• Physical Therapy Korea
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• v.26 no.1
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• pp.37-50
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• 2019

Background: Stroke is one of the most common diseases responsible for physical disabilities. In addition to their physical and occupational therapy, the self-exercise programs were developed for patients with hemiplegia to increase the intensity of their therapeutic exercise. Objects: The purpose of this study was to assess the effect of a customized self-exercise program (CSP) to walking function on improving stroke survivors' muscle strength and ambulation function. Method: To test the effect of the self-exercise program, the following tests were conducted: The functional ambulation category (FAC), Tinetti performance-oriented mobility assessment gait part (POMA-G), timed up and go (TUG), 10-meter walk, and 2-minute walk. The study included 161 consenting stroke patients (FAC score>1) from a randomized, screened sample of 217. The CSP group participated in a 30-minute CSP each day for 10 weeks in addition to completing a routine rehabilitation program. The control group received only a routine rehabilitation program. All the subjects were monitored by a therapist once a week and had to submit an exercise checklist at the end of each session. Result: The strength of the participants' upper and lower extremity muscles showed no significant differences between the CSP group and the control group. The FAC score and POMA-G also showed no significant differences. However, there were significant differences in the TUG, 10-meter walk test, and 2-minute walk test (p<.05). Conclusion: The findings of this study suggest that a CSP may improve gait-related function in stroke survivors.

• Clinical and Experimental Pediatrics
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• v.62 no.2
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• pp.62-67
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• 2019

Purpose: We aimed to determine the prognostic significance of lymphocyte counts and the lymphocytemonocyte ratio (LMR) in pediatric patients with osteosarcoma. Methods: We retrospectively reviewed the medical records of 27 pediatric patients with localized extremity osteosarcoma, treated at the Korea Cancer Center Hospital between May 2002 and March 2016. Leukocyte counts and LMR before treatment and on day 14 (LMR14) of the first cisplatin-doxorubicin chemotherapy round were evaluated. Patients were dichotomized according to the median value of these parameters, and survival rates were compared. Results: The median age of the 27 patients was 9.9 years (range, 3.2-14.1 years) and tumor sites were: distal femur (n=14), proximal humerus (n=7), proximal tibia (n=2), proximal fibula (n=2), and elsewhere (n=2). Patients were followed up on for a median of 76.4 months (range, 4.5-174.7 months), and 5-year overall (OS) and event-free survival (EFS) rates were $66.0%{\pm}9.8%$ and $60.9%{\pm}9.7%$, respectively. Patients with a higher pretreatment lymphocyte count (${\geq}2,320/{\mu}L$) had better OS (90.9% vs. 46.2%, P=0.04) and EFS (83.9% vs. 38.5%, P=0.02). However, the day 14 lymphocyte count was not associated with survival. While no survival difference was observed between patients grouped according to pretreatment LMR (median value, 6.3), patients with a higher LMR14 (${\geq}5$) fared better than those with lower LMR14 (5-year OS: 83.3% vs. 46.3%, P=0.04). Conclusion: Pretreatment lymphocyte count and LMR during chemotherapy had prognostic significance in pediatric osteosarcoma patients. Further studies involving larger cohorts are necessary to validate our findings.

• Clinical and Experimental Pediatrics
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• v.62 no.3
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• pp.90-94
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• 2019

Purpose: Several published policy statements have warned against the risks associated with trampoline use and recommended safety guidelines. However, few studies have focused on trampoline-related injuries in Korea. This study aimed to assess the incidence and characteristics of pediatric trampoline-related injuries presented to Ulsan University Hospital. Methods: We retrospectively reviewed the medical records of children aged <16 years with trampoline-related injuries who visited our Emergency Department between 2008 and 2017. Results: Over the 10-year period, 178 trampoline-related injuries were reported, which represented a significant increase (P=0.016). Most (87.6%) of the injuries occurred during the last 5 study years, and a rapid increase in injuries was observed in children aged <6 years. Lower extremity injuries (62.4%) were the most common, followed by injuries of the upper extremities, head and face, and trunk, including injuries to the neck and spine. Sixty-seven children (37.6%) had fractures, and proximal tibia fractures were the most common. Fractures were significantly more common in younger children (<6 years old) than in older children (P=0.026). Conclusion: In Korea, the mechanism of trampoline injury is similar to that of injuries incurred in indoor trampoline parks but is characterized by smaller spaces and multiple users. Trampoline use and the incidence of trampoline-related injuries in children aged <6 years are increasing rapidly. Prohibiting the use of trampolines for children aged <6 years, restricting simultaneous use by multiple children, and ensuring adult supervision should be strictly emphasized. Public awareness and policy guidelines are needed to reduce the incidence of trampoline-related injuries.

