• 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.

• Clinics in Shoulder and Elbow
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• v.22 no.3
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• pp.128-134
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• 2019

Background: Patients with rotator cuff tears are usually afflicted with shoulder pain and disability. However, it is unclear which factors are related to shoulder pain in patients with rotator cuff tears. This study was therefore undertaken to determine the factors correlated with shoulder pain in patients with painful rotator cuff tears, but without any history of trauma. Methods: We evaluated a cohort of 745 patients with painful rotator cuff tears having no trauma history, and analyzed the relationship between pain and multiple factors including demographic data, tear characteristics, and passive range of motion. Pain was analyzed with a questionnaire concerning the visual analogue scale (VAS) for pain. Tear characteristics were determined by evaluating tear size, muscle atrophy, number of torn tendons, and presence of arthritis. Multivariate linear regression analysis and chi-squared test were applied to evaluate the relationship between the VAS for pain and variable factors. Results: Shoulder pain was associated with young age (p=0.01), male sex (p=0.01) and the presence of diabetes mellitus (p<0.001). Measurements of rotator cuff tear characteristics including tear size (p=0.53), muscle atrophy (p=0.16) and the number of torn tendons (p=0.34) did not correlate with shoulder pain. Symptom duration (p=0.60) and range of motion (p>0.05) also showed no correlation with VAS for pain. Conclusions: Young age, male sex and the presence of diabetes mellitus correlated positively with preoperative shoulder pain in patients with painful rotator cuff tears without a trauma history. Combined treatment of pain management and risk factor correction could be helpful to control preoperative shoulder pain.

• Physical Therapy Rehabilitation Science
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• v.12 no.2
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• pp.92-104
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• 2023

Objective: The purpose of this study was to investigate the effect of spinal mobilization with leg movement (SMWLM) and neural mobilization (NM) in patients with lumbar disc herniation (LDH) accompanied by radiating pain. Design: Three-group pre-test-post-test control group design. Methods: We enrolled 48 participants, whom we randomly assigned to three groups. The SMWLM group (n=16) underwent 20 min of conventional physical therapy (CT) and 20 min of SMWLM. The NM group (n=16) underwent 20 min of CT and 20 min of NM. The control group (n=16) underwent 20 min of CT. These interventions in all the groups were performed three times a week for 4 weeks. Numeric pain rating score (NPRS), body grid chart score (BGCS), passive straight leg raise (PSLR), active lumbar flexion range of motion (ALFROM), korean version oswestry disability index (KODI), and korean version fear avoidance beliefs questionnaire (KFABQ) were measured pre- and post-intervention. Results: In all three groups, the NPRS, PSLR, KODI, and KFABQ scores were significantly different pre- and post-intervention (p<0.05). Significant differences were observed in BGCS and ALFROM in the SMWLM and NM groups pre- and post-intervention (p<0.05). The SMWLM group showed more improvement in the NPRS of leg pain, ALFROM, and KFABQ score than that exhibited by the NM and control groups (p<0.05). Conclusions: Both SMWLM and NM were effective for improving back and leg pain, centralization of symptoms, mechanical sensitivity, lumbar mobility, lumbar functional disability, and psychosocial functioning in patients with LDH with radiating pain.

• Physical Therapy Korea
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• v.21 no.1
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• pp.47-54
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• 2014

The aim of this study was to compare the duration of hamstring flexibility improvement after 3 stretching interventions in people with limited hamstring flexibility. Twenty-two subjects (12 men, 10 women) with limited hamstring flexibility of the dominant leg received 3 stretching interventions- modified dynamic stretching (MDS), hold-relax (HR), and static stretching (SS)-in a random order. All the subjects received all 3 interventions at intervals of at least 24 hours to minimize any carry-over effect. Modified dynamic stretching was applied as a closed kinetic chain exercise in the supine position by using the sling suspension system (Redcord Trainer(R)). The SS and HR interventions were individually performed in the straight leg raising (SLR) position, and all 3 interventions were performed for 3 minutes. Outcome measures included passive knee extension (PKE) measurements. Five post-test measurements were recorded for all subjects at 3, 6, 9, 15, and 30 minutes after the interventions. MDS was associated with a significant increase in knee extension range of motion even at 30 minutes post-treatment. In contrast, the HR and SS stretching methods showed increased hamstring flexibility for only 6 minutes post-treatment. Improvements in the range of motion of knee extension (indicating enhancement in hamstring flexibility) with MDS were maintained longer than those with the HR and SS interventions. Therefore, MDS may be more effective than the other interventions for maintaining hamstring flexibility.

