• Title/Summary/Keyword: Further flexion

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Short-term Comparison of Supervised Rehabilitation and Home-based Rehabilitation for Earlier Recovery of Shoulder Motion, Pain, and Function after Rotator Cuff Repair

  • Song, Si-Jung;Jeong, Tae-Ho;Moon, Jung-Wha;Park, Han-Vit;Lee, Si Yung;Koh, Kyoung-Hwan
    • Clinics in Shoulder and Elbow
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    • v.21 no.1
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    • pp.15-21
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    • 2018
  • Background: This study was undertaken to compare the outcome of supervised and home exercises with respect to range of motion (ROM), pain, and Single Assessment Numeric Evaluation (SANE). We further correlated the ROM recovery and pain reduction as well. Methods: The study included 49 patients who underwent arthroscopic rotator cuff repair. Rehabilitation was initiated after 4 weeks of immobilization. A total of 29 patients performed supervised exercise 3 times a week. Standardized education and brochures for review were provided to the remaining 20 patients who insisted on home rehabilitation. Statistical analysis was performed for comparing pain Numerical Rating Scale (NRS), SANE, and ROM. In addition, we also evaluated the correlation between pain and ROM. Results: Comparison of the two groups revealed no significant differences in forward flexion, internal rotation, abduction, and pain NRS. However, SANE at the 9th week (63.8 vs. 55.0, p=0.038) and improvement of external rotation from the 5th to the 9th week (17.6 vs. 9.3, p=0.018) were significantly higher in the supervised exercise group as compared to the home exercise group. Correlation of pain NRS with forward flexion, external rotation, internal rotation and abduction were statistically not significant (correlation coefficient=0.032 [p=0.828], -0.255 [p=0.077], 0.068 [p=0.642], and -0.188 [p=0.196], respectively). Conclusions: The supervised rehabilitation after arthroscopic rotator cuff repair showed better improvement in external rotation and higher SANE score after 4 weeks of rehabilitation exercise. However, no statistically significant correlation was observed between the recovery of ROM and short-term pain relief.

Changes in Range of Motion after Intra-Articular Corticosteroid Injection in Frozen Shoulder: A Retrospective 3-Month Follow-Up Study (동결견 환자에서 관절강내 스테로이드 주사 후 관절가동범위의 변화)

  • Cho, Hyoung Jun;Yoon, Seung-Hyun;Kim, Minchul;Kim, Dae Hwan
    • Clinical Pain
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    • v.18 no.2
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    • pp.76-81
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    • 2019
  • Objective: To examine (1) the degree of reduction of passive range of motion (PROM) on the affected side compared to that on the unaffected side and (2) the degree of increase in PROM following intra-articular corticosteroid injection (IACI) in patients with frozen shoulder. Method: The medical records of 120 patients with frozen shoulder were retrospectively reviewed. PROM of the unaffected and affected shoulder (flexion, extension, abduction, internal rotation, external rotation) was compared, and changes in PROM of the affected shoulder after a single IACI (triamcinolone 20 mg) were evaluated after 12 weeks. Results: At the time of diagnosis, PROM of the affected shoulder was most limited in external rotation, followed by internal rotation, abduction, extension, and flexion, compared to that of the unaffected shoulder. Compared to before IACI, PROM of external rotation demonstrated the greatest increase compared to all the other movements after IACI. Conclusion: Limitation in PROM of the frozen shoulder at the time of diagnosis was greatest for external rotation. Moreover, external rotation experienced the greatest improvement after IACI. Our findings should help to further clarify the clinical characteristics of frozen shoulder, aid in its diagnosis, and allow the prediction of the effects of IACI.

