• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.1
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• pp.11-23
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• 2023

Purpose: This study aimed to determine the effects of cervico-thoracic (C-T) mobilization technique and therapeutic exercise on muscle activity, craniovertebral angle (CVA), and neck disability index (NDI) in patients with neck pain. Methods: : A total of 30 patients with neck pain were included and divided into C-T mobilization combined with Pilates group (Experimental group; EG) and thoracic mobilization and self-exercise (Control group; CG) group; each group consisted of 15 patients. The exercises were performed by patients in both groups three times a week, for four weeks. NDI was used to measure functional disability and sEMG was used to measure muscle activity. Results: The EG participants showed significant improvement in the CVA and NDI after the intervention than the CG (p<.05). While both groups presented after intervention decreased muscle activity(upper trapezius), there were no statistically significant differences between the groups (p>.05). Conclusion: The findings of this study suggest that thoracic mobilization technique combined with Pilates exercise may have beneficial effects on CVA and NDI in patients with neck pain and forward head posture.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.28 no.1
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• pp.39-51
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• 2022

Background: The purpose of this study is to investigate the effect of neck and shoulder self-stretching exercise using audiovisual media on neck pain, postural alignment, and joint position error in women with chronic neck pain. Methods: The subjects included 20 women that gave consent to participate in the study voluntarily. They performed the self-stretching exercises using audiovisual media was carried out 20 minutes 5 times a week during 3 weeks. Neck disability index (NDI) and visual analogue scale (VAS) were used to measure the functional disability and pain, A pressure pain threshold was measured using an algometer, and a cervical range of motion (CROM) measurement tool was used to measure the range of motion and error of proprioceptive position sense of the cervical spine. To assess posture alignment, forward head angle (FHA), forward shoulder angle (FSA) were measured using image J software. Results: The neck pain intensity was statistically significantly within group (p<.05). Neck and shoulder functional disability were a statistically significant difference within group (p<.05). Splenius capitis and upper trapezius pressure pain threshold were statistically significant difference in within group (p<.05). The postural alignment was statistically significantly within group (p<.05). The cervical range of motion in neck extension, right and left lateral flexion were statistically significantly within group (p<.05). The joint position error in neck flexion, extension, right and left lateral flexion decreased statistically significantly within group (p<.05). Conclusion: Self-stretching exercise using audiovisual media increased the mobility of the neck, decreased neck pain and joint position error, and improved posture alignment. As a result, there was a positive effect by applying the self-stretching exercise using audiovisual media to people with neck pain. Based on this, it is thought that it can be used as the basis for research related to home training programs for healthy self-management.

• Clinical Nutrition Research
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• v.12 no.2
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• pp.126-137
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• 2023

Hemodialysis (HD) patients face a common problem of malnutrition due to poor appetite. This study aims to verify the appetite alteration model for malnutrition in HD patients through quantitative data and the International Classification of Functioning, Disability, and Health (ICF) framework. This study uses the Mixed Method-Grounded Theory (MMGT) method to explore various factors and processes affecting malnutrition in HD patients, create a suitable treatment model, and validate it systematically by combining qualitative and quantitative data and procedures. The demographics and medical histories of 14 patients were collected. Based on the theory, the research design is based on expansion and confirmation sequence. The usefulness and cut-off points of the creatinine index (CI) guidelines for malnutrition in HD patients were linked to significant categories of GT and the domain of ICF. The retrospective CIs for 3 months revealed patients with 3 different levels of appetite status at nutrition assessment and 2 levels of uremic removal. In the same way, different levels of dry mouth, functional support, self-efficacy, and self-management were analyzed. Poor appetite, degree of dryness, and degree of taste change negatively affected CI, while self-management, uremic removal, functional support, and self-efficacy positively affected CI. This study identified and validated the essential components of appetite alteration in HD patients. These MM-GT methods can guide the selection of outcome measurements and facilitate the perspective of a holistic approach to self-management and intervention.

• The Journal of Korean Physical Therapy
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• v.28 no.5
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• pp.321-327
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• 2016

Purpose: The purpose was to link items of questionnaires that measure functioning and disability of persons with Low Back Pain (LBP) into the International Classification of Functioning, Disability and Health (ICF). Methods: The Oswestry Disability Index (ODI), Roland and Morris Disability Questionnaire (RM), Fear-Avoidance Beliefs Questionnaire (FABQ), and Short Form-36 health survey (SF-36) were evaluated to map items of those questionnaires into the ICF categories. The linking rule was employed and linking was performed independently by 10 health professionals. One-hundred and two patients with LBP were recruited from 19 medical institutes to this study for a field test to examine relations between the scale and its linked ICF category set. Pearson correlation coefficient was used to analyze their relationships. Results: Walking was only found to be one-to-one linking between the scale and the ICF. Sixty questions in FABQ were to be linked to 9 of ICF categories. Ten and 14 ICF categories were able to be linked to RM and ODI respectively. It was found that majority of items from ODI and RM scale had similar concept and linked to the same ICF category. SF-36 had only 15 categories of the ICF linked. Strong relationship was observed between measurement scales and linked ICF code sets (r=0.79, r=0.65, r=0.47, and r=-0.31 for ODI, RM, FABQ and SF-36 respectively). Conclusion: It was found that commonly used clinical tools for LBP may be linked to ICF. The study results may suggest that clinical data can be standardized to communicate between related professionals.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.10
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• pp.3846-3852
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• 2010

