• Archives of Plastic Surgery
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• v.48 no.6
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• pp.635-640
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• 2021

Background Injuries to the proximal interphalangeal (PIP) joint are common and complex. However, the treatment of osteochondral defects of the head of the proximal phalanx has rarely been described. Herein, we propose a new technique for the management of unicondylar defects of the proximal phalanx that can restore joint amplitudes and provide PIP stability. Methods In this cadaveric feasibility study, unicondylar defects were generated using striking wedges and chisels. First, a transverse tunnel measuring 2 mm in diameter passing through the head of the proximal phalanx was made. A second tunnel at the base of the middle phalanx with the same diameter was then created. The hemitendon of the flexor carpi radialis graft was passed through each of these tunnels. The proximal end of the graft was interposed in the area with a loss of bone substance. The ligamentoplasty was then tensed and fixed by two anchors on the proximal phalanx. Joint amplitudes and frontal stability were measured preoperatively and postoperatively. Results There was no significant change in the joint's range of motion: preoperatively, the mean mobility arcs were -2° to 113.80°, and they were -2° to 110° after the procedure (P=0.999). There was no significant difference in joint stability (P>0.05). Conclusions Ligamentoplasty with PIP interposition appears to be a possible solution for the management of unicondylar defects of the proximal phalanx. An evaluation of clinical results is planned in order to definitively confirm the validity of this procedure.

• Physical Therapy Korea
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• v.28 no.2
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• pp.132-137
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• 2021

Background: Flat feet can be identified by assessing the collapse of the medial longitudinal arch (MLA) and these conditions can trigger epidemiological changes in the feet. Many of previous studies compared the muscle activity of lower body in terms of intervention and dynamics to treat the structural defect of flat feet. However, few studies have investigated or analyzed the muscle activity of gastrocnemius muscle in the subjects with flat feet. Objects: This study investigated the differences in changes of medial and lateral plantar flexors in subjects with flat feet during bipedal heel-rise (BHR) task and analyzed the differences in muscle activity between two groups by measuring the electromyography (EMG) of abductor hallucis (AH), tibialis anterior (TA), medial gastrocnemius (MG), lateral gastrocnemius (LG). Methods: A total of Twenty one adult females participated in this experiment. Subjects were assigned to groups according to the navicular drop test. The task was applied to the leg, where the heel lifting action prevailed. The muscle activity of the medial and lateral feet plantar flexors was evaluated, and the % maximum voluntary isometric contractions (%MVIC) of these were compared. Results: For the difference between groups the muscle activity (%MVIC) of LG muscle was statistically significantly low in flat feet group compared to healthy feet group (flat feet: 64.57, healthy feet: 90.17; p < 0.05). Conclusion: The results of this study will contribute to identifying the muscle activities of medial and lateral feet plantar flexors among subjects with flat feet, which can cause abnormal epidemiological changes in the feet.

• Annals of Rehabilitation Medicine
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• v.42 no.6
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• pp.804-813
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• 2018

Objective To elucidate the effect of a 12-week horizontal vibration exercise (HVE) in chronic low back pain (CLBP) patients as compared to vertical vibration exercise (VVE). Methods Twenty-eight CLBP patients were randomly assigned to either the HVE or VVE group. All participants performed the exercise for 30 minutes each day, three times a week, for a total of 12 weeks. Altered pain and functional ability were evaluated using the visual analog scale (VAS) and Oswestry Disability Index (ODI), respectively. Changes in lumbar muscle strength, transverse abdominis (TrA) and multifidus muscle thicknesses, and standing balance were measured using an isokinetic dynamometer, ultrasonography, and balance parameters, respectively. These assessments were evaluated prior to treatment, 6 weeks and 12 weeks after the first treatment, and 4 weeks after the end of treatment (that is, 16 weeks after the first treatment). Results According to the repeated-measures analysis of variance, there were significant improvements with time on VAS, ODI, standing balance score, lumbar flexor, and extensor muscle strength (all p<0.001 in both groups) without any significant changes in TrA (p=0.153 in HVE, p=0.561 in VVE group) or multifidus (p=0.737 in HVE, p=0.380 in VVE group) muscle thickness. Further, there were no significant differences between groups according to time in any of the assessments. No adverse events were noticed during treatment in either group. Conclusion HVE is as effective as VVE in reducing pain, strengthening the lumbar muscle, and improving the balance and functional abilities of CLBP patients. Vibrational exercise increases muscle strength without inducing muscle hypertrophy.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.4
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• pp.75-84
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• 2018

