• Journal of Korean Society of Forest Science
• /
• v.113 no.2
• /
• pp.210-221
• /
• 2024

This study aimed to investigate the effects of forest walking based on an exercise prescription on body composition of older adults. Forty-four older adults (average age: 69.3 ± 3.1 years) participated in this study. The experimental group engaged in forest walking based on a prescribed exercise intensity considering the participants' respective health conditions. The participants walked three times a week for more than an hour each time for 8 weeks. By contrast, the participants in the control group spent their days according to their usual lifestyle. The analysis involved the following: ① a comparison of the measurements taken before and after the 8-week period of forest walking in the experimental group, ② a comparison between pre- and post-study measurements in the control group, and ③ a comparison of the changes (post-study minus pre-study values) between the experimental and control groups. The results were as follows: ① the experimental group showed significant decreases in weight, body fat mass, and body mass index; ② the control group exhibited significant decreases in muscle mass and ratio in right arm and left leg, muscle ratio in trunk, and body water mass in right arm; and ③ weight and body fat index decreased in the experimental group but increased in the control group. In conclusion, forest walking based on an exercise prescription had a positive impact on body composition of older adults.

• Archives of Plastic Surgery
• /
• v.46 no.6
• /
• pp.589-593
• /
• 2019

Post-traumatic defects of the distal third of the leg often require skipping a few steps of the well-established reconstructive ladder, due to the limited local reliable reconstructive options. In rare cases, the reconstructive plan and flap choice may encounter challenges when the patient has psychiatric illness affecting compliance with postoperative care. We describe a case of a patient with severe intellectual disability and an open fracture of the distal lower limb. After fracture management and debridement of devitalized tissues, the resultant soft tissue defect was covered with a free gracilis flap. On postoperative day 7, the patient ripped out the newly transplanted flap. The flap was too traumatized for salvage, so a contralateral free gracilis muscle flap was used. The patient showed good aesthetic and functional outcomes at a 1-year follow-up. When planning the postoperative management of patients with psychiatric illness, less complex and more robust procedures may be preferred over a long and complex surgical reconstruction requiring good compliance with postoperative care. The medical team should be aware of the risk of postoperative collapse, focus on the prevention of pain, and be wary of drug interactions. Whenever necessary, free tissue transfer should be performed despite potential compliance issues.

• The Journal of Internal Korean Medicine
• /
• v.39 no.4
• /
• pp.772-783
• /
• 2018

The aims of this study were to use the Rydoraku test, electrogastrography, and enterotachography to examine the presence of familial gastric dysmotility among monozygotic twins and their mothers; to determine the relationship between the symptoms and the indexes of the Rydoraku test, electrogastrography, and enterotachography; and to observe the therapeutic reaction for each differential treatment between twins with familial gastric dysmotility. The same herbal medication (Banhasasim-tang extract three times/day and Sojuckkunbi-tang extract three times/day) was given to each twin, but the younger twin also underwent manual acupuncture on the CV 10, 12, and 13 points of the abdominal wall and electrical stimulation of both ST 36 points of the lower leg 2-3 times per week. Evaluation of the therapeutic effect was followed after six weeks. The presence of familial gastric dysmotility was shown in the autonomic nerve system and gastric muscle and was thought to be a common pathophysiology induced by genetic co-ownership. Only the younger twin showed any marked relief of the dyspeptic symptoms associated with improvement of pyloric sphincter function, which was induced by acupuncture treatment. The Rydoraku test, electrogastrography, and enterotachography results showed the presence of familial gastric dysmotility. Although Korean traditional medicine had no effect on the familiar gastric dysmotility associated with genetic influences, the acupuncture treatment had a beneficial effect on the secondary disorder of pyloric sphincter function, which is associated with the relief of dyspeptic symptoms.

• Archives of Plastic Surgery
• /
• v.41 no.6
• /
• pp.709-715
• /
• 2014

Background The distally based sural artery flap is a reliable, local reconstructive option for small soft tissue defects of the distal third of the leg. The purpose of this study is to describe an adipofascial flap based on a single sural nerve branch without sacrificing the entire sural nerve, thereby preserving sensibility of the lateral foot. Methods The posterior aspect of the lower limb was dissected in 15 cadaveric limbs. Four patients with soft tissue defects over the tendo-achilles and ankle underwent reconstruction using the adipofascial flap, which incorporated the distal peroneal perforator, short saphenous vein, and a single branch of the sural nerve. Results From the anatomical study, the distal peroneal perforator was situated at an average of 6.2 cm (2.5-12 cm) from the distal tip of the lateral malleolus. The medial and lateral sural nerve branches ran subfascially and pierced the muscle fascia 16 cm (14-19 cm) proximal to the lateral malleolus to enter the subcutaneous plane. They merged 1-2 cm distal to the subcutaneous entry point to form the common sural nerve at a mean distance of 14.5 cm (11.5-18 cm) proximal to the lateral malleolus. This merging point determined the pivot point of the flap. In the clinical cases, all patients reported near complete recovery of sensation over the lateral foot six months after surgery. All donor sites healed well with a full range of motion over the foot and ankle. Conclusions The distally based sural artery adipofascial flap allowed for minimal sensory loss, a good range of motion, an aesthetically acceptable outcome and can be performed by a single surgeon in under 2 hours.

