Colak, Ozlem;Kankaya, Yuksel;Sungur, Nezih;Ozer, Kadri;Gursoy, Koray;Serbetci, Kemal;Kocer, Ugur
Archives of Plastic Surgery
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제46권3호
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pp.228-234
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2019
Background The management of flexor tendon injuries has evolved in recent years through industrial improvements in suture materials, refinements of repair methods, and early rehabilitation protocols. However, there is no consensus on the ideal suture material and technique. This study was conducted to compare the tensile strength, repair time, and characteristics of 4-strand cruciate, modified Kessler, and 4-strand horizontal intrafiber barbed sutures for flexor tenorrhaphy with a 12-mm suture purchase length in an animal model. Methods The right third deep flexors of 60 adult Leghorn chicken feet were isolated and repaired with a 12-mm suture purchase length. The tendons were randomly assigned to three groups of equal number (n=20 each). Groups 1 and 2 received 4-strand cruciate and modified Kessler repair with conventional suture materials, respectively. A 4-strand horizontal intrafiber barbed suture technique was used in group 3. The repaired tendons were biomechanically tested for tensile strength, 2-mm gap resistance, and mode of failure. Repair times were also recorded. Results The maximum tensile strength until failure was $44.6{\pm}4.3N$ in group 1, $35.7{\pm}5.2N$ in group 2, and $56.7{\pm}17.3N$ in group 3. The barbed sutures were superior to the other sutures in terms of the load needed for 2-mm gap formation (P<0.05). Furthermore, the barbed sutures showed the shortest repair time (P<0.05). Conclusions This study found that 4-strand horizontal intrafiber barbed suture repair with a 12-mm purchase length in a chicken flexor tendon injury model showed promising biomechanical properties and took less time to perform than other options.
PURPOSE: The purpose of this study was to investigate the effect of short-term lumbar stabilization exercise to patients suffering from chronic low back pain(CLBP) on the strength of their lumbar flexor and extensor and the postural balance of them and to suggest effective treatment duration for them. METHODS: Study subjects were 20 patients with CLBP who's been reported the pain for more than 12 weeks. For these subjects, muscle strength of both extensor and flexor of lumbar and the balancing ability were measured before and after the intervention. Lumbar stabilization exercise was composed of matt, ball and sling exercise. The intervention was applied for total 12 sessions for 4 weeks (3 times a week) and each session was for 40 minutes. RESULT: For muscle strength of both extensor and flexor of lumbar, there was significant differences after the application of lumbar stabilization exercise(p<.05). For balancing ability, stabilization shows significant differences in all of the positions except PC(eyes closed on pillows)(p<.05). Distribution of weight shows no significant differences but it was generally distributed within normal range after the exercise and Fall index shows significant differences between before and after the exercise(p<.05). CONCLUSION: These results could have positive effect on deciding different periods of therapeutic intervention.
Purpose : The time spent using smart devices is constantly increasing, particularly in recent times. Using smart devices for a long time with an incorrect posture may lead to cerebral palsy (CP), instability, and abnormal muscle tone. Therefore, we aimed to investigate the relationships among cervical instability, deep neck flexor (DNF) activity, range of motion (ROM), and muscle tonus. Methods : Fifty subjects with CP participated in this study, and they were physiotherapists at W Hospital in Daejeon. Those who voluntarily participated in the research were selected as candidates who fulfilled the selection criteria. According to an instability test, 25 subjects were assigned to the instability and control groups. All subjects first underwent the instability test to be allocated to the appropriate group. Those in the instability group tested positive on the instability test. The Neck Disability Index (NDI), ROM, muscle tone, and DNF activity were measured to evaluate their relationships. The DNF strength and endurance were measured using a cranio-cervical flexion test. The upper trapezius (UT), sternocleidomastoid (SCM), and suboccipital (SO) muscle tones were measured using a contact soft tissue tone measuring instrument. The statistical significance level was set to .05. Results : There were significant differences in the flexion, extension, and rotation of the cervical ROM (CROM) between the two groups (p<.05). The SCM, UT, and SO muscle tones were significantly different between the two groups (p<.05). The DNF strength and endurance showed a significant difference between the two groups (p<.05). Conclusion : We found that there were significant increases in the CROM and muscle tone and decrease in the DNF strength and endurance in the instability group. This indicated that cervical instability is affected by the DNF strength and endurance. We may recommend DNF exercises in cases of cervical instability in clinical environments.
