• Archives of Plastic Surgery
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• v.37 no.5
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• pp.650-658
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• 2010

Purpose: In the case of repair for far distal parts of FDP (Flexor digitorum profundus) division, the method of either pull-out suture or fixation of tendon to the distal phalanx is preferred. In this paper, the results of a modified loop suture technique used for the complete division of FDP from both zone 1a and distal parts of zone 1b in Moiemen classification are presented. Methods: From July 2006 to July 2009, the modified loop suture technique was used for the 10 cases of FDP in complete division from zone 1a and distal parts of zone 1b, especially where insertion sites were less than 1 cm apart from a tendon of a stump. In a suture technique, a loop is applied to each distal and proximal parts of tendon respectively. Core suture of 2-strand and epitendinous suture are done with PDS 4-0. Out of 10 patients, the study was done on 6 patients who were available for the followup. The average age of the patients was 49.1 years (in the range from 26 to 67). 5 males and 1 female patients were involved in this study. There were 3 cases with zone 1a and distal parts of zone 1b. The average distance to the distal tendon end was 0.6 cm. There were 5 cases underwent microsurgical repair where both artery and nerve divided. One case of only tendon displacement was presented. The dorsal protective splint was kept for 5 weeks on average. The results of the following tests were measured: active & passive range of motion, grip strength test, key pinch and pulp pinch test. Results: The follow-up period on average was 11 months, in the range from 2 to 20 months. There was no case of re-rupture, but tenolysis was performed in 1 cases. In all 6 cases, the average active range of motion of distal interphalangeal joint was 50.8 degree. The grip strength (ipsilateral/contralateral) was measured as 88.7% and the pulp pinch test was 79.2% as those of contralateral side. Flexion contracture was presented in 2 cases (15 degree on average) and there was no quadrigia effect found. Conclusion: Despite short length of tendon from the insertion site in FDS rupture in zone 1a and distal parts of zone 1b, sufficient functional recovery could be expected with the tendon to tendon repair using the modified loop suture technique.

• Clinics in Shoulder and Elbow
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• v.6 no.2
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• pp.143-148
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• 2003

Objectives: To analyze the postoperative functional outcome of shoulder in patients with arthroscopically assisted repair of large to massive rotator cuff tears with or without acromioplasty and role of acromioplasty. Materials and Methods: From June 1996 to June 2002, twenty six patients with large to massive rotator cuff tears were undergone arthroscopically assisted repair. Mean follow up was over one year. Fourteen were male and twelve were female. Mean age was 51 years old(39-66). Mean duration was 9 months. Acromioplasty was done in 14 cases concomitantly. They were divided into two groups. Group I: arthroscopic cuff repair with acromioplasty(14 cases). Group II: arthroscopic cuff repair without acromioplasty(12 cases). Each shoulder was evaluated at preoperative and final follow-up with Visual Analogue Scale(VAS), University of Pennsylvania Patient self-assessment of pain, University of Pennsylvania Patient self-assessment of function, ASES standardized shoulder assessment form, Simple Shoulder Test, UCLA score and range of motion(ROM). We analyzed the differences between the two groups. Shoulder ROM and acromioplasty were determining factors. Statistics was tested by correlation analysis and repeated measure ANOVA test. Results: At the final follow up, functional outcome and pain were improved but they had no statistical significance between the two groups(p>0.05). Combined procedure, acromioplasty, didn't affect on VAS. UCLA score, University of Pennsylvania Patient self-assessment of pain, University of Pennsylvania Patient self-assessment of function, ASf:S standardized shoulder assessment form and Simple Shoulder Test(p>0.05). In group II, forward flexion and abduction were statistically improved at the final follow up than in group I(p<0.05). Conclusions: It appears that arthroscopic repair is satisfactory procedure in patients with large to massive cuff tears. Combined procedure, acromioplasty, doesn't affect on postoperative functional outcome of shoulder.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.14 no.1
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• pp.48-60
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• 2008

Purpose : The purpose of this study was to compare the effects of Joing Mobilization and Group back Pain Exercise Program on the disability level and the pain of flexibility and the back muscle strength in the hearing impairment patients with Low back pain. Methods : The subjects of this study were 12 patients, 8 males and females. They visited clinic for physical treatment within 6 months after onset of low back pain. One group was applied with Joing Mobilization and other group was with Group back Pain Exercise Program. The patient were treated special program 3 times session weekly. And treatment 2 times session was 15min with physiotherapy weekly. The muscle strength was measured by Cybex 660, the level of disability by Oswestry low back pain disability scale, the intensity of pain by visual analogue scale (VAS). The data was analysed by paired T-test and independent T-test. Results : The results of this study were summarized as follow : 1. The Oswestry disability score of experimental and control group were significantly decreased and there was no difference in the Oswestry disability score change between joint mobilization group and back pain exercise group. 2. The pains in anterior, postrior, lift lateral and right lateral bending and in rotation of back pain exercise group were significantly increased compared with those of joint mobilization group. 3. The flexors and extensors peak torque of back pain exercise group were significantly increased at test velocities $30^{\circ}$/sec, $60^{\circ}$/sec compared with those of the joint mobilization group. There was no significant difference in extensors and flexors peak torque at $30^{\circ}$/sec, $60^{\circ}$/sec between two group. The results showed that the back pain exercise group were effective in decreasing disability score and pain of trunk activity, increasing trunk extension and flexion peak torque. Conclusion : It is suggested theat the back pain exercise program could be an essential factor for the effective intervension to the hearing impairment patients suffere from low back pain.