• The Korean Journal of Pain
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• v.32 no.1
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• pp.47-50
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• 2019

Background: It is uncommon for patients who have received a permanent implant to remove the spinal cord stimulator (SCS) after discontinuation of medication in complex regional pain syndrome (CRPS) due to their completely painless state. This study evaluated CRPS patients who successfully removed their SCSs. Methods: This 10-year retrospective study was performed on patients who had received the permanent implantation of an SCS and had removed it 6 months after discontinuation of stimulation, while halting all medications for neuropathic pain. Age, sex, duration of implantation, site and type of CRPS, and their return to work were compared between the removal and non-removal groups. Results: Five (12.5%, M/F = 4/1) of 40 patients (M/F = 33/7) successfully removed the permanent implant. The mean age was younger in the removal group ($27.2{\pm}6.4$ vs. $43.5{\pm}10.7$ years, P < 0.01). The mean duration of implantation in the removal group was $34.4{\pm}18.2$ months. Two of 15 patients (13.3%) and 3 of 25 patients (12%) who had upper and lower extremity pain, respectively, had removed the implant. The implants could be removed in 5 of 27 patients (18.5%) with CRPS type 1 (P < 0.01). All 5 patients (100%) who removed their SCS returned to work, while only 5 of 35 (14.3%) in the non-removal group did (P < 0.01). Conclusions: Even though this study had limited data, younger patients with CRPS type 1 could remove their SCSs within a 5-year period and return to work with complete pain relief.

• PNF and Movement
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• v.17 no.1
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• pp.119-127
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• 2019

Purpose: The purpose of this study is to show the effect of elastic band on balance and functional ability in chronic stroke patients living in community. Methods: The subjects who participated in the study were 9 patients with chronic stroke. One of them gave up during the study, finally 8 patients performed. The intervention was conducted once a week for 10 weeks. In this study functional reach test (FRT), timed up and go test (TUG), Tinetti performance oriented mobility assessment (Tinetti-POMA) were measured for balance. The coordination training of arms and legs using the elastic band was performed in three positions as supine, side lying, sitting. One arm performed flexion-adduction- external rotation with elbow flexion pattern and the opposite side(diagonal) leg was performed flexion-adduction-external rotation with knee flexion pattern, the other arm's pattern was extension-abduction-internal rotation with elbow extension and the opposite side (diagonal) leg was in extension-abduction-internal rotation with knee extension pattern. The training was performed in each position for 15 minutes in per position. The participants had a five minute break after each training. Results: The results are as follows. FRT and Tinetti-POMA showed significant increase statistically in each position. The TUG showed significant decrease statistically in each position. Conclusion: Even though the coordination training with elastic band had performed once a week, it showed positive effects on balance in chronic stroke patients. Therefore, if we can suggest the appropriate frequencies of coordination training of arms and legs using the elastic band, it can be a method to improve daily life and life quality to patients with chronic stroke.

• The Journal of the Convergence on Culture Technology
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• v.5 no.2
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• pp.337-344
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• 2019

The purpose of this study men and women 20 to 30 of 16 patients wearing thick insoles 5cm before and after squat exercise based on the angle of the knee joint(0-, 60-, 90-degree) was to observe the muscle activities. For this through the analysis of the rectus femoris EMG, vatus medialis vatus lateralis, tibialis anterior, gastrocnemius MVIC were quantified using. The results following results were obtained. After wearing the thick insole standing position(0') had increased EMG activity of vastus lateralis muscle, the knee angle is rectus femoris, vatus medialis, vastus lateralis, tibialis anterior, gastrocnemius muscles were increased muscle activity. thick insole of the ankle joint, causing plantar flexion forward weight distritbution by focusing is normally the body would lead to an array. When an array of everyday life, these abnormalities increases energy consumption, and muscle fatigue, increase will cause an imbalance in the muscles. Therefore, wearing thick insoles by changing the activity of the muscles may cause knee pain.

