• The Journal of Korean Physical Therapy
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• 제30권4호
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• pp.129-134
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• 2018

Purpose: This study aims to investigate the changes in pulmonary function, gait ability, and quality of life when NMES is applied along with CBE and to provide basic clinical data to be used in pulmonary rehabilitation guidelines for patients with COPD to treat patients with severe COPD. Methods: For this study, CBE and NMES of quadriceps femoris on both sides were applied to the experimental group (n=10), and only CBE was applied to the control group (n=10). For a pre-test, a 6-minute walk test was performed, and pulmonary function and health-related quality of life were measured. Moreover, an exercise program was applied to each group for 30 minutes per session, 5 times a week, for 6 weeks. After that, a post-test was conducted the same way as the pre-test. Results: In the within-group comparison, there were significant differences in forced expiratory volume in one second, 6-minute walk test and health-related quality of life between the experimental group and the control group (p<0.01)(p<0.05). In the between-group comparison, the experimental group showed an increase in forced expiratory volume in one second and 6-minute walk test (p<0.05) and showed a decline in health-related quality of life (p<0.05). Conclusion: The 6-weeks NMES program improved health-related quality in patients with severe COPD by increasing expiratory volume by reinforcing the function of quadriceps femoris. This finding implies that NMES could be an alternative mode for improving physical functions of patients with severe COPD, who cannot participate in a breathing exercise program or are reluctant to participate.

• Archives of Reconstructive Microsurgery
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• 제9권2호
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• pp.147-153
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• 2000

Soft tissue defects of the dorsum of foot and ankle can be covered from skin graft to free tissue transfer. The extent of injury which may be complex including the exposure of paratenons or bones requires free flap reconstruction. Some of the precautions for reconstruction are providing minimal bulkiness and well conforming to irregular contour thus making normal footwear possible. Though the muscle flap having its advantages and versatility, the fascial flap such as temporoparietal fascial flap has been considered the choice for reconstruction of the dorsum of foot and ankle. The purpose of our study is to utilize the advantages and versatility of the muscle flap as a first choice for reconstruction for the defects involving the dorsum of foot and ankle. The gracilis muscle with its anatomic and donor characteristics, it can be utilized to maximal effect by expanding its slim muscle width removing the epimysium and reducing its bulk by muscle atrophy through denervation. We present our experience with ten cases of reconstruction for the dorsum of foot and ankle using the gracilis muscle free flap. Results were satisfactory without flap loss, skin loss and infection. The contour and aesthetic aspect of the foot was satisfactory. Gait analysis showed near normal gait without limitations from everyday activities. Normal footwear was tolerable in all the cases. The keys to consider in the reconstruction of the dorsum of foot and ankle are appropriate bulkiness, conforming to its contour and able to apply normal footwear. With minimal donor morbidity and satisfying results, the extended gracilis muscle should be considered as the first line for reconstruction of the ankle and dorsum of foot.

• 한국운동역학회지
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• 제26권1호
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• pp.135-142
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• 2016

Objective: The purpose of this study was to investigate the acute effect of walking on high heels on the behavior of fascicle length and activation of the lower limb muscles. Methods: Twelve healthy inexperienced high heel wearers (age: $23.1{\pm}2.0yr$, height: $162.4{\pm}4.9cm$, weight: $54.4{\pm}8.5kg$) participated in this study. They walked in high heels (7 cm) and barefoot on a treadmill at their preferred speed. During the gait analysis, the lower limb joint kinematics were obtained using a motion analysis system. In addition, the changes in fascicle length and the level of activation of the medial gastrocnemius (MG) were simultaneously monitored using a real-time ultrasound imaging technique and surface electromyography, respectively. Results: The results of this study show that the MG fascicle operates at a significantly shorter length in high heel walking ($37.64{\pm}8.59mm$ to $43.99{\pm}8.66mm$) in comparison with barefoot walking ($48.26{\pm}9.02mm$ to $53.99{\pm}8.54mm$) (p < .05). In addition, the MG fascicle underwent lengthening during high heel walking with relatively low muscle activation while it remained isometric during barefoot walking with relatively high muscle activation. Conclusion: Wearing high heels alters the operating range of the MG fascicle length and the pattern of muscle activation, suggesting that prolonged wearing of high heels might induce structural alterations of the MG that, in turn, hinder normal functioning of the MG muscle during walking.

