• Korean Journal of Radiology
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• v.22 no.11
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• pp.1841-1849
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• 2021

Objective: To prospectively investigate the feasibility of shear wave elastography (SWE) as a new quantitative and objective method for evaluating the stiffness of the gastrocnemius medialis (GM) muscle during passive stretching in patients with Parkinson's disease (PD). Materials and Methods: SWE of the GM muscle was performed in 28 patients with PD [13 female and 15 male; mean age ± standard deviation (SD): 63.0 ± 8.5 years] and 12 healthy controls (5 female and 7 male; mean age ± SD: 59.3 ± 6.4 years) during passive ankle rotation. A Young's modulus-ankle angle curve was constructed. The GM slack angle and baseline Young's modulus (E₀) were compared between the markedly symptomatic and mildly symptomatic sides of patients with PD, and healthy controls. Additionally, the correlation between the GM slack angle and the severity of rigidity, and the observer reproducibility of SWE in determining the GM slack angle were evaluated. Results: The GM slack angle was smaller on both the markedly and mildly symptomatic sides in patients with PD than in healthy controls (mean ± SD of -29.13° ± 3.79° and -25.65° ± 3.39°, respectively, vs. -21.22° ± 3.52°; p < 0.001 and p = 0.006, respectively). Additionally, in patients with PD, the GM slack angle on the markedly symptomatic side was smaller than that on the mildly symptomatic side (p = 0.003). The E0 value was lower on both the markedly and mildly symptomatic sides in patients with PD than in healthy controls (mean ± SD of 10.11 ± 2.85 kPa and 10.08 ± 1.88 kPa, respectively, vs. 12.23 ± 1.02 kPa; p = 0.012 and p < 0.001, respectively). However, no significant difference was found between the markedly and mildly symptomatic sides in patients with PD (p = 0.634). A negative linear relationship was observed between the GM slack angle and lower limb rigidity score on the markedly symptomatic side in patients with PD (r = -0.719; p < 0.001). The intraclass correlation coefficients for observer reproducibility of SWE ranged from 0.880 to 0.951. Conclusion: The slack angle determined by SWE may be a useful quantitative and reproducible method for evaluating muscle stiffness in patients with PD.

• The Korean Journal of Pain
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• v.5 no.2
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• pp.239-248
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• 1992

Two hundred sisty five patients who complained of neck pain with stiffness and pain of the suprascapular area were studied. In most cases the anatomical locations of pain were in the levator scapulae muscles or trapezius muscles. Hyperactivity of dorsal scapular nerve or spinal accessory nerve which innervate those muscles was thought to be responsible for these pains. The hyperactivity of the nerves may be due to the spasm of the sternocleidomastoid muscle and the scalenus medius muscle which the nerves meet during their courses to the levator scapulae or trapezius muscles. Therefore, spasmolytic treatment on the scalenus medius provided effective relief for neck or shoulder pain.

• Physical Therapy Rehabilitation Science
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• v.13 no.1
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• pp.124-133
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• 2024

Objective: This study aims to investigate the immediate effects of myofascial release and Duoball assisted self-relaxation (DASR) techniques on pain and muscle tension in patients experiencing chronic cervical pain. Design: A randomized controlled trial. Methods: This study is a randomized controlled experimental study. Eighteen patients with chronic neck pain who met the selection criteria were randomly assigned to myofascial release group and myofascial release group using Duoball. Results: The frequency results for assessment muscle tension showed a decrease of about 10% in the suboccipital muscle, SCM, Pect m, UT, and LS in both the MFR and DASR groups, and the stiffness results showed a decrease in all muscles except the upper trapezius in the MFR group and the DASR group. All were found to decrease by about 10% in the suboccipital muscle, SCM, Pect m, UT, and LS, and the decrement results showed an increase of about 15% in the suboccipital muscle, SCM, Pect m, UT, and LS in both the MFR and DASR groups(p<0.05). Conclusions: In patients experiencing chronic neck pain, application of MFR and duoball assisted self relaxion was shown to be effective on pain and muscle tension. MFR is a non-pharmacological intervention method with few potential side effects and is considered a universal and easily applicable treatment method.

