Connective tissue massage(CTM, Bindegewebs massage) are developed and named by Mrs. Elizabeth Dicke, a German physical therapist. The CTM is used primarily for internal disorder such as myocarditis, coronary insufficiency, high blood pressure, functional stomach and intestinal disorders, inflamma-tion of the gallbladder, and hepatitis, arterial circulatory problems, venous disorders, headache, particularly trauma to the head, and some gynecologic disorder, etc. Which is performed with special stroking technique of the subcutaneous tissue of the trunk, extremities, and face. The mechanism of effectiveness of CTM is based on a viscerocutaneous reflex. The stroking stimulates the nerve end-ings of the autonomic nervous system. The impulses activated by stroking travel to the sympathetic trunk and the spinal cord and brain, which causes a change in reaction susceptibility. The most important for apply CTM is necessary to know the reflex zone (Head's zone, Mackenzie's zone and Dicke's connective tissue zone). Dicke's connective tissue zones are only found by the special dia-gnostic stroking. Because the connective tissue zones no discomfort when unmanipulated, and thus the patient is unaware of them. It is characterized by diagnostic stroking that causes a sharp pain in the tissue. As a general rule, all treatment are preceded by the basic stroke from the level of the coccyx to the first lumbar vertebra and each stroke is done three times. The right side is done first, then the left side.
In oriental medicine Acupuncture treatment is one of the most valuable therapy. Through the acupuncture humen have been healed many diseaes with his own natural therapic power, without medicine or surgery ect. But there have not formed a clear definition on the supplement & eradication(補瀉). I recognised the difference between the original meaning of Young-su(迎隨) mentioned in $\ll$Whang-Je-Nae-Kyung(黃帝內經)$\gg$ and Young-su-Bo-Sa(迎隨補瀉) that are recently used. The results were summerized as follow; 1. In the $\ll$Whang-Je-Nae-Gyung$\gg$, when they give medical teatment, they have totally used all methods of the supplement & eradication(補瀉). Therefore as now divided into respiration, speed, rotation and close-open supplement & eradication(補瀉) have many problomes. And Young-su(迎隨) did not mean the treatement of supplement and eradication which go with or against the flowing of channel energy(經氣). Young-su(迎隨) is not a simple technique of treatment, but is the totall principle of the supplement and eradication. 2. The direction of channel energy(經氣) connected with the O-su point (五輸穴) is from extremities to the trunk of body, therefore the direction of supplement is to the trunk of body and the direction of eradication is to extermities. 3. In the case of using the treatment which go with or against the flowing of channel energy(經氣), in oder to avoid the confusion of term, it must be defined another term. 4. It is necessary that we must define the procedure of supplement & eradication, and the objective indication that ascertain whether the doctor's purposes are really obtained.
Objective: There are many types of exercises with upper and lower-limb action for activation of abdominal muscles for trunk stabilization. A comparison of the different exercise methods been very useful to enhance the result from the exercise for treatment. The purpose of this study was to investigate through surface electromyography (EMG) the changes in abdominal muscle activity during the performance of three different dead-bug exercise methods performed at three different speeds. Design: Cross-sectional study. Methods: The subjects were 30 healthy adults (13 males and 17 females). We instructed the subjects to perform three different dead-bug exercises. We also applied three different speeds to the dead-bug exercises; 60 bpm, 90 bpm, and 120 bpm with use of a metronome. The assessment of EMG was percentage of maximal voluntary isometric contraction on the rectus abdominis (RA), external oblique (EO), and internal oblique (IO). Results: EMG activation of the RA, EO and IO muscles was significantly greater at the higher speed (p<0.05). There was a significant increase in abdominal muscle activity during the dead-bug exercise performed with both the upper and lower extremities compared to that with only the upper extremity or the lower extremities (p<0.05). Conclusions: These findings demonstrate that the performance of the dead-bug exercise with both the upper and lower extremities combined at a high speed is more effective compared to other exercises. Therefore, it is suggested that more favourable and effective outcomes may occur when the type and speed of the exercise is chosen appropriately.
Park, Sun Kyung;Sung, Min Ha;Suh, Hae Jin;Choi, Yun Suk
The Korean Journal of Pain
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제29권1호
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pp.18-22
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2016
Background: The interscalene brachial plexus block is widely used for pain control and anesthetic purposes during shoulder arthroscopic surgeries and surgeries of the upper extremities. However, it is known that interscalene brachial plexus block is not appropriate for upper limb surgeries because it does not affect the lower trunk (C8-T1, ulnar nerve) of the brachial plexus. Methods: A low approach, ultrasound-guided interscalene brachial plexus block (LISB) was performed on twenty-eight patients undergoing surgery of the upper extremities. The patients were assessed five minutes and fifteen minutes after the block for the degree of block in each nerve and muscle as well as for any complications. Results: At five minutes and fifteen minutes after the performance of the block, the degree of the block in the ulnar nerve was found to be $2.8{\pm}2.6$ and $1.1{\pm}1.8$, respectively, based on a ten-point scale. Motor block occurred in the median nerve after fifteen minutes in 26 of the 28 patients (92.8%), and in all of the other three nerves in all 28 patients. None of the patients received additional analgesics, and none experienced complications. Conclusions: The present study confirmed the achievement of an appropriate sensory and motor block in the upper extremities, including the ulnar nerve, fifteen minutes after LISB, with no complications.
