• Title/Summary/Keyword: Orthopedic Manual Therapy

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Alteration of Forearm Local Temperature and Median Nerve Conduction Velocity by Therapeutic Ultrasound in Healthy Adult Subjects (초음파에 의한 전완 국소 온도와 정중 운동 신경전도 속도의 변화)

  • Jeon, Cha-Sun;Kim, Taek-Yean
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.12 no.1
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    • pp.37-43
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    • 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.

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Immediate Effects of Cervical and Thoracic Mobilization on Cervical Range of Motion in the Sagittal Plane and Pain in Patients with Forward Head Posture

  • Choi, Won-Jae;Kang, Si-Nae;Lee, Seung-Won
    • PNF and Movement
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    • v.20 no.3
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    • pp.371-381
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    • 2022
  • Purpose: Forward head posture (FHP) is known to cause pain, limit range of motion, and reduce quality of life. Joint mobilization is commonly used to correct FHP. However, no study has compared cervical, thoracic, and combined cervical and thoracic joint mobilization for FHP. The aim of this study was to investigate and compare the effects of each mobilization technique on range of motion in the sagittal plane and pain in patients with FHP. Methods: Forty-five patients were recruited and randomly divided into three groups: the mobilization group (CM; n = 15), the cervical and thoracic mobilization group (CTM; n = 15), and the thoracic mobilization group (TM; n = 15). Each intervention was performed in sets of three and repeated six times. Range of motion and pain were assessed pre- and post-intervention. The cervical range of motion was evaluated using a goniometer, and pain was evaluated using a visual analogue scale and pain thresholds of the suboccipital and upper trapezius muscles. Results: All groups showed an increase in range of motion post-intervention, but the increase in the CTM group was significantly greater than in the CM and TM groups (p < 0.05). Pain measured using the visual analogue scale decreased in all groups, but the decreases in the CM and CTM groups were significantly greater than in the TM group (p < 0.05). The pain thresholds of the suboccipital and upper trapezius muscles increased in all groups, but the increase in the CTM group was significantly greater than in the CM and TM groups (p < 0.05). Conclusion: Overall, our findings suggest that CTM may be more effective than CM or TM for improving cervical range of motion in the sagittal plane and pain in patients with FHP.

Electromyographic Analysis of the Biceps Brachii during Provocative Tests (상완 이두 건 병변에 대한 유발 검사시의 근전도 분석)

  • Lee Young-Soo;Shin Dong-Rae;Cho Sang-Hyun;Nam Ki-Sun;Kim Sung-Jae
    • Clinics in Shoulder and Elbow
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    • v.2 no.2
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    • pp.170-177
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    • 1999
  • The electromyographic activity of four muscles(biceps, supraspinatus, infraspinatus and subscapularis) was mea­sured from non-dominant shoulders of 12 volunteers by six different provocative test for the biceps pathology. The provocative tests were Speed, Yergason, Ludington, Heuter, O'Brien and the abduction-extension test. Each test was performed in a force of 30% of maximal voluntary contraction. The levels of activity of the biceps were higher than those of the other rotator cuff muscles only in Speed's test: 28% in the biceps, 26% in the infraspinatus, 25% in the supraspinatus and 21 % in the subscapularis. The levels of activity of the biceps as a percent of MMT(maximal manual test) were higher in Speed's(42%) and O'Brien's test with the arm supinatecl(42%). Speed's test can isolate the activity of biceps better than the other tests but it is a nonspecific test by which the biceps tendon was also activated within other rotator cuff muscles.

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Effect of Lower Extremity Patterns of Proprioceptive Neuromuscular Facilitation on Balance Ability in Patients with Hemiplegia (고유수용성 신경근 촉진법의 하지패턴이 편마비환자의 균형능력에 미치는 영향)

