• PNF and Movement
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• v.22 no.2
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• pp.181-189
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• 2024

Purpose: This study aimed to identify the effect of sling-applied plank exercise on the frequency, stiffness, and decrement of the rectus abdominis and longissimus muscles of the trunk according to the stability of the base of support. Methods: Thirty-three young adults volunteered to participate and were randomly assigned to one of three groups (SS, stable support; LES, lower extremity support; and ULES, upper and lower extremity support) according to the stability of the base of support. The muscular properties of the rectus abdominis and longissimus muscles during sling-assisted plank exercise according to the stability of the base of support. were measured by using Myoton PRO (Myoton AS, Tallinn, Estonia). Statistical analysis was performed MANOVA to determine the effect of sling-assisted plank exercise on the muscular properties of the rectus abdominis and longissimus muscles according to the stability of the base of support. Post hoc analysis was conducted using Bonferroni. The level of statistical significance was set at α = 0.05. Results: When comparing the muscular properties, the muscle frequency and stiffness of the left rectus abdominis of ULES were significantly decreased compared to that of SS (p < 0.05). In the measurement time, the muscle frequency and the muscle stiffness of the right rectus abdominis increased significantly after the intervention (p < 0.05). Conclusion: It was concluded that the more unstable the base of support (ULES), the higher the exercise strength, and the muscle frequency and stiffness decreased on the rectus abdominis at rest.

• PNF and Movement
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• v.22 no.2
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• pp.233-242
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• 2024

Purpose: The aim of this study was to investigate the effects of different types of unstable loads on core and lower limb muscle activity during squatting. Methods: Nineteen subjects (all females) with resistance experience but no unstable resistance experience participated in the study. Subjects performed squats under three load conditions, and core and lower limb muscle activity was measured during eccentric and concentric contractions. Results: During the eccentric contraction, core and hip flexor activity was significantly higher with the aqua bag than with the barbell or resistance band, and for the quadriceps, the resistance band was significantly higher than the barbell. During the concentric contraction phase, core and hamstring muscle activity was significantly higher with the aqua bag than with the barbell and elastic band (p < 0.05). Conclusion: Squats with an aqua bag increase core and biceps brachii activation and can be recommended as a training method to improve trunk stability.

• Journal of The Korean Society of Integrative Medicine
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• v.12 no.3
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• pp.155-161
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• 2024

Purpose : Wearing high-heeled shoes leads to foot and ankle instability, which requires leg muscles to remain in constant contraction. In order to adapt to the instability of the feet and ankles caused by wearing high heels, the muscles of the legs continuously repeat contraction and relaxation. Previous studies of the impact of stair climbing in high-heeled shoes have involved placing the entire stepping area of the shoe on the stair. However, high-heeled shoe wearers sometimes unconsciously contact the stair using only half of the stepping area. Therefore, the objective of this study was to examine differences in leg and ankle muscle activation according to stepping area during stair climbing in high-heeled shoes. Methods : Twenty young women in their early 20s voluntarily agreed to participate in this study. We used surface electromyography to measure gastrocnemius and tibialis anterior activation in the right leg during stair climbing under three conditions: barefoot, using half of high-heeled shoe stepping area, and using the total of high-heeled shoe stepping area. Barefoot, half of high heeled shoe, and total of high-heeled shoe were used to evaluate the effects of different areas of the foot or high heels touching the stairs. Results : Both muscles showed significant activity differences among the three stair climbing conditions. Gastrocnemius activity was significantly different between the high-heeled shoe conditions (p= .032), and tibialis anterior activity was significantly different between barefoot stair climbing and climbing with half of the high-heeled shoe stepping area (p= .021). Conclusion : The stepping area increased as heel size increased, thus increasing excessive gastrocnemius and tibialis anterior activity to control excessive ankle joint movement. We infer that using half of the high-heeled shoe stepping area prevents muscle fatigue by reducing excessive leg and ankle muscle activation.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.1
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• pp.15-21
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• 2012

