• Physical Therapy Korea
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• v.23 no.4
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• pp.55-62
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• 2016

Background: The functioning of the serratus anterior (SA) muscle is essential to normal scapulohumeral rhythm during forward flexion (FF) of the shoulder. Also, SA weakness and overuse of the upper trapezius (UT) is observed in patients with shoulder dysfunction and trapezius myalgia. We designed a combination exercise involving FF and scapular protraction with resistance (CFFSP) to activate the SA muscle and to deactivate the UT muscle. Objects: The purpose of this study was to determine whether or not CFFSP would be more effective in activating the SA muscle than FF alone and FF with scapular protraction (FFP). Methods: Nineteen subjects (12 men and 7 women) participated in this study and performed FF, FFP, and CFFSP at $120^{\circ}$. Surface electromyography was applied to the SA, UT, and pectoralis major (PM) muscles, as was one-way analysis of variance (ANOVA) with repeated measures. Statistical significance was set at .05. Bonferroni adjustment was used to counteract the problem of multiple comparisons, with a statistical level of significance of .017 (.05/3). Results: A statistically significant difference was found in relation to the three positions for the SA muscle (p<.001) and the SA/UT ratio (p=.005) using ANOVA. Significantly different results, depending on the position, were also demonstrated using the Bonferroni post-hoc test for the SA muscle ($FF=28.27{\pm}16.20$, $FFP=45.66{\pm}15.81$, and $CFFSP=62.4{\pm}27.21$) and for the SA/UT ratio ($FF=3.04{\pm}2.14$, $FFP=3.61{\pm}2.38$, and $CFFSP=5.95{\pm}3.01$). Significant differences between the three positions was not found regarding the average amplitude of SA/PM muscle ratio (SA/PM: p=.060). Conclusion: We recommend the use of CFFSP to strengthen the SA muscle at $120^{\circ}$.

• Journal of Korean Academy of Nursing
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• v.29 no.3
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• pp.665-678
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• 1999

Stroke is a major cause of death and long-term disability. Because muscle weakness is one of the most prominent consequences of stroke, it was considered important to determine whether exercise in order to improve muscle strength and range of motion could have an effect in limiting the learned disuse of the affected side. The purpose of the study was to identify the effects of an 8 week rehabilitation program on physical and cognitive ability in stroke patients. A total of 18 patients who were admitted to the oriental medicine unit of a K medical center in Seoul were recruited : ten for the experimental group and eight for the control group. The rehabilitation program consisted of three level's of active and passive exercises for prevention of muscle contracture and at range of motion. Muscle strength, flexibility of the upper and lower extremity, perceived balance, functional independence, depression, and quality of life for the two groups were compared at the pretest and 4 and 8 weeks after the rehabilitation program. The results are as follows : 1) When measuring muscle strengths of shoulder abduction and elbow flexion, hip flexion and knee extensor, ankle dorsi-flexor and muscle strength of knee flexor. Muscle strength of knee flexor for the experimental group was significantly higher than the comparison group at the 4 weeks. 2) Muscle strength and flexibility of the ankle dorsi -flexor for the experimental group was significantly better than for the control group at 8 weeks. 3) Functional independence, perceived balance, and Tinetti balance for the experimental group as measured at 4 and 8 weeks were better than for the control group. Also, there were changes over time in physical balance and functional ability, but there was no significant differences between the groups. 4) The experimental group showed a higher quality of life and lower depression than the control group at 8 weeks. 5) Muscle strength and flexibility of ankle dorsi -flexor were significantly changed over time and an interaction between group and time. The findings suggested that the rehabilitation program would improve the physical and psychological status of the stroke patients. Thus, the gains in actual or perceived ability to perform physical activities was marked.