• Journal of the Korean Society of Physical Medicine
• /
• v.15 no.1
• /
• pp.77-84
• /
• 2020

PURPOSE: This study compared the activities of the trunk muscles during crutch walking to determine which of the crutch length measurements is most beneficial. METHODS: Twenty young women volunteered to participate in this study. After adjusting crutch length, the participants performed a three-point walking with nondominant leg limited in weight bearing. This study used six crutch length measurements: (1) Height-40.6cm, (2) Height'.77, (3) Olecranon-to-finger length, (4) Axillary-toheel length, (5) Arm-span length-40.6cm, and (6) Arm-span length'.77. The EMG activities of the internal oblique (IO), rectus abdominis (RA), multifidus (MF), and erector spinae (ES), muscles on the weight bearing side were monitored using wireless surface EMG. RESULTS: The EMG activities of the RA and ES appeared to be significantly different among the crutch length measurements (p<.05). The post-hoc test showed that the 'Arm-span length-40.6cm' was significantly greater in the RA activity when compared to the 'Height'.77' and 'Axillary-to-heel length' measurements, and in the ES activity when compared to 'Height'.77' measurements. Furthermore, IO/RA and MF/ES ratios showed significant differences among the crutch length measurements (p<.05). In the post-hoc test, significant difference was observed between 'Olecranon-to-finger length' and 'Arm-span length-40.6cm' for the IO/RA ratio, and between 'Height'.77' and 'Olecranon-to-finger length' and between 'Height'.77' and 'Arm-span length-40.6cm' measurement for the MF/ES ratio. CONCLUSION: These findings suggest that the 'Height'.77' measurement is relatively advantageous to optimize the activities of trunk muscles during the crutch walking, and allow simple measurements of the crutch length.

• Journal of Korean Neurosurgical Society
• /
• v.46 no.6
• /
• pp.515-521
• /
• 2009

Objective : The purpose of this study was to compare clinical and radiological outcomes of percutaneous endoscopic lumbar discectomy (PELD) and open lumbar microdiscectomy (OLM) for recurrent disc herniation. Methods : Fifty-four patients, who underwent surgery, either PELD (25 patients) or repeated OLM (29 patients), due to recurrent disc herniation at L4-5 level, were divided into two groups according to the surgical methods. Excluded were patients with sequestrated disc, calcified disc, severe neurological deficit, or instability. Clinical outcomes were assessed using Visual Analogue Scale (VAS) score and Oswestry Disability Index (ODI). Radiological variables were assessed using plain radiography and/or magnetic resonance imaging. Results : Mean operating time and hospital stay were significantly shorter in PELD group (45.8 minutes and 0.9 day, respectively) than OLM group (73.8 minutes and 3.8 days, respectively) (p < 0.001). Complications occurred in 4% in PELD group and 10.3% in OLM group in the perioperative period. At a mean follow-up duration of 34.2 months, the mean improvements of back pain, leg pain, and functional improvement were 4.0, 5.5, and 40.9% for PELD group and 2.3, 5.1, and 45.0% for OLM group, respectively. Second recurrence occurred in 4% after PELD and 10.3% after OLM. Disc height did not change after PELD, but significantly decreased after OLM (p = 0.0001). Neither sagittal rotation angle nor volume of multifidus muscle changed significantly in both groups. Conclusion : Both PELD and repeated OLM showed favorable outcomes for recurrent disc herniation, but PELD had advantages in terms of shorter operating time, hospital stay, and disc height preservation.

• Journal of the Korean Society of Physical Medicine
• /
• v.11 no.1
• /
• pp.23-34
• /
• 2016

PURPOSE: This study aimed to assess the relationship between the severity of radiographic features and pain and function in patients with knee osteoarthritis (KOA). METHODS: Seventy-eight subjects (14 men, 64 women) with KOA, between the ages of 41 and 83 years (mean age, 61.29 years), were included. All the subjects diagnosed with KOA were scored for severity of radiographic KOA according to the Kellgren-Lawrence (K/L) grade, visual analogue scale (VAS), knee joint range of motion (ROM), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), maximum muscle power (MMP), and sit-to-stand (STS) and one-leg standing (OLS) tests. Associations among the K/L grade, diagnosis, pain, and function were examined by correlation analysis. RESULTS: There were no significant differences between the K/L grade, and the VAS, STS test time, and WOMAC scores (p>.05). There were no significant differences between the K/L grade, bilateral ROM, MMP, and left OLS test time (p>.05). However, there was a significant difference between the K/L grade and right OLS test time (p<.05). The K/L grade was negatively correlated with the left OLS test time(r=-.24, p<.05) and with the right OLS test time (r=-.307, p<.01). CONCLUSION: These results suggest that radiographic KOA was not associated with pain, knee MMP, ROM, and STS test time, but had a weak negative correlation with OLS test time.

