Journal of the Korean Society of Physical Medicine
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v.5
no.3
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pp.477-485
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2010
Purpose : The clinical scale to assess spasticity of muscle was wildly used the modified Ashworth scale (MAS). But reliability of the MAS has been controverted for ambiguity among the grades. The purpose of this study was to establish the inter-rater reliability of the modified MAS (MMAS) translated into Korean in stroke patients. Methods : Twenty-five patients (sixteen men and nine women) with hemiplegia (ten right and fifteen left) were measured by two raters who were physical therapist in the rehabilitation hospital. The raters assessed spasticity of shoulder adductor, elbow flexor, wrist flexor, hip adductor, knee extensor, and ankle plantar flexor in the same patients according to ratings criteria of the MAS and the MMAS. Results : For the inter-rater reliability of the MAS, two raters agreed on 57.3% and the Kappa values were moderate ($\kappa$=0.41) between two rater. The inter-rater reliability of the MAS was fair for the wrist flexor and the hip adductor and moderate for the other muscles. The intra-rater reliability was good for the shoulder adductor and the knee extensor and moderate for the other muscles. For the inter-rater reliability of the MMAS, two raters agreed on 84.7% and the Kappa values were good ($\kappa$=0.78) between two rater. The inter-rater reliability of the MMAS was moderate for the hip adductor, and good for the shoulder adductor and the wrist flexor, and very good for the other muscles. The intra-rater reliability was good for the wrist flexor and the hip adductor and very good for the other muscles. Conclusion : This study suggests that the MMAS translated into Korean is reliable test scale for the spasticity with stroke patients in the clinical field.
Kang, Hyung Joo;Lee, Dong Chul;Kim, Jin Soo;Ki, Sae Hwi;Roh, Si Young;Yang, Jae Won
Archives of Plastic Surgery
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v.39
no.4
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pp.397-403
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2012
Background Nonabsorbable sutures are favorable for repairing flexor tendons. However, absorbable sutures have performed favorably in an animal model. Methods Two-strand sutures using the interlocking modified Kessler method with polydioxanone absorbable sutures 4-0 were used to repair completely ruptured flexor tendons in 55 fingers from 41 consecutive patients. The medical records of average 42 follow up weeks were analyzed retrospectively. The data analyzed using the chi-squared test, and Fisher's exact test was used for postoperative complications. The results were compared with those of other studies. Results Among the index, middle, ring, and little fingers were injured in 9, 17, 16, and 13 fingers, respectively. The injury levels varied from zone 1 to 5. Of the 55 digits in our study, there were 26 (47%) isolated flexor digitorum profundus (FDP) injuries and 29 (53%) combined FDP and with flexor digitorum superficialis injuries. Pulley repair was also conducted. Concomitant injuries of blood vessels and nerves were found in 17 patients (23 fingers); nerve injuries occurred in 5 patients (10 fingers). Two patients had ruptures (3.6%), and one patient had two adhesions (3.6%). Using the original Strickland criteria, all the patients were assessed to be excellent or good. Also, fibrosis and long-term foreign body tissue reactions such as stitch granuloma were less likely occurred in our study. Compared to the Cullen's report that used nonabsorbable sutures, there was no significant difference in the rupture or adhesion rates. Conclusions Therefore, this study suggests that appropriate absorbable core sutures can be used safely for flexor tendon repairs.
Purpose: Adhesion after flexor tendon injury is a result of fibrosis between tendon and tendon sheath. This, finally interfere with gliding mechanism of tendon and results in functional problem of hands. Therefore, there have been many trials to reduce adhesion around the tendon. However, there is no standard procedure clinically practiced in hospitals. Mitomycin-C is an antineoplastic alkylating agent that decrease fibroblast proliferation and scar formation. It is commonly used in many surgery to reduce postoperative adhesion. This study was designed to observe the effect of Mitomycin-C on preventing adhesion in injured flexor tendon. Methods: The deep flexor tendon of digit 2 and 4 in the left forepaw of 15 New Zealand White rabbits were subjected to partial tenotomy. In study group, injury site was exposed to a single 5-minute application of Mitomycin-C, and in control group was left untreated. Digit 2 and 4 in the right forepaw of each rabbit were considered as nonadhesion control group. After 2 weeks, the animals were sacrificed and digits were amputated for biomechanical test and histological study. Results: In biomechanical study to measure yield point, mean yield point of non-adhesion control was $17.43{\pm}2.33$ and $25.07{\pm}4.03$ for adhesion control, which proves increase of adhesion in adhesion control group (p<0.05) in 95% confidence. In Mitomycin-C group, mean yield point was $12.71{\pm}4.97$. Compared with adhesion control, there was decrease in adhesiveness in Mitomycin-C group (p<0.05) in 95% confidence. In histological study, the result of adhesion control revealed massive adhesions of bony structure, fibrotic tissue and tendon structure with ablation of the border. However in Mitomycin-C group, we could find increased fibrotic tissue, but adhesion is much lesser than adhesion group and borders between structures remain intact. Conclusion: This study suggests that Mitomycin-C can significantly reduce adhesion of injured flexor tendon in rabbit model.