• Physical Therapy Rehabilitation Science
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• v.8 no.1
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• pp.32-39
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• 2019

Objective: The aim of this study is to investigate the effects of whole body vibratory stimulation on muscle strength, balance, and fall efficacy among super-aged women. Design: Randomized controlled trial. Methods: Twenty-eight super-aged women over 80 years of age were assigned to either the experimental group (n=14) and control group (n=14). The experimental group received an exercise program that used the whole body vibratory stimulation with a frequency of 30 Hz and amplitude of 3 mm, and the control group received an exercise program without vibratory stimulation. Intervention was provided for 4 weeks, 3 sessions per week, and 30 minutes per session. In order to measure lower extremity muscle strength the 30-second chair stand test (CST) was used. The Berg Balance Scale (BBS) was used to measure dynamic balance. Static balance was measured by tracking the path length, velocity, and area of the center of pressure (CoP). The Falls Efficacy Scale (FES) was used to measure the subjects' fear of falling. Results: Both the experimental and control group demonstrated statistically significant increase in muscle strength, dynamic balance, and fall efficacy (p<0.05). Only the experimental group showed significant improvements in static balance before and after the intervention (p<0.05). The experimental group showed significantly greater improvements in CST, BBS, and CoP (path length, velocity) than control group (p<0.05). Conclusions: Whole body vibratory stimulation exercise is shown to be a safe and appropriate physical therapy intervention method to enhance muscle strength, balance, and fall efficacy of super-aged women.

• PNF and Movement
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• v.9 no.3
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• pp.11-17
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• 2011

Purpose : The purpose of this study was to analyze the effects of proprioceptive neuromuscular facilitation (PNF) leg flexion patterns according to the hip joint angle on electromyographic activity of the trunk. Methods : Thirty healthy adults volunteered to participate in this study. Subjects were required to complete following the PNF leg flexion patterns on three different hip joint flexion $30^{\circ}$, $60^{\circ}$ and $90^{\circ}$. An surface electromyogram (SEMG) was used to record the electromyographic activities of the trunk muscle in rectus abdominis, internal oblique abdominal, external oblique abdominal, erector spinae. The data were analyzed using the a repeated measures of one-way ANOVA with post-hoc Bonferroni's correction. Result : The results of this study are summarized as follows: The EMG activities of internal abdominal oblique and elector spinae muscle showed a statistically significant difference (p<.05). Conclusion : The result show that electromyographic activity of the trunk muscles significantly changed on PNF leg flexion patterns with difference hip joint angle. Therefore, this study used to basis for the intervention of the trunk muscle strength and stabilization.

• PNF and Movement
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• v.10 no.1
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• pp.61-70
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• 2012

Purpose : The purpose of this study was to investigate thigh muscle-bone CSA and leg strength during low-intensity exercise program with leg blood flow restriction by external compression to reduce muscle outflow. Methods : Eighteen health students gave informed written consent to participate in this investigation. An occlusion cuff was attached to the proximal end of the leg so that blood flow was reduced during the training. The training was conducted one times a day, three times a week, for 8 weeks using one sets of 30 minutes. The training program performed to squat with standing, lunge with standing and heel raise with one leg standing. Measurements of thigh muscle-bone CSA(cross-sectional area) and leg strength were evaluated pre and post-training. Statistical evaluation of these data was accomplished utilizing a paired t-test by SPSS 12.0 program for windows. Significance level was set at p <.05. Results : All data are reported as means and standard deviations(SD) for all variables. The result of the study is followed; After the training, muscle-bone CSA, gluteus maximus m, quadriceps m, hamstring m of both legs were significantly improved but not calf muscle(p<.05). There was no significant difference of change quantity between muscle-bone CSA and leg strength in Lt. and Rt. side. But the variation in leg muscle strength of Rt. leg(dominant) was much more increased than Lt. leg(non-dominant) after 8 weeks training. Conclusion : Low-intensity training with leg blood flow restriction offers a potentially useful method for improving leg muscle strength.

• Archives of Craniofacial Surgery
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• v.21 no.6
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• pp.376-379
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• 2020

Supraclavicular lymph node (SCLN) flap is a common donor site for vascularized lymph node transfer for the treatment of lymphedema. Chyle leakage is a rare but serious complication after harvesting SCLN flap in the neck. We report a case of chyle leakage at the SCLN donor site and its successful management. A 52-year-old woman underwent SCLN transfer for treatment of lower extremity lymphedema. After starting a regular diet and wheelchair ambulation on the 3rd postoperative day, the amount of drainage at the donor site increased (8-62 mL/day) with the color becoming milky, which suggested a chyle leak. Despite starting a low-fat diet on the 4th postoperative day, the chyle leakage persisted (70 mL/day). The patient was started on fat-free diet on the 5th postoperative day. The amount of drainage started to decrease and the drain color became more clear within 24 hours. The drainage amount remained less than 10 mL/day from the 8th postoperative day, and we removed the drain on the 12th postoperative day. There was no seroma or other wound complications at follow-up 4 weeks after the operation. The current case demonstrates that a fat-free diet can be a first-line treatment for low output chyle leakage after a SCLN flap.