• 대한정형도수물리치료학회지
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• 제27권3호
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• pp.99-105
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• 2021

Purpose: This study aims to report on the effect of providing customized visiting exercise, a musculoskeletal intervention method, to the elderly in the community. Methods: In this study, subjective pain was measured to evaluate pain and physical ability of the elderly, and timed up & go (TUG) test and psychological level test were performed for myofascial pain perception symptoms and gait function. Measurements were performed twice before and 4 weeks after treatment. Participants in the exercise group (n=108) performed the spine exercise, whereas those in the spine exercise group (n=108) performed the spine exercise using complex exercise program (3 times/week for 4 weeks). Results: The significant test of visual analogu scale (VAS), pain pressure threshold (PPT), TUG, psychosocial factor according to applying the exercise within groups used T-test. In the result following analysis, there was significance on VAS (p=.000), PPT (p=.000), TUG (p=.000), Psychosocial factor (Depresion; p=.000, Anxiety; p=.000) within group. Conclusion: Then, exercise has benefit on the VAS, PPT, TUG, psychosocial factor in patients with myofacial pain syndrome. So, it may suggest that exercise will be helpful of the pain, gait and psychosocial factor improvement the patients with spine pain.

• 한국산학기술학회논문지
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• 제18권12호
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• pp.352-358
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• 2017

이마관자엽 치매는 조기 발현형 치매 중 두 번째로 흔한 형태로 행동, 언어, 인지 장애를 보이는 신경퇴행성 질환이다. 이마관자엽 치매에서 운동 기능 이상이 동반되는 경우는 운동 신경원 질환과 파킨슨증, 진행성 핵상 마비 등으로 대표되나, 다른 동반 질환 없이 이마관자엽 치매가 중추신경계의 운동신경영역을 직접 침범하여 나타난 운동 기능 이상은 보고된 바가 없다. 또한, 임상적 치매 집단과 복합부위 통증 증후군 사이의 연관성은 보고된 바가 없다. 저자들은 이마관자엽 치매환자에서 나타난 중추신경계 원인의 하지 근력 저하를 뇌 자기공명영상과 전기진단학적 검사를 통해 진단하였고, 동반된 복합부위 통증증후군을 삼상 골주사 검사를 통해 진단하였으며, 이에 따른 임상적 치료를 시행하였다. 스테로이드를 이용한 복합부위 통증증후군 치료 후에 환자의 통증은 호전되었고, 입원 상태에서 하지 근육에 대한 기능적 전기 자극 치료, 근력 강화 운동 및 보행 훈련을 포함한 포괄적 재활치료를 시행한 후에 저명한 기능적 호전을 보였다. 이마관자엽 치매에서 관찰된 중추신경계 원인의 근력 저하에 대한 재활 치료는 전반적 기능의 향상에 효과적일 것으로 추정된다.

• Archives of Plastic Surgery
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• 제32권4호
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• pp.441-446
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• 2005

Sole reconstruction should consider both functional and aesthetic aspects; durable weight bearing surface, adequate contour for normal footwear, protective sensation and solid anchoring to deep tissue to resist shearing. The anterolateral thigh perforator free flap has such favorable characteristics as long pedicle, reliable perforators and minimal donor site morbidity. This flap can be safely thinned to 3-4 mm. It can also be elevated with sufficient bulk with muscles like vastus lateralis for complex defect. Between June 2002 and December 2004, 48 cases of sole reconstruction were performed with anterolateral thigh perforator free flaps. Follow up period ranged from 4 to 34 months with a mean of 14.7 months and with exception of one case, all flaps survived. One case of total flap loss was noted due to infection in a patient who was administered lifetime immunosuppressant. Partial necroses developed in three cases but were treated conservatively. Satisfactory aesthetic and functional results were achieved and acceptable gait recovery was noted. Seventy-eight percent of the patients regained protective sensation by 6 months and earlier sensory recovery was noted in sensate flap group. The authors also present a standardized protocol for preoperative patient evaluation and postoperative management and rehabilitation.