  • Gweon, Gyeong-Ho;Jung, Yeon-Woo;Bae, Sung-Soo
    • PNF and Movement
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    • v.5 no.2
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    • pp.21-35
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    • 2007
  • Objective : The main purpose of this study was to investigate the influence on lower extremity pattern of PNF to balance ability of patients with chronic hemiplegia. Methods : The subjects were consisted of 52 patients with chronic hemiplegia. All subjects were randomly devide to two group which was ROM exercise group and PNF group. Each group had a treatment for 30 minutes per day and three times a week during 10 weeks period. BPM was used to measure sway area, path, velocity, and BBS FRT TUG to measure patient's balance ability, ABC to measure patient's self-confidence. Results : 1. Sway area was showed that PNF group had more significantly decreased than ROM exercise group(p<.05). 2. Sway path was showed that PNF group had more significantly decreased than ROM exercise group(p<.05). 3. Max velocity was showed that PNF group had more significantly decreased than ROM exercise group(p<.05). 4. BBS was showed that PNF group had more significantly increased than ROM exercise group (p<.05). 5. FRT was showed that PNF group had more significantly increased than ROM exercise group (p<.05). 6. TUG was showed that PNF group had more significantly decreased than ROM exercise group(p<.05). 7. ABC was showed that PNF group had more significantly increased than ROM exercise group (p<.05). Conclusion : it was showed that the lower extremity pattern of PNF would increase balance abilities of the chronic hemiplegia patients. So it would be possible to make good use of lower extremity pattern of PNF for improving balance abilities of chronic hemiplegia patients.

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A home-based exercise program for temporomandibular joint osteoarthritis: pain, functionality, and joint structure

  • Macias-Hernandez, Salvador Israel;Morones-Alba, Juan Daniel;Tapia-Ferrusco, Irene;Velez-Gutierrez, Oscar Benjamin;Hernandez-Diaz, Cristina;Nava-Bringas, Tania Ines;Cruz-Medina, Eva;Toro, Lya Contreras-del;Soria-Bastida, Ma. de los Angeles
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.1
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    • pp.50-58
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    • 2022
  • Objectives: Osteoarthritis (OA) is the most prevalent and disabling joint disease in the world. Temporomandibular joint (TMJ) exercise is a widely used treatment and could be a beneficial and long-term tool for treating TMJ OA. The present study aims to evaluate the effects of therapeutic exercise in the conservative treatment of TMJ OA. Materials and Methods: A single-group experimental pre-post test was performed. We included patients who met the diagnostic criteria for TMJ OA. Outcome variables were pain intensity (visual analogue scale), functionality (Helkimo index), and structural changes (ultrasound). Follow-up periods were at months 1, 3, and 6. The intervention included a home-based program with thermotherapy, manual therapy, and therapeutic exercise during the entire follow-up period. Results: We included 15 patients and 26 joints, all women with a median age of 57 years (range, 49-62 years). Median change in pain intensity on joint palpation, mouth opening, and at rest at the first month was 47.5 mm, 51 mm, and 60 mm, respectively, and 48 mm, 49.5 mm, and 42.5 mm, at six months (P=0.001). The Helkimo index showed significant improvement in medians from baseline severe dysfunction (17 points) to minimal dysfunction at three and six months (2 points) (P=0.001). Ultrasound showed improved disc position. Conclusion: This study demonstrated significant improvements in pain, function, and joint disc position and represents a valuable tool for the long-term treatment of patients with TMJ OA.

A Review on the Effect of Traditional Medicine Treatments in Korea and China for Recurrent Lumbar Disc Herniation: Systematic Review and Meta-Analysis (재발성 요추간판탈출증의 한의학적 치료에 대한 국내·외 연구 동향 체계적 문헌고찰 및 메타분석)

  • Ah-Ra Koh;Young-Jin Lee;Ji-Eun Choi;So-Jung Kim;Hyun-Woo Kim;Hye-Jeong Jo;Go-Eun Chae
    • Journal of Korean Medicine Rehabilitation
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    • v.34 no.3
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    • pp.13-26
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    • 2024
  • Objectives This study aimed to examine the efficacy of Korean traditional medicine treatments for recurrent lumbar disc herniation by analyzing randomized controlled trials (RCTs). Methods The following 6 databases were used Korean studies Information Service System, Oriental Medicine Advanced Searching Integrated System, Research Information Sharing Service, ScienceON, PubMed, and China National Knowledge Infrastructure. Only RCTs were selected. The risk of bias was assessed by Cochrane's risk of bias tool. Results A total of 10 RCTs were analyzed, which utilized 8 types of interventions, including acupuncture, moxibustion, warm needling, electroacupuncture, herbal medicine, cupping, and chuna manual therapy. Acupuncture and moxibustion were the most frequently used treatments. There were 7 outcome measures, including the effective rate, visual analog scale, Japanese Orthopedic Association. The effective rate was assessed in all studies. Meta-analysis results indicated that warm needling therapy and traditional Chinese medicine interventions were more effective compared with the control. Conclusions In this study, warm needling therapy and herbal medicine interventions demonstrated beneficial effects. As the meta-analysis was conducted with only a subset of RCT studies, further large-scale, systematic RCT studies are needed.

