• Journal of Acupuncture Research
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• v.23 no.1
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• pp.187-215
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• 2006

Objectives : To determine whether the pragmatic acupuncture treatment provides more effective pain relief than treatment using the same acupuncture point to the all patients. Methods : We randomly allocated participants to treatment group 1 and 2. The group 1 is the pragmatic treatment group and the group 2 is using the same acupuncture point to the all patients. Primary outcomes were measured by the Western Ontario and McMaster Universities Osteoarthritis index(WOMAC) pain and function scores at 4, 8, and 14 weeks. Secondary outcomes were measured by 100mm VAS(Visual Analog Scale), ROM(Range of Motion) using Goniometer, and pain threshold using pressure algometer. Results : When patients were extension of the knee, they were statistically significant in improvement of the ROM in 14 weeks. Whole body condition and pain rate through VAS measurement were improved significantly in 14 weeks. Also pain score and function score of WOMAC were improved significantly in 14 weeks. We could get difference in pain score of two acupuncture groups significantly in 14 weeks. But we could not get difference in whole score of two acupuncture groups significantly. Local temperature using T.C thermometer was changed significantly in 14 weeks. But we could not get difference in whole score of two acupuncture groups significantly. Excluding above item, DITI, pain threshold, and ROM of the knee flexion were no difference in before and after treatment.

• Journal of the Ergonomics Society of Korea
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• v.35 no.6
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• pp.595-609
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• 2016

Objective: The purpose of this study was to develop and validate the guidelines for Medic Work Table (MWT) based on the anthropometric data of medical technologists. Background: Users' anthropometric data such as sitting height, sitting elbow height, knee height, and so on are significant factors for designing comfortable and useful furniture. Thus, many guidelines for different types of desks and chairs based on the users' anthropometric data have been suggested to many researchers. However, few researches have been conducted to provide design guidelines for MWT for blood collecting task. Medical technologists often use their upper extremities to perform blood collecting task with high repetitions. These repeated motions could be a critical factor in the prevalence rate of Work-related Musculoskeletal Disorders (WMSDs). Therefore, a study on ergonomic design of MWT would be essential in preventing the WMSDs and improving the quality of the working environment of medical technologists. Method: This study suggested design guidelines for ergonomic MWT by focusing on the heights of the upper side and underside, depths of the inside and outside, and width of MWT through anthropometric studies and literature reviews. Afterwards, a new MWT was made using the suggested design guidelines for this study. Five healthy medical technologists participated to evaluate the original MWT and new MWT. All participants took part in the range of motion (ROM) test, electromyography (EMG) muscle activity test, and usability test to validate the suggested guidelines in this study. EMG signals of related muscles (Flexor Carpi Ulnaris, Extensor Carpi Ulnaris, Deltoid Anterior, and Biceps Branchii) were recorded through the surface electromyography system from both the original MWT and the new MWT. The ROM test of the shoulder and elbow flexion was also assessed using motion sensors. Results: The newly designed MWT showed decreased ROMs of the shoulder and elbow up to 22% and 18% compared to the original MWT. The muscle activities in the new MWT also showed a decrease of 13% in Anterior Deltoid, 6% in Biceps Brachii, 5% in Flexor Carpi Ulnaris, and 8% in Extensor Carpi Ulnaris muscle groups, compared to the original MWT. In the usability test, the satisfaction score of the new MWT was also 56.1% higher than that of the original MWT. Conclusion: This study suggested guidelines for designing MWT and validating the guidelines through qualitative and quantitative analyses. The results of motion analysis, muscle activity, and usability tests demonstrated that the newly designed MWT may lead to less physical stress, less awkward posture, and better physical user interface. Application: The recommended guidelines of the MWT would be helpful information for designing an ergonomic MWT that reduces physical loads and improves the performance of many medical technologists.

