• The Korean Journal of Pain
• /
• 제3권2호
• /
• pp.165-171
• /
• 1990

The reflex sympathetic dystrophy syndrome (RSDS) consists of sustained burning pain and tenderness, vasomotor instabilitiy, swelling, occasional functional instability, trophic skin change and edema of extremity following trauma, peripheral nerve injury, spinal cord injury, infection, burn and other etiologic factors. The most important thing in RSDS is to start the treatment as soon as the disease was diagnosed. Most patients with RSDS respond dramatically and permanently to sympathetic blocks if treatment is instituted before irreversible trophic changes. The characteristic radiological finding in RSDS is a patchy osteoporosis in the cancellous bone. Periarticular hyperactivity is seen in RSDS by Tc99m bone scan. We have managed 4 cases of RSDS. The methods of management and effects are as follows: 1) In case 1, 28 lumbar sympathetic blocks in both sides were performed. The patient did not complain of pain or tenderness and the limping improved. 2) In case 2, 7 lumbar sympathetic blocks were performed, but we could find only a slight improvement in the symptoms. 3) In case 3, 8 stellate ganglion blocks were carried out. The patient refused the treatment of RSDS because of the lack of rapid improvement. 4) In case 4, total 64 stellate ganglion blocks were carried out; the patient was permanently improved.

• 재활복지공학회논문지
• /
• 제11권3호
• /
• pp.207-214
• /
• 2017

몸통안정성에 문제가 발생하면 허리에 통증이 발생된다. 허리 불안정성을 해소하기 위한 몸통안정화운동 방법 중 하나인 복부드로우인기법(ADIM)은 복부안정화근육 중 선행적자세조절과 관련된 배가로근에 대한 선택적인 수축을 유도하는 운동법이다. ADIM은 일반적으로 바로누운자세에서 허리 밑에 압력생체되먹임장치(PBU)을 적용하여 시각적되먹임을 한 상태에서 실시하는데 이러한 자세는 앉은자세에 비해 기능적이지 못하다. 본 연구에서는 바로누운자세와 앉은자세에서 실시하는 ADIM의 효과를 알아보기 위해 31명의 건강한 남녀를 대상으로 무선 근전도를 이용해 배곧은근(RA), 배바깥빗근(EO), 배가로근/배속빗근(TrA/IO), 그리고 척추세움근(ES)에 대한 근활성도를 비교하였다. 본 연구 결과 RA와 EO에서는 두 자세 간에 유의한 차이가 없었으며 TrA/IO와 ES에서는 두 자세 간에 유의한 차이가 나타났다. 또 RA에 비해 TrA/IO의 활성도가 높게 나타나 ADIM로 인한 몸통안정화는 두 자세 모두에서 효과적으로 나타났으며 반면 TrA/IO와 ES는 앉은 자세에서 더 높은 활성도를 보여 자세 안정화 근육의 활성도가 앉은 자세에서 더 증가한 것으로 사료된다. 따라서 일상생활에서 보다 쉽게 적용할 수 있는 앉은 자세의 ADIM은 허리안정성 향상에 유용할 것이다.

• 한국전문물리치료학회지
• /
• 제28권1호
• /
• pp.27-35
• /
• 2021

A weak or dysfunctional gluteus medius (Gmed) is related to several pathologies, and individuals with hip abductor weakness have Gmed weakness. This study aimed to systematically review the literature associated with the anatomy and function of the Gmed, and the prevalence, pathology, and exercise of Gmed weakness. Papers published between 2010 and 2020 were retrieved from MEDLINE, Google Academic Search, and Research Information Sharing Service. The database search used the following terms: (glut* OR medius OR hip abduct*) AND weak*. The Gmed plays an important role in several functional activities as a primary hip abductor by providing pelvic stabilization and controlling hip adduction and internal rotation. Weakness of the Gmed is associated with many disorders including balance deficit, gait and running disorders, femoroacetabular impingement, snapping hip, gluteal tendinopathy, patellofemoral pain syndrome, osteoarthritis, iliotibial band syndrome, anterior cruciate ligament injury, ankle joint injuries, low back pain, stroke, and nocturia. Overuse of the tensor fasciae latae (TFL) as a hip abductor due to Gmed weakness can also cause several pathologies such as pain in the lower back and hip and degenerative hip joint pathology, which are associated with dominant TFL. Similarly, lateral instability and impaired movements such as lumbar spine lateral flexion or lateral tilt of the pelvis can occur due to compensatory activation of the quadratus lumborum for a weakened Gmed while exercising. Therefore, the related activation of synergistic muscles or compensatory movement should be considered when prescribing Gmed strengthening exercises.

• Hip & pelvis
• /
• 제36권2호
• /
• pp.87-100
• /
• 2024

Total hip arthroplasty (THA) is an effective treatment for osteoarthritis, and the popularity of the direct anterior approach has increased due to more rapid recovery and increased stability. Instability, commonly caused by component malposition, remains a significant concern. The dynamic relationship between the pelvis and lumbar spine, deemed spinopelvic motion, is considered an important factor in stability. Various parameters are used in evaluating spinopelvic motion. Understanding spinopelvic motion is critical, and executing a precise plan for positioning the implant can be difficult with manual instrumentation. Robotic and/or navigation systems have been developed in the effort to enhance THA outcomes and for implementing spinopelvic parameters. These systems can be classified into three categories: X-ray/fluoroscopy-based, imageless, and computed tomography (CT)-based. Each system has advantages and limitations. When using CT-based systems, preoperative CT scans are used to assist with preoperative planning and intraoperative execution, providing feedback on implant position and restoration of hip biomechanics within a functional safe zone developed according to each patient's specific spinopelvic parameters. Several studies have demonstrated the accuracy and reproducibility of robotic systems with regard to implant positioning and leg length discrepancy. Some studies have reported better radiographic and clinical outcomes with use of robotic-assisted THA. However, clinical outcomes comparable to those for manual THA have also been reported. Robotic systems offer advantages in terms of accuracy, precision, and potentially reduced rates of dislocation. Additional research, including conduct of randomized controlled trials, will be required in order to evaluate the long-term outcomes and cost-effectiveness of robotic-assisted THA.