Neurilemmomas are the most common benign tumor of the peripheral nerve trunks, and arises from the cells in the sheath of Schwann. Neurilemmomas are well encapsulated and may be separated easily from surrounding tissue and lie completely within a larger nerve trunk, with bundles of neurofibrils spread out over the surface of the tumor. A careful dissection and retraction of the nerve bundles will allow the tumor to be enucleated from the parent nerve without any significant interference with the function of the nerve. Resection of the involved nerve is seldom necessary and should be avoided if at all possible. Our aim in microscopic excision of neurilemmoma of extremities is to reduce any disturbance of the intact neurofibrils of the parent nerve. Thirteen cases of neurilimmomas were treated by microscopic excision at the Department of Orthopaedic Surgery, Korea University Hospital between January 1990 and March 1995. The results was as follows ; 1. The average age at surgical intervention was 40.1 years. Cases in fourth and fifth decades predominated. 2. In their anatomical distribution, 8 cases were in the upper extremity and 5 cases in the lower extremity. 11 cases were on the flexor surface. 3. On the operative field, all the tumors were well encapsulated, however 1 case of 13 was adherent to the periosteum of fibula. 4. In all cases, the tumor were enucleated from the parent nerve without any injury to nerve under high-power magnification, preserving individual fascicles, and sensory and motor function.
PURPOSE: The purpose of this study was to compare the lower extremities muscle activation between squatting exercise with gym ball and wall for improving muscle strengthening in lower extremities. METHODS: Participants were 21 university students (males 10, females 11) who didn't have any problem with orthopedic surgery. Participants performed squatting exercise with gym ball and wall. Squatting exercise with gym ball were performed using by gym ball behind back, and the gym ball were fixed in back and wall. We asked participants to push back the gym ball slightly to prevent fall of ball. Wall squatting exercise, we ask participants to contact their back in wall slightly in order to prevent trunk flexion during performed squatting exercise. Each squatting exercise had performed until knee joint were flexed at 60 degree, and maintained five seconds. We collected data from E.M.G of Biceps femoris, Gastrocnemius, Vastus medialis and lateralis, Tibialis anterior of lower extremity in isometric phase of knee joint angle 60 degree of each squatting exercise. We analysed data using by ANOVA and independent t-test of SPSS PC ver.20.0 in order to compare the muscle activation between squatting exercise with gym ball and wall. RESULT: All of lower extremities muscle activation showed more higher value in squatting exercise with gym ball than squatting exercise with wall, especially there was significantly difference of muscle activation in vastus medialis, tibialis anterior between squatting exercise with gymball and with wall. CONCLUSION: On comprehensively considering the results of the present study, we suggested that squatting exercise with gym ball was more effective method improving lower extremity muscle strengthening.
Few studies address the use of manual muscle stretching to improve spinal active range of motion(AROM). There is evidence that' Hold-Relax'(HR) is effective for increasing ROM in the extremities, which leads the researchers to anticipate similar benefits in the spine. The purpose of this study is to investigate the effects of HR(trunk flexors) and active thoracic flexion and extension on thoracic mobility, specifically flexion and extension in healthy individuals. A convenience sample of 30 physical therapy students(22-38 years) were randomly assigned to intervention sequence 'A-B' or 'B-A', with at least 7 days between interventions. Intervention' A' consisted of HR of the ventral trunk musculature while 'B' consisted of thoracic flexion-extension AROM. Thoracic flexion and extension AROM were measured before and after each intervention using the double inclinometer method. Paired t-tests were used to compare AROM pre and post-intervention for both groups, and to test for carry-over and learning effects. There was a statistically significant increase(mean=$3^{\circ}$ ; p=0.006) in thoracic extension following HR of the trunk flexors. There were no significant changes in thoracic flexion following HR, or in flexion or extension following the AROM intervention. No carryover or learning effects were identified. HR may be an effective tool for improving AROM in the thoracic spine in pain free individuals. Further investigation is warranted with symptomatic populations and to define the minimal clinical difference(MCD) for thoracic spine mobility.