• 한방재활의학과학회지
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• 제27권4호
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• pp.155-161
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• 2017

The purpose of this study is to research and report the effect of Bee Venom pharmacopuncture therapy at facet joint for the two patients who was diagnosed as herniated intervertebral disc (HIVD) of lumbar spine. Two patients were hospitalized and treated with Complex Korean Medical treatment such as acupuncture, herbal medicine and Essential bee venom (EBV) pharmacopuncture in Dongsuwon hospital of oriental medicine. We measured their pain and function of daily life by numerical rating scale (NRS), straight leg rasing test (SLRT), Roland-morris disability questionnaire (RMDQ). As the result, we found the improvement of gait disturbance, functional disorder, and pain. This study suggested that Bee Venom pharmacopuncture therapy at facet joint is considered to conservative treatment for HIVD of lumbar spine. But further clinical studies are needed to clarify the effect of Bee Venom pharmacopuncture therapy at facet joint for the two patients with HIVD of lumbar spine.

• 국제물리치료학회지
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• 제10권4호
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• pp.1873-1878
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• 2019

Background: Walking is a complex activity. The main components of walking include balance, coordination, and symmetrical posture. The characteristics of walking patterns of stroke patients include slow walking, measured by gait cycle and walking speed. This is an important factor that reflects post-stroke quality of life and walking ability. Objective: This study aimed to examine the effect of deep lumbar muscle stabilization exercise on the spatiotemporal walking ability of stroke patients. Design: Quasi-experial study Methods: The experiment was conducted 5 times per week for 4 weeks, with 30 minutes per session, on 10 subjects in the experimental group who performed the deep lumbar muscle stabilization exercise and 10 subjects in the control group who performed a regular exercise. Variables that represent the spatiotemporal walking ability (step length, stride length, step rate, and walking speed) were measured using GAITRrite before and after the experiment and were analyzed. Results: There was a significant difference in the pre- and post-exercise spatiotemporal walking ability between the two groups (p<.05). Furthermore, there was a significant difference in the step rate and walking speed between the two groups (p<.05). Conclusions: Deep lumbar muscle stabilization exercise is effective in improving the walking ability of stroke patients. Therefore, its application will help improve the spatiotemporal walking ability of stroke patients.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• 제25권3호
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• pp.322-332
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• 2023

We describe a rare case of sacral epidural arteriovenous fistulas (edAVFs) with atypical clinical course of treatment. A 78-year-old man with a history of spinal surgery presented progressive gait disturbance and urinary incontinence. Spinal angiography demonstrated a sacral spinal AVF fed by bilateral lateral sacral arteries, draining to the venous pouch with subdural drainage. The first treatment by direct interruption of a subdural drainer was incompletely finished. Postoperative reassessment by 3D imaging analysis led to the diagnosis of sacral edAVF and 3D understanding of its angioarchitecture. The second treatment by transarterial embolization (TAE) resulted in complete occlusion of a sacral edAVF. However, spinal venous congestion didn't improve, because the recruitment of occult edAVFs at the multiple lumbar levels and complex-shaped sacral ventral epidural venous plexus (VEP) were involved in the remnant of prior subdural drainage. The third treatment was performed by TAE for three occult edAVFs and the VEP compartment connecting between a patent edAVF and subdural drainage, which resulted in complete disappearance of spinal cord edema. Endovascular embolization of VEP compartment connecting to subdural drainage in addition to fistulous occlusion may be one of the treatment options for several edAVFs at the multiple spinal levels.

• 대한약침학회지
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• 제11권2호
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• pp.117-124
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• 2008

Objective This study was investigated on the Scolopendrid Pharmacopuncture of Caude equina syndrome which has been described as a complex of low back pain, bilateral sciatica, saddle anesthesia and motor weakness in the lower extremity that progress to paraplegia with baldder and bowel incontinence. Methods & Results Clinical observation was done on Cauda equina syndrome in the Department of Acupuncture & Moxibustion, Woosuk jeonju Oriental Medical Hospital frome May 30 to July 13. The patient was treated with Scolopendrid Pharmacopuncture at Shinsu(B23), Gihaesu(B24), Taejangsu(B25), Gwanweonsu(b26), Dangryo(b31), Charyo(b32), Jang-gang(gv1) and Hoe-eum(cv1) with Oriental Medicine treatment. We evaluated SF-36, the bladder incontinence, bowel incontinence, sensibility by sting skin, before and after treatmeat. Conclusion 1. At the early time, gait disturbance was treated well, but discomfort of bladder incontinence, bilateral sciatica, saddle anesthesia and motor weakness was remained. 2. The symptoms of Cauada equina syndrome, especially bladder incontinence and bilateral sciatica, was recurred in short duration by scolopendrid Pharmacopuncture and oriental medicine treatment.