PURPOSE: This study was conducted to determine the effects of whole-body tilt exercise with visual feedback on trunk control, strength, and balance in patients with acute stroke. METHODS: The study included 18 patients with acute stroke who were randomly allocated to a Whole Body Tilt Exercise Group (WBTEG, N=9) and a General Trunk Exercise Group (GTEG, N=9). The WBTEG conducted whole-body tilt exercises with visual feedback, and the GTEG performed general trunk exercises. Both groups performed the exercises five times a week for 4 weeks. Outcomes were assessed using the trunk impairment scale (TIS), the trunk flexor and extensor strength test, the static balance test, and the Brunel Balance Assessment. RESULTS: After 4 weeks of intervention, both groups showed significantly improved TIS scores, muscle strength, and balance components (p<.05 in both groups). However, the improvement in TIS, muscle strength, and static balance in the WBTEG was significantly better than that in the GTEG (p<.05). CONCLUSION: Although both groups in this study showed post-intervention improvement, patients from the WBTEG who received visual feedback demonstrated more improvement. These findings indicate that whole-body tilt exercise with visual feedback may be effective at improving trunk control, trunk muscle strength, and balance in patients with acute stroke. Further studies are needed to gain a better understanding of the effectiveness of whole-body tilt exercise in patients with acute stroke.

• PNF and Movement
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• v.16 no.3
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• pp.441-449
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• 2018

Purpose: This study aimed to compare the impact of proprioceptive neuromuscular facilitation leg patterns emphasizing hallux abduction (PNF-LPHA) on the intrinsic foot muscles of participants with hallux valgus (HV) using the toe-spread-out exercise (TSO). Methods: The present study recruited 12 individuals with HV. All the participants voluntarily agreed to participate in the study after hearing explanations of its purpose and process. All participants performed the TSO, PNF-LPHA 1, and PNF-LPHA 2. The participants' abductor hallucis (AbH), adductor hallucis (AdH), extensor hallucis longus (EHL), and flexor hallucis brevis (FHB) activity was measured, and the ratio of AbH:AdH was measured during the three interventions using electromyography. Additionally, the participants' AbH thickness was measured by ultrasonography. An intraclass correlation coefficient (ICC) was used to verify the intra-rater reliability of ultrasonography at rest and during contraction. Results: The intra-rater reliability was excellent at rest and during contraction ($ICC_{3,1}=0.90$ and $ICC_{3,1}=0.83$, respectively). There were no statistically significant differences in the activity of the AbH, the ratio of AbH: AdH, and the thickness of AbH between the TSO and PNF-LPHA2 groups. Additionally, EHL activity was significantly higher in the PNF-LPHA2 group than in the TSOgroup. Conclusion: PNF-LPHA 2 can be recommended as a method to optimize AbH and EHL activity, the ratio of AbH:AdH, and the thickness of AbH in individuals with HV.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.2
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• pp.53-61
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• 2019

PURPOSE: Forward head posture (FHP) is a head-on-trunk malalignment that results in musculoskeletal dysfunction and neck pain. To improve forward head posture, both the craniocervical flexion exercise (CCFE) and the visual guide (VG) technique have been used. This study compared the immediate effects of CCFE and VG combined with CCFE on craniovertebral angle (CVA), as well as on the activity of the sternocleidomastoid (SCM) and anterior scalene (AS) muscles during CCFE in subjects with FHP. METHODS: In total, 16 subjects (nine males, seven females) with FHP were recruited using the G-power software. Each subject conducted CCFE and CCFE combined with VG in random order. The CVA was recorded using a digital camera and the ImageJ image analysis software. The EMG data of SCM and AS were measured by surface electromyography. A paired T-test was used to assess differences between the effects of the CCFE and VG combined with CCFE interventions in the same group. RESULTS: The CVA was significantly greater for CCFE combined with the VG than for CCFE alone (p<.05). The activity of the SCM and AS muscles was also significantly greater when the VG was combined with CCFE than during CCFE alone across all craniocervical flexion exercise phases (p<.05). CONCLUSION: Use of the VG technique combined with CCFE improved FHP in subjects with FHP compared to CCFE alone.

• Physical Therapy Korea
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• v.26 no.2
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• pp.69-75
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• 2019

Background: Knee osteoarthritis (OA) diagnosis using Kellgren-Lawrence scores is commonly used to help decision-making during assessment of the severity of OA with assessment of pain, function and muscle strength. The association between Kellgren-Lawrence scores and functional/clinical outcomes remains controversial in patients with knee OA. Objects: The purpose of this study was to examine the relationships between Kellgren-Lawrence scores and knee pain associated with OA, function during daily living and sports activities, quality of life, and knee muscle strength in patients with knee OA. Methods: We recruited 66 patients with tibiofemoral knee OA and determined knee joint Kellgren-Lawrence scores using standing anteroposterior radiographs. Self-reported knee pain, daily living function, sports/recreation function, and quality of life were measured using the knee injury and OA outcome score (KOOS). Knee extensors and flexors were assessed using a handheld dynamometer. We performed Spearman's rank correlation analyses to evaluate the relationships between Kellgren-Lawrence and KOOS scores or muscle strength. Results: Kellgren-Lawrence scores were significantly negatively correlated with KOOS scores for knee pain, daily living function, sports/recreation function, and quality of life. Statistically significant negative correlations were found between Kellgren-Lawrence scores and knee extensor strength but not flexor strength. Conclusion: Higher Kellgren-Lawrence scores were associated with more severe knee pain and lower levels of function in daily living and sports/recreation, quality of life, and knee extensor strength in patients with knee OA. Therefore, we conclude that knee OA assessment via self-reported KOOS and knee extensor strength may be a cost-effective alternative to radiological exams.

