• Physical Therapy Rehabilitation Science
• /
• 제6권1호
• /
• pp.7-13
• /
• 2017

Objective: The aim of this study was to investigate the inter-rater and intra-rater reliability of rehabilitative ultrasound imaging (RUSI) for measurement of muscle thickness with changes in angles of the gluteus maximus (GM) at rest and during contraction. Design: Cross-sectional study. Methods: Twenty-two healthy men volunteered for this study. GM muscle images were obtained in the resting position and during prone hip extension with knee flexion at hip abduction angles of $0^{\circ}$ and $30^{\circ}$, respectively. Two examiners randomly measured the thickness of the GM twice in three different positions. The first position was a comfortable prone position. The second position was prone hip extension with knee flexion (PHEKF) to $90^{\circ}$. The third position was achieved by hanging a 1-kg weight on the ankle of the lifted leg during PHEKF with the angle of the lifted leg the same as the second position. Intra-class correlation coefficients (ICCs), standard error measurements, and minimal detectable changes were used to estimate reliability. Results: The intra-rater reliability ICCs (95% confidence interval) of the GM were >0.870, indicating good reliability. Inter-rater reliability ICCs ranged from 0.668 to 0.913. The reliability of measurements of muscle thickness at each position was similar to the reliability of the angle change. Differences in muscle thickness and ratios for each position with $0^{\circ}$ and $30^{\circ}$ of hip abduction were not statistically significant. Conclusions: In the present study, the intra-rater reliability of muscle thickness measurements of the GM was good, and the inter-rater reliability was moderate to good. Reliable RUSI measurements of wide and large muscles, such as the GM muscle at rest and during contraction, are feasible. Further investigation is required to establish the reproducibility of the protocols presented in this study.

• 대한물리의학회지
• /
• 제8권3호
• /
• pp.289-294
• /
• 2013

PURPOSE: The purpose of this study was to examine differences in erect spinae activities at different height of table during ultrasound therapy in order to propose a optimum work environment. METHODS: Twenty five healthy adult males and females volunteered to participate in this study. EMG signals of both erector spinae(T10, T12, L2, L4) were recorded throught the surface electromyography system at different height of table(45cm, 56.2cm, 67.5cm) during ultrasound therapy work. RESULTS: The higher table heights was, the lower %RVC of the T10, T12, L2, L4 erect spinae at both sides. The left and right T10, T12 and the left L4 showed significant differences. The lower the spinal level was, the higher %RVC of both erect spinae at 45cm, 56.2cm, 67.5cm. The left erect spinae at 56.2cm, right erect spinae at 45cm, 67.5cm showed significant differences. CONCLUSION: The muscle activities of both erect spinae decreased at higher table height and increased lower spinal level. We identified lower table height are risk factor of spine work related musculoskeletal disorders.

• 대한정형도수물리치료학회지
• /
• 제12권1호
• /
• pp.37-43
• /
• 2006

PURPOSE: Previous studies have documented the lack of ultrasound's non-thermal effects on nerve conduction using frequencies of 1 MHz and 870 kHz. The purpose of this study was to determine the biophysical effects of continuous ultrasound on median local forearm temperature and motor nerve conduction velocities using frequencies of 3.0 MHz. SUBJECTS: Twelve healthy subjects (6 males, 6 females, age $22.30{\pm}2.41$ yrs, weight $61.33{\pm}10.16$ kg, height $167.58{\pm}8.04$ cm) without a history of neurological or musculoskeletal injury to their dominant arm volunteered for this study. METHODS AND MATERIALS: Each subject received a total of five treatments, one each at .0, 0.5, 1.0, 1.5, 2.0 W/$cm^2$ of 3 MHz continuous ultrasound on the anterior surface of the middle area of dominant forearm for 10 minutes. Dependent measures for forearm local temperature and median motor nerve conduction velocity (MNCV) were taken pretreatment and immediately post-treatment. One-way ANOVA were used for each dependent measure. RESULTS: The posttreatment forearm local temperature were differed significantly (p<0.001) between intensities of ultrasound. The posttreatment forearm local temperature of the ultrasound treated with 1.0 w/$cm^2$, 1.5 w/$cm^2$ and 2.0 w/$cm^2$ were significantly higher than 0.5 w/$cm^2$ and 0.0 w/$cm^2$ of ultrasound (p<0.05). The posttreatment median MNCV were differed significantly from the respective pretreatment velocities (p<0.001). The MNCV of the ultrasound treated with 0.0 w/$cm^2$ and 0.5 w/$cm^2$ were significantly (p<0.05) slower than that observed pretreatment, while the three ultrasound intensities produced significantly increased posttreatment MNCV: 1.0 w/$cm^2$ and 1.5 w/$cm^2$ and 2.0 W/$cm^2$. The posttreatment MNCV at 2.0 w/$cm^2$ and 1.5 w/$cm^2$ was significantly faster than that at 0 w/$cm^2$, 0.5 w/$cm^2$ and 1.0 w/$cm^2$ (p<0.05), the MNCV at 1.0 w/$cm^2$ was significantly faster than that associated with 0 w/$cm^2$ and 0.5 w/$cm^2$ of ultrasound (p<0.05). CONCLUSIONS: The decreased median motor forearm local temperature and MNCV of the ultrasound treated with 0.0 w/$cm^2$ and 0.5 w/$cm^2$ were attributed to the cooling effect by ultrasound transmission gel. Local forearm temperature and nerve conduction velocity were directly related to the intensity of ultrasound. Alterations in MNCV from ultrasound on healthy nerves appeared to be related to temperature changes induced by thermal effects of ultrasound.