Low back pain is commonly experienced by both adolescents and adults. The aim of this study is to research the prevalence of the Oswestry disability index(ODI) in their 20s of college students. The data was collected from the ODI questionnaire on functional disability measures for college students(males: 233, females: 407). Statistical analysis was carried out with SPSS 12.0 program, which was used for descriptive statistics and Pearson correlation analysis. The results were : Firstly, 'sitting' item was showed 'the highest score' and 'the lowest score' was 'personal care' in ODI items. Secondly, there was statistically significant between female(6.13) and male(4.62) on ODI but not ODI grade(p<0.01). Thirdly, there was a statistically significant relationship between ODI grade and each ODI items(p<0.01). These results have specific meaning as future clinical and epidemiological studies.

• PNF and Movement
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• v.16 no.1
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• pp.33-42
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• 2018

Purpose: The aim of this study was to investigate the effects of trapezius and serratus anterior strengthening exercise on the shoulder pain and muscle activation of patients with spinal cord injury and functional shoulder impingement syndrome. Methods: The study consisted of 10 patients with spinal cord injury who were hospitalized in Rehabilitation Hospital U, Uijeongbu, South Korea. The exercise was implemented three times a week for 10 weeks. In each session, the subjects performed one of a total of five types of exercise at mid-level intensity. The shoulder pain and disability index (SPADI) was used to evaluate the patients before and after the intervention. The muscle activation of the upper trapezius, middle trapezius, lower trapezius, and anterior serratus muscle was assessed by surface electromyography (EMG) at the beginning of the experiment and 10 weeks later. Wilcoxon's singed-rank test was conducted to determine differences in the pain index and muscle activation before and after the exercise. The level of statistical significance was set at ${\alpha}=0.05$. Results: SPADI scores significantly decreased after the exercise (p<0.05). In comparisons of muscle activation, there was a significant improvement in the upper trapezius at $60^{\circ}$ shoulder joint flexion (p<0.05). There was no significant improvement at $90^{\circ}$ shoulder joint flexion. The middle trapezius showed a significant improvement at $120^{\circ}$ shoulder joint flexion (p<0.05). Conclusion: Trapezius and serratus anterior strengthening exercise reduced pain in spinal cord injury patients with functional shoulder impingement syndrome. The decreased muscle activation of upper trapezius and increased muscle activation of the anterior serratus muscle at $60^{\circ}$ shoulder joint flexion point to positive effects of the exercise on supraduction of the scapula.

• Physical Therapy Korea
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• v.27 no.2
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• pp.102-110
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• 2020

Background: There is an opinion that improper postures of the head and cervical spine are associated with temporomandibular joint (TMJ) disorders (TMDs). Objects: The aim of this study was to investigate the proportions among the cervical kyphotic angle, physical symptoms including the pain intensity level of the TMJ, and severity of TMD disability in patients diagnosed with TMD. Methods: Sixty-two subjects participated in the study. The evaluation tools included measurements of the cervical kyphotic angle based on the Ishihara index, pressure pain threshold (PPT) on the TMJ, maximal mouth opening (MMO) without pain, current pain intensity level of the TMJ measured using the Quadruple Visual Analogue Scale (QVAS), Korean TMD (KTMD) disability index, KTMD Symptom Frequency/Intensity Scales (SFS/SIS), and Korean Headache Impact Test-6. Correlation analysis was conducted to investigate the correlations between the cervical kyphotic angle and parameters related to TMJ symptoms. Results: Variables that were significantly correlated with the cervical kyphotic angle were the PPT around the TMJ (r = 0.259, p < 0.05), current pain intensity level of the TMJ based on the QVAS (r = -0.601, p< 0.01), and usual pain intensity level based on the SIS (r = -0.379, p < 0.01). The level of TMD functional disability was significantly correlated with the degree of headache (r = 0.551, p < 0.01), level of PPT of the TMJ (r = -0.383, p < 0.01), pain-free MMO (r = -0.515, p < 0.01), pain intensity level of the TMJ based on the QVAS (r = 0.393, p < 0.01), TMD symptom frequency (r = 0.739, p < 0.01), usual pain intensity of the TMJ (r = 0.624, p < 0.01), and most severe pain intensity of the TMJ (r = 0.757, p < 0.01). Conclusion: There is a positive correlation between the cervical kyphotic angle and PPT and a negative correlation between the current and usual pain intensity levels of the TMJ. The cervical kyphotic angle was a predictor of the pain level, tenderness threshold, and intensity of pain in the TMJ.

