• Physical Therapy Rehabilitation Science
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• 제7권1호
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• pp.41-47
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• 2018

Objective: To investigate the effect of performing three different toe touch (TT) task condition on the activities of four different muscles using surface electromyography (sEMG) in healthy young adults. Design: Cross-sectional study. Methods: A total of 20 healthy young adults (6 males, 14 females) voluntarily participated in this study. All subject randomly performed three different TT task conditions as follows: general toe-touch (GTT) task, one side toe touch (TT) task during weight bearing, and one side foward toe touch (FTT) task during weight bearing. The muscle activities of erector spinae (ES), gluteus maximus (GM), hamstring (HAM), tibialis anterior (TA) muscles during the TT task were measured using sEMG. Subject performed each of the three conditions three time in random order and mean values were obtained. Results: With the trunk flexion period, the TT and FTT showed significantly greater muscle activity in the GM, HAM and TA compared to the GTT task (p<0.05). The TT position showed significantly greater HAM muscle activity than the GTT position. The dominant and nondominant ES muscle activity was significantly greater in the FTT compared to the GTT position (p<0.05). The dominant GM, HAM, and TA was significantly greater in the TT and FTT compared to the GTT position (p<0.05). Although the dominant ES was significantly greater in the TT and FTT compared to the GTT position (p<0.05), the dominant GM muscle activity was signifcantly greater in the TT compared with the GTT position (p<0.05). Conclusions: These findings may be applicable within the clinical field for selective trunk and lower extremity muscle activation and basic biomechanics purpose.

• 한국전문물리치료학회지
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• 제14권3호
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• pp.23-31
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• 2007

The purpose of this study was to determine the influence of high-heeled shoes on walking of obese women as it was already proven an extrinsic factor of knee osteoarthritis in women with normal weight. In this study the aimed therefore in particular was to utilize high-heeled shoes in proving it's causal influence on knee osteoarthritis by measuring the angle and torque of the knee joint. Fifteen obese women (BMI>25 $kg/m^2$) were measured in their twenties. Each angle and torque of their knee joints during walking on 6.5 cm high-heeled shoes and with a bare feet, were compared with each other and analyzed with a 3D motion analysis system. There was no significant difference in walking speed, cadence and stride length between the two conditions. However, there was a significant increase in a double limb support time and the stance phase when walking on high-heeled shoes as when walking with bare feet. The peak knee flexion angle and peak knee varus torque was higher when walking on high-heeled shoes than with bare feet. On the contrary, the peak knee flexion angle in the swing phase was not statistically different. The prolongation of peak knee varus torque was also proven. There was a significant increase in peak knee varus torque in the initial and last stance phases during walking on high-heeled shoes as compared to walking on bare feet. Through the above results, it was proven that when obese women walked on high-heeled shoes, rather than with bare feet, peak knee flexor and varus torque increased along with the changes of the in knee joint angle. Therefore, the influence of high-heeled shoes might be a significant intrinsic factor in knee osteoarthritis of obese women.

• 한국운동역학회지
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• 제23권2호
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• pp.109-116
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• 2013

The purpose of this study was to provide fundamental information for the enhancement of performance through kinematic analysis of cornering according to the radius of curve course in short track speed skating. To perform this study, six skaters: three narrow radius players(N, body mass: $56.0{\pm}7.2$ kg, height: $163.7{\pm}5.1$ cm, age: $21.3{\pm}1.5$ yrs) and three wide radius players(W, body mass: $61.0{\pm}9.5$ kg, height: $169.0{\pm}4.4$ cm, age: $20.0{\pm}1.7$ yrs). Three-dimensional motion analysis was performed on the section from the forth block starting to show the change of radius to the sixth block using eight infrared cameras(sampling frequency of 100 Hz for N and W players). The time of push-off was greater for N than for W(p<.05) while the radius of center of mass was greater for W than for N(p<.05). The flexion and extension of knee and hip joint were greater for N than for W(p<.05). The external rotation of left knee joint was greater for N than for W(p<.05). Based on the findings, a small radius by increasing the range of the flexion and extension of knee and hip joint with greater external rotation of left knee joint would be related to more efficient run at curve. It is expected that these results will be useful in developing a training program for enhancing performance of short track speed skating athletes.

• Journal of Korean Neurosurgical Society
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• 제29권4호
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• pp.528-535
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• 2000

Objective : To investigate objectively the postoperative improvement of gait disturbance in patients with cervical myelopathy through a gait analysis. Patients and Methods : Ten patients who underwent cervical decompression and fusion for cervical myelopathy caused by spondylosis, OPLL, or concomitant hypertrophy of ligamentum flavum were studied. Preoperatively, gait disturbance was present in all patients. The patients were evaluated by gait analysis using three dimensional motion analyzer to collect data of linear and kinematic parameters before surgery, 1 week and 3 months after surgery. Statistical analysis of the related pre-and post-operative data were performed. Results : In the linear parameters, average value of cadence, walking speed, stride length, step time, width and double support were increased postoperatively compare to preoperative value. In the kinematic parameters, average value of knee flexion during initial swing phase, plantar flexion of ankle and range of motion of hip joint were increased as well. These differences were statistically significant(p<0.05). Conclusion : This study suggests that gait analysis can be used as a method of quantitative analysis of postoperative gait improvement in patients with cervical myelopathy.