So, Kyoung-Min;Kim, Joo-Ho;Lee, Hae-Beom;Heo, Su-Young;Ko, Jae-Jin;Lee, Cheol-Ho;Chon, Seung-Ki;Kim, Nam-Soo
Journal of Veterinary Clinics
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v.24
no.2
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pp.276-279
/
2007
A 2-year-old male, 3 kg body weight Japanese Chin was injured in the automobile accident three months ago. The dog became antebrachiocarpal joint instability, and performed pancarpal arthrodesis using 3 K-wires in localanimal hospital. But, the result was failure. Therefore the dog was referred to Chonbuk Animal Medical Center, Chonbuk National University. In physical examination, right carpal joint instability, knuckling sign and pain were evident. In radiography, sclerosis was observed on the 4th carpal bone. Complete blood count (CBC), serum chemistry and urinalysis finding were within reference ranges. Pancarpal arthrodesis was re-performed using 7-hole plate. However, mild skin and muscle defects was appeared by skin tension of extremity. We expected that granulation would fill the defect, but inflammation was continued on the lesions for 3 days. So, operation which is filling it was done by using the muscle flap and tubed skin flap. The donor muscles were flexor carpi radialis and superficial digital flexor muscles. After 7 days, the muscle flap was survived, but tubed skin flap was necrosed. After 20 days, the skin defect was substituted with granulation tissues. The flexor carpi radialis muscle and superficial digital flexor muscle transposition can be a useful procedure for reconstructing soft tissue defects in the carpal and metacarpal areas.
Journal of the Korea Academia-Industrial cooperation Society
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v.20
no.6
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pp.239-244
/
2019
The purpose of this study was to determine the correlation between upper limb muscle power and bat swing speed in elementary school baseball players. This study subjects were 32 subjects. Upper extremity muscle strength was measured in the Both Shoulder joints extensor flexor abductor adductor, Both elbow joints extensor flexor and bat swing speed. The correlation between upper extremity muscle strength and bat swing speed was analyzed using pearson's correlation analysis. There was a significant correlation between dominant upper extremity muscle strength and bat swing speed in the order of shoulder adductor, shoulder abductor, elbow flexor, and shoulder flexor and in correlation between non-dominant upper extremity muscle strength and bat swing speed in the order of shoulder adductor, elbow flexor, shoulder abductor, shoulder extensor, elbow extensor, and shoulder flexor. From these results, it can be seen that the stronger the upper extremity muscle strength, the bat swing speed is the more positive correlation.
The purpose of the present study was to the investigate the effect of aging in men and women on muscle strength of knee extensor and flexors by using the cybex 6000 isokinetic dynamometer. A total of 100 volunteers participated in this study and were divided into five groups according to their chronological age as follows: 20s, 30s, 40s, 50s, 60s, 10 men and 10 women in each decade respectively. Isokinetic ($60^{\circ}{\cdot}s-l$) knee extensor and flexor peak torque, peak torque to body weight ratio, opposing muscles(flexor/extensor) peak torque ratio, deficit of peak torque between dominant and non-dominant were measured. The results obtained were as follows: 1) In men, While the aged increased. the peak torque of the knee flexor and extensor statistically sig nificant decreased in the dominant and non-dominant side. 2) In women, Statistically significant difference of knee extensor peak torque was found as the aged increased in the dominant and non-dominant side, but significant difference of knee flexor peak torque did not that. 3) In men, No significant difference in the peak torque of knee flexor to body weight ratio was found as the aged increased in the non-dominant side, but statistically significant difference in the peak torque of knee flexor to body weight weight ratio was found as the aged increased in the dominant side. 4) In women. No significant difference in the peak torque of knee flexor to body weight ratio was found as the aged increased in the dominant side, but statistically significant difference in the peak torque of knee flexor to body weight ratio was found as the aged increased in the non-dominant side. 5) In men and women, While the aged increased, statistically significant difference was found the dominant and non-dominant side in the peak torque of knee extensor to body weight ratio. 6) Peak torque of hamstring to quadriceps ratio of dominant and non-dominant side in men and women were not significantly different as the age increases. 7) Mean deficit of peak torque between dominant and non-dominant side in men and women were not significantly different as the age increases. From these results we conclude a proper exercise program is need before 50s decade to preserve in muscle strength of knee flexors and extensors.
