• Title/Summary/Keyword: Joint range of motion

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Wheelchair-based New Millennium Health Gymnastics: Muscle Activity and Upper Limbs Coordination by Elbow Exercise Velocity (휠체어 새천년 건강체조의 팔꿈치 운동속도에 따른 상지협응과 근활성도 변화)

  • Lee, Kang-Jin;Kim, Tack-Hoon
    • Journal of the Korean Society of Physical Medicine
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    • v.9 no.2
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    • pp.161-170
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    • 2014
  • PURPOSE: This study concerns the wheelchair-based rehabilitation of elderly people, investigating muscle activity and coordination of upper limbs during wheelchair-based new millennium health gymnastics with varying elbow exercise velocity. METHODS: Twelve elderly people participated in new millennium gymnastics twice per week during 12-weeks. The group was separated into 0.4, 1.0, and 1.6 Hz groups (controlled by the metronome speed). Range of motion was measured by electrogoniometer, electromyography signals used root mean square values. The data application was normalized using reference voluntary contraction (%RVC). Upper limb (wrist and elbow joint) data gathered while standing up after the "falling on hips" was investigated in terms of coordination of angle-angle plots. One-way ANOVA, paired t-test and Scheffe's post hoc comparisons, were used for statistical analyses. RESULTS: There were results taken before and after the experiments. The results demonstrated a significant improvement in the triceps brachii and flexor carpi radialis of the 0.4 Hz group (p<.05). There was significant difference in the triceps brachi of the 1 Hz group. No significant differences were found in all muscles of the 1.6 Hz group. Muscle co-activation indexes of the 0.4 Hz group were larger than the others. The 0.4 Hz graph was turning point synchronized clockwise. The 1 Hz graph was out of phase with the negative slope. The 1.6 Hz graph was turning point synchronized counterclockwise, and uncontrolled factor phase was offset on angle-angle plots. CONCLUSION: It is found that improvement of muscle activity and upper limbs coordination of elderly people using wheelchair-based new millennium gymnastics is optimal with elbow exercise velocity with a frequency of 0.4 Hz.

The Comparison of Effect of MC Intensity in Pain and ROM in Delayed Onset Muscle Soreness (미세전류 자극 강도에 따른 지연성 근육통의 통증과 관절가동범위에 미치는 영향)

  • Kim, Seun-Deuck;Park, Hye-Mi;Jung, Hwa-Su
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.7 no.1
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    • pp.1-6
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    • 2009
  • Purpose : We investigated the effects of microcurrent(MC) electrical stimulation on each intensity($100{\mu}A,\;200{\mu}A,\;500{\mu}A$ - 30pps frequency was same) on delayed onset muscle soreness(DOMS). Methods : Subjects were assigned randomly divided into three groups of eight for three different treatment protocoals($100{\mu}A,\;200{\mu}A,\;500{\mu}A$-experimental groups). Twenty-four healthy males and females subjects were participated in this study. All subjects performed eccentric exercise of elbow flexor(biceps brachii) until exhausted. The measured items of elbow flexor muscle strength were Nicholas Manual Muscle Taster(NMMT). The measured items of elbow joint range of motion ROM) were Goniometer. The measured items of elbow flexor muscle pain were visual analogue scale(VAS). Treatment were applied at 30 minute exercise after and again at 24 hours and at 48 hours and at 72 hours after. Measurements were taken after treatment. Analysis of Results using repeated measures analysis of variance(ANOVA) and post hoc tests were as follows: two-way ANOVA with repeated measurement for muscle strength, flexion ROM, extension ROM and VAS. Results : This results showed eccentric exercise casused DOMS, DOMS response to eccentric exercise were reduces by microcurrent therapy. DOMS was significant decreased at $100{\mu}A,\;200{\mu}A,\;500{\mu}A$. Muscle strength was significant difference at all intensity. Elbow flexion ROM was significant difference at all intensity but elbow extension ROM was insignificant difference at all intensity. VAS score was significant difference at $100{\mu}A$ and $500{\mu}A$ but insignificant difference at $200{\mu}A$. All experimental groups showed insignificant difference with all intensity MENS. Conclusion : These findings indicate that microcurrent therapy is had effect on recovery from exercise induced muscle damage. In our's suggestion, microcurrent therapy is particularly more appropriate therapeutic modality.