• PNF and Movement
• /
• 제17권2호
• /
• pp.329-337
• /
• 2019

Purpose: Ultrasound imaging is commonly used to measure the pennation angle of human skeletal muscles in vivo. However, manual assessment of the pennation angle using ultrasound images is subjective and time-consuming and requires a high level of examiner skill. The architectural analysis of human skeletal muscles is thus challenging. Automated approaches using image processing techniques are therefore required to estimate the pennation angle in ultrasound images. The purpose of this study was thus to assess the intra-tester and inter-tester reliability and validity of the pennation angle using an automatic measurement program. Methods: Twenty-two healthy young adults (mean age = 22.55 years) with no medical history of neurological or musculoskeletal disorders voluntarily participated in this study. Ultrasound imaging was used to measure the pennation angle of the gastrocnemius muscle at rest. One examiner acquired images from all the participants. The intra-tester and inter-tester reliability were evaluated using the intraclass correlation coefficient (ICC) to estimate reliability. Validity was measured using Pearson's correlation coefficient. Results: The intra-rater reliability was excellent for the automatic pennation angle measuring program and the manual pennation angle assessment method (ICC>0.95). The inter-rater reliability was also excellent for both methods (ICC>0.93). All the correlation coefficients for the automatic pennation angle measuring program and the manual pennation angle assessment method were 0.79, which indicated a significantly positive correlation (p<0.05). Conclusion: Pennation angle measurement using the automatic pennation angle measuring program showed acceptable reliability and validity. This study therefore demonstrated that the automatic measuring program was able to automatically measure the pennation angle of skeletal muscles using ultrasound images, and thus made it easy to investigate skeletal muscle architecture.

• 대한정형외과 초음파학회지
• /
• 제2권1호
• /
• pp.27-36
• /
• 2009

근골격계 분야에서의 초음파는 검사 비용이 비교적 낮고 동적인 검사가 가능하다는 장점에 힘입어 빠르게 발전하고 있다. 족부 및 족관절 분야는 초음파 검사가 용이하며 국소 증상이 있는 경우 그 감별 진단에 초음파가 중요한 역할을 할 수 있다. 본 종설에서는 흔하게 접할 수 있는 족부 및 족관절 질환을 중심으로 그 원인 및 초음파적 진단에 대해 설명하고자 하였다.

• Clinical Pain
• /
• 제20권2호
• /
• pp.70-73
• /
• 2021

A minimally invasive procedure refers to a procedure that minimizes tissue damage due to incision. By limiting the size of the incision, it can be expected to reduce the time taken for wound healing, reduce pain, and reduce the risk of infection. Recently, studies have been attempted to dissect the structures of the neuromusculoskeletal system using ultrasound-guided minimally invasive technique. Among those, dissecting thread may be utilized in several musculoskeletal diseases, including carpal tunnel syndrome, cubital tunnel syndrome, trigger finger, and selective crural fasciectomy. In this brief review, the use of dissecting thread in treating neuromusculoskeletal diseases are described.