• 대한물리의학회지
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• 제14권3호
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• pp.13-20
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• 2019

PURPOSE: Sitting with crossed legs may have an effect on maintaining a healthy body posture and proper functioning of the respiratory system. Thus, this study's objective was to identify whether or not sitting with crossed legs affects the vertebral angle, chest wall mobility, the pulmonary function, and the activity of the respiratory muscles. METHODS: Thirty healthy subjects were recruited for this study (16 males and 14 females). The vertebral angle, chest wall mobility, pulmonary function, and the activity of the respiratory muscle were measured while the subjects sat in the correct posture and these factors were again measured with the subjects seated with their legs crossed. Three-dimensional motion analysis was used to determine the trunk and lumbar vertebral angles. Surface electromyography was employed to measure the sternocleidomastoid, the rectus abdominis, and the external and internal oblique abdominis muscles. A tapeline was utilized to evaluate the subjects' chest wall mobility. Spirometry was assessed to determine the forced vital capacity and forced expiratory volume in one second. Paired t-tests were then performed (p<.05). RESULTS: There were significant differences in the trunk and lumbar flexion angles, the chest wall mobility, the activity of the right external oblique muscle, and the left internal oblique abdominis muscle. However, the difference in pulmonary function did not reach statistical significance. CONCLUSION: A crossed leg posture caused slight thoracic extension and lumbar flexion, which may lead to a decrease of the chest wall mobility and also to an imbalance of the abdominal muscles. Therefore, sitting with a crossed leg posture should be avoided. Yet a crossed leg posture did not have any clinical effect on the pulmonary function of healthy people. It may be necessary to study the effects of sitting with crossed legs over an extended period of time for patients suffering with impaired respiratory function.

• 대한물리의학회지
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• 제16권2호
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• pp.115-123
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• 2021

PURPOSE: This study aimed to investigate the benefits of thoracic manipulation and the trunk stability exercises on spine trunk flexibility and the pain index of chronic low back pain patients. METHODS: The study included 44 patients suffering from chronic low back pain. The participants were divided into two groups: the first group was assigned for trunk stability exercises (TSE), and the second group was randomly assigned TSE and thoracic manipulation at the same time (TSE+TM). Both groups carried out each assigned treatment thrice a week for 8 weeks. The study outcome was based on assessment of spine trunk flexibility and the pain index. Spine trunk flexibility was measured by spine flexion and extension through a range of motion and thoracic cage circumference. The pain index was measured using a visual analog scale (VAS). RESULTS: Spine flexion and extension range of motion showed a significant difference within each group and between the groups before and after the treatment. The measurement of the thoracic cage circumference also showed a notable difference within each group and between the groups before and after the treatment. There was no change in the pain index. CONCLUSION: These results indicate that thoracic manipulation with the trunk stability exercises is an efficient treatment for improving the spine trunk flexibility and soothing pain for chronic low back pain patients.

• Clinical Pain
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• 제19권1호
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• pp.1-7
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• 2020

Objective: A prospective, assessor-blinded, randomized controlled trial was conducted in patients with chronic low back pain to evaluate the efficacy of portable low power laser therapy (LPLT) and the effect when combined with exercise therapy on pain and functions. Method: 60 patients were recruited and 56 patients, excluding 4 dropouts, were randomly allocated to the LPLT group (Group 1: 19 patients), placebo laser therapy with exercise group (Group 2: 18 patients), and LPLT with exercise group (Group 3: 19 patients). Laser therapy and exercise was performed five times a week for 4 weeks. Visual analogue scale (VAS), Schober test, lumbar range of motion (ROM) measures (flexion, extension and lateral flexion), Oswestry Disability index (ODI) were measured at baseline, at 4 weeks after intervention, and at 6 weeks after 2 weeks of no intervention. Results: Statistically significant improvements were noted in all group by time interaction with respect to all outcome parameters (p<0.05). All parameters in each group improved not only in the period of treatment (4 weeks), but also in the final evaluation (6 weeks) 2 weeks after the end of treatment. Post-hoc analysis showed statistically significant difference between the LPLT with exercise group and the other groups in all outcome parameters except for the ODI at 4 weeks and at 6 weeks. Conclusion: Portable LPLT is effective treatment in reducing pain and improving lumbar ROM and with exercise is more effective than laser or exercise monotherapy for the chronic low back pain patients.