Neuromuscular difference between normal subjects and low-back pain patients: Neural excitation measured by dynamic electromyography (정상인과 요통환자의 생체역학적 차이에 관한 연구:신경근육계의 동적 근전도 반응형태를 중심으로)

  • 김정룡
    • Journal of the Ergonomics Society of Korea
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    • v.14 no.2
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    • pp.1-14
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    • 1995
  • Neuromuscular difference between normal subjects and low-back pain patients has been identified in terms of neural excitation signal measured by Electromyography (EMG) under the dynamic flexion/extension trunk motion. Ten healthy subjects and ten low-back pain patients were recruited for this study. New parameters and normalization technique were introduced to quantify the muscle excitation pattern among the flexor-extensor pairs of muscles : rectus abdominis (RA)-erector spinae (ES at L1 and L5 level), external oblique (EO)-internal oblique (IO), rectus femoris (quadricep : QUD)-biceps femoris( hamstring : HAM), and tibialis anterior (TA)-gastrocnemius (GAS). Results indicated that the temporal EMG pattern such as peak timing difference between the hip flexor (QUD) and extensor (HAM) and the duration of coexcitation between ES at L5 and RA muscle pairs showed a statistically significant difference between normal subjects and low-back pain patients. Improtantly, this study presented a new technique to identify the dynamic muscle excitation pattern that canb be least affected by EMG-length-velocity relationship. Further study can performed to validate this method for clinical application to quantitatively identify the low-back pain patients in the future.

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Arthroscopic Treatment for the Pigmented Villonodular Synovitis in the Knee (관절경을 이용한 슬관절의 색소 응모 결절성 활액막염의 치료)

  • Kim, Kyung-Taek;Kim, Chul-Hong;Lee, Myung-Jin
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.2
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    • pp.111-115
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    • 2001
  • Purpose : To confirm the efficacy of arthroscopic synovectomy for the pigmented villonodular synovitis in the knee. Materials and Methods : We analysed 8 patient(9 cases) that were diagnosed and performed arthroscopic synovectomy as pigmented villonodular synovitis from July 1992 to May 2000. The diagnosis was confirmed by pathologist. The average follow-up period was 29 months(range, $15\~48$ months). The average age at initial visit was 40.4 years(rage, $15\~67$ years). Male were 6 cases and female 2 cases. The average duration from onset of the symptom to the operation was 23 months($2\~86$ months). Previous history of the trauma was noted in 2 case. There was 1 case involved both knee joints. Results : According to the athroscopic findings, there were 4 localized forms and 5 diffuse forms. At preoperational examinations, the average of flexion contracture was $4.4^{\circ}(0\~5^{\circ})$ and that of the further flexion was $117.8^{\circ}(90\~135^{\circ})$. At last follow-up examinations, the knee range of motion was normalized, the average of flexion range was $133.9^{\circ}(120\~140^{\circ})$. All patients had improvement in pain, swelling and range of motion and there was no evidence of recurrence. Conclusion : In the pigmented villonodular synovitis, arthroscopic synovectomy can be considered one of the good modality to expect good results.

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Functional analysis of isolated posterior cruciate ligament deficient subjects (후방 십자 인대 단독 손상 환자의 기능적 분석)

  • Kim Jin Goo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.1
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    • pp.66-72
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    • 2004
  • Purpose: To evaluate the compensatory mechanism in vivo and develop the treatment guide by performing the comprehensive functional tests of the posterior cruciate ligament (PCL) deficient subjects. Material and Methods: 10 PCL deficient subjects and 10 healthy control group were evaluated. Performed functional tests were range of motion, posterior drawer test, Telos, 30$^{\circ}$ flexion wt-bearing view, KT-1000 arthrometer, gait analysis, EMG test and isokinetic tests. Results: Physical, KT-1000, Telos posterior tests showed significant differences, but 300 full weight bearing lateral view, muscle strength test revealed no difference between two groups. Less knee flexion at initial contact and reduced maximum valgus moment were observed in PCL deficient group. In vertical drop landing, PCL group had increased plantar flexion angle at initial contact. Conclusion: Compensatory mechanisms such as reduced unstable components and absorbing the maximal load of the joint were occurred after PCL insufficiency, which result in good clinical and functional outcomes. Further investigations would be needed to understand the functional adaptations of PCL deficient subjects.