Purpose: This study was conducted to develop & to determine the effect of an tailored falls prevention exercise for older adults. Method: Subjects consisted of 59 older adults (experimental group : 29, control group : 30) living at nursing homes. Experimental group participated in tailored falls prevention exercise for 16 weeks(3 times a week, 50 min every session). Data were collected before the exercise, 16 weeks & 24 weeks after the beginning of exercise. Results: 1) the experimental group significantly improved the muscle strength of hip extensor & flexor, knee extensor & flexor, ankle dorsiflexor, & plantar flexor compared to the control group. 2) the experimental group significantly decreased the mean time for 10 times chair stand. 3) the experimental group significantly increased the standing time on one leg and the number of heel raise for 30 seconds compared to the control group. In addition more older adults in the experimental group completed the tandem stance & semi-tandem stance for 10 seconds than the control group. 4) The experimental group significantly decreased the mean time of 6m walk and the fall frequency compared to the control group. Conclusions: This results suggest that tailored falls prevention exercise for older adults can improve muscle strength, static & dynamic balance and decrease the fall frequency of older adults.
Purpose: To determine the effect of the Fall Prevention Program(EPP) on gait, balance and muscle strength in elderly women at a nursing home. Method: The subjects of this consisted of 38 elderly women between the ages of 70 to 89 years living at a nursing home located in Seoul. Each of the experimental group and control group was composed of 19 subjects. The subjects in experimental group have participated in FPP for the 8 weeks which consisted of exercise, education and foot care. They started to exercise for 40 minutes per session, 3 sessions a week during the 1st week at 40% of age adjusted maximum heart rate. From the 2nd week to the 4th week, they increased the duration of exercise to 50 minutes per session and the intensity to 60% of age-adjusted maximum heart rate. They participated in 50 minutes at 60% of age-adjusted maximum heart rate from the 5th week to the 8th week. Each exercise session consisted of 10 minutes of warming-up exercise, 30 minutes of conditioning exercise and 10 minutes of cooling-down exercise. They participated in education for 20 minutes per week from the 1st week to the 4th week. Then they participated in a 30-minute foot care program per week from the 5th week to the 8th week. Gait, balance and muscle strength for each subject were measured before and after FPP. Gait was evaluated by step length, step width, gait speed and walking distance. Balance was measured by the duration of standing on one leg with their eyes closed and open each, and a get-up and go test. Grip strength was measured by hand dynamometer. Hip extensor and flexor strength, knee extensor and flexor strength and ankle plantarflexor and dorsiflexor strength were measured by manual muscle tester. Data was analyzed using SPSS form Windows. t-test and Chi square test were utilized as a homogeneity test. Repeated measure ANOVA was used to test the effect of FPP. Result: 1) Step width significantly decreased, and step length, gait speed and walking distance significantly increased in the experimental group compared with the control group after FPP(p<0.005). 2) There was no significant change in standing time on one leg with their eyes closed after FPP. The standing time on leg with their eyes open and the time of "get-up and go" significantly decreased in the experimental group compared with the control group after FPP(p<0.005). 3) Muscle strength-grip strength, hip extensor and flexor strength-significantly increased in the experimental group compared with the control group after FPP(p<0.005). 4) There was no significant difference of frequency of fall between the experimental group and control group during the period of FPP. Conclusion: These results suggest that FPP can increase gait, balance and muscle strength of elderly women at a nursing home.
The purpose of this study was to examine the isokinetic moment of quadriceps and hamstring strength ratio among women of different ages. The study population consisted of 1,184 women referred to the Health Promotion Center at the S district. All subjects were aged 20 to 69 years old and divided into 5 groups; 20s (n=248), 30s (n=255), 40s (n=248), 50s (n=228), and 60s (n=205). The strength of the knee extensor and flexor, quadriceps, and hamstring of all the participants were assessed at 60 degrees/second with an isokinetic machine. We calculated the peak torque, peak torque %BW (%Body Weight), deficit of peak torque and hamstring/quadriceps ratio of the knee. The data were analyzed by one way ANOVA to investigate statistical differences in strength variation between different age groups and were computed by ${\Delta}%$ difference from women in their 20's. The results were obtained as follows: 1. Peak torque of the knee extensor, quadriceps, were significantly reduced in women older than 30, but peak torque of the knee flexor, hamstring, were significantly reduced in women older than 50 compared to women in their 20's. (p<.05). 2. Peak torque %BW of the knee extensor, quadriceps, were significantly reduced in women older than 20, but peak torque %BW of knee flexor, hamstring, were significantly reduced in women older than 40 compared to women in their 30's (p<.05). 3. Compared to the women in their 20's, there was no significant difference among any of the age groups in the deficit of peak torque of the knee extensor and flexor, but the deficit of peak torque of knee extensor among women between 30 and 50showed significant difference within the normal range of deficit. 4. Compared to the women in their 20's, there was no significant difference among any of the age groups in the hamstring/quadriceps ratio These results showed that peak torque, peak torque %BW, deficit of peak torque, and hamstring/quadriceps ratio of the knee were reduced in each age group, but especially among the women over 50. Further longitudinal study may be needed to see if volume of muscle mass and intervention of exercise affect knee strength in spite of aging.
