• PNF and Movement
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• v.21 no.1
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• pp.63-74
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• 2023

Purpose: This study aims to compare hamstring flexibility and pressure pain threshold (PPT) after an intervention with proprioceptive neuromuscular facilitation contract-relax (PNF CR) technique, myofascial release (MFR), and a massage gun (MG), as well as to verify the effectiveness of the MG. Methods: This study recruited 36 participants (22 males and 14 females) with shortening of less than 70 degrees upon a straight leg raise (SLR) test, and they were randomly assigned to one of the PNF, MG, and MFR groups, each of which underwent its own protocol for 30 minutes. Flexibility of the hamstring was measured after the intervention using the active and passive knee extension (AKE and PKE) test, the sit and reach test, and PPT. Results: The AKE and PKE angles significantly decreased, as well as significantly increased in flexibility when each of the PNF, MFR, and MG interventions was performed (p<0.05). In addition, there was no significant difference among groups. However, according to the Cohen's D effect size, the MG demonstrated the largest effect size in AKE (d = 1.41) and PNF demonstrated the largest effect size in PKE (d = 1.66) and flexibility (d = 0.63). Conclusion: All interventions used in our study are effective in increasing hamstring flexibility. Based on the Cohen's D effect size, an MG is beneficial to increase the AKE, whereas PNF CR technique is recommended for increasing PKE and flexibility.

• Physical Therapy Rehabilitation Science
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• v.11 no.4
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• pp.414-420
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• 2022

Objective: In this study, the test-retest reliability and validity were presented to evaluate the usability of isokinetic rehabilitation equipment for the knee joint. Design: Cross-sectional design, reliability & validity study. Methods: Thirty healthy adults participated in the study. A CSMI dynamometer was used as a standardized measuring device to present the validity of the equipment. It was measured based on the dominant leg. The average peak torque value was selected as the measurement variable. After the measurement, a questionnaire was conducted on safety, satisfaction, and performance through the usability evaluation questionnaire. Results: The knee joint isokinetic rehabilitation equipment showed high reliability with Intraclass Correlations Coefficients (ICC) =0.883~0.956. In order to check the validity of the equipment, the 95% confidence interval of the mean difference limit was confirmed by the Bland & Altman plot. As a result, all three angular velocities showed a smaller confidence interval in the flexion than in extension. There were less than 10 plots that were not included in 2 Standard Deviation (SD) between all measurements. As a result of the usability evaluation questionnaire, the average of the safety domain(4.9±0.4), satisfaction domain(4.1±0.8), performance domain(4.3±0.8). Conclusions: If the product is improved by supplementing the items identified in the usability evaluation process, it is judged that it can be used as a useful device in various knee joint rehabilitation fields.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.2
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• pp.49-59
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• 2023

PURPOSE: This study examined the relationship between lumbar instability and shortening of the iliopsoas muscles in patients with chronic low back pain. METHODS: Forty-nine patients with chronic low back pain participated in this study. The modified Thomas test was used to examine the shortening state of the iliopsoas muscle. The length of the iliopsoas muscle was measured using the hip flexion angle, and those with a flexion angle of 10° or more were classified as positive. Five subtests were used for the lumbar instability test: testing for prone lumbar instability, passive lumbar extension, anterior-posterior mobility, passive straight leg raise, and age. Those who tested positive for at least three of these tests were classified as positive for the lumbar segment instability test. RESULTS: There was a significant association between the results of the lumbar instability test and the shortening of the iliopsoas test (p < .05). After analyzing the association between the iliopsoas length test and the five lumbar instability subtests, the results of the prone lumbar instability test (p < .001) and the anterior-posterior mobility test (p < .05) showed a significant association with the iliopsoas length test. CONCLUSION: The association between lumbar instability and shortening of the iliopsoas muscles was examined in 49 patients with chronic low back pain. Patients with shortened iliopsoas muscles tested positive in the lumbar instability tests more often. Hence, the length test of the iliopsoas muscle can be used to determine lumbar instability in patients with chronic low back pain.