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Comparison of Muscle Strength between Dominant and Non-dominant Sides of College Students in Their 20s according to Contraction Type (수축 형태에 따른 20대 대학생의 우세 측과 비우세 측의 근력비교)

  • Jong-Hyup Lee;Seung-Kyu Lee;Young-Sun Na;Jeong-Woo Jeon;Jae-Ho Yu;Ji-Heon Hong;Jin-Seop Kim;Dong-Yeop Lee
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.2
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    • pp.47-53
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    • 2024
  • Purpose : This study investigated the effects of concentric and eccentric contractions on muscle strength using an isokinetic dynamometer (ID) in college students in their 20s. It aimed to understand the impact of differences between the dominant and non-dominant sides on strength asymmetry and to elucidate the clinical implications of these differences to establish an appropriate posture and environment for patients. Methods : The experiment was conducted with 30 healthy adult participants. Prior to the experiment, participants underwent a warm-up targeting the shoulders, and efforts were made to eliminate factors that could potentially influence the measurement results. Subsequently, the maximum safe range of motion of shoulder joint abduction, extension, and flexion was measured using an isokinetic muscle function testing device. Muscle strength was assessed using concentric and eccentric contractions alternating between the dominant and non-dominant sides, and paired sample t-tests were used for the analysis. Results : There was no significant difference between bilateral peak torques for eccentric contraction in shoulder joint abduction, extension, and flexion (p>0.05). There was also no significant difference between bilateral peak torques for concentric contraction in shoulder joint abduction, extension and flexion (p>0.05). Conclusion : This study found no statistically significant difference in muscle strength between the dominant and non-dominant sides during concentric and eccentric contractions. However, previous studies have shown significant differences between the dominant and non-dominant sides during eccentric and concentric contractions during internal shoulder rotation in the general population, as well as significant differences in the upper trapezius muscle. Therefore, further research is needed to support the application of different intensities for bilateral muscle strengthening exercises in clinical practice.

Effect of Exercise Programs for Chronic Low Back Pain Patients : A Systematic Review (만성 허리통증환자의 운동프로그램에 대한 효과)

  • Kang, Kwon-Young;Kim, Eun-Kyung;Hong, Gi-Hoon
    • Journal of Korean Physical Therapy Science
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    • v.18 no.2
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    • pp.1-8
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    • 2011
  • Background: The purpose of this study was to systematic review the effect of exercise programs for chronic low back pain patients. We needs systematic development of low back pain exercise program to reduce economic cost further doing great service to public health promotion. Methods: We searched to the effects of exercise programs for chronic low back pain patients by Dankook University electronic library databases of DBPIA, KSI KISS, CINAHL, MEDLINE and PEDro combined with a hand search of papers published in relevant journals. Any type of study relevant to the topic published during time period from 1970 to 2007 was included. Results: The literature search identified 30 studies. 1.Performing the flexion exercise increased abdominal muscle activity but acute herniated intervertebral disc should be avoided. 2.The general lumbar extension exercise used lumbar extension machine and the muscle power increases, significant probability the change. 3.The spinal segments exercise for the patients offered significant efficacy and appeared to be a reasonable therapeutic option. 4.Spinal stabilization exercises appear to improve trunk endurance and balance to patients with chronic low back pain. This exercise programs had effective decrease pain and disability. Conclusion: The review suggests that although the exercise programs for chronic low back pain patients, and we expected the efficacy of the exercise programs for chronic low back pain patients used in this study should be further investigated in a long period study and objective outcomes.

