• Journal of Korean Neurosurgical Society
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• 제58권6호
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• pp.560-562
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• 2015

It is well known that spinal instability should be evaluated in the standing lateral position. Standing dynamic flexion and extension radiographs are usually used to assess spinal instability. Here, we report a patient who experienced distraction instability while in the supine position rather than the standard standing position. To our knowledge, this is the first report of lying-down instability undetected on standing dynamic flexion and extension radiographs. We discuss the pathophysiological mechanism of this uncommon but possible entity and provide a review of the literature.

• Journal of Yeungnam Medical Science
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• 제37권2호
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• pp.84-89
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• 2020

Spinal pain is a common patient complaint in clinical practice. Conservative treatment methods include oral medication, physical therapy, injections, and spinal orthoses. The clinical application of orthoses is debated because of potential complications associated with long-term use, such as muscle weakness and joint contracture. We reviewed the orthoses most frequently used to manage spinal pain. We review the use of soft cervical and Philadelphia collars, lumbosacral corsets, and thoracolumbosacral orthosis to manage spinal pain. Spinal orthoses can help reduce pain by protecting the muscles and joints of the injured spinal region, preventing or correcting malformations, and limiting trunk flexion, extension, lateral flexion, and rotation. The short-term use of spinal orthoses is known to improve pain and disability during the treatment period without significant adverse effects. Spinal orthoses are expected to alleviate pain and improve patients' lifestyle.

• 대한정형도수물리치료학회지
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• 제15권1호
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• pp.58-63
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• 2009

Purpose: The purpose of this study is to figure out that the scapular stability exercise on unstable position can effect on the pain relief of the patient with lateral epicondylitis. Methods: The subject was 35 year old male, diagnosed as lateral epicondylitis. This patient was controled to do scapular stability exercise with crawling position on unstable surface, changing elbow movement from flexion to extension for 4 weeks, 5 times a week, 20 times in total. We used VAS to find the degree of pain and Cozen's test, Mill's test and Resisted middle finger test were determined for the measurement of epicondylitis changed. Results: The following is the result of this study. 1. Pain on lateral epicondylitis was relived from VAS 7 to VAS 0. 2. There were improvements that the results of tests for epicondylitis, Cozen's test, Mill's test and Resisted middle finger test, changed positive into negative signs. Conclusion: The result of this study indicates that the application scapular stability exercise on the unstable surface to the patient with lateral epicondylitis can relief the pain degree on the lateral epicondylitis and be used as one of lateral epicondylitis treatments.

• 한국전문물리치료학회지
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• 제28권2호
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• pp.93-100
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• 2021

Background: Lateral epicondylitis (LE) is the most common chronic musculoskeletal conditions of the upper extremity with pain and wrist extension disability. The tendon which is most affected is the extensor carpi radialis brevis (ECRB). Previous study evaluated the effect of taping technique on patient with LE, but no study investigated the changes of electromyography (EMG) on ECRB when using dynamic taping (DT) technique. Objects: The aim of this study was to investigate the effect of DT technique using dynamic tape on muscle activity of ECRB during wrist isometric extension, isotonic extension and flexion. Methods: Twenty-one healthy subjects volunteered to participate in this study. Subjects were instructed to perform wrist isometric extension, isotonic extension and flexion without and with DT on origin area of ECRB. Wrist isometric extension was performed at 75%, 50% and 25% (%maximal voluntary contraction force), respectively, based on maximum contraction force. Isotonic extension and flexion test used dumbbell. EMG data was collected from ECRB. Results: EMG of ECRB were statistically significant decrease in wrist isotonic extension after DT (p < 0.05). Significant increase in wrist isometric extension during 25% and 50% force task (p < 0.05). Conclusion: This study applied DT technique to suppress the wrist extensor muscles in 21 healthy adults in their twenties. Change in muscle activity was compared in the ECRB muscle during wrist isometric extension, isotonic extension and flexion task. Based on the results of this study, the DT technique applied to the wrist and forearm area can reduce the load on the wrist extensors when the wrist performs various movements during daily life movements or repetitive tasks, and by using these effects, excessive stress is applied to tennis elbow patients.