• 한국체육학회지인문사회과학편
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• v.56 no.4
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• pp.575-584
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• 2017

The purpose of this study was to examine the effects of low intensity resistance training speed on body composition, muscle activity and muscle strength in obese middle-aged women. The subjects (n = 12) were randomly assigned to normal resistance training speed group (NSG, n = 6) and slow resistance training speed group (SSG, n = 6). NSG was performed the for 3 sets ${\times}$ 35 times and total 3-s per repetition (eccentric: 1-s, isometric: 1-s, concentric: 1-s), and SSG performed for 3 sets ${\times}$ 15 times and total 7-s per repetition (eccentric: 3-s, isometric: 1-s, concentric: 3-s). Both groups performed the low intensity resistance training at 30% of 1-RM for 105-s per set, rest for 1 min between sets, rest for 3 min between exercises, and 2~3 times per week, for 4 weeks. The body composition, muscle activity and muscle strength were measured before and 4 week after resistance training. WHR at NSG and body fat at SSG were significantly decreased after resistance training compared with before (P<.05). Ｍuscle activity of biceps brachii, vastus medialis and vastus lateralis at both groups were significantly decreased after resistance training compared with before (P<.05, P<.01). Muscle strength of biceps curl and leg extension at both groups were significantly increased after resistance training compared with before (P<.01). However, body composition, muscle activity and muscle strength did not show statistically significant differences between the groups. Our results suggest that body composition, muscle activity and muscle strength should closely related to the performance time of resistance training (development time of muscle contraction), rather than resistance training speed (repetition frequency).

• Radiation Oncology Journal
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• v.21 no.3
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• pp.199-206
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• 2003

Purpose: This study was undertaken to evaluate the efficacy of postoperative radiotherapy, and to investigate the prognostic factors for FIGO stages IB-IIB cervical cancer patients who were treated with simple hysterectomy, or who had high-risk factors following radical hysterectomy and pelvic lymph node dissection. Materials and Methods: Between March 1986 and December 1998, 58 patients, with FIGO stages IB-IIB cervical cancer were included in this study. The indications for postoperative radiation therapy were based on the pathological findings, including lymph node metastasis, positive surgical margin, parametrial extension, lymphovascular invasion, invasion of more than half the cervical stroma, uterine extension and the incidental finding of cervix cancer fellowing simple hysterectomy. All patients received external pelvic radiotherapy, and 5 patients, received an additional intracavitary radiation therapy. The radiation dose from the external beam to the whole pelvis was $40\~50$ Gy. Vagina cuff Irradiation was peformed, after completion of the external beam irradiation, at a low-dose rate of Cs-137, with the total dose of $4488\~4932$ chy (median: 4500 chy) at 5 mm depth from the vagina surface. The median follow-up period was 44 months ($15\~108$ months). Results: The 5-yr actuarial local control rate, distant free survival and disease-free survival rate were $98\%,\;95\%\;and\;94\%$, respectively. A univariate analysis of the clinical and pathological parameters revealed that the clinical stage (p=0.0145), status of vaginal resection margin (p=0.0002) and parametrial extension (p=0.0001) affected the disease-free survival. From a multivariate analysis, only a parametrial extension independently influenced the disease-free survival. Five patients ($9\%$) experienced Grade 2 late treatment-related complications, such as radiation proctitis (1 patient), cystitis (3 patients) and lymphedema of the leg (1 patient). No patient had grade 3 or 4 complications. Conclusion: Our results indicate that postoperative radiation therapy can achieve good local control and survival rates for patients with stages IB-IIB cervical cancer, treated with a simple hysterectomy, as well as for those treated with a radical hysterectomy, and with unfavorable pathological findings. The prognostic factor for disease-free survival was invasion of the parametrium. The prognosic factor identified in this study for treatment failure can be used as a selection criterion for the combined treatment of radiation and che motherapy.