The purposes of this study were to determine the effects of rehabilitation programs on functional performance of the lower extremities and whether additional therapeutic exercise with routine rehabilitative therapy improves functional performance more than just routine rehabilitative therapy by it self for inpatients who have suffered a stroke with below moderate severity within 3 to 6 months after the onset of the stroke. Fifty-eight subjects were divided into two groups. Group I was given routine rehabilitative therapy and group II was given additional therapeutic exercise along with the routine rehabilitative therapy. Each group received 6 weeks of rehabilitation. The timed get-up and go test (TUG), the Fugl-Meyer score (FMS), functional independence measure (FIM), functional reach (FR), gait velocity (GV), and the strength of knee extensor and flexor were selected to measure effect of rehabilitation programs. The main results were measured and analysed at baseline, 3 weeks, and 6 weeks after the start of the rehabilitation programs. The results revealed that all of functional performance of the lower extremities in 3 weeks after the start of the rehabilitation programs were significantly improved compared with before the rehabilitation programs in both groups. In 6 weeks, TUG, FIM, FR, GV, and the strength of knee extensor in group I, TUG, FMS, FIM, FR, GV, and the strength of knee extensor and flexor in group II were significantly improved compared with the results after 3 weeks. At 3 weeks after rehabilitation programs, group II made significantly greater gains in TUG, FR, GV, and the strength of the knee flexor compared to the group I. At 6 weeks, group II made significantly greater gains in TUG, FR, GV, and the strength of the knee extensor and flexor compared to the group I. In conclusion, rehabilitation programs for stroke patients within 3 to 6 months after stroke onset significantly contributed to improve functional performance of the lower extremities. It is desirable for improvement of functional performance of the lower extremities to perform additional exercise with routine rehabilitative therapy.
Objective : Compare the results of CPM and PNF in recovery rates when applied as an initial physical therapy. Methods : Randomly selected 19 patients who underwent through total knee replacement surgery. 23 cases were studied and divided into 12 CPM and 11 PNF cases. CPM case was carried out for 60 minutes, a maximum allowed exercise without pain. PNF case was carried out for 20 minutes by a therapist to a patient as 'one on one'. Result : Result showed that PNF treatment was increased significantly at P<0.05 in flexor muscle strength in 8 days after the surgery. Conclusion : The study revealed that in comparison with CPM, PNF was more effective treatment increase of flexor muscle strength in rehabilitation on after total knee replacement surgery.
The object of study who healthufl thirty persons have been enforced Isokinetic exercise of non-dominant muscular strength. The next same that each dominant muscular strength and non-dominant strength, peak torque and total work have been comparative analysis 1, Shoulder muscles comparion increase peak torque at low speed from pretraining Isokinetic exercise of non-dominant strength side to ten week of post-training.. Flexor and extensor come out high and statistically significant 6, 8, 10 week than pretraining. Adductor and abductor come out high and statistically significant 4, 6, 8. 10 week then pre-training, Internal rotator and external rotator come out statistically significant 2, 4, 6, 8, 10 week then pre-ttraining. 2. Shoulder muscles comparion increase peak torque at high speed from pre-training Isokinetic execise of non-dominant strenght side to ten week of post-training. Flexor and extensor come out high and statistically significant 4, 6, 8, 10 week then pie-training. Adductor and abductor come out high and statistically significant 2, 4, 6, 8, 10 week than pre-training. Futernal rotator and external rotator come out statistically significant 4. 6, 8, 10 week than pre-training.
Purpose : The purpose of this study was to assess more effective exercise prescription for the people with chronic neck pain by comparing stretching exercise and isometric exercise about strength and pain. Method : The research design of the study was that 20 young adults with mild neck disability (5-14 out of 50 in Neck Disability Index) were randomized into 2 groups and underwent stretching exercise(10 peoples) and isometric exercise(10 peoples) at 3 times a week for 5weeks. Measures of pain scale (Visual Analog Scale) and Muscle strength of deep neck flexor (Pressure Biofeedback) were assessed before and after intervention. The pre and post exercise results were compared using paired t-test and the effectiveness of intervention of two groups were compared using Independent t test. Results : The results of this study were that pain reduction was seen after stretching and isometric exercise and significantly difference. There was significantly improvement of cervical flexor strength after stretching and isometric exercise. But, there was no significant difference between stretching and isometric exercise groups. Conclusion : The stretching and isometric exercise for chronic neck pain patients may use according to preference of patient because the effects of treatment was same. Further studies are needed to analyzed psycho social factors, cost effects, group approach.
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