• PNF and Movement
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• v.19 no.1
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• pp.147-152
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• 2021

Purpose: This study was conducted to investigate the functional differences of the two heads of the biceps brachii by measuring the functions in supination according to pronation by the angle of the flexion of the elbow joint, except for the activities of the elbow flexors. Methods: This study was conducted with 25 healthy men in their 20s. At a glenohumeral-joint 0˚ flexion posture, angles of flexion of the elbow joint of 0˚, 30˚, 60˚, 90˚, and 120˚ were randomly provided, and they were asked to perform supination and pronation with an elastic band. Using an eight-channel surface electromyogram, the muscle activities of the long and short heads of the biceps brachii were measured. The activities of the short and long heads according to the angle were analyzed using a one-way ANOVA, and as a post-test, LSD was employed. Results: The analysis of the impact of the resistance of the elastic band in supination on the differences in the muscle activities in the short and long heads suggests there was a significant difference between 0˚ and 30˚ (p < 0.05). Conclusion: In supination according to forearm pronation, the long head had greater action in the early flexion posture of the elbow joint, and it is judged that the ratio of the flexion of the elbow joint according to the actions of the biceps brachii was considered small.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.1
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• pp.173-181
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• 2021

Purpose : The purpose of this study is to compare muscle activity after applying two muscle energy techniques (MET) to subjects with forward head posture to see if the post isometric relaxation (PIR) technique is more effective than the reciprocal inhibition (RI) technique. Methods : The muscle activity was measured using EMG after applying the PIR and RI techniques to 30 adults at K College. Subjects were selected for forward head posture whose ear center was 2.5 ㎝ front of the center of the shoulder. EMG equipment was used to measure muscle activity, and the measurement sites were measured in cervical flexor and extensor muscles. The experiment period was performed once a week for a total of two weeks, and after the pre-measurement was performed for 5 minutes PIR and RI exercise. In the PIR technique, the head is tilted back in a sitting position, and the experimenter applies resistance with the same force for 7~10 seconds and repeats 3-5 times after rest. In the RI technique, in a sitting position, the subject gives the force to bend the head forward, and the experimenter applies resistance with the same force for 7 to 10 seconds, and repeats 3 to 5 times after rest. Results : The result is same as the following. In the comparison of muscle activity, there was a significant decrease in both PIR and RI at 1 and 2 weeks. And there was a greater decrease in muscle activity in PIR. There was no difference in the comparison of decrease in muscle activity at 1 week and 2 week. Conclusion : Both PRI and RI can be said to be effective in improving the function of the forward head posture in the neck muscles. Therefore, the selection of the two techniques in clinical practice should be appropriately performed under the judgment of experts according to the patient's situation.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.4
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• pp.183-190
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• 2020

Purpose : The purpose of this study was to investigate the effect of increased gait function enhancement exercise in three adolescent convulsive cerebral palsy sinuses on children's large movement function, balance and gait function, self-efficacy, and guardian attitude. Methods : The purpose of this study was to conduct a program to strengthen trunk muscles and strengthen walking ability 5 times a week for 8 weeks in 3 children with convulsive cerebral palsy in adolescence. The main reinforcement of the program was 20 minutes of muscle strength and 20 minutes of walking on a treadmill five times a week. Exercises were focused on the reinforcement of the flexor muscles of the proprioceptive neuromuscular promotion (PNF) and the extension of the legs in the bridge posture exercise and squat movements. Results : The results of GMFM-88 to determine the effects of this functional enhancement program on the body of children with convulsive cerebral palsy, and PBS & TUG to determine the effects of balance and gait ability were improved. In addition, parenting attitudes of guardians, self-efficacy of children, and self-efficacy of parents increased positively due to mental consequences. Conclusion : The results of GMFM-88 to determine the effects of this functional enhancement program on the body of children with convulsive cerebral palsy, and PBS & TUG to determine the effects of balance and gait ability were improved. In addition, parenting attitudes of guardians, self-efficacy of children, and self-efficacy of parents increased positively due to mental consequences.