• The Journal of Korean Physical Therapy
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• v.22 no.5
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• pp.57-61
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• 2010

Purpose: The purpose of this study was to identify the effect of active foot arch support on the muscles of lower extremity electromyographic activity during squat exercise in persons with pronated foot. Methods: The study subjects were 16 persons with pronated foot. They have no history of surgery in lower extremity and trunk and limitation of range of motion or pain when performing squat exercise. Each subject was measured the navicular drop (ND) to determine the pronated foot. And then the subjects were asked to perform three repetitions of a $90^{\circ}$ knee flexion squat in both conditions which are 1) preferred squat and 2) squat with active foot arch support. Results: Paired t-test revealed that squat with active foot arch support produced significantly greater EMG activities in abductor hallucis (p=0.00), proneus longus (p=0.03) and gluteus medius (p=0.04) than preferred squat. But the EMG activities of tibialis anterior, vastus medialis oblique and vastus lateralis were not showed significantly different between the both squat conditions. Conclusion: The findings of this study suggest that active foot arch support during squat increase the activities of lower extremity muscles which are the abductor hallucis, proneus longus and gluteus medius. Also, the abductor hallucis which is one of the planter intrinsic muscle and peroneus longus play a role in support of the foot arch and active foot arch support induced the increase of the activity of gluteus medius. Therefore active foot arch support can change the lower extremity biomechanics as well as passive foot support such as foot orthotics and taping.

• Physical Therapy Korea
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• v.27 no.2
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• pp.133-139
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• 2020

Background: The gastrocnemius (GCM) is one of the lower extremity muscles that tend to tighten easily. GCM tightness results in limited ankle dorsi-flexion (DF), especially when the knee joint is fully extended. Joint flexibility is determined by the morphological and physiological characteristics of joints, muscles, tendons, and ligaments. Impaired joint flexibility can be attributed to increased susceptibility to muscle injury. High-frequency diathermy is clinically used to reduce pain and muscle tightness and to improve limited range of motion. Objects: This study aimed to investigate the immediate effects of high-frequency therapy in subjects with GCM tightness. Methods: The study was designed as a one-group before-after trial. The subjects included 28 volunteers with GCM tightness (an active ankle DF angle of less than 12°) without any known neurological and musculoskeletal pathologies in the ankle and calf areas. WINBACK Transfer Electrode Capacitive and Resistive Therapy equipment was used to apply high-frequency therapy to the subjects' GCMs for 10-15 minutes. The pennation angle and the fascicle length of the GCM were measured using ultrasonography. The flexibility of the ankle joint, peak torque to the passive ankle DF (Biodex), and soft tissue stiffness (MyotonPRO) were also measured. Results: The pennation angle was significantly decreased following the treatment; however, no significant difference in the fascicle length was found (p < 0.05). The flexibility was significantly increased and both the passive peak torque to passive ankle DF and the soft tissue stiffness significantly decreased (p < 0.05). Conclusion: High-frequency therapy is immediately effective for improving the muscle's architectural properties and functional factors in subjects with GCM tightness. Further longitudinal clinical studies are required to investigate the long-term effects of high-frequency therapy on subjects with GCM tightness from various causes.

• The Journal of Korean Physical Therapy
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• v.20 no.3
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• pp.29-34
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• 2008

Purpose: The purpose of this study was to identify the effect of anterolateral (45$^{\circ}$) and lateral (90$^{\circ}$) direction resistance, with using an elastic band, on the electromyographic(EMG) activity ratio of the vastus medialis oblique (VMO) and the vastus lateralis (VL) during squat exercise. Methods: The study subjects were 19 active people with no history of patellofemoral pain, limitation of range of motion or pain when performing squat exercise. A 'repeated measures within subjects' design was used. The subjects were asked to perform three repetitions of a 90$^{\circ}$ knee flexion squat exercise with anterolateral (45$^{\circ}$) and lateral (90$^{\circ}$) resistance and without resistance, respectively. The EMG activity of the VMO and VL were recorded by surface EMG electrodes and the results were normalized by the % MVIC value. Results: Repeated measures ANOVA's revealed that squat exercise with anterolateral (45$^{\circ}$) resistance produced significantly greater VMO/VL EMG activity ratio than that with lateral (90$^{\circ}$) resistance and without resistance (p=.013). Yet the result of contrast testing revealed that squat exercise with lateral (90$^{\circ}$) resistance showed no significant difference of the VMO/VL EMG activity ratio, as compared with squat exercise without resistance (p>0.05). Conclusion: The findings of this study suggest that squat exercise combining anterolateral (45$^{\circ}$) resistance can contribute positively to the patients with patellofemoral pain as they increase the VMO/VL EMG activity ratio.