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A Review of Studies Comparing of Surface Electromyography Values between the Low-back Pain Group and Healthy Controls (요통환자군과 정상대조군 사이의 표면근전도값 비교에 관한 연구문헌 고찰)

  • Yoo, Duk-Joo;Cho, Jae-Heung;Chung, Seok-Hee
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.4
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    • pp.83-93
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    • 2013
  • Objectives To present reviews of studies comparing surface-electromyography (SEMG) values between low back pain group and control group. Methods We searched 8 databases including KoreaMed, Google, KISS (Korean studies Information Service System), RISS (Research Information Sharing Service), OASIS (Oriental medicine Advanced Searching Integrated System), Pubmed, Ovid-MEDLINE and EMBASE. After searching, we conducted study selection by using inclusion and exclusion criteria and quality-assessment. We reviewed the selected studies concerning about the subject's measuring position, findings, sensitivities and specificities. Results 27 Studies were searched and reviewed. In static surface electromyography, more muscle activities observed in low back pain subjects than in controls. In dynamic surface electromyography, the low back pain subjects showed more muscle activites during flexion, while the control group showed more muscle activities during extension. Faster muscle fatigue observed in isometric muscle analysis. Conclusions Surface electromyography values will be able to be objective marker for evaluating low back pain. Further research is needed to determine additional unified protocol such as the type of SEMG and its directions.

Concurrent Validity, Inter-Tester and Intra-Tester Reliability of Goniometric Measurement of Active Elbow Range of Motion Using 4 Different Types of Measuring Instruments (주관절 가동범위 측정법에 대한 동시타당도와 신뢰도)

  • Current, Marion E.;Yi, Chung-Hwi
    • Physical Therapy Korea
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    • v.2 no.2
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    • pp.46-55
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    • 1995
  • The purpose of this study was to assess the concurrent validity and reliability of goniometric measurement of joint motion. Subjects were 40 healthy university students. Measurements were performed by 4 inexperienced physical therapy students. Four different instruments were used and three readings were taken with each instrument in random order making a total of 12 readings for flexion of the right elbow of each subject. Goniometers used were 1. universal 2. fluid-based goniometer/inclinometer 3. digital LCD goniometer 4. electronic goniometer/torsiometer. The results were as follows: Concurrent validity was highest (r= .94) with the universal and digital LCD tools. Interrater reliability (Pearson Product Moment Correlation) was good for each tool. Interrater reliability calculated by ICC(2,1) was highest (.96) with the tensiometer and lowest (.78) with the digital LCD goniometer. Intrarater reliability calculated by ICC was excellent (${\geq}.90$) for all instruments. These results show that concurrent validity, intrarater and interrater reliability are very good in the used of all four types of goniometers/inclinometer/tensiometer, even with inexperienced raters. These results confirm the almost universal reliance on hand held goniometers for joint measurement by physical therapists as being a reliable practice. Further research should be done clinically with actual patients.

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A Comparison of Methods for Estimating the Proper Cane Length for Hemiplegic Patients (성인편마비환자의 지팡이 길이 측정법 비교)

  • Yi, Chung-Hwi;Kim, Jong-Man
    • Physical Therapy Korea
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    • v.3 no.2
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    • pp.1-7
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    • 1996
  • Two standard methods of cane length measurements were compared to find which methods really achieve the elbow flexion of 20 degrees to 30 degrees Twenty-four patients with hemiplegia who were ambulatory participated in this study. Method I : Length of the cane measured from the floor to the top of the greater trochanter. Method II : Length of the cane measured from the floor to the distal wrist crease with the arm at the side. Using an adjustable cane, each individual was fitted according to the two methods, and elbow angle was measured after each adjustment. The elbow angle according to Method I and Method II was $46.4{\pm}20$, $44.3{\pm}12.2$, respectively. No significant difference was found in the elbow angle or the cane length between the two methods. Of the 24 participants, 5(20.8%) measured according to method I and 3(12.5%) measured according to method II showed the elbow angle between 20 degrees and 30 degrees. These low predictive rates of agreement between ideal cane length and actually achieved elbow angle showed that these two methods which have conventionally been accepted as a standard to measure ideal cane length need to be revised through further research.

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