• 한국전문물리치료학회지
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• 제30권2호
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• pp.110-119
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• 2023

Background: Osteoarthritis is a common condition with an increasing prevalence and is a common cause of disability. Osteoarthritic pain decreases the quality of life, and simple gait training is used to alleviate it. Knee osteoarthritis limits joint motion in the sagittal and lateral directions. Although many recent studies have activated orthotic research to increase knee joint stabilization, no study has used patellar tendon straps to treat knee osteoarthritis. Objects: This study aimed to determine the effects of patellar tendon straps on kinematic, mechanical, and electromyographic activation in patients with knee osteoarthritis. Methods: Patients with knee osteoarthritis were selected. After creating the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), leg length difference, Q-angle, and thumb side flexion angle of the foot were measured. Kinematic, kinetic, and muscle activation data during walking before and after wearing the orthosis were viewed. Results: After wearing the patellar tendon straps, hip adduction from the terminal stance phase, knee flexion from the terminal swing phase, and ankle plantar flexion angle increased during the pre-swing and initial swing phases. The cadence of spatiotemporal parameters and velocity increased, and step time, stride time, and foot force duration decreased. Conclusion: Based on the results of this study, the increase in plantar flexion after strap wearing is inferred by an increase due to neurological mechanisms, and adduction at the hip joint is inferred by an increase in adduction due to increased velocity. The increase in cadence and velocity and the decrease in gait speed and foot pressure duration may be due to joint stabilization. It can be inferred that joint stabilization is increased by wearing knee straps. Thus, wearing a patellar tendon strap during gait in patients with knee osteoarthritis influences kinematic changes in the sagittal plane of the joint.

• PNF and Movement
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• 제22권1호
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• pp.129-137
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• 2024

Purpose: The aim of this study was to investigate and compare the risk factors focusing on the neck and lower back between general workers (GW) and mild intellectual disability workers (MIDW) in the automobile manufacturing industry. Methods: A total of 32 participants were required for this study design to achieve 80% power, 0.9 effect size, and an alpha level of 0.05. Each group consisted of 16 subjects, including GW and MIDW. Pain levels in the neck and lower back were measured for all participants using the visual analog scale (VAS). A dual digital inclinometer was used to measure the range of motion (ROM) in the neck and lower back three times, and the average was used for analysis. The independent t-test was used to compare between the wo groups. Cohen's d effect analysis was employed to determine the effect size. The significant level was set at 0.05. Results: In the MIDW, neck pain was significantly higher, and left cervical flexion was significantly decreased compared with the GW. There was no significant difference in lower back pain between the MIDW and GW. However, both lumbar flexion and extension, as well as lateral flexion, were significantly reduced in the MIDW compared with the GW. Conclusion: This study reveals that MIDW working in the automobile manufacturing industry have a greater risk of neck pain, limitation in left cervical flexion, and overall restriction in the ROM of the lower back compared with GW.

• 한국안전학회지
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• 제31권4호
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• pp.111-119
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• 2016

This study aimed to analyze postures that were frequently conducted in manufacturing industry. To find grip strength and muscle activities of each posture, Maximum Voluntary Contraction (MVC) and ElectroMyoGraphy (EMG) were measured. Based on the results of this study, the most appropriate posture could be suggested and used as a basic information for preventing musculoskeletal disorders. Most work-related musculoskeletal disorders have been occurred in the fields of manufacturing industry. According to previous studies, it was reported that the rate of musculoskeletal diseases of upper extremity was higher than that of other body parts. Accordingly, there were many studies about discomfort and grip strength of upper extremity. However, these studies dealt with single selection of wrist, elbow and shoulder. So, it was insufficient for comprehensive studies about upper extremity. And in order to improve the work posture, the physiological changes being generated by the combination of wrist, elbow and shoulder postures should be observed and analyzed. In order to conduct this study, thirty university students who had no records of MSDs involved were recruited. Independent variables were postures of wrist(pronation, neutral, supination), postures of elbow(flexion $45^{\circ}$, $90^{\circ}$) and postures of shoulder(flexion $0^{\circ}$, $90^{\circ}$). And dependent variables were MVC values and EMG values. Jamar dynamometer and TeleMyo 2400T G2 was used to measure MVC and EMG. MVC and EMG for 12 postures were measured for three second and for three times. Experiment was performed randomly. A 10 minutes rest period was provided after each t. To measure muscle load, the EMG signals of eight muscles (Biceps, Medial triceps, Lateral triceps, Brachioradialis, Extensor carpi ulnaris, Extensor carpi radialis, Flexor carpi ulnaris and Flexor carpi radialis) were evaluated. MVC values and EMG values were analyzed using Minitab ver. 14. The results showed that MVC value was the highest at shoulder $0^{\circ}$, elbow $45^{\circ}$ and wrist supination. In case of wrist postures, MVC of supination is the highest. In case of elbow and shoulder postures, MVC of flexion $45^{\circ}$ and $0^{\circ}$ was the highest. It was found that there were interaction between wrist and elbow posture under shoulder flexion and between shoulder and wrist under elbow flexion $45^{\circ}$. In case of the angle of shoulder $0^{\circ}$, elbow $45^{\circ}$ and wrist supination, the EMG values of four muscles(Medial Triceps, Extensor carpi ulnaris, Extensor carpi radialis, Flexor carpi ulnaris) were the highest. Based on this study, it is worth to note that the combination postures of upper extremity have a large impact on the MVC and EMG. The optimal condition upper extremity was shoulder flexion $0^{\circ}$, elbow flexion $45^{\circ}$ and wrist supination for preventing work-related musculoskeletal disease.