• PNF and Movement
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• v.19 no.3
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• pp.391-399
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• 2021

Purpose: As laptop use increases throughout the COVID-19 pandemic and its use outside of traditional workstations proliferates, it is imperative to expand the limited research available regarding ergonomic exposure. This study aimed to identify the effects of a laptop supporter on biomechanical characteristics in the wrist joint muscles of healthy young adults. Methods: This was a cross-sectional observational study design with thirty-four healthy young adults as participants. They conducted a typing exercise performed under two different conditions, which were with and without a notebook computer supporter. This study measured the biomechanical characteristics of the muscles of the wrist joints including the flexor carpi ulnaris (FCU), the flexor carpi radialis (FCR), the extensor carpi radialis longus (ECRL), and the extensor carpi ulnaris (ECU). Measurements were taken three times: before typing, immediately after typing for 30 minutes with a supporter, and immediately after typing for 30 minutes without a supporter. The statistical method to compare the three different measurement conditions was the repeated measures ANOVA. Results: The participants showed significantly different levels of dynamic stiffness in both the FCU before typing and immediately after 30 minutes of typing with a supporter, and showed significantly different levels of dynamic stiffness in the FCR before typing and immediately after 30 minutes of typing with a supporter. The dynamic stiffness level immediately after 30 minutes of typing without a supporter was significantly different than that immediately after 30 minutes of typing with a supporter. However, the muscle tone was not significantly different among the three different conditions. Conclusion: The results of this study revealed that a laptop supporter used to correct the eye level of the electronic screen increases the dynamic stiffness of the wrist joint flexors, so it is necessary to consider the neutral position of the wrist joint during typing.

• Journal of Veterinary Science
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• v.21 no.6
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• pp.82.1-82.10
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• 2020

Background: The clinical presentation of horses with back pain (BP) vary considerably with most horse's willingness to take part in athletic or riding purpose becoming impossible. However, there are some clinical features that are directly responsible for the loss or failure of performance. Objectives: To investigate the clinical features of the thoracolumbar region associated with BP in horses and to use some of the clinical features to classify equine BP. Methods: Twenty-four horses comprised of 14 with BP and 10 apparently healthy horses were assessed for clinical abnormality that best differentiate BP from normal horses. The horses were then graded (0-5) using the degree of pain response, muscular hypertonicity, thoracolumbar joint stiffness and overall physical dysfunction of the horse. Results: The common clinical features that significantly differentiate horses with BP from non-BP were longissimus dorsi spasm at palpation (78.6%), paravertebral muscle stiffness (64.3%), resist lateral bending (64.3%), and poor hindlimb impulsion (85.7%). There were significantly (p < 0.05) higher scores for pain response to palpation, muscular hypertonicity, thoracolumbar joint stiffness and physical dysfunction among horses with BP in relation to non-BP. A significant relationship exists between all the graded abnormalities. Based on the cumulative score, horses with BP were categorized into mild, mild-moderate, moderate and severe cases. Conclusions: BP in horse can be differentiated by severity of pain response to back palpation, back muscle hypertonicity, thoracolumbar joint stiffness, physical dysfunctions and their cumulative grading score is useful in the assessment and categorization of BP in horses.

• The Journal of Korean Physical Therapy
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• v.25 no.2
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• pp.56-63
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• 2013

Purpose: This study was conducted in order to examine how an effective rehabilitation exercise program influences the activity of shoulder muscles, and to help the clinical application of a rehabilitation program, for prevention and relief of pain, adhesion, and joint stiffness of patients who undergo rotator cuff repair. Methods: Nine test subjects were placed randomly into each group for a total of 27 subjects and exercise program interventions according to the group were conducted for six weeks, after which maximum voluntary isometric contraction (%MVIC) value was re-measured for supraspinatus muscle, infraspinatus muscle, serratus anterior muscle, and middle deltoid muscle in all groups in order to compare changes in muscle activity before and after the experiment in order to perform comparative analysis of changes in muscle activity between groups, based on which four experimental hypotheses were confirmed. Results: Changes in muscle activity according to %MVIC showed a statistically significant difference (p<0.01) (p<0.001) in all muscles, except the middle deltoid muscle, and post-verification results showed that changes in muscle activity according to %MVIC were greater in test groups I and II, compared with the control group, for the supraspinatus muscle, infraspinatus muscle, and serratus anterior muscle. Conclusion: Therefore, rehabilitation through use of the methods described above should be applied efficiently in clinical settings and more research in development of much more efficient rehabilitation program interventions must be conducted.

• Physical Therapy Korea
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• v.28 no.1
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• pp.65-71
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• 2021