Comparison of Operative Results of Distal Chevron Osteotomy with and without Akin Osteotomy for Moderate to Severe Hallux Valgus (중등도 및 중증의 무지 외반증에서 Akin 절골술 동반 유무에 따른 원위부 갈매기형 절골술의 수술 결과 비교)

  • Park, Sang Soo;Lee, Jun Young;Kim, Woong Hee
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.2
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    • pp.56-61
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    • 2014
  • Purpose: This study was conducted among patients with moderate to severe hallux valgus who underwent distal chevron osteotomy and groups of patients with or without Akin osteotomy were compared for evaluation of the relationship between their radiological and clinical outcomes. Materials and Methods: From January 2009 to January 2012, among patients with moderate to severe hallux valgus who underwent distal chevron osteotomy at our institution, 28 cases with additional Akin osteotomy and 35 cases without Akin osteotomy available to follow up of more than one year were included in this study. For radiologic evaluation, hallux valgus angle, 1, 2 intermetatarsal angle, and hallux interphalangeal angle were measured before and after surgery. For clinical assessment, visual analogue scale score, American Orthopaedic Foot and Ankle Society score, subjective satisfaction of the patients, and passive range of motion of the first metatarsophalangeal joints were evaluated. Results: At the final follow up, correction of valgus hallux angle and 1, 2 intermetatarsal angle was obtained from radiation results of both groups and it was found that patients who underwent Akin osteotomy showed radiographically larger angle correction but less subjective satisfaction. Conclusion: Patients with moderate to severe hallux valgus who underwent distal chevron osteotomy showed not only functional but also radiographically satisfactory results, and patients who underwent additional Akin osteotomy showed decreased subjective satisfaction. Therefore, if an incongruent first metatarsophalangeal joint is not observed, distal chevron osteotomy without Akin osteotomy seems preferable.

Surgical Treatment of Multiple Rice Bodies in Chronic Subacromial and Subdeltoid Bursitis: A Case Report (만성 견봉하 및 삼각근하 점액낭염에 발생한 다발성 쌀소체의 수술적 치료: 증례 보고)

  • Kim, Do-Young;Hwang, Jung-Taek;Lee, Sang-Soo;Seo, Eun-Min;Jo, Yoon-Geol
    • The Journal of the Korean bone and joint tumor society
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    • v.19 no.2
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    • pp.69-73
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    • 2013
  • Multiple rice body formation is a complication of chronic bursitis frequently associated with seronegative rheumatoid arthritis or tuberculosis. It resembles synovial chondromatosis on imaging and clinically. We report on a pathologically diagnosed multiple rice body formation in subacromial and subdeltoid bursitis in a 44-year-old man who was treated by surgical removal and bursectomy. At 16 months after the removal, range of motion of affected shoulder was normal. No evidence of recurrence of rice body in plain X-ray and ultrasonography. Multiple rice body formed in chronic subacromial and subdeltoid bursitis could be treated with surgical removal and bursectomy successfully.

Intermittent Bleeding Method after Replantation o the Distal Phalanx (원위 수지 재접합술 뒤 간헐적 실혈 요법)

  • Lee, Byung-Ho;Park, Chan-Il;Lee, Jun-Mo
    • Archives of Reconstructive Microsurgery
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    • v.20 no.1
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    • pp.38-42
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    • 2011
  • Purpose: To evaluate the effect of intermittent bleeding method in the distal phalanx replantation. Materials and Methods: From January 2007 through June 2009, authors have replanted 117 cases of distal phalangeal amputation in adults at Soo Hospital and Chonbuk National University Hospital. Cases of zone II were 60 cases and zone III 57 according to Allen classification. Male to female ratio was 8.7:1.3. The most common cause was machinery injury in the factory, 98 cases(83.8%), next one was belt injury of the machine, 11 cases(9.4%) and others, 8(6.8%). At least one digital artery and digital nerve were anastomosed under the operating microscope, but vein was impossible to anastomosis as unable to find out in the zone II and III. After anastomosis of one or more digital arteries and nerves, heparine(6,000-10,000 units) was kept to intravenous injection for 24 hours and at the same time fish mouth incision in 2-3 millimeter diameter was made in the distal radial and ulnar margin of the replanted distal phanlanx. From the first 30 minutes to an hour after replantation, incision site was swabbed with heparinized cotton ball for 5 minutes in every 30 to 40 minutes to make sure perfusion for 24 hours, every an hour at the second day, every two hours at the postoperative third to fifth day. Results: 92 cases(78.6%) was completely survived at average postoperative third week follow-up and satisfied with preservation of the finger nail, digit length, good range of motion of the distal interphalangeal joint and acceptable sensibility at average 1.2 years follow-up. Conclusions: Intermittant bleeding method in replantation of crushed distal phalanx impossible to anastomosis of vein at zone II and III of Allen classification was regarded as one of the notable salvage procedure.

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Comminuted Radial Head Fracture in All-arthroscopic Repair of Elbow Fracture-dislocation: Is Partial Excision of the Radial Head an Acceptable Treatment Option?