• Journal of the Korean Society of Physical Medicine
• /
• v.11 no.1
• /
• pp.11-21
• /
• 2016

PURPOSE: This study was examined the effects of aerobic exercise using a step box and lower extremity strengthening exercise with an elastic band on the balance ability and lower extremity muscular strength in elderly subjects. METHODS: Forty-one healthy adults were randomly divided into experimental group 1 (Exp 1, n=14), experimental group 2 (Exp 2, n=14), and a control group (n=13). The Exp 1 conducted lower limb strengthening exercise using an elastic band and the Exp 2 performed aerobic exercise with a step box 50 minutes per day, twice per week, for eight weeks. RESULTS: There was significant increase in the Exp 1 and Exp 2 in comparison of the change of lower limb muscle strength according to measurement time (p<.05). But there was no significant difference according to intervention methods. In one-leg standing test change among the three groups after the intervention, the Exp 1 and Exp 2 saw significant improvement compared to the control group (p<.05) but there was no significant difference according to intervention methods. The change of the functional reaching test results, the Exp 1 and Exp 2 saw significant improvement according to the time of measurement. In the change of the Timed Up and Go test, there was significant improvement in the Exp 1 and Exp 2 compared to the control group (p<.01), but there was no significant difference according to intervention methods. CONCLUSION: Exercise to lower extremity strengthening program accompanied with aerobic exercise is considered more effective in dynamical balance and ability to walk.

• Journal of the Korean Society of Physical Medicine
• /
• v.14 no.4
• /
• pp.29-35
• /
• 2019

PURPOSE: The aim of this study was to provide the standard value of the Five Times Sit to Stand Test (FTSST) measurement on the daily life independence of the elderly in Korea and examine the effects of this test on their daily lives. METHODS: This study was conducted on elderly people over 65 years of age living in Gyeongsangbuk-do, Korea. FTSST was performed while sitting position on a chair. The subjects were classified into independent and dependent living groups according to their lifestyle, and their influence was then examined through logistic regression analysis. To determine the usefulness and cut-off value of the FTSST, the analysis was performed using the ROC curve. RESULTS: The elderly were more likely to live in a group rather than independently as the FTSST time increased (p<.05) (OR=1.098). The area of the lower part of the ROC curve was .707, and as the FTSST increased, a subject was more likely to live in a group rather than independently (p<.05). The cut-off value was assigned to the point where both the specificity and sensitivity were at the coordinates. The sensitivity and specificity were .626 and .753, respectively at 15.62 seconds. CONCLUSION: The elderly in Korea are more likely to live a group-dependent lifestyle than live independently; the likelihood of this outcome is increased further for every additional second beyond 15.62 seconds. The loss of independence of daily life could be predicted based on the status of a subject's lower leg strength using the FTSST.

• Archives of Plastic Surgery
• /
• v.33 no.5
• /
• pp.536-540
• /
• 2006

Purpose: The soft tissue injuries of the patellar area are difficult problems because of insufficient arterial blood supply and lack of muscle layer. There have been many methods for reconstructing the soft tissue injuries of the patellar area such as primary closure, skin graft, local flap and free tissue transfer. However, each method has some limitations in their application. After the first introduction, the fasciocutaneous flaps are widely used to reconstruct the soft tissue injuries. The saphenous nerve, one of the superficial sensory nerves in the lower leg, is supplied by the saphenous artery and its vascular network. We used the saphenous fasciocutaneous island flap to reconstruct the soft tissue injuries of the patellar area. Methods: From March 2002 to May 2005, we used the saphenous fasciocutaneous island flap to reconstruct the soft tissue injuries of the patellar area. The flap was elevated with saphenous nerve, saphenous vein and saphenous artery and its vascular network. The flap donor site was reconstructed with primary closure or split-thickness skin graft. Results: Five cases survived completely but 1 case developed partial necrosis of the skin on the upper margin of the flap. However, the necrosis was localized on skin layer, and we reconstructed with debridement and split-thickness skin graft only. After the operation, there was no contracture or gait disturbance in any patient. Conclusion: In conclusion, the saphenous fasciocutaneous island flap is safe, comfortable and effective method to reconstruct the soft tissue injuries of the patellar area.