After warming-up exercise for 20 minutes, Isokinetic measurement of trunk strength for flexor and extensor was done by using Cybex 6000 TEF Unit on 91 healthy male white workers from 22years old to 49 years old, and compared each other. 20 repetitions of trunk extension-flexion were done at $120^{\circ}$/sec angular velocity. After resting for 1 minutes, Four repetitions at two different angular velocities($60^{\circ}$/sec, $120^{\circ}$/sec) were done with 30 seconds of resting interval between each angular velocity. The purpose of this study is to obtain the isokinetic normative strength values for trunk extensors and flexors, and is to know the correlation between age, height, weight of subjects and data from isokinetic trunk strength measurement, and is to provide a guideline for exercise program of male white collar workers The collected data were analyzed by ANOVA, Duncan's Multiple Range Test, and Pearson correlation coefficiency in PC-SAS program. The results obtained were as follow; 1. There is significant positive-correlation with the statistic value between weight and peak torque of trunk muscles at two different angular velocities($60^{\circ}$/sec, $120^{\circ}$/sec)(p<01), between height and peak torque of trunk muscles at two different angular velocities($60^{\circ}$/sec, $120^{\circ}$/sec) except peak torque of trunk flexor at $60^{\circ}$/sec(p<01). 2. There is nagitive-correlation between age and peak torque of trunk muscles at two different angular velocities($60^{\circ}$/sec, $120^{\circ}$/sec), there is significant differences with statistic value between age and peak torque of trunk extensor at $120^{\circ}$/sec(p<.01). 3. Mean peak torque and mean peak torque % by body weight of trunk extensor is 1.1 times higher values than trunk flexor at $60^{\circ}$/sec. 4. There is the increase in peak torque angle of trunk flexor with increasing of age, and the decrease in peak torque angle of trunk flexor with increasing of age at two different angular velocities($60^{\circ}$/sec, $120^{\circ}$/sec). there is significant differences with statistic value in peak torque angle of trunk flexor at $120^{\circ}$/sec(p<.01). 5. There is significant decrease in endurance ratio of trunk extensor with increasing of age at $120^{\circ}$/sec(p<.01). In conclusion, peak torque of trunk extensor is 1.1 times higher values than trunk flexor in healthy male white collar workers.
Tenosynovial chondromatosis is a multinodular cartilaginous proliferation that arises from the tenosynovial membranes. It is rare, benign neoplasm, most commonly affects the tendon of the wrist and hand. It is clinically important because of its high rate of recurrence with a unique histopathological pattern which not infrequently displays considerable focal cellular atypia and hypercellurality nevertheless it is benign, but it has not been well recognized because of its rarity. We report here a rare case of tenosynovial chondromatosis of the tendon sheath of flexor hallucis longus and flexor digitorum longus in plantar area.
Purpose: The purpose of this study was to investigate the effects of a rehabilitation nursing program(RNP) for persons with disabilities. Method: a quasi-experimental pretest and post test study was used to examine the changes of patient's muscle strength, flexibility, self efficacy and health related quality of life at the completion of an 8-week education and physical exercise with a Thera-Band and Exercise Ball course. The subjects consisted of 40 adults who were disabled. Twenty-two experimental and 18 control subjects completed pre and post-test measures. Outcome variables were flexibility, hand grip, elbow flexor and extensor, knee flexor and extensor, self efficacy and quality of life. Independent t-test and ANCOVA were used to examine group differences by using SPSS 12.0 Result: Mean comparisons of the change scores revealed that the experimental group increased significantly in knee extremity flexor(p=0.035), extensor(p=0.039), flexibility(p=0.008), self efficacy(p=0.000), and quality of life(p=0.000). No significant group differences were found in each patient's hand grip, elbow flexor and extensor. Conclusion: RNP can improve lower extremity flexibility, muscle strength, self efficacy and health related quality of life in people with disabilities. The intervention to tailor exercise and education to the unique needs of the disability was suggested for further study.
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