Neuromuscular Skeletal Plasticity Moving on from Traditional Physiotherapy Concepts

  • Horst, Renata
    • PNF and Movement
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    • v.7 no.1
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    • pp.33-46
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    • 2009
  • Purpose : N.A.P.(Neuromuscular Skeletal Plasticity) an integrative neuro-orthopedic concept to facilitate motor strategies in daily life. The primary thesis is, that treatment of body functions and structural impairments should be integrated within goal-oriented activities. The purpose of this article is to demonstrate that the functional activity itself, determines the structure. Material and Methods : A case report of a dentist with brachial plexus lesion after a motor vehicle accident is presented. The necessity for training body functions within relevant tasks is undermined by references which emphasize the importance of training realistic activities to enhance long-term changes in neural representation. Results : The treatment methods presented in this case show significant effects for the patient's ability to participate in his profession within less than a year's time after his motor vehicle accident. Conclusions : Current evidence supports the treatment methods of this concept. The inability to flex his elbow and supinate his forearm placed a considerable doubt to his ability to ever be able to participate in his profession again. Structural reorganization is possible and depends on functional demands, which need to be trained task-specifically. Single case reports may serve as the basis for further randomized controlled studies to support the efficacy of the treatment methods within the N.A.P. concept.

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The Effect of a Hip Joint Strengthening Exercise using PNF on Balance, Sit-to-Stand Movement, and Gait in a Tibia Fracture Patient with Skin Defects - A Single Case Study - (PNF을 이용한 엉덩관절 강화운동이 피부 결손을 동반한 개방성 정강뼈 골절 환자의 균형과 앉았다 일어서기, 보행에 미치는 영향 - 단일사례연구 -)

  • Jung, Du-Kyo;Chung, Yi-Jung
    • PNF and Movement
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    • v.16 no.3
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    • pp.317-332
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    • 2018
  • Purpose: Patients with tibial fractures can have functional problems with balance and gait, as well as lower extremity muscle weakness. This case report aimed to describe the effect of hip joint strengthening exercises using proprioceptive neuromuscular facilitation (PNF) on balance and gait and lower limb function in a patient with tibia fracture. Methods: One patient diagnosed with tibial fracture was treated for seven weeks with the basic procedure, pattern, and technique of PNF for a hip joint strengthening exercise. Results: The results of pre- and post-intervention treatment showed improvements in physical function and structure in the clinical tests, including the manual strength test; the modified Ashworth scale; sensory evaluation; balance, sit-to-stand, and gait performance; and evaluation of lower limb function. Conclusion: Based on the results of this study, it is suggested that the use of theory-based proprioceptive neuromuscular stimulation for hip joint strengthening exercises positively affects patients' functional improvement in tibial fracture patients, and this may be used as a therapeutic exercise method for those with orthopedic problems in the lower extremities. One limitation of this study was that it was performed on only one tibia fracture patient, which makes it difficult to extend the treatment effects to all patients with this condition.

The Effect of Kinesio Taping on the Change of Muscle Strength and Endurance in Trunk Flexion and Extension in Chronic Low Back Pain(CLBP) (만성요통 환자의 테이핑 적용 시체간의 굴곡과 선전의 근력과 지구력의 변화 측정)