• PNF and Movement
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• 제14권3호
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• pp.185-193
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• 2016

Purpose: The purpose of this study was to investigate the effects of neck patterns in proprioceptive neuromuscular facilitation (PNF) for neck movement and the neck disability index (NDI) among adults with forward head posture. Methods: Thirty-nine subjects were randomly assigned into two groups. Subjects in the proprioceptive neuromuscular facilitation exercise group (PNFG, n = 20) received 20 minutes of PNF neck pattern (flexion-Rt. lateral flexion-Rt. rotation followed by extension-Lt. lateral flexion-Lt. rotation) 3 times weekly for 4 weeks. Outcomes were measured using absolute rotation angle (ARA), anterior weight bearing (AWB), range of flexion and extension motions (RFEM), and neck disability index (NDI) methods before and after the 4-week intervention period. Results: There were significant effects for the PNFG, pre- and post-intervention, in ARA, AWB, RFEM, and NDI. There were significant differences in ARA, AWB, RFEM, and NDI compared with CG. Conclusion: The results of this study suggest the PNF neck pattern could be beneficial for adults with forward head posture.Purpose: This study investigates how abdominal muscular exercise based on proprioceptive neuromuscular facilitation (PNF) can affect chronic low back pain patients in terms of their pulmonary function, pain, and functional disability indexes. Methods: Fourteen target subjects with chronic low back were randomly assigned to the control group (n = 7) that performed abdominal muscle exercises and the experimental group (n = 7) that performed PNF abdominal muscular exercises. The exercises were performed five times a week for six weeks. To check the change in pulmonary function, the forced expiratory volume at one second (FEV1) and visible analogue scale (VAS) were measured to check the pain level. The disability level caused by back pain was measured by the Oswestry Disability Index (ODI). A paired t-test was applied to compare the differences between the groups before and after the intervention, and an independent t-test was used to compare the differences between the groups. The level of statistical significance was set as ${\alpha}=0.05$. Results: Before and after the intervention, the experimental group showed a significant change in FEV1 (p < 0.01), and both the experimental and the control groups showed significant changes in VAS and ODI (p < 0.01). A comparison of the differences between the groups indicated that the experimental group showed more significant changes in FEV1 (p < 0.05). Conclusion: According to the study results, PNF abdominal muscular exercise effectively improved pulmonary function, pain, and functional disability indexes in subjects with chronic back pain. The proposed program can be applied to chronic back pain patients as a useful therapy.

• Clinics in Shoulder and Elbow
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• 제13권2호
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• pp.293-298
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• 2010

목적: 주관절은 굴곡 구축 40도 이상 굴곡 제한 105도 이하일 경우 일상 생활에 상당한 장애를 일으킬 수 있는 관절로 그 치료의 정도 및 시기를 결정하기가 상당히 어려운 것으로 알려져 있다. 이에 이 종설에서는 현재까지 인정된 주관절 구축의 수술적 접근법에 대하여 고찰하여 보도록 하겠다. 대상 및 방법: 환자의 병력을 포함하여 충분한 임상적 조사를 하는 것이 중요하다. 그리고 방사선학적 방법을 이용하여 환자의 주관절 구축에 대한 원인 및 상태를 정확히 파악하고 그에 적합한 수술법을 선택한다. 수술법으로는 관절경적 유리술 (arthroscopic release) 및 관혈적 유리술 (Open release), 견인 관절 성형술 (Distraction Arthroplasty), 인공관절 치환술 (Total elbow replacement)이 있으며 관혈적 유리술은 4가지 기본 도달법 -전방 도달법 (anterior approach), 내측 도달법 (medial "over the top" approach), 제한된 외측 도달법 (limited lateral approach: column procedure) 광범위 후방 도달법 (posterior extensile approach)-으로 분류될 수 있다. 결과 및 결론: 현재 주관절 구축의 수술은 관절경의 발달로 인한 최소 침습적인 방법이 대두되고 있으나 그 경과의 판정은 아직 미미하며 그에 대한 문헌 보고가 많지 않은 상태로 고식적인 개방성 접근법을 이용하는 것을 원칙으로 하고 있으며 접근법에 따른 분류를 사용하고 있다.

• 대한관절경학회:학술대회논문집
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• 대한관절경학회 제21차 추계 학술대회
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• pp.128-129
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• 2009