• 한국전문물리치료학회지
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• 제29권2호
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• pp.147-155
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• 2022

Background: Although various conventional approaches have been employed to reduce spasticity in neurological rehabilitation, only a few studies have shown scientific evidence for its effectiveness. Thus, we introduced a different concept (Ueda method) of rehabilitation therapy that can complement the limitations of conventional therapy. Objects: This study aimed to investigate the immediate effects of the application of the Ueda method on patients with spasticity after stroke via an electrophysiological study. Methods: We conducted a randomized double-blind pilot study in two rehabilitation hospitals involving 30 stroke patients who were randomly allocated to the Ueda (n = 15) and convention (n = 15) groups. Electromyographic data of six examined muscles in both upper extremities of all patients were recorded. The A-ApA index and activation ratios of upper extremity muscles were evaluated and compared between the groups to confirm post-intervention changes in upper-extremity flexor spasticity and flexion synergies. Repeated-measures analysis of variance was conducted to confirm the therapeutic effect (2 × 2) as a function of group (Ueda vs. convention) and time (pre-/post-intervention) on all outcome measures (p < 0.05). Results: In the Ueda group, the mean A-ApA index values differed significantly before and after the intervention (p = 0.041), indicating a weak evidence level; however, the effect size was medium (d = -0.503). The interaction effects of the A-ApA index between the Ueda and convention groups and between pre-intervention and post-intervention stages were significant (p = 0.012). The effect size was large (n_p² = 0.220). In the Ueda group, the activation ratios of the anterior deltoid fiber significantly decreased after the intervention in all reaching tasks. Conclusion: The Ueda method reduces upper-extremity flexor spasticity and changes its synergy in stroke patients and should be considered a rehabilitation therapy for spastic stroke patients.

• 한국전문물리치료학회지
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• 제31권1호
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• pp.29-39
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• 2024

Background: Landing from a step or stairs is a basic motor skill but high incidence of lateral ankle sprain has been reported during landing with inverted foot. Objects: This study aimed to investigate the effect of landing height and visual feedback on the kinematics of landing and supporting lower limbs before and after the touch down and the ground reaction force(GRF)s. Methods: Eighteen healthy females were voluntarily participated in landing from the lower (20 cm) and the higher (40 cm) steps with and without visual feedback. To minimize the time to plan the movement, the landing side was randomly announced as a starting signal. Effects of the step height, the visual feedback, or the interaction on the landing duration, the kinematic variables and the GRFs at each landing event point were analyzed. Results: With eyes blindfolded, the knee flexion and ankle dorsiflexion on landing side significantly decreased before and after the touch down. However, there was no significant effect of landing height on the anticipatory kinematics on the landing side. After the touch down, the landings from the higher step increased the knee flexion and ankle dorsiflexion on both landing and supporting sides. From the higher steps, the vertical GRF, anterior GRF, and lateral GRF increased. No interaction between step height and visual feedback was significant. Conclusion: Step height and visual feedback affected the landing limb kinematics independently. Visual feedback affected on the landing side while step height altered the supporting side prior to the touch down. After the touch down, the step height had greater influence on the lower limb kinematics and the GRFs than the visual feedback. Findings of this study can contribute to understanding of the injury mechanisms and preventing the lateral ankle sprain.

• Archives of Plastic Surgery
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• 제51권1호
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• pp.52-61
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• 2024

Background Although prepectoral implant-based breast reconstruction has recently gained popularity, dual-plane reconstruction is still a better option for patients with poor-quality mastectomy skin flaps. However, shoulder morbidity is aggravated by subpectoral reconstruction, especially in irradiated patients. This study aimed to demonstrate shoulder exercise improvement in subpectoral reconstruction by delayed prepectoral conversion with an acellular dermal matrix (ADM) inlay graft technique at the time of expander-to-implant exchange after irradiation. Methods Patients with breast cancer treated for expander-to-implant exchange after subpectoral expander insertion and subsequent radiotherapy between January 2021 and June 2022 were enrolled. An ADM inlay graft was inserted between the pectoralis major muscle and the previously inserted ADM. The ADM was sutured partially overlapping the pectoralis muscle from the medial side with the transition part, to the muscle border at the lateral side. Perioperative shoulder joint active range-of-motion (ROM) for forward flexion, abduction, and external rotation was also evaluated. Results A total of 35 patients were enrolled in the study. Active shoulder ROM significantly improved from 163 degrees preoperatively to 176 degrees postoperatively in forward flexion, 153 to 175 degrees in abduction, and 69 to 84 degrees in external rotation. There was no difference in patient satisfaction regarding the final outcome between the conventional prepectoral reconstruction group and the study group. Conclusion Shoulder exercises in irradiated patients who underwent subpectoral reconstruction were improved by delayed prepectoral conversion using an ADM inlay graft. It is recommended that subpectoral reconstruction not be ruled out due to concerns regarding muscle contracture and shoulder morbidity in radiation-planned patients with poor mastectomy skin flaps.