• The Journal of Korean Physical Therapy
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• v.17 no.3
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• pp.429-440
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• 2005

The purpose of this study was to compare the effects of knee joint position sense following local and general load protocols in 25 healthy male subjects. Proprioception of the knee joint was evaluated by measuring absolute angular errors at matching angles before, after and between 2 different types of load protocols. Proprioception tests(on the dominant knee) were performed in which proprioception of the passivepassive reproduced and active-active reproduced knee position was measured. Local load was provided with maximum isokinetic knee extension-flexion on the isokinetic dynamometer(Cybex), and general load was 10 minutes running on a treadmill. Peak torque(knee extension and flexion) and heart rate(beats per minute) was evaluated as an indicator of local and general fatigue during load protocols. The results were as follows: 1. For pasive-pasive reproduced knee position test, significant difference in absolute angular errors after general load protocol was detected compared with that before general load protocol(P<.05), significant difference in absolute angular errors after local load protocol was detected compared with that before local load protocol(P<.05). However, no significant difference in absolute angular errors of general load protocol was detected compared with that of local load protocol (P>.05), no significant difference in absolute angular errors of local load protocol was detected compared with that of general load protocol(P>.05). 2. For active-active reproduced knee position test, significant difference in absolute angular errors after general load protocol was detected compared with that before general load protocol(P<.05), significant difference in absolute angular errors after local load protocol was detected compared with that before local load protocol (P<.05). Also, significant difference in absolute angular errors of general load protocol was detected compared with that of local load protocol(P<.05), significant difference in absolute angular errors of local load protocol was detected compared with that of general load protocol(P<.05). 3. A significant decrease of peak torque of knee extensors and flexors was seen after local load, although heart rate was significantly increased(P<.05). No significant change of peak torque of knee extensors and flexors was seen after general load(P>.05), although heart rate was also significantly increased(P<.05). The previous study revealed that knee proprioception is significantly altered when the muscle mechanoreceptors are dysfunctional due to muscle fatigue, although the joint mechanoreceptors have no significantly effect on knee proprioception when the presence of knee muscle fatigue. However, the results of this study are different from those of the previous study in that muscle weakness of the knee could not be seen after general load. This study shows that general load may diminish motor control by the central nervous system. Proprioceptional decline without muscle weakness of knee after general load suggests a change in the proprioceptional pathway without influence from muscle mechanoreceptors.

• Korean Journal of Acupuncture
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• v.34 no.3
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• pp.172-178
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• 2017

Objectives : The purpose of this study is to report a case of traditional Korean Medicine effect on a patient with rhabdomyolysis who appealed leg pain, numbness and weakness. Methods : A patient received traditional Korean Medicine including acupuncture, herbal medicine, moxibustion, and cupping therapy daily. We evaluated the clinical results by observing the patient's symptoms, NRS(Numerical Rating Scale), MMT(Manual Muscle Test) grade and DITI(Digital Infrared Thermal Imaging). Results : After traditional Korean Medicine, the patient's pain and numbness decreased from NRS 10 to 1~2 and weakness improved from Gr3- to Gr4. And CPK(creatine phosphokinase) numerical value decreased from 330(IU/L) to 164 and body heat status improved. Conclusions : Traditional Korean Medicine can be effective in reducing rhabdomyolysis patients' symptoms and changing examination numerical value. And further studies on traditional Korean Medicine of rhabdomyolysis should be carried out.

• Annals of Clinical Neurophysiology
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• v.3 no.2
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• pp.115-121
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• 2001

The occurrence of muscle weakness in patients with sepsis or multiple organ failure managed in the intensive care unit has been recognized with increasing frequency in the last two decades. The difficulty in examining critically ill patients may explain why this complication has been only recently recognized. This weakness is due to an axonal polyneuropathy which is called critical illness polyneuropathy(CIP). It must be differentiated from myopathy or neuromuscular junction disturbance that can also occur in the intensive care setting. Neither the cause nor the exact mechanism of CIP has been elucidated. Electrophysiological studies demonstrated an acute axonal damage of the peripheral nerves. Before the recognition of CIP, these cases were usually misdiagnosed as Guillain-$Barr{\acute{e}}$ syndrome. Clinical recovery from the neuropathy is rapid and nearly complete in those patients who survive. Thus, neuropathy acquired during critical illness, although causing a delayed in weaning from ventilatory support and hospital discharge, does not worsen long-term prognosis.

• Journal of Genetic Medicine
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• v.15 no.2
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• pp.107-109
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• 2018

X-linked Charcot-Marie-Tooth disease type 1 (CMTX1) is caused by the mutation in GJB1 gene, characterized by the transient central nervous system involvement and long standing peripheral polyneuropathy which does not fulfill the criteria of demyelination or axonopathy. We describe a 37-year-old man with progressive bilateral leg weakness since his early teen. He suffered transient right hemiparesis, followed by quadriparesis at 14 years of age. When we examined him at 37 years of age, he presented a distal muscle weakness on lower extremities with a sensory symptom. The nerve conduction study demonstrated a motor conduction velocity between 26 and 49 m/s. The whole exome sequencing revealed a novel variant c.136 G>A in GJB1. This report will raise awareness in this rare disease, which is frequently misdiagnosed early in its course.