Background: The hamstring is a muscle that crosses two joints, that is the hip and knee, and its flexibility is an important indicator of physical health in its role in many activities of daily living such as sitting, walking, and running. Limited range of motion (ROM) due to hamstring tightness is strongly related to back pain and malfunction of the hip joint. High-frequency diathermy (HFD) therapy is known to be effective in relaxing the muscle and increasing ROM. Objects: To investigate the effects of HFD on active knee extension ROM and hamstring tone and stiffness in participants with hamstring tightness. Methods: Twenty-four participants with hamstring tightness were recruited, and the operational definition of hamstring tightness in this study was active knee extension ROM of below 160° at 90° hip flexion in the supine position. HFD was applied to the hamstring for 15 minutes using the WINBACK device. All participants were examined before and after the intervention, and the results were analyzed using a paired t-test. The outcome measures included knee extension ROM, the viscoelastic property of the hamstring, and peak torque for passive knee extension. Results: The active knee extension ROM significantly increased from 138.8° ± 9.9° (mean ± standard deviation) to 143.9° ± 10.4° after the intervention (p < 0.05), while viscoelastic property of the hamstring significantly decreased (p < 0.05). Also, the peak torque for knee extension significantly decreased (p < 0.05). Conclusion: Application of HFD for 15 minutes to tight hamstrings immediately improves the active ROM and reduces the tone, stiffness, and elasticity of the muscle. However, further experiments are required to examine the long-term effects of HFD on hamstring tightness including pain reduction, postural improvement around the pelvis and lower extremities, and enhanced functional movement.

• Journal of Electrical Engineering and Technology
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• v.9 no.5
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• pp.1774-1779
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• 2014

It is known that muscle strength of human body can alter or deteriorate as aging. In this study, we present an inverse dynamics simulation to investigate the effect of muscle strength on performing the daily activities. A 3D musculoskeletal model developed in this study includes several segments of whole body, long and short muscles, ligaments and disc stiffness. Five daily activities such as standing, flexion, finger tip to floor, standing lift close and lifting flexed were simulated with varying the maximum muscle force capacities (MFC) of each muscle fascicles from 30 to $90N/cm^2$ with an increment of $30N/cm^2$. In the result, no solution can be obtained for finger tip to floor and lifting flexed with $30N/cm^2$. Even though the solution was available for standing lift close activity in case of $30N/cm^2$ capacity, many of muscle fascicles hit the upper bound of muscle strength which means that it is not physiologically possible to perform the acvities in reality. For lifing flexed, even the case of $60N/cm^2$ capaciy, represents the moderate healthy people, was not able to find the solutions, showing that 18 muscles among 258 muscle fascicles reached 100% of muscle capacity. The estimated results imply that people who have low muscle strength such as elders or rehabilitation patients were required higher muscle work to perform and maintain the same daily activities than healthy one.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.4
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• pp.39-47
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• 2021

Purpose : This study aimed to investigate age-related mechanical changes in the erector spinae muscles, specifically in terms of tone, elasticity, and stiffness, in the elderly population compared to the younger population Methods : The mechanical properties, including tone, elasticity, and stiffness, of the erector spinae muscles were measured using myotonometry in 47 male adult subjects, divided into the younger group (23 subjects aged 19 to 28 years) and the elderly group (22 subjects aged 69 to 83 years). The measurements were performed in both the prone and sitting positions. The tone, elasticity, and stiffness of the erector spinae muscles were statistically compared between the two groups using a t-test. Results : The study showed increased stiffness and decreased elasticity in the erector spinae muscles in the elderly group compared to the younger group (p<0.01~0.001). The results were similar in both the prone and sitting positions. Conclusion : There are age-related degenerative changes that affect the mechanical properties of the erector spinae muscles. In addition, myotonometry can be suggested to be a useful examination tool in evaluating these changes provided that further studies are conducted and standard methods of application have been established in the future.

• Physical Therapy Rehabilitation Science
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• v.9 no.4
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• pp.287-294
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• 2020

Objective: This study aimed to investigate the effects of an ultrasound-based bar graph proportional to the quadriceps muscle thickness as a real-time visual feedback training tool in the elderly. Design: Cross-sectional study. Methods: Twenty-four elderly persons participated in this study and were randomly divided into three groups: oral training group (n=8, group 1), ultrasound imaging group (n=8, group 2), and graph group (n=8, group 3). In the pre condition, all participants performed maximal voluntary isometric contraction (MVIC) of the quadriceps with knee extension three times with oral training. In the post condition, group 1 performed MVIC of the quadriceps with oral training, group 2 performed MVIC of the quadriceps with real-time visual feedback using ultrasound imaging, and group 3 performed MVIC of the quadriceps with real-time visual feedback using a bar graph proportional to the quadriceps muscle thickness, three times for all groups. Muscle thickness, activity (mean, peak), tone, stiffness, logarithmic decrement, relaxation, and creep were measured in both conditions in all participants. Results: Visual feedback with a bar graph showed significant effects on muscle thickness, mean muscle activity, and peak muscle activity compared with oral training and visual feedback with ultrasound imaging (p<0.05). Conclusions: Isometric training of the quadriceps with real-time visual feedback using a bar graph proportional to the quadriceps muscle thickness may be more effective than other methods in improving muscle thickness and muscle activity. This study presented a tool that can help increase muscle thickness in the elderly.