Purpose: Image Guided Radiation Therapy (IGRT) has been carried out using On-Board Imager system (OBI) in Asan Medical Center. For this reason, This study was to analyze and evaluate the impact on Cone-Beam CT according to variation of material and respiration. Materials and Methods: This study was to acquire and analyze Cone-Beam CT three times for two material: Cylider acryl (lung equvalent material, diameter 3 cm), Fiducial Marker (using clinic) under Motion Phantom able to adjust respiration pattern randomly was varying period, amplitude and baseline vis-a-vis reference respiration pattern. Results: First, According to a kind of material, when being showed 100% in the acryl and 120% in the Fiducial Marker under the condition of same movement of the motion phantom. Second, According to the respiratory alteration, when being showed 1.13 in the baseline shift 1.8 mm and 1.27 in the baseline shift 3.3 mm for acryl. when being showed 1.01 in 1 sec of period and 1.045 in 2.5 sec of period for acryl. When being showed 0.86 in 0.7 times the standard of amplitude and 1.43 in 1.7 times the standard of amplitude for acryl. when being showed 1.18 in the baseline shift 1.8 mm and 1.34 in the baseline shift 3.3 mm for Fiducial Marker. when being showed 1.0 in 1 sec of period and 1.0 in 2.5 sec of period for Fiducial Marker. When being showed 0.99 in 0.7 times the standard of amplitude and 1.66 in 1.7 times the standard of amplitude for Fiducial Marker. Conclusion: The effect of image size of CBCT was 20% in the case of Fiducial marker. The impact of changes in breathing pattern was minimum 13% - maximum 43% for Arcyl, min. 18% - max. 66% for Fiducial marker. This difference makes serious uncertainty. So, Must be stabilized breathing of patient before acquiring CBCT. also must be monitored breathing of patient in the middle of acquire. If you observe considerable change of breathing when acquiring CBCT. After Image Guided, must be need to check treatment site using fluoroscopy. If a change is too big, re-acquiring CBCT.

• Journal of Veterinary Clinics
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• v.30 no.5
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• pp.346-352
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• 2013

The study was aimed to investigate the influence of diode laser on osteoarthritis (OA) of stifle joint induced by anterior cruciate ligament transection (ACLT). Sixty 10-week-old male Sprague-Dawley rats were used in this study. Right stifle joint was operated to create ACLT or sham. There were five study groups: control, Sham, ACLT, ACLT + Laser irradiation (ACLT+L) and ACLT + meloxicam administration (ACLT+M). Low-level laser therapy (LLLT) was applied at the operated stifle joint twice a week using an 808-nm indium-gallium-arsenide (InGaAs) diode laser during 8-week experimental period. Radiographical, gross morphological and histopathological findings were examined at 2, 4 and 8 weeks post-surgery. Radiography, CBC and chemistry tests showed no significant difference between groups. ACLT+L group showed remarkable cartilage damages compared with sham group morphologically and histopathologically at 2, 4 and 8 weeks after surgery. ACLT+M group also had more cartilage damages compared with sham group. Low-level laser therapy (LLLT) showed limitation to prevent progression of OA in the rat anterior cruciate ligament transection models; on the contrary it accelerated cartilage damage. It is assumed that the aggravating results of LLLT in this study might be due to excessive unstable movement of stifle joint from the pain-relieving effect of LLLT, rather than direct damaging effect of irradiation since LLLT did not affect cell viability.

• PNF and Movement
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• v.19 no.3
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• pp.423-433
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• 2021

Purpose: Proprioceptive neuromuscular facilitation (PNF) is a method for promoting functional movements by facilitating neuromuscular responses through the stimulation of proprioceptors in the body using spiral and diagonal patterns. Irradiation, a basic principle of PNF, is a phenomenon in which the muscle activity of a body part caused by resistance is increased or spread into muscles in other parts via their connected muscles. Resistance training can be divided by body alignment into closed and open chain exercises. Methods: In this study, 19 healthy men in their 20s and 30s were selected as subjects. They performed PNF hip flexion, abduction, and internal rotation motions on their dominant side in an open chain exercise posture in which the nondominant sole was away from the wall, and in a closed chain exercise posture in which the sole was fixed to the wall. The nondominant leg's muscle activity was measured while resistance was maintained with applied pressure at 0%, 25%, 50%, 75%, and 100% of the maximum muscle strength in the last range of motions. A two-way analysis of variance (ANOVA) was conducted for a comparative analysis of the contralateral leg's muscle activity according to the chain exercise postures and the intensity of resistance intensity during PNF hip flexion, abduction, and internal rotation. In addition, an independent sample T-test was conducted for a comparative analysis of each chain exercise posture according to the intensity of resistance. A one-way ANOVA and a Scheffe post-hoc test were also performed to analyze the contralateral leg's muscle activity according to the intensity of resistance in the closed and open chain exercise postures. Results: Results of the two-way ANOVA found that the gluteus medius and the biceps femoris had statistically significant differences in both the chain exercise postures and resistance intensity (p<0.05), and that the vastus medialis and the gastrocnemius did not exhibit statistically significant differences in the chain exercise postures (p>0.05) but showed statistically significant differences in resistance intensity (p<0.05). As a result of the independent sample T-test, the application of the PNF hip flexion-abduction-internal rotation pattern led to a statistically significant difference in the contralateral gluteus medius during the closed chain exercise posture (p<0.05). According to the results of the one-way ANOVA and the Scheffe post-analysis, statistically significant differences were observed in the gluteus medius at 50%, biceps femoris at 75%, vastus medialis at 100%, and gastrocnemius at 100% during the closed chain exercise posture based on a resistance intensity of 0% (p<0.05). In the open chain exercise posture, statistically significant differences were found in the gluteus medius at 50%, biceps femoris at 50%, and vastus medialis at 75% based on the resistance intensity of 0% (p<0.05). In the same posture, there was no significant difference in the gastrocnemius's resistance intensity (p>0.05). Conclusion: When the PNF leg pattern is applied, each muscle requires effective chain exercise postures and resistance intensity to generate the contralateral leg muscle's irradiation.