Purpose: This study aimed to verify the effect of integrated patterns (IPs) of PNF on individuals with malalignment using upper extremity and lower extremity patterns simultaneously. This information was then compared to the effect of bowling exercises on malalignment. The study population included individuals in their twenties with malalignment in their posture. Methods: Individuals with malalignment (40 participants in total) were divided into 2 groups based on trunk inclination and side deviation. In one group, IPs of PNF were used as interventions, while the other group used bowling exercises. This process was completed over the course of four weeks. The IP group used two patterns simultaneously: flexion-adduction-external rotation and extension-abduction-internal rotation. These patterns were used in the upper and lower extremities and were crossed diagonally. Results: The trunk inclination decreased in the IP and the bowling group. In the IP group, the degree of inclination decreased from 0.94 to 0.33. The side deviation also decreased to 1.53 (p < 0.05). In the bowling group, the two measured values decreased significantly (p < 0.05). Conclusion: Compared to the bowling exercises used in the bowling group, the results of this study indicate that the use of IPs had a significant effect on trunk inclination and side deviation for malalignment posture patients. Individuals can easily improve malalignment using IPs of PNF (for example, at home or at their office), which suggests that they are not required to seek assistance from a fitness or bowling center, which may save them time.
The regain of independent ambulatory ability is a important goal in the rehabilitation program of hemiplegic patient. Not only the function of lower extremity muscles, but also trunk muscles which stabilize extremities and pelvis, are important factors in normal gait. Therefor, it is necessary to develop an effective program which can improve muscle strength and symmetric activity of trunk muscles. The purpose of this study was to evaluate the influence of trunk muscle strengthening by forceful respiratory exercise on the gait asymmetry ratio in hemiplegic patient. 45 Hemiplegic patients due to stroke was randomized in 3 groups, forceful expiratory training(FET), forceful inspiratory training(FIT) and control group. In the experimental groups, ordinary physical therapy with forceful expiratory training and forceful inspiratory training for 20 minutes duration 3 times per week for 6 weeks were respectively performed. In the control group, only ordinary physical therapy was done. Before and after experiments, temporal-spatial gait parameters was measured in all patients. The data of 28 patients who carried out the whole experimental course were statistically analysed. The results of these experiment are as follows : 1. In comparison of difference of single support time asymmetry ratio among 3 groups, the FET group was significantly decreased than the control group (p<.05). 2. In comparison of difference of step length asymmetry ratio among 3 groups, the FIT group was significantly decreased than the control group (p<.05). Based on these results, it is concluded that the forced respiratory exercise program for 6 weeks can be improve the gait asymmetry ratio in hemiplegic patients. Therefore, the forced respiratory exercise is useful to improve the walking ability in hemiplegic patients. Since this study dealt only with the patients who could walk more than 3 meters in distance on floor independently, the further study for evaluating the influence of the forceful respiratory exercise on patients with acute stage stroke and also the development in various methods of use are expected.
Everett B. Lohman;Mansoor Alameri;Fulden Cakir;Chih Chieh Chia;Maxine Shih;Owee Mulay;Kezia Marceline;Simran Jaisinghani;Gurinder Bains;Michael DeLeon;Noha Daher
Physical Therapy Rehabilitation Science
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제13권1호
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pp.53-70
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2024
Background: The conventional deadlift is a popular exercise for enhancing trunk, core, and lower extremity strength. However, its use in sports medicine is constrained by concerns of lumbar injuries, despite evidence supporting its safety and rehabilitative benefits. To optimize muscle activation using resistive bands in variable resistance therapy, we explored their feasibility in the deadlift. Design: Comparative experimental design Methods: Surface electromyography recorded muscle activity in the trunk and lower extremities during lifting, with normalization to the isometric Floor Lift using Maximal Voluntary Contraction. Kinematics were measured using inclinometer sensors to track hip and trunk sagittal plane angles. To prevent fatigue, each subject only used one of the three pairs of bands employed in the study. Results: Our study involved 45 healthy subjects (mean age: 30.4 ± 6.3 years) with similar baseline characteristics, except for years of lifting and strength-to-years-of-lifting ratio. Various resistance band groups exhibited significantly higher muscle activity than conventional deadlifts during different phases. The minimal resistance band group had notably higher muscle activity in the trunk, core, and lower extremity muscles, particularly in the end phase. The moderate resistance band group showed increased muscle activity in the mid-and end-phases. The maximum resistance band group demonstrated greater muscle activity in specific muscles during the early phase and overall higher activity in all trunk and lower extremity muscles in the mid and end phases of the deadlift (p<0.05). Conclusion: Our findings provide valuable insights into muscle activation with various resistance bands during deadlift exercise in clinical and gym settings. There appears to be a dose-response relationship between increased resistance bandwidth, external load, myoelectric activation, and range.
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