• 한국컴퓨터정보학회논문지
• /
• 제19권6호
• /
• pp.11-17
• /
• 2014

초음파 영상은 미세한 명암도 차이 등에 의해 분석 과정에서 근육 영역의 위치와 크기를 판단하는데 어려움이 발생하고 이로 인해 근육 영역을 파악하는데 주관성이 개입된다. 본 논문에서는 근육 영역을 객관적으로 분석하기 위해ART2 신경망을 적용하여 양자화를 수행한 후, 국부적 영역에서 근육 영역을 추출한다. 초음파 영상에서 히스토그램 평활화와 엔드인 탐색 알고리즘을 적용하여 명암도의 분포와 밝기 값을 보정한 후, ART2 신경망을 이용하여 유사한 영역을 클러스터링 한다. 클러스터링 된 각 영역의 크기, 위치 및 명암도 정보를 분석하여 피하지방, 근막, 기타 배경 영역으로 분류한다. 최종적인 근육 영역은 근막 내부 객체들 간의 거리, 각도를 이용하여 추출된다. 실제 초음파 영상 대상 실험 결과, 일반적인 클러스터링 기법을 적용한 방법 보다 ART2 기반 양자화와 제안된 영역 확장 기법으로 근육 영역을 추출하고 분석하는 것이 효율적임을 확인하였다.

• Physical Therapy Rehabilitation Science
• /
• 제5권1호
• /
• pp.47-52
• /
• 2016

Objective: This study surveyed the perceptions of physical therapists on muscle re-education through visual feedback obtained from rehabilitative ultrasound imaging (RUSI). Design: Survey. Methods: For this study, 500 physical therapists who participated in a refresher training held by the Seoul City Association in March 2015 were selected for a questionnaire-based survey. Subjects were randomly selected targets physiotherapists who participated in a refresher training.The questionnaire had 21 items in total. Questions 1 to 15 could be answered by everyone. However, questions 16 to 21 could be answered only by people who used RUSI. Results: The majority of respondents were aged 20 to 30 years. Respondents in their twenties, thirties, forties, and fifties accounted for 32.4%, 40.2%, 21.9%, and 5.6%respectively. Therapists with careers spanning one to 5 years accounted for 27.8%, while those with careers spanning 5 to 10 years and 10 to 15 years accounted for 34.6% and 17.0%, respectively. Those with careers over 20 years accounted for 9.2%. The types of work have not been various including work related to the nervous system (49.0%), the musculoskeletal system (41.5%), sports (0.7%), juvenile physical therapy (4.2%), and others (4.6%). Conclusions: In this study, we examined the perceptions of physical therapists on rehabilitation ultrasound imaging used in muscle re-education. We also examined how to use this technique. Many therapists who participated in the refresher training were found to be unaware of RUSI. In the future, further investigations on RUSI for muscle re-education are required through refresher training or training lectures at the national level.

• 대한정형외과 초음파학회지
• /
• 제4권2호
• /
• pp.111-122
• /
• 2011

혈소판 풍부 혈장은 자가 혈액으로부터 농축된 혈소판을 이용하여 성장 인자들을 제공함으로써 손상된 조직의 재생과 치유를 도모한다는 이론적 근거를 배경으로, 근골격계 손상의 치료를 위해 최근 많이 사용되고 있다. 성장 인자를 통한 조직 치유 효과는 여러 기초 과학적 연구를 통해 규명되어 왔고, 혈소판 풍부 혈장을 이용한 동물 연구 및 임상 연구들도 좋은 결과를 보고하고 있다. 그러나, 대부분의 연구들이 혈소판 풍부 혈장의 적용 방법 및 결과 측정 방법 등에서 문헌 별로 차이가 커서 서로 비교가 어렵고, 연구 대상 환자 수가 너무 적거나 대조 군이 없는 등 연구로서의 한계가 있다. 특히 잘 디자인 된 전향적 무작위 대조 연구들은 거의 없는 상황이다. 따라서, 현재까지의 결과를 확증하고 혈소판 풍부 혈장의 임상적 사용에 대한 과학적 근거를 제시하기 위해서는 좀 더 높은 수준의 잘 디자인 된 전향적 무작위 연구가 필요하다 할 수 있다. 결론적으로, 혈소판 풍부 혈장의 임상적 적용은 아직 과학적 근거가 부족한 상황이고, 따라서 혈소판 풍부 혈장을 사용하여 근골격계 질환을 치료할 때는 신중을 기해야 할 것이다.

• Journal of Acupuncture Research
• /
• 제35권1호
• /
• pp.4-10
• /
• 2018

The aim of this report was to show the effects of acupotomy in patients with carpal tunnel syndrome. Four patients were treated with acupotomy twice. Visual analogue scale (VAS), Tinel's sign, Phalen's test, Boston carpal tunnel syndrome questionnaire (BCTQ), muscular strength test, and a cross-sectional area of median nerve was measured using ultrasound before and after treatment. In all 4 cases, the VAS score, BCTQ score and cross-sectional area of median nerve, all decreased and muscular strength test score increased. Tinel's sign and the Phalen's test changed from a positive to a negative in most cases. This report shows that acupotomy is an effective treatment for carpal tunnel syndrome. Further larger are needed to fully evaluate the beneficial effects of this treatment.