• Korean Journal of Applied Biomechanics
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• v.16 no.2
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• pp.145-151
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• 2006

A large interindividual variability and some abnormally kinematic patterns at the lower extremity were the main features of the gait in children with Down syndrome. The purposes of this study were to investigate the gait asymmetry and biomechanical difference between dominant leg and non dominant leg in children with Down syndrome. Seven boys with Down Syndrome(age: $120{\pm}0.9yrs$, weight $34.4{\pm}8.4kg$, leg length: $68.7{\pm}5.0cm$) participated in this study. A 10.0 m ${\times}$ 1.3 m walkway with a firm dark surface was built and used for data collection. Three-dimensional motion analyses were performed to obtain the joint angles and range of motions. The vertical ground reaction forces(%BW) and impulses($%BW{\cdot}s$) were measured by two force plates embedded in the walkway. Asymmetry indices between the legs were computed for all variables. After decision the dominant leg and the non dominant leg with max hip abduction angle, paired samples t-test was employed for selected kinematic and ground reaction force variables to analyze the differences between the dominant leg and the non dominant leg. The max hip abduction angle during the swing phase showed most asymmetry, while the knee flexion angle at initial contact showed most symmetry in walking and running. The dominant leg showed more excessive abduction of hip in the swing phase and more flat-footed contact than the non dominant leg. Vertical peak force in running showed more larger than those of in walking, however, vertical impulse showed more small than walking due to decrease of support time. In conclusion, the foot of dominant leg contact more carefully than those of non dominant leg. And also, there are no significant difference between the dominant leg and the non dominant leg in kinematic variables and ground reaction force due to large interindividual variability.

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.107-113
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• 2012

Purpose: The purpose of this study was to evaluate the posterior cruciate ligament (PCL) reconstruction with single bundle, single-incision technique using Achilles tendon and tibialis anterior allograft with ligament remnant preservation. Materials and Methods: Twenty six patients underwent PCL reconstruction was included. There were 21 males and 5 females. Mean age was 32 years. Used graft was a fresh frozen Achilles tendon allograft (group I, 14 cases) and tibialis anterior allograft (group II, 12 cases). Arthroscopic PCL reconstruction was performed using transtibial, single-incision and single bundle technique with remnant preserving as possible. For clinical evaluation, range of motion, posterior drawer test, Lysholm score, Tegner activity scale, International Knee Documentation Committee (IKDC) grade and posterior stress radiograph were used. The mean follow-up period was 21.6 months (12-40 months). Associated injuries were 5 medial collateral ligament injuries, which were treated by conservative method. Results: Range of motion (ROM) was returned to normal range in 24 cases, but ROM deficit under $10^{\circ}$ flexion was 2 cases at final follow-up period. Preoperative posterior drawer test was 17 cases in grade II and 9 cases in grade III. At final follow-up 13 cases returned within normal grade, 7 cases grade I and 6 cases grade II posterior instability. Lysholm mean score was improved from preoperatively 62 to 90 at final follow-up period. Tegner activity mean scale improved from preoperatively 3.5 to 5.6 at final follow-up period. IDKC grade was grade A was 3 cases, grade B 17 cases, grade C 6 cases. In posterior stress radiograph, posterior displacement was improved from mean 12 mm preoperative to 4.5 mm at final follow-up. There were no statistical differences between two groups in clinical evaluations. There were two cases of re-rupture of graft at the bone-tendon junction in group I. Conclusion: We had successful results of PCL reconstruction with single-incision, single bundle technique using Achilles and tibialis anterior allograft without difference between two groups in patients with PCL injury. There were more re-rupture of graft in Achilles tendon group.

• Korean Journal of Applied Biomechanics
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• v.19 no.3
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• pp.467-479
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• 2009

The purpose of this study was to present the quantitative data which riders can utilize teaching field by comparison analysis of kinematics according to skill level of rider during 2 strides rising trot with the JeJu's-Horse. Participated subjects was consisted of total 10 riders(unskilled: n=5, skilled: n=5). The method of experiment & analysis was based on 3D cinematography. Variables were consisted of temporal, linear & angular kinematics by each event & phase. The skilled assigned more ratio of elapsed time in air than support phase, had the less range of motion in up-down direction and more consistent velocity in lateral & forward direction and performed periodic up-down movement with alignment in vertical direction according to elapsing of phases. The skilled more flexed at elbow and extended backwardly according to elapsing of phases, while more flexed forwardly at hip & knee and plantarflexion at ankle. The skilled postured backward extension but the unskilled do forward flexion. That is, It was considered that the unskilled continued more unstable posture than the skilled during 2 strides in rising trot.