• Radiation Oncology Journal
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• v.28 no.1
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• pp.32-38
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• 2010

Purpose: Although radiation-induced fibrosis is one of the common sequelae occurring after irradiation of skin and soft tissues, the treatment methods are not well standardized. This study aimed to establish the skin fibrosis mouse model by fractionated radiation for the further mechanism studies or testing the efficacy of therapeutic candidates. Materials and Methods: The right hind limbs of BALB/c mice received two fractions of 20 Gy using a therapeutic linear accelerator. Early skin damages were scored and tissue fibrosis was assessed by the measurement of a leg extension. Morphological changes were assessed by H&E staining and by Masson's Trichrome staining. TGF-${\beta}1$ expression from soft tissues was also detected by immunohistochemistry and PCR. Results: Two fractions of 20 Gy irradiation were demonstrated as being enough to induce early skin damage effects such as erythema, mild skin dryness, dry and wet desquamation within several weeks of radiation. After 13 weeks of irradiation, the average radiation-induced leg contraction was $11.1{\pm}6.2mm$. Morphologic changes in irradiated skin biopsies exhibited disorganized collagen and extracellular matrix fibers, as well as the accumulation of myofibroblasts compared to the non-irradiated skin. Moreover, TGF-${\beta}1$ expression in tissue was increased by radiation. Conclusion: These results show that two fractions of 20 Gy irradiation can induce skin fibrosis in BALB/c mice accompanied by other common characteristics of skin damages. This animal model can be a useful tool for studying skin fibrosis induced by radiation.

• Journal of the Korean Orthopaedic Association
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• v.54 no.3
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• pp.244-253
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• 2019

Purpose: Total hip arthroplasty was performed using a direct anterior approach (DAA) on an ordinary operation table and a short femoral stem. The clinical radiographic results were evaluated by a comparison with those performed using the modified hardinge (anterolateral approach, ALA) method. Materials and Methods: From January 2013 to November 2015, 102 patients who underwent total hip arthroplasty using DAA (DAA group) and the same number of patients using ALA (ALA group), both performed by a single surgeon, were compared and analyzed retrospectively. The operation time and amounts of bleeding were compared, and the improvement in post-operative pain, ambulatory capacity and functional recovery of the hip joint were checked. The location of insertion of the acetabular cup and femoral stem were evaluated radiologically, and the complications that occurred in the two groups were investigated. Results: The amount of bleeding was significantly smaller in the DAA group (p=0.018). Up to 3 weeks postoperatively, recovery of hip muscle strength was significantly higher in the DAA group (flexion/extension strength p=0.023, abduction strength p=0.031). The Harris hip score was significantly better in the DAA group for up to 3 months (p<0.001) and the Koval score showed significantly better results in the DAA group up to 6 weeks (p≤0.001). The visual analogue scale score improvement was significantly higher in the DAA group by day 7 (p=0.035). The inclination angle (p<0.001) and anteversion angle (p<0.001) of the acetabular cup were located in the safe zone of the DAA group more than in the ALA group, and there was no statistically significant difference in the position of the femur stem and leg length difference. During surgery, two cases of greater trochanter fracture occurred in the DAA group (p=0.155). Conclusion: The DAA performed in the ordinary operation table using a short femoral stem showed post-operative early functional recovery. Because a simple to use fluoroscope was used during surgery with an anatomical position familiar to the surgeon, it is considered to be useful for the insertion of implants into the desired position and for an approach that is useful for the prevention of leg length differences.

• Science of Emotion and Sensibility
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• v.20 no.3
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• pp.141-150
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• 2017

The purpose of this study was to analyze the effect of the shape and attached position of E-textile-based stretchable sensors on motion-sensing performance and to investigate the requirements for the optimal structure of clothes for sensing limb motions. An experimental garment was prepared with different sensor shapes, and attachment positions. A child subject, wearing the experimental garment, performed arm and leg bending and extension motions at $60^{\circ}$, $90^{\circ}$ and $120^{\circ}$ motion angles, at a rate of 60 deg/sec. The changes in voltage triggered by the stretching and contracting of the fabric-sensor were measured, and an acceleration sensor was utilized to verify that the experimental motions were correctly performed. Dummy arms and legs of a child were manufactured to perform an identical test, in order to compare the dummy results with the actual human body experiment results. The analysis showed that the reproducibility and reliability of the rectangular sensor, showing uniform and stable were higher than those of the boat-shaped sensor, in both the dummy and the human body experiments. The attachment position of the sensor was more reproducible and reliable when placed on 4 cm below the elbow and knee joints in the dummy test, when placed in the joints of the elbow and knee, in children experiment. The appropriate shapes and attached positions of the sensor for sensing the motions were analyzed, and the results proved that motion-sensing of the human body is possible by utilizing flexible fabric-sensors integrated into clothes.