• The Journal of Korean Society for Radiation Therapy
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• v.33
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• pp.35-46
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• 2021

Purpose : By comparing and analyzing treatment plans using abdominal compression and The Continuous Positive Air Pressure(CPAP) during SABR of lung cancer, we try to contribute to the improvement of radiotherapy effect. Materials & Methods : In two of the lung SABR patients(A, B patient), we developed a SABR plan using abdominal compression device(the Body Pro-Lok, BPL) and CPAP and analyze the treatment plan through homogeneity, conformity and the parameters proposed in RTOG 0813. Furthermore, for each phase, the X, Y, and Z axis movements centered on PTV are analyzed in all 4D CTs and compared by obtaining the volume and average dose of PTV and OAR. Four cone beam computed tomography(CBCT) were used to measure the directions from the center of the PTV to the intrathoracic contacts in three directions out of 0°, 90°, 180° and 270°, and compare the differences from the average distance values in each direction. Result : Both treatment plans obtained using BPL and CPAP followed recommendations from RTOG, and there was no significant difference in homogeneity and conformity. The X-axis, Y-axis, and Z-axis movements centered on PTV in patient A were 0.49 cm, 0.37 cm, 1.66 cm with BPL and 0.16 cm, 0.12 cm, and 0.19 cm with CPAP, in patient B were 0.22 cm, 0.18 cm, 1.03 cm with BPL and 0.14 cm, 0.11 cm, and 0.4 cm with CPAP. In A patient, when using CPAP compared to BPL, ITV decreased by 46.27% and left lung volume increased by 41.94%, and average dose decreased by 52.81% in the heart. In B patient, volume increased by 106.89% in the left lung and 87.32% in the right lung, with an average dose decreased by 44.30% in the stomach. The maximum difference of A patient between the straight distance value and the mean distance value in each direction was 0.05 cm in the a-direction, 0.05 cm in the b-direction, and 0.41 cm in the c-direction. In B patient, there was a difference of 0.19 cm in the d-direction, 0.49 cm in the e-direction, and 0.06 cm in the f-direction. Conclusion : We confirm that increased lung volume with CPAP can reduce doses of OAR near the target more effectively than with BPL, and also contribute more effectively to restriction of tumor movement with respiration. It is considered that radiation therapy effects can be improved through the application of various sites of CPAP and the combination with CPAP and other treatment machines.

• The Journal of Korean Society for Radiation Therapy
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• v.35
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• pp.41-51
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• 2023

Purpose: This study compares and analyzes the image quality of 3D-CBCT(Cone Beam Computed-Tomography) and Gated CBCT according to baseline changes during SBRT(Stereotactic Body RadioTherapy) in lung cancer patients to find a useful CBCT method for correcting movement due to breathing Materials and methods : Insert a solid tumor material with a diameter of 3 cm into the QUASAR^TM phantom. 4-Dimentional Computed-Tomography(4DCT) images were taken with a speed of the phantom at period 3 sec and a maximum amplitude of 20 mm. Using the contouring menu of the computerized treatment planning system Eclipse^TM Gross Tumor Volume was outlined on solid tumor material. Set-up the same as when acquiring a 4DCT image using Truebeam STx^TM, breathing patterns with baseline changes of 1 mm, 3 mm, and 5 mm were input into the phantom to obtain 3D-CBCT (Spotlight, Full) and Gated-CBCT (Spotlight, Full) images five times repeatedly. The acquired images were compared with the Signal-to-Noise Ratio(SNR), Contrast-to-Noise Ratio(CNR), Tumor Volume Length, and Motion Blurring Ratio(MBR) based on the 4DCT image. Results: The average Signal-to-Noise Ratio, Contrast-to-Noise Ratio, Tumor Volume Length and Motion Blurring Ratio of Spotlight Gated CBCT images were 13.30±0.10%, 7.78±0.16%, 3.55±0.17%, 1.18±0.06%. As a result, Spotlight Gated-CBCT images according to baseline change showed better values than Spotligtht 3D-CBCT images. Also, the average Signal-to-Noise Ratio, Contrast-to-Noise Ratio, Tumor Volume Length and Motion Blurring Ratio of Full Gated CBCT images were 12.80±0.11%, 7.60±0.11%, 3.54±0.16%, 1.18±0.05%. As a result Full GatedCBCT images according to baseline change showed better values than Full 3D-CBCT images. Conclusion : Compared to 3D-CBCT images, Gated-CBCT images had better image quality according to the baseline change, and the effect of Motion Blurring Artifacts caused by breathing was small. Therefore, it is considered useful to image guided using Gated-CBCT when a baseline change occurs due to difficulty in regular breathing during SBRT that exposes high doses in a short period of time