• Anxiety and mood
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• v.9 no.1
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• pp.25-30
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• 2013

Objective : Panic disorder is a chroni, debilitating illness, and has been known to be affected by high anxiety sensitivity and a poor quality of life. We examined if 12 weeks of pharmacotherapy with escitalopram could affect anxiety sensitivity, quality of life, and general disability in patients with panic disorder. Method : We enrolled 27 patients who met the DSM-IV-TR criteria for panic disorder, with or without agoraphobia, and completed 12 weeks of escitalopram treatment. We enrolled 29 normal control subjects who were matched for age and sex compared with the panic patients. All subjects were assessed using the Hamilton Rating Scale for depression (HAM-D), Hamilton Rating Scale for Anxiety (HAM-A), Panic Disorder Severity Scale (PDSS), Anxiety Sensitivity Index-Revised (ASI-R), WHO quality of life assessment (WHO-QOL) and Sheehan Disability Scale (SDS) before and after 12 weeks of treatment. Result : Panic disorder patients had a higher Anxiety sensitivity, a poorer Quality of life, and significant disability than normal control subjects at baseline. After the treatment, Panic disorder patients showed significant improvement in the severity of panic symptoms in terms of the HAM-A p<0.001), HAM-D (p<0.001) in addition, the reached a remission state in terms of the PDSS score. They also showed significant improvement in the ASI-R (p<0.001), WHO-QOL (p<0.001) and SDS (p<0.001), but mean scores of the ASI-R, WHO-QOL and SDS in panic disorder patients were did not reach normal levels. Conclusion : This study suggests that 12 weeks of pharmacotherapy with escitalopram could improve anxiety sensitivity, quality of life, and disability in panic disorder patients, although their anxiety sensitivity, quality of life and disability were not yet normalized after short-term pharmacotherapy. Thus, long-term pharmacotherapy may be necessary for panic disorder patients in order to get an optimal clinical response in terms of anxiety sensitivity, quality of life, and general disability.

• The Journal of Korean Physical Therapy
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• v.28 no.5
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• pp.341-347
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• 2016

Purpose: The aim of the study was to investigate items of commonly used questionnaires that measure functioning status of persons with stroke and map to the International Classification of Functioning, Disability and Health (ICF). Methods: Eighty-six patients with stroke were recruited from 12 medical institutes for the study. Each item of the Modified Bathel Index (MBI), Stroke Impact Scale (SIS), Mini Mental Status Evaluation (MMSE) and SF-36 were examined and compared its concept with the ICF. Concept linking was performed by 10 health professionals independently. A field test was performed to assess its correlation between those of scales and their linked ICF category sets. Results: It was found that 11 items in MBI was linked to 14 ICF categories, whereas 27 items of MMSE had 10 categories of ICF linked. 60 items of SIS were to be linked with 35 ICF categories. Agreement between professionals in linking was found to be high: 97.5% for MBI items, 78.0%, 78.0%, and 74.8% for MMSE, SIS, and SF-36 respectively. Strong relationship was observed between measurement scales and linked ICF code sets (r=-0.76 for SIS, r=-0.78 for MBI, r=-0.47 for MMSE) whereas there was no relationship was found between SF-36 and its ICF code set (r=-0.06) from the field test. Conclusion: It was found that items of SIS, MMSE and MBI may be linked to ICF categories. Those of linking concept between clinical tools and the ICF could be helpful for clinical data standardization.

• Physical Therapy Rehabilitation Science
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• v.4 no.1
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• pp.55-59
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• 2015

Objective: This study aimed to elucidate the effects of thoracolumbar fascia release (TLFR) on the degree of pain and disability in patients with shoulder pain. Design: Randomized control trial. Methods: Thirty subjects with shoulder pain participated in this study. They were allocated to TLFR group (n=15) and manual physical therapy (MPT) group (n=15). Shoulder pain and disability index (SPADI) and the score on the visual analogue scale (VAS) were measured before and after TLFR. Results: In the TLFR group, the degree of shoulder pain as indicated by SPADI measured after the intervention significantly differed from that before the intervention (p<0.05); moreover, in the MPT group, the degree of shoulder pain was significantly lower (p<0.05). The data of the 2 groups before the intervention significantly differed from those after the intervention (p<0.05). SPADI significantly differed within the groups (p<0.05), but not between the groups. The sum of SPADI did not differ significantly between the groups. The VAS scores of shoulder pain measured before the intervention significantly differed from those measured after the intervention (p<0.05) in the both groups. After the intervention, shoulder pain decreased significantly in the TLFR group as compared to that in the MPT group. Conclusions: TLF release was effective in reducing shoulder pain. The results of this study can be applied in clinical practice for TLFR performed to reduce shoulder pain. Further studies will need to be performed to elucidate the effects of TLFR on functional recovery.