• Korean Journal of Applied Biomechanics
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• v.25 no.2
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• pp.183-190
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• 2015

Objective : Walking with a Material handling is an activity frequently undertaken by agricultural workers in Korea, due to the nature of their work. This study aimed to investigate differences in biomechanical variables according to the mechanical alignment of the lower limbs when walking with a heavy load, and to use this as basic data in the design of various working environments to reduce the skeletomuscular burden on the knee joint. Method : The study subjects comprised of 22 right-foot dominant adult men and women aged between 20 and 23 years. The subjects were divided into a varus or valgus group according to the mechanical alignment of the lower limb by using radiographic findings. The subjects walked without any load and with a load of 10%, 20%, or 30% of their body weight held in front of them. The Kwon3d XP program was used to calculate biomechanical variables. Results : The flexion/extension moment of the knee joint showed a decreasing trend with increased load, irrespective of the mechanical alignment of the lower limb, while the varus group did not show normal compensatory action when supported by one leg at the point of maximum vertical ground reaction force. In addition, in terms of the time taken, subjects showed no difficulties in one-foot support time up to 20%/BW, but at 30%/BW, despite individual differences, there was an increase in single limb. The increased load resulted in a decrease in the ratio of standing phase to ensure physical stability. The valgus group showed a trend of increasing the stability of their center of mass with increasing load, through higher braking power in the early standing phase. Conclusion : In conclusion, although there was no statistical difference in biomechanical variables according to the mechanical alignment of the lower limbs, the varus group showed a more irregular walking pattern with a Material handling than the valgus group, partially proving the association between lower limb alignment and walking with a Material handling.

• The Korean Journal of Rehabilitation Nursing
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• v.1 no.1
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• pp.51-60
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• 1998

The result of studying papers about management of lower back pain published in domestic and foreign nursing and medical magazines in these 10 years is as follows ; 1. General characteristic of lower back pain ; 1) In sex distribution, there were more men than women in 5 papers and more women than men in 4 papers among 9 papers surveryed. 2) In age distribution, thirties to forties of patients had more lower back pain as surveyed by general hospitals and fifties to sixties of patients had more lower back pain as surveyed by oriental medical hospitals. 3) In cause factor, there were 50 to 65% of sprain, 32 to 44% of herniated intervertebral disc and 13 to 29% of degenerative changes. 4) In symtom distribution, there were 26 to 57% of lower back pain, 42 to 65% of lower back pain with radiating pain and 34 to 99% of paravertevral muscle spasm. 5) In period of pain management distribution, 18 to 40% of patients experienced pain for less than 6 months and 59 to 82% of them experienced pain for more than 6 months in 3 papers among 4 papers. 6) In surveying the treatment, 66 to 88% of patients had conservative treatment and there were treatments of general hospital, oriental medicine, self remedy and traditional practice in conservative treatment. 7) In job distribution, 12 to 50% of them were housekeepers, 23 to 31% office workers, 4.6 to 36% blue color workers and 11 to 15% students. 2. As psychological character lower back pain paients had anxiety, depression, anger-hostility, phobic anxiety, neurasthenia, hypochondriasis, and interpersonal sensitivity. 3. To distinguish the cause of lower back pain, plain lumbar roentgenogram, straight leg rasing test, eletromyelogic findings, somatosensory evoked potentials CT and MRI were performed. 4. To relieve lower back pain. epidural adhesiolysis, epidulal injection of local anesthetic in mixture with steroid, lumbar spinal root block, low level laser therapy, acupuncture like transcutaneous nerve stimulation(AL TENS), topical capsaicin and lumbar orthotics were used in medical field, and relaxation technique was used in nursing field. 5. Mckenzie's extension exercise and William's flexsion exercise for lower back pain were used in medical field and Yoga exercise was applied in nursing field. 6. The more school education and self efficacy were high, the better they had active coping lower back pain positively and the less self efficacy was the more they had serious pain. As a result of studying the paper there have been very little research for lower back pain in nursing fields of Korea and foreign countries. Because 60 to 80% of population expeience lower back pain at least more than once, it is necessary to develop the study and clinical practice for management of lower back pain.