• The Journal of the Korean bone and joint tumor society
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• v.7 no.4
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• pp.139-143
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• 2001

Purpose : Limb salvage for osteosarcoma of proximal tibia is challenging problem due to difficulties in mobilizing or retracting the main neurovascular structure, inadequate soft tissue coverage, and unsolved problem of patellar tendon reattachment to endoprosthesis. The authors analyzed the functional result of limb salvage using tumor prosthesis with medial gastrocnemius rotation plasty for osteosarcama of the proximal tibia. Materials and Methods : Eleven patients with histologically proven osteosarcoma of the proximal tibia, treated with adjuvant and neoadjuvant chemotherapy and limb salvage operation with tumor prosthesis between January 1992 and December 1998 at our Medical Center, were selected. There were 6 male and 5 female. Age ranged from 15 years to 23.7 years with an average of 23.7 years. Follow-up period ranged from 1 year to 4.5 years with an average of 2.5 years. The final functional result was evaluated using the method by ISOLS, 1993. The factors include pain, functional activities, emotional acceptance, use of external supports, walking ability and gait. Each of the factors has been scored from 0 to 5 depending on the appropriate description or data. The rating score is determined by dividing the individual factor scores into the total score and indicates percentage of normal function. Results : The overall functional result ranged from 53,3% to 86.7% with an average of 68.3% of normal function. In details, the averages were 82.5% for pain, 62.5% for functional activities, 67.5% for emotional acceptance, 77.5% for use of external supports, 62.5% for walking ability, and 57.5% for gait. The average range of motion of the knee joint was $5^{\circ}$ extension and $85^{\circ}$ flexion. Five patients have extension lag ranged from $5^{\circ}$ to $15^{\circ}$ with an average of $10^{\circ}$. Two patients suffered postoperative infection. One was treated with antibiotics injection only, but the other needed removal of the prosthesis and knee fusion. Both of them showed unsatisfactory result. C o n c l u s i o n : The overall functional result after limb salvage using tumor prosthesis with medial gastrocnemius rotational flap for osteosarcoma of the proximal tibia was relatively satisfactory in case of no postoperative infection. The patients were less satisfactory in functional activities, emotional acceptance and gait than pain, use of external supports due to limitation of motion and extension lag. More aggressive postoperative physical therapy and protection with brace for 6~9 months as well as surgical technique is mandatory for more satisfactory result.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.9
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• pp.6099-6111
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• 2015

This study was a systematic review and meta-analysis comparing the effects of aquatic exercise and land-based exercise in the treatment of knee osteoarthritis. 7 studies (n=449) met selection and exclusion criteria out of 287 potential studies obtained from the literature search via Ovid-Medline, Cochrane Library CENTRAL, CINAHL, RISS and KISS. The overall risk of bias of selected studies using SIGN (Scottish Intercollegiate Guidelines Network) checklist for randomized controlled trials (RCT) was regarded as low. As a result of meta analysis, Standardized Mean Difference (SMD) for pain was -0.26(95% CI -0.49, -0.03, p=0.03, $I^2=14%$), which implies that aquatic exercise groups had significant less pain than land-based exercise groups. On the other hand, there was no significant difference between aquatic exercise groups and land based exercise groups for flexion Range of Motion (ROM) (-0.12, 95% CI -0.51, 0.27, p=0.53, $I^2=0%$), extension ROM (-0.04, 95% CI -0.55, 0.48, p=0.89, $I^2=43%$), physical function (-0.12, 95% CI -0.44, 0.19, p=0.44, $I^2=0%$), Quality of Life (QOL) (-0.15, 95% CI -0.54, 0.24, p=0.46, $I^2=0%$). This study has some limitations due to few RCTs comparing aquatic exercise groups and land-based exercise groups in the treatment of knee osteoarthritis. Therefore, further RCTs should be conducted along with long-term outcomes.