• The Journal of Korean Society for Radiation Therapy
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• v.32
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• pp.7-15
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• 2020

Purpose: In modern radiotherapy technology, several methods of image guided radiation therapy (IGRT) are used to deliver accurate doses to tumor target locations and normal organs, including CBCT (Cone Beam Computed Tomography) and other devices, ExacTrac System, other than CBCT equipped with linear accelerators. In previous studies comparing the two systems, positional errors were analysed rearwards using Offline-view or evaluated only with a Yaw rotation with the X, Y, and Z axes. In this study, when using CBCT and ExacTrac to perform 6 Degree of the Freedom(DoF) Online IGRT in a treatment center with two equipment, the difference between the set-up calibration values seen in each system, the time taken for patient set-up, and the radiation usefulness of the imaging device is evaluated. Materials and Methods: In order to evaluate the difference between mobile calibrations and exposure radiation dose, the glass dosimetry and Rando Phantom were used for 11 cancer patients with head circumference from March to October 2017 in order to assess the difference between mobile calibrations and the time taken from Set-up to shortly before IGRT. CBCT and ExacTrac System were used for IGRT of all patients. An average of 10 CBCT and ExacTrac images were obtained per patient during the total treatment period, and the difference in 6D Online Automation values between the two systems was calculated within the ROI setting. In this case, the area of interest designation in the image obtained from CBCT was fixed to the same anatomical structure as the image obtained through ExacTrac. The difference in positional values for the six axes (SI, AP, LR; Rotation group: Pitch, Roll, Rtn) between the two systems, the total time taken from patient set-up to just before IGRT, and exposure dose were measured and compared respectively with the RandoPhantom. Results: the set-up error in the phantom and patient was less than 1mm in the translation group and less than 1.5° in the rotation group, and the RMS values of all axes except the Rtn value were less than 1mm and 1°. The time taken to correct the set-up error in each system was an average of 256±47.6sec for IGRT using CBCT and 84±3.5sec for ExacTrac, respectively. Radiation exposure dose by IGRT per treatment was measured at 37 times higher than ExacTrac in CBCT and ExacTrac at 2.468mGy and 0.066mGy at Oral Mucosa among the 7 measurement locations in the head and neck area. Conclusion: Through 6D online automatic positioning between the CBCT and ExacTrac systems, the set-up error was found to be less than 1mm, 1.02°, including the patient's movement (random error), as well as the systematic error of the two systems. This error range is considered to be reasonable when considering that the PTV Margin is 3mm during the head and neck IMRT treatment in the present study. However, considering the changes in target and risk organs due to changes in patient weight during the treatment period, it is considered to be appropriately used in combination with CBCT.

• The Journal of Korean Society for Radiation Therapy
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• v.23 no.2
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• pp.109-117
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• 2011

Purpose: To analyze the accuracy of tumor volume dose following field width change, to check the difference of dose change by using self-made moving car, and to evaluate practical delivery tumor dose when tomotherapy in the treatment of organ influenced by breathing. Materials and Methods: By using self-made moving car, the difference of longitudinal movement (0.0 cm, 1.0 cm, 1.5 cm, 2.0 cm) was applied and compared calculated dose with measured dose according to change of field width (1.05 cm, 2.50 cm, 5.02 cm) and apprehended margin of error. Then done comparative analysis in degree of photosensitivity of DQA film measured by using Gafchromic EBT film. Dose profile and Gamma histogram were used to measure degree of photosensitivity of DQA film. Results: When field width were 1.05 cm, 2.50 cm, 5.02 cm, margin of error of dose delivery coefficient was -2.00%, -0.39%, -2.55%. In dose profile of Gafchromic EBT film's analysis, the movement of moving car had greater motion toward longitudinal direction and as field width was narrower, big error increased considerably at high dose part compared to calculated dose. The more field width was narrowed, gamma index had a large considerable influence of moving at gamma histogram. Conclusion: We could check the difference of longitudinal dose of moving organ. In order to small field width and minimize organ moving due to breathing, it is thought to be needed to develop breathing control unit and fixation tool.