  • Kim, Su-Hyung
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.11 no.2
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    • pp.40-48
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    • 2005
  • In this study, the muscle strength and endurance of the lumbar at flexion and extension were determined using an isokinetic muscle strength meter (Biodex) in patients with chronic lumbar go (10 male and 10 females), and the changes in muscle strength and endurance of the lumbar at flexion and extension after application of Y-shaped sacrospinalis muscle taping, typically used for patient with lumbar go, were studied. In addition, the sacrospinalis muscle taping of a different shape (I-shaped taping) was applied bilaterally centering on the spine, and the muscle strength and endurance of the lumbar at flexion and extension were determined and compared with those before taping. In addition, the results after application of Y-shaped taping and I-shaped taping were also compared. 1. The extensor muscle strength of the lumbar at loading of $60^{\circ}$/sec before application of kinesio Taping and after application of Y-shaped taping showed the level of significance (p<.05). The flexor muscle strength of the lumbar at loading of $60^{\circ}$/sec before application of kinesio taping and after application of Y-shaped taping did not show the level of significance. 2. The flexor muscle endurance of the lumbar at loading of $90^{\circ}$/sec before application of kinesio Taping and application of Y-shaped taping did not show the level of significance. The extensor muscle endurance of the lumbar at loading of $90^{\circ}$/sec before application of kinesio Taping and after application of Y-shaped taping did not show the level of significance. 3. The extensor muscle strength of the lumbar at loading of $60^{\circ}$/sec before application of kinesio Taping and after application of I-shaped taping showed the level of significance (p<.05). The flexor muscle strength of the lumbar at loading of $60^{\circ}$/sec before application of kinesio Taping and after application of I-shaped taping showed the level of significance (p<.05). 4. The flexor muscle endurance of the lumbar at loading of $90^{\circ}$/sec before application of kinesio taping and after application of I-shaped taping showed the level of significance. The extensor muscle strength of the lumbar at loading of $90^{\circ}$/sec before application of kinesio Taping and after application of I-shaped taping showed the level of significance (p<.05). 5. In comparison between after application of Y-shaped taping and after application of I-shaped taping, the flexor muscle strength of the lumbar at loading of $60^{\circ}$/sec did not show the level of significance. In comparison between after application of Y-shaped taping and after application of I-shaped taping, the extensor muscle strength of the lumbar at loading of $60^{\circ}$/ sec showed the level of significance (p<.05). 6. In comparison between after application of Y-shaped taping and after application of I-shaped taping, the flexor muscle strength of the lumbar at loading of $90^{\circ}$/sec did not show the level of significance. In comparison between after application of Y-shaped taping and after application of I-shaped taping, the extensor muscle strength of the lumbar at loading of $90^{\circ}$/sec did not showed the level of significance (p<.05).

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Measurement of Bone mineral density According to Middle aged Women with Low Back Pain (중년여성의 요통에 따른 골밀도 측정)

  • Kang, Jeom-Deok;Kim, Jong-Bong
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.7 no.1
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    • pp.5-28
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    • 2001
  • Objectives: The objective of this study was to investigate analysis of bone mineral density according to Women with low back pain women. Methods: The data were collected from women who visited Physical Examination Center of a Catholic university hospital located in Daegu. Questionnaires were completed by 50 women during the period from July 20, 2000 to January 12, 2001. The sample was divided into three groups(the normal group of 16 cases and the osteopenia group of 12cases and the osteoporosis group of 22 cases). Bone mineral density(BMD) of lumbar spine was measured using energy absorptiometry. Results: The bone mineral density of the lumbar spine decreased with aging. The bone mineral density of the lumbar spine decreased with the serum Calcium and Phosphorus and Alkaline phosphatase increased. The mean bone mineral density of the lumbar spine of healthy women in age(50~59) was 0.87g/$cm^2$, the lumbar spine of women with low back pain in age(50~59) was 0.77g/$cm^2$. In the multiple regression of risk factors to bone mineral density(BMD) of lumbar spine were correlated with age, marriage existence, exercise time, the loving food of taste, calcium, bone mineral density standard T scores(p<0.05). The experience for LBP increased as weight increased(Odds ratio=999.000). The experience for LBP increased as number of Exercise decreased(Odds ratio=999.000). The experience for LBP increased as menopause existence increased(Odds ratio=999.000). The experience for LBP increased as serum Calcium and Phosphorus increased (Odds ratio=999.000). however all four variables had significant no relationship. The correlation in variables in relation to low back pain and bone mineral density, age showed contra-correlation with low back pain existence, Alkaline phosphatase(p<0.01). Weight showed contra-correlation with body mass index(BMI)(p<0.01). Exercise time showed correlation with number of exercise(p<0.01). The loving food of taste showed contra-correlation with Alkaline phosphatase(p<0.05). Bone mineral density showed correlation with menopause existence(p<0.05). Conclusions: Results from this study indicated that a statistically significant association between bone mineral density of the lumbar spin and age, marriage existence, exercise time, the loving food of taste, calcium, bone mineral density standard T scores. In logistic regression test, there were no related variables. The combination of bone mineral density measurement and assessment of the bone turnover rate by measuring biochemical would be helpful for the treatment of patients with risks of osteoporosis. The more precise study for risk factors to osteoporosis is essential.

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