• Physical Therapy Korea
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• v.20 no.2
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• pp.20-27
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• 2013

The purpose of this study was to compare the slouched and upright sitting positions on lumbar joint reposition error (LJRE). Twenty subjects without low back pain were recruited for this study and, using a random number table, were randomly assigned to two groups; the upright sitting position group (UP group) and the slouched sitting position group (SP group). UP group was first asked to sit in an upright position and the SP group to sit in a slouched position as an intervention, and then the LJRE of both groups was measured at the neutral sitting position (lumbar flexion $0^{\circ}$). The measurement of the LJRE was repeated after one day. The sitting positions were performed for five minutes each and the LJRE was measured using an electronic goniometer. An independent t-test was used to compare the LJRE of both groups after each sitting position and after one day. The results of this study showed that the LJRE after an intervention in the UP group was lower than in the SP group (p<.05) and the LJRE after one day in the UP group was lower than in the SP group (p<.05). The findings of this study indicate that the upright sitting position can be applied to decrease LJRE, compared with the slouched sitting position. These findings also support that the upright sitting position reduces the potential for proprioceptive loss.

• Korean Journal of Applied Biomechanics
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• v.27 no.3
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• pp.157-164
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• 2017

Objective: The purpose of this study was to investigate kinematic differences in back pike somersault in platform diving according to skill level and to apply the findings to improve performance. Method: Korean divers participating in this study were divided into a skilled group (age: $21.6{\pm}4.16y$, height: $1.68{\pm}0.03m$, weight: $62.0{\pm}3.94kg$, career: $12.6{\pm}5.13y$) and a less-skilled group (age: $20.6{\pm}2.7y$, height: $1.72{\pm}0.05m$, weight: $64.8{\pm}6.76kg$, career: $12.2{\pm}2.49y$) and an independent t-test was performed to analyze differences between groups at the moment of takeoff. Results: The two groups showed significant differences in displacement and velocity of center of mass (COM), takeoff angle, hip joint angle, knee joint angular velocity, and hip joint angular velocity at the takeoff (p<.05), and significant differences in displacement of COM, hip joint, and ankle joint during flight (p<.05). Conclusion: For a successful back pike, the COM should rise quickly in the vertical direction and the hip joint angle and angular velocity should increase. To improve performance, the back pike turn should be practiced on the ground before an attempt on a 10-m platform, to stretch the ankle and knee joints and enable quick flexion of the hip joint when turning in flight.

• Journal of Korean Neurosurgical Society
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• v.41 no.2
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• pp.77-81
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• 2007

Objective : In a variety of thoracolumbar diseases, corpectomy followed by interbody bone graft and anterior instrumentation has allowed direct neural decompression and reconstruction of the weight-bearing column by short segments fusion. In this study, we compared spinal stability of the two different anterior thoracolumbar instruments : Z-plate and Kaneda device representing plate and two-rods type, respectively. Methods : A retrospective review was performed for all the patients with thoracolumbar diseases or traumas treated with anterior corpectomy, autologous iliac bone graft, and fixation with instruments from 1996 to 2000. For the anterior instrumentation, Z-plate or Kaneda device was used for 24 [M:F=5:9, average age=37] and 12 [M:F=9:3, average age=41] patients, respectively. The plain AP and lateral flexion-extension films were taken immediately after surgery and at each follow-up. The sagittal and coronal Cobb's angles at the operation segments were used to observe the change of initial fixation status. The surgical time length and bleeding amount of the two groups were compared. Intra-operative and post-operative instrument associated complications were evaluated. Student t-test was used for statistical analysis and p-value less than 0.05 was considered to be significant. Results : Mean follow-up durations for Z-plate and Kaneda device were 24 and 21 months, respectively. The fusion rate was 91% for Z-plate and 100% for Kaneda device. Two cases of Z-plate group showed instrumentation failure during the follow up period, in which additional surgery was necessary. The mean differences of sagittal Cobb's angles among the AP images immediate after surgery and at follow-up were 7 and 2 degrees for Z-plate and Kaneda device, respectively [p<0.05]. The mean differences of coronal Cobb's angles were 5 and 2 degrees for Z-plate and Kaneda device, respectively [p<0.05]. No Intra-operative complication has occurred in both groups. There was no difference in surgery time and bleeding amount between two groups. Conclusion : We think that Kaneda device [rod type] is stronger than Z-plate [plate type] to keep the spinal stability after anterior thoracolumbar surgery.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.13 no.2
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• pp.55-68
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• 2007

