller than those of mMEP amplitude recorded from the APB and ADM muscles. Conclusion : The mMEP from across the APB-ADM muscles showed a high yield with high stability compared to those in each case from the APB and ADM muscles. The configuration across the APB-ADM muscles would be best for mMEP recordings from the upper extremities for intraoperative neurophysiological monitoring purposes.

• PNF and Movement
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• 제18권1호
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• pp.77-86
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• 2020

Purpose: This study investigated the effects of progressive resistance task-oriented strengthening exercises (PRTSE) on the strength of the lower extremities, balance, and activities of daily living (ADL) of patients following a stroke. The purpose of the study was to provide fundamental data regarding the use of PRTSE with stroke patients. Methods: Twenty stroke patients were randomly divided into an experimental group (n = 10) who took part in PRTSE and a control group (n = 10) who performed general rehabilitation exercises. Both groups performed their respective exercises for 30 minutes five times a week for four weeks. The strength of their lower extremities was measured using a hand-held dynamometer. The balance of the participants was assessed using a Berg balance scale. The modified Barthel index was conducted to measure ADL. A paired t-test was performed to compare within-group changes before and after the PRTSE. Differences between the experimental and the control groups were analyzed using an independent t-test. For all tests, the level of statistical significance was α = 0.05. Results: After the exercises, there was a significant within-group change in the strength of lower extremities, balance, and ADL in the experimental group and the control group (p < 0.05). There was also a significant between-group difference in the strength of lower extremities after the intervention (p < 0.05). Conclusion: General rehabilitation is commonly applied as a treatment for stroke patients and is relatively effective. The application of PRTSE may be useful in such patients, considering its effects on the strength of lower extremities, balance, and ADL.

• PNF and Movement
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• 제13권3호
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• pp.127-134
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• 2015

Purpose: The current study seeks to examine the effect of coordinative pattern exercises of the upper and lower extremities using harnesses and walking rails on the walking and balance abilities of chronic stroke patients, and to develop effective programs and training methods to improve the functions of such patients. Methods: Subjects included 16 patients with hemiplegia caused by stroke. The subjects were randomly divided into an experimental group (n=8), on which coordinative pattern exercises of the upper and lower extremities were conducted, and a comparison group (n=8) that received typical exercise therapy. The experimental group underwent 30 minutes of typical exercise therapy and 30 minutes of coordinative pattern exercises of the upper and lower extremities, while the comparison group underwent typical exercise therapy for 30 minutes twice a day, five days per week for a six-week period. To evaluate walking ability, 10-m walking tests (10MWT) and 6-m walking tests (6MWT) were conducted. To assess balance ability, timed up and go tests (TUG) were performed. Results: After the intervention, significant (p<0.05) differences were seen in the 10MWT, 6MWT, and TUG in both the experimental and comparison groups. As for the 10MWT, the experimental group showed more significant improvement than the comparison group (p<0.05). In terms of the 6MWT, no significant differences were found between the groups, while the experimental group showed more significant differences than the comparison group in the TUG (p<0.05). Conclusion: The results from the current research indicate that training programs that apply coordinative pattern exercises of the upper and lower extremities with harnesses are extremely effective for improving the walking and balance abilities of chronic stroke patients.

• 대한물리치료과학회지
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• 제30권3호
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• pp.1-13
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• 2023

Background: The bridge exercise prevents repeated damage to the tissues around the spine by reducing stimulus transmission to the ligaments and joint capsules, thereby alleviating back pain. It also contributes to strengthening the muscles of the lower extremities. Design: A Single Subject experience design. Methods: This study was conducted on 28 healthy adults in their 20s to 30s and conducted at St. Mary's Hospital in C City from May to July 2021. Four types of bridge exercise were performed in this study: the normal bridge exercise and bridge exercises with 0.5%, 1%, or 1.5% body weight resistance applied on the pelvis through manual resistance during the bridge exercise and to determine the effect of resistance applied in the bridge exercise on the activation of the trunk and lower extremities muscles. Results:This study showed that the muscle activity of the trunk and lower extremities improved significantly in response to stronger resistance when manual resistance equivalent to 0.5%, 1%, or 1.5% of body weight was applied during the bridge exercise compared to when the normal bridge exercise was performed. Conclusion: This study shows that manual resistance can be applied as an effective method of bridge exercise since muscle activity in the trunk and lower extremities increases when manual resistance causing isometric contraction is applied.

• Journal of Chest Surgery
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• 제9권1호
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• pp.50-54
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• 1976

Erythermalgia has typical triad of burning pain, redness and localized elevation of body temperature at the involved extremities and according to the etiolgy it can be divided as primary (unknown) and secondary erythermalgia. One case of typical primary erythermalgia involving both lower extremities in 20 year old male patient was reported with dramatic symptomatic improvement for 4 months after bilateral lumbar sympathectomy. And there was another case of primary erythermalgia involving both upper and lower extremities in 12 year old girl, and all the symptoms and signs were disappeared about one week later with combined bilateral thoracic and lumbar sympathectomy. It is considered the first case of primary erythermalgia treated completely with sympathectomy in Korea.

• 한국전문물리치료학회지
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• 제22권2호
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• pp.59-69
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• 2015

The purpose of this study was to identify the effects of an upper extremities group exercise program based on motor learning in chronic stroke patients and to assess improvements in upper sensory motor function and activities of daily living (ADL). Five chronic stroke patients participated for the duration of 25 weeks. On the assessment of motor and process skills, there was a statistically significant improvement in motor area functioning in 4 of the subjects. In process area functioning, there was a statistically significant change in 3 of the subjects. Therefore, further studies are needed to assess sensorimotor area and ADL changes in chronic stroke patients to reduce medical cost and assess for positive psychological changes.