• Physical Therapy Korea
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• v.19 no.3
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• pp.20-30
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• 2012

The purpose of this study was to determine the effect of ankle joint mobilization with movement (MWM) on the range of motion (ROM) in the ankle, on the muscle strength of lower extremities, and on spatiotemporal gait parameters in chronic hemiplegic patients. Fifteen subjects with chronic stroke were divided into two groups: an experimental group (8 subjects) and a control group (7 subjects). Both groups attended two or three sessions of physical therapy each week. The experimental group also attended additional MWM training sessions three times a week for five weeks. For both groups, the ROM of the ankle, the muscle strength of the lower extremities, and the spatiotemporal gait parameters in paretic limbs were evaluated before and after the training period. The results showed that the experimental group experienced more significant increases than did the control group in terms of passive (6.10%) and active (21.96%) ROM of the ankle, gait velocity (12.96%), and peak torque, of the knee flexor (81.39%), the knee extensor (24.88%), and the ankle plantar flexor (41.75%)(p<.05). These results suggest that MWM training in patients with chronic stroke may be beneficial in increasing ROM in the ankle, muscle strength in the lower extremities, and gait speed.

• Physical Therapy Korea
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• v.21 no.2
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• pp.8-17
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• 2014

The purpose of this study was to examine the effects of hip joint mobilization (HJM) on walking ability, balance ability, and the joint range of motion in stroke patients to minimize the problems of the musculoskeletal system in patients with central nervous system diseases. All volunteers were randomly assigned to the HJM group ($n_1=14$) and the general neurodevelopment therapy (NDT) group ($n_2=16$). The HJM procedure involved applying Maitland mobilization techniques (distraction, lateral gliding, inferior gliding, and anterior gliding) by grade 3 to both hip joint. The mobilization process included mobilization and NDT for 15 min/day, 3 days a week for 4 weeks. The outcome measures were evaluated, including the hip joint passive range of motion (ROM) test and femur head anterior glide test (FHAG) using prone figure four test, dynamic and static balance abilities [timed up and go (TUG) test and center of pressure (COP) analysis], and walking ability [10-meter walking test (10MWT) and 6-min walking test (6MWT)]. Both the groups showed significant post-training differences in the hip joint ROM (FHAG and degree of hip extension) and 10MWT. The post-training improvements in the TUG test were significantly greater in patients of the HJM group than in the NDT group; however, there were no post-training improvements in COP in both groups. Patients in the HJM group showed post-training improvement in the 6MWT; however, statistically significant differences were not observed. Patients in the NDT group showed post-training improvements in the 6MWT. These results suggest that HJM improves hip joint ROM, dynamic balance ability, and walking speed in stroke patients. However, further studies are required to evaluate the long-term therapeutic efficacy of HJM in stroke patients.

• Journal of Convergence for Information Technology
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• v.9 no.10
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• pp.220-226
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• 2019

Transcutaneous electrical nerve stimulation and interferential current therapy were applied to the plantar flexor of the stroke patients, and the immediately effects on gait and ankle ROM were investigated. TENS group (n=15) and ICT group (n=15) were applied to the paretic side plantar flexor, respectively. After 60 minutes of application, evaluation of the gait and passive ankle dorsiflexion range of motion (ROM) using smartphone. After 60 minutes of application, immediate post evaluation was carried out. Two electrotherapy methods showed a significant increase in gait speed, cadence, and ankle ROM. Two electrotherapy methods were intervention methods that could increase the gait and ankle ROM of stroke patients. More subjects will be needed to pinpoint differences between the two electrotherapy methods.