• The Journal of Internal Korean Medicine
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• v.43 no.6
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• pp.1255-1263
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• 2022

Objective: To report a clinical case of Guillain-Barré syndrome-like neurological symptoms, including limb weakness, phantosmia, and nausea/vomiting after COVID-19 vaccination (AstraZeneca) that was improved by traditional Korean medicine (TKM) treatment. Methods: A 73-year-old male complained of extreme limb weakness, severe phantosmia, and nausea/vomiting after COVID-19 vaccination. No abnormalities had appeared in various radiological and laboratory tests, but the symptoms had continued to worsen for three months before visiting our clinic. Results: The patient was diagnosed with neurological complications suspicious of Guillain-Barré syndrome after COVID-19 vaccination. The patient was treated with acupuncture, moxibustion, herbal drugs (Banhabakchulchunma-tang), and nasal inhalation therapy with Aquilariae Lignum. Three weeks after Korean medicine treatment, his neurological symptoms had improved. Nausea/vomiting and phantosmia continued to show improvement, and muscle strength was gradually recovered in both lower limbs. Conclusion: Traditional Korean medicine could be a choice for the treatment of neurological complications after COVID-19 vaccination.

• Annals of Clinical Neurophysiology
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• v.25 no.1
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• pp.41-44
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• 2023

Overlap myositis (OM) associated with Sjögrens syndrome (SS) is a relatively uncommon disorder. It is more difficult to detect OM when a patient had not been previously diagnosed with SS. We report a case of OM associated SS that initially presented with dysphagia followed by proximal weakness. If proximal muscle weakness is preceded by dysphagia, the possibility of OM associated with connective-tissue disease should be considered.

• Physical Therapy Korea
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• v.18 no.3
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• pp.38-48
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• 2011

The aim of the study was to identify which fall-prevention program offered in community settings in Korea is the most effective in strengthening muscles. Muscle weakness is one of the major risk factors causing falls among the elderly. Randomized controlled trials and clinical controlled trials published between 1996 and February 2011 were included in this study. Seventeen of the 69 identified studies met the study's criteria and were included in this meta-analysis. The overall effect size of the program was .822 (95% confidence interval= .717~.927). The general strengthening exercise (1.608), dance sports training (1.538), Thera-band exercise for lower extremities (1.517), Seniorobic exercise (1.146), gait training (.959), balance training (.909), gradual resistive exercise (.888), and multifactorial fall prevention (.842) programs all show positive effects on muscle strengthening. Subgroup analyses found that more relative effects are seen in programs offered to the more elderly. In this study, the effect of increasing muscle strength on the prevention of falls can only be indirectly suggested; there are few available studies that report the frequency or history of falls in Korea. Further studies are needed to examine the direct effect of fall prevention exercise programs among the elderly.

• Annals of Clinical Neurophysiology
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• v.19 no.1
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• pp.40-45
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• 2017

Background: Telbivudine is a nucleoside analogue used for the treatment of chronic hepatitis B, but it often develops mitochondrial toxicity leading to symptomatic myopathy. In this study, three patients with telbivudine induced myopathy were enrolled in order to investigate the nature and pathogenesis of mitochondrial toxicity caused by long-term use of telbivudine. Methods: Clinical features, laboratory findings, muscle pathology, and quantitation of mitochondrial DNA were studied in three patients. Results: Patients presented with progressive muscle weakness with high serum creatine kinase levels. Light microscopic findings of muscle pathology showed ragged red fibers that reacted strongly with succinate dehydrogenase stain, but negative for cytochrome c oxidase activities. Electron microscopy revealed abnormal mitochondrial accumulation with rod shaped inclusions. The quantitative peroxidase chain reaction showed a depletion of mitochondrial DNA in skeletal muscle of the patients. Conclusions: Nucleoside analogues including telbivudine are potent inhibitors of viral DNA polymerases. However, they are not specific for viral DNA and can disturb mitochondrial replication at the same time. All nucleotide analogues should be used with close clinical observation in order to avoid development of mitochondrial myopathy.