  • Yang, Hee Seok;Kim, Jeong Woo;Lee, Sung Hyun;Yoo, Byung Min
    • Clinics in Shoulder and Elbow
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    • v.21 no.4
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    • pp.234-239
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    • 2018
  • Background: In elbow fracture-dislocation, partial excision of the comminuted radial head fracture that is not amenable to fixation remains controversial considering the accompanying symptoms. This study was undertaken to evaluate the results of radial head partial excision when the comminuted radial head fracture involved <50% of the articular surface in all-arthroscopic repair of elbow fracture-dislocation. Methods: Patients were divided into two groups based on the condition of the radial head fracture. In Group A, the patients had a radial head comminuted fracture involving <50% of the articular surface, and underwent arthroscopic partial excision. Group B was the non-excision group comprising patients with stable and non-displacement fractures. Follow-up consultations were conducted at 6 weeks and at 3, 6, 12, and 24 months after surgery. Results: In all, 19 patients (Group A: 11; Group B: 8) met the inclusion criteria and were enrolled in the study. At the final follow-up, all 19 patients showed complete resolution of elbow instability. No significant differences were observed in the range of motion, visual analogue scale score, and Mayo elbow performance score between groups. Radiological findings did not show any complications of the radiocapitellar joint. However, nonunion of the coracoid fracture was observed in 3 patients (Group A: 1; Group B: 2), without any accompanying instability and clinical symptoms. Conclusions: Considering that the final outcome is coronoid fracture fixation and lateral collateral ligament complex repair for restoring elbow stability, arthroscopic partial excision for radial head comminuted fractures involving <50% of articular surface is an effective and acceptable treatment for elbow fracture-dislocation.

Effects of Neck Stabilizing Exercise Combined with Transcranial Direct Current Stimulation on Muscle Characteristics and Function in Patients with Cervicogenic Headache (경두개 직류자극을 결합한 목 안정화 운동이 경추성두통환자의 근육특성과 기능에 미치는 영향)

  • Park, Seungkyu;Yang, Daejung;Kim, Jeho;Park, Samheon;Yoon, Jonghyuk
    • Journal of The Korean Society of Integrative Medicine
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    • v.7 no.3
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    • pp.159-169
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    • 2019
  • Purpose: The purpose of this study was to provide an effective method of exercise therapy for patients with cervicogenic headache. Methods: The subjects were divided into the following three groups according to the intervention received: cervix-stabilizing exercise (n=12, group 1), transcranial direct current stimulation (n=12, group 2), and cervix-stabilizing exercise combined with transcranial direct current stimulation (n=12, group 3). The intragroup and intergroup differences in muscle characteristics and neck disability index were compared and analyzed. Results: The comparison and analysis of the changes in muscle tone and post hoc analysis revealed statistically significant intragroup decreases in the upper trapezius and suboccipitals in groups I and III, and statistically significant intergroup differences in the upper trapezius, with greater changes in group III than in group II, and in the suboccipitals, with greater changes in groupIII than in groups Iand II. The comparison and analysis of the change in muscle stiffness and post hoc analysis revealed a statistically significanti ntra group decrease in the upper trapezius in group Iand suboccipitals in group III, and a statistically significant intergroup difference in both muscles, with greater change in group III than in group II. The comparison and analysis of change in neck disability index and post hoc analysis revealed a statistically significant intragroup decrease in all the three groups and a statistically significant intergroup difference, with greater change in group III than in groups I and II. Conclusion: The neck-stabilizing exercise and transcranial direct current stimulation were shown to be effective in decreasing the tone of the cervical muscles by stabilizing the cervical bone and improving muscle durability, and in improving the movement and limitation of joint range of motion by decreasing muscle tone and stiffness.

The Effects of Physical Therapy Intervention with Local Vibration on Physical Function in Patients with Traumatic Patella Fracture: Case Series (외상으로 인한 슬개골 골절을 가진 환자의 국소진동을 동반한 물리치료 중재가 신체기능에 미치는 영향: 사례군 연구)