Object: to evaluate the effects of two different treatments-joint mobilization and therapeutic exercise on difference for length of lower limbs. Method: The subjects were participated twenty six who has difference for length of lower limbs more 10mm. All subjects randomly assigned to Joint mobilization group(n=13) and therapeutic exercise group. Joint mobilization group received joint mobilization for 2 minutes, Therapeutic exercise group received for 15 minutes per day and 3 times a week during 4 week period. Tape measure method was used to measure the difference for length of lower limbs. Biodex was used to measure the muscle power of lower limbs(Knee flexion, extension). Finger to floor test was used to measure the mobility of spinal column. All measurement of each subjects were measured at pre-experiment, after 2weeks and post-experiment. Result: The result of this study were summarized as follows : 1. Both treatment decreased difference for length of lower limbs while joint mobilization more decreased difference for length of lower limbs than therapeutic exercise. 2. Both treatment increased mobility of spinal column while joint mobilization more increased mobility of spinal column than therapeutic exercise. 3. Joint mobilization increased muscle power while therapeutic exercise decreased muscle power. Conclusion: in a group-wise comparison joint mobilization is more effective than therapeutic exercise.

• Archives of Reconstructive Microsurgery
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• v.10 no.2
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• pp.111-117
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• 2001

Introduction : The Functional muscle transfer is used to reconstruct the injuried muscle and paralysis of the shoulder. Especially transfer of the trapezius has been the treatment of choice but it has disadvantages of inadequate function and deformed contour, and instability of humeral head in case of acromion resection. We report an operation for shoulder reconstruction after wide resection of malignant fibrous histiocytoma, using rotational latissimus dorsi flap and review the operation method and clinical outcome. Materials and Methods : A patient, 53 year old, with malignant fibrous histiocytoma in the acromioclavicular joint area had been underwent wide excision, including the deltoid, clavicular head of pectoralis major, part of trapezius, lateral 1/3 of clavicle and acromion including scapular spine. The rotational latissimus dorsi flap with its neurovascular pedicle was dissected and then placed over the resected area and transfer of muscle attached at coracoid process was done to achieve stability of the humeral head. The range of motion of the shoulder and test of muscle power were evaluated for functional outcome. Total follow-up period is 2 years 11 months. Results : At last follow-up, the range of motion of the shoulder is abduction $90^{\circ}$, flexion $90^{\circ}$, internal rotation $40^{\circ}$, external rotation $50^{\circ}$ and the muscle power is 4 grade in all direction and then we obtained good functional results. There are no complications such as instability or subluxation of the humeral head and deformed contour and he is a disease-free survival state. Conclusions : The transfered latissimus dorsi flap provides adequate lever arm and stabilization and covering of the humeral head by sufficient muscle volume and width. This procedure can be useful not only for the paralysed deltoid reconstruction but also for use in reconstructive surgery after wide resection of the shoulder for malignant tumor.

• The Journal of Korean Physical Therapy
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• v.22 no.5
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• pp.57-61
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• 2010

Purpose: The purpose of this study was to identify the effect of active foot arch support on the muscles of lower extremity electromyographic activity during squat exercise in persons with pronated foot. Methods: The study subjects were 16 persons with pronated foot. They have no history of surgery in lower extremity and trunk and limitation of range of motion or pain when performing squat exercise. Each subject was measured the navicular drop (ND) to determine the pronated foot. And then the subjects were asked to perform three repetitions of a $90^{\circ}$ knee flexion squat in both conditions which are 1) preferred squat and 2) squat with active foot arch support. Results: Paired t-test revealed that squat with active foot arch support produced significantly greater EMG activities in abductor hallucis (p=0.00), proneus longus (p=0.03) and gluteus medius (p=0.04) than preferred squat. But the EMG activities of tibialis anterior, vastus medialis oblique and vastus lateralis were not showed significantly different between the both squat conditions. Conclusion: The findings of this study suggest that active foot arch support during squat increase the activities of lower extremity muscles which are the abductor hallucis, proneus longus and gluteus medius. Also, the abductor hallucis which is one of the planter intrinsic muscle and peroneus longus play a role in support of the foot arch and active foot arch support induced the increase of the activity of gluteus medius. Therefore active foot arch support can change the lower extremity biomechanics as well as passive foot support such as foot orthotics and taping.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.4
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• pp.647-653
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• 2013

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.