• Physical Therapy Rehabilitation Science
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• v.3 no.1
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• pp.38-42
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• 2014

Objective: In this study, we applied a neurodynamic sciatic nerve sliding technique to healthy adults to elucidate its effects on hamstring flexibility and postural balance. Design: Cross-sectional study. Methods: This study targeted twenty four healthy adults (16 men, 8 women). A neurodynamic sciatic nerve sliding technique was applied 5 times to all subjects' dominant leg. The subjects were asked to sit on the bed while performing cervical and thoracic flexion, as well as knee flexion with ankle plantar flexion. Then, they were asked to perform cervical and thoracic extension and knee extension with their ankle in dorsiflexion and maintain the position for 60 s. For postural balance, we measured postural sway while the subjects maintained a one-legged standing posture using the Good Balance System and measured the hip joint flexion range of motion using a standardized passive straight leg raise (SLR) test. Results: SLR test increased significantly from $79^{\circ}$ before the intervention to $91.67^{\circ}$ after the intervention (p<0.05). Regarding the participants' balance evaluated using the one-legged standing test, the X-speed decreased significantly from 18.61 mm/s to 17.17 mm/s (p<0.05), the Y-speed decreased from 22.28 mm/s to 20.52 mm/s (p<0.05), and the velocity moment was significantly decreased from $89.33mm^2/s$ to $74.99mm^2/s$ after the intervention (p<0.05). Conclusions: Application of the neurodynamic sciatic nerve sliding technique exhibited improved hamstring flexibility and postural balance of healthy adults.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.242-249
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• 1998

Stiffness of the elbow joint is relatively common after trauma, ectopic ossification, bum, postoperative scar, and etc. Mild flexion deformity can be reduced by use of active or passive motion exercise, dynamic sling, hinged distractor device, or turnbuckle orthosis. But these methods have disadvantages of difficulty in gaining acceptable range of motion only with stretching exercise, re-contracture after conservative managements and poor results that flexion contracture remained. The common described operative exposures for treatment of the stiff elbow are anterior, lateral, posterior, and medial approach. Through Anterior, lateral and medial approach each has not access to all compartments of the elbow. But, posterior approach has benefits that access to posterior, medial and lateral aspects of the elbow and as needed, fenestration to the olecranon fossa that produces a communication between the anterior and posterior compartments of the elbow are possible. From June 1991 through April 1997, 11 patients who had posttraumatic stiff elbow, were treated with debridement arthroplasty through the posterior approach. The purpose of this study are to introduce technique of the debridement arthroplasty and to evaluate final outcomes. With regarding to preoperative pain degree, mild degree matches to 3 cases, moderate to 3 cases, and severe to 2 cases. In preoperative motion, flexion was average 85° and extension was 30°. Postoperatively nine patients had got the complete relief of pain and two patients continued to have mild pain intermittentely. Postoperative flexion improved to 127° and extension to 2°, so that elbow flexion had improved by an average of 42° and elbow extension by 28°. On the objective scale all patients had good or excellent results and they all felt that they were improved by operation. Debridement arthroplasty is one of excellent procedures for the intractable stiff elbow if it is not unstable or it has not incongrous. But it need a meticulous operative technique and a well-programmed rehabilitation.

• Physical Therapy Rehabilitation Science
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• v.10 no.1
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• pp.1-9
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• 2021

Objective: Joint mobilization for arthrokinematics altered by the positional fault of chronic ankle instability (CAI) is an effective intervention for stabilization. In this study, we compared the effects of ankle dorsi flexion range of motion (DFROM) and dynamic balance ability (DBA) in CAI patients via passive joint mobilization (PJM), a method traditionally performed in previous studies, and active joint mobilization (AJM), a method that can have a greater effect on cortical excitability with spontaneous movements. Design: Single-blind two-arm randomized controlled trial Methods: A total of 30 participants were registered: 15 each to the PJM and AJM groups. Each participant received a total of 10 intervention sessions, 10 minutes per session, 5 times a week for 2 weeks. PJM used Maitland's mobilization method to apply joint mobilization with talus in the posterior direction and AJM used an angular joint motion to induce patient's voluntary motion of medial malleolus anterior gliding and lateral malleolus posterior gliding, respectively. DFROM of the ankle was measured by using tape and DBA was evaluated by using the balance system. Results: Significant improvement was observed after intervention in both the PJM and AJM groups except for the DBA-anterior and DBA-right variables of the PJM group. There were statistically significant differences between the AJM and PJM groups in the DFROM, DBA-anterior, DBA-posterior, and DBA-right variables. Conclusions: The overall improvement of DFROM and DBA was found to be more effective in joint mobilization including voluntary movement. When it is accompanied by voluntary movement, it further affects the neuromuscular system of the ankle.