  • Seung-won, Ahn
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.28 no.3
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    • pp.89-99
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    • 2022
  • Background: The purpose of this study was to investigate the effects of physical therapy intervention with local vibration on the physical function of patients with traumatic patella fractures. Methods: This study recruited 6 subjects who had suffered traumatic patella fractures. The study was conducted for an average of 12.8 weeks. Before the treatment (2 weeks post-surgery), they were evaluated using the numeric pain rating scale (NPRS), the Korean-version of the impact of event scale-revised (IES-R-K), pressure pain threshold (PPT), range of motion (ROM) of the knee joint, and the Korean knee injury and osteoarthritis outcome score (K-KOOS) and were reevaluated after 7 and 12 weeks, post-surgery. This study was conducted according to ORIF Patella Fracture Post-Operative Rehabilitation Protocol after applying local vibration. The protocol consists of Phases 1~5 and this study has been applied from phase 2. Results: A comparison of the performance of the participants before and after the intervention showed a decrease in NPRS (9.83±.41→4.83±.98), IES-R-K (68.67±2.73→23.83±2.40), and K-KOOS (Function, Daily living: 70.5±5.96→34.0±3.35, Function, Sports and Recreational activities: 22.83±2.32→10.77±1.37, Quality of Life: 19.33±7.33→7.33±.52) scores. And the ROM (Knee flexion: 30.0±4.47°→128.73±3.6°, Knee extension: -6.83±2.48°→-1.33±1.03°) and PPT (9.67±.52kg/cm2→22.44±2.33kg/cm2) scores increased. Conclusion: These results show that physical intervention with local vibration using a Blackroll® booster and head can help to improve pain, physical function, and psychological status. Also, it was possible to select interventions depending on the patient's condition and the desired goal, using physical intervention with the Blackroll® booster technique.

Comparison of Tibialis Anterior Muscle Thickness with 4 Different Toe and Ankle Postures: Ultrasonographic Study

  • Jang, Tae-Jin;Hwang, Byeong-Hun;Jeon, In-Cheol
    • The Journal of Korean Physical Therapy
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    • v.34 no.1
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    • pp.12-17
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    • 2022
  • Purpose: Ankle dorsiflexion is an essential element of normal functions, including walking, activities of daily living and sport activities. The tibialis anterior (TA) muscle functioned as a dorsiflexor and as a dynamic stabilizer of the ankle joint during walking and jumping. This study aimed to compare TA muscle thickness using ultrasonography according to the four different toe and ankle postures for the selective TA strengthening exercise. Methods: This study were recruited 26 (males: 15, females: 11) aged 20-30 years, with no injury ankle and calf in the medical history, had normal dorsiflexion and inversion range of motion (ROM). The thickness of the TA muscle was measured by ultrasonography in the four different toe and ankle postures: 1. Ankle dorsiflexion with all toe extension and ankle inversion (ITEDF); 2. Ankle dorsiflexion with all toe flexion and ankle inversion (ITFDF); 3. Ankle dorsiflexion with all toe extension and neutral position (NTEDF); 4. Ankle dorsiflexion with all toe flexion and neutral position (NTFDF). One-way repeated analysis of variance (ANOVA) and Bonferroni correction were used to confirm the significant difference among conditions. The level of statistical significance was set at α=0.01. Results: TA muscle thickness with ITFDF was significantly greater than in any other ankle positions, including ITEDF, NTFDF, and NTEDF (p<0.01). Conclusion: Among the four toe and ankle postures, isometric contraction in ITFDF postures showed the greatest increase in thickness of TA rather than ITEDF, NTEDF, and NTFDF postures. Based on these results, ITFDF can be recommended in an efficient way to selectively strengthen TA muscle.

Prosthetic resurfacing of engaging posterior capitellar defects in recurrent posterolateral rotatory instability of the elbow

  • Dani Rotman;Jorge Rojas Lievano;Shawn W. O'Driscoll
    • Clinics in Shoulder and Elbow
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    • v.26 no.3
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    • pp.287-295
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    • 2023
  • Background: Posterolateral rotatory instability (PLRI) is a common mechanism of recurrent elbow instability. While the essential lesion is a deficiency in the lateral ulnar collateral ligament (LUCL), there are often associated concomitant bony lesions, such as an Osborne-Cotterill lesions (posterior capitellar fractures) and marginal radial head fractures, that compromise stability. Currently, there is no standard treatment for posterior capitellar deficiency associated with recurrent PLRI. Methods: We conducted a retrospective review of five patients with recurrent PLRI of the elbow associated with a posterior capitellar impaction fracture engaging with the radial head during normal range of motion. The patients were treated surgically with LUCL reconstruction or repair and off-label reconstruction of the capitellar joint surface using a small metal prosthesis designed for metatarsal head resurfacing (HemiCAP toe classic). Results: Five patients (three adolescent males, two adult females) were treated between 2007 and 2018. At a median follow-up of 5 years, all patients had complete relief of their symptomatic instability. No patients had pain at rest, but two patients had mild pain (visual analog scale 1-3) during physical activity. Three patients rated their elbow as normal, one as almost normal, and one as greatly improved. On short-term radiographic follow-up there were no signs of implant loosening. None of the patients needed reoperation. Conclusions: Recurrent PLRI of the elbow associated with an engaging posterior capitellar lesion can be treated successfully by LUCL reconstruction and repair and filling of the capitellar defect with a metal prosthesis. This treatment option has excellent clinical results in the short-medium term. Level of evidence: IV.