Objective: This study aimed to identify the area with greatest effect using self-myofascial release technique (self-MFR) in the hamstring, suboccipital, and plantar regions. Design: Cross-sectional study. Methods: Twenty-two adult subjects were evaluated for flexibility and hamstring pain threshold after self-MFR. Based on the superficial back line, the self-MFR application areas were the suboccipital region, hamstring, and plantar regions. Self-MFR was applied to each area using a wooden pole for a total of 4 minutes. Self-MFR was applied for 3 days at the same time of day, which was randomly assigned for each subject. Treatment was applied to one area each day. The sit and reach test (SRT), active range of motion (AROM), and passive ROM (PROM) were used to determine changes in flexibility, and an algometer was used to determine pain threshold. Pre/post-self-MFR effectiveness was tested using a paired t-test. Repeated measurement was used to compare self-MFR effects in the suboccipital, hamstring, and plantar regions. Results: When the self-MFR technique was applied to the 3 areas, the SRT showed significant improvement over baseline (p<0.05). Bilateral AROM and PROM showed significant improvements (p<0.05). When the self-MFR technique was applied to the hamstring, the semimembranosus showed a significant change in pain threshold (p<0.05). Conclusions: Our findings suggest that indirect application based on the Anatomy Trains could be effective for those who need to improve muscle flexibility. Moreover, self-MFR easily alleviates myofascial pain while maintaining flexibility, and can be performed at any time and place.
The purpose of this study is to report the case of a patient with idiopathic Parkinson's disease treated with scalp acupuncture and Chuna manual therapy. A total of 10 sessions of scalp acupuncture and Chuna manual therapy were performed. At the beginning of the treatment, the Korean version of modified Barthel index (K-MBI) was 25 points, and the range of motion (ROM) of both knee joints was 150° in passive flexion, while active movement was impossible. In addition, both knee joints were flexed and contracted at -40° on the right and -30° on the left. Over the course of treatment, the ROM of both knee joints improved to -20° on the right and -10° on the left. The patient was even able to maintain a standing position and was allowed to walk approximately 10 steps with support. Temporary improvement was observed as a result of applying scalp acupuncture treatment and Chuna manual therapy to a patient whose symptoms were gradually worsening.
Purpose: This study was conducted among patients with moderate to severe hallux valgus who underwent distal chevron osteotomy and groups of patients with or without Akin osteotomy were compared for evaluation of the relationship between their radiological and clinical outcomes. Materials and Methods: From January 2009 to January 2012, among patients with moderate to severe hallux valgus who underwent distal chevron osteotomy at our institution, 28 cases with additional Akin osteotomy and 35 cases without Akin osteotomy available to follow up of more than one year were included in this study. For radiologic evaluation, hallux valgus angle, 1, 2 intermetatarsal angle, and hallux interphalangeal angle were measured before and after surgery. For clinical assessment, visual analogue scale score, American Orthopaedic Foot and Ankle Society score, subjective satisfaction of the patients, and passive range of motion of the first metatarsophalangeal joints were evaluated. Results: At the final follow up, correction of valgus hallux angle and 1, 2 intermetatarsal angle was obtained from radiation results of both groups and it was found that patients who underwent Akin osteotomy showed radiographically larger angle correction but less subjective satisfaction. Conclusion: Patients with moderate to severe hallux valgus who underwent distal chevron osteotomy showed not only functional but also radiographically satisfactory results, and patients who underwent additional Akin osteotomy showed decreased subjective satisfaction. Therefore, if an incongruent first metatarsophalangeal joint is not observed, distal chevron osteotomy without Akin osteotomy seems preferable.
The purpose of this study was to determine the effects of weight shift training with joint mobilization on the ankle joint passive range of motion (PROM), balance capacity and gait velocity in hemiplegic patients. Fourteen subjects were randomly assigned to either the experimental group (EG) or the control group (CG), with seven subjects in each group. The EG received weight shift training with joint mobilization in the paretic leg's subtalar joint in order to increase ankle dorsiflexion. The CG received general physical therapy training. Both groups received training five times a week over a period of two consecutive weeks. The figures for PROM of ankle dorsiflexion on the paretic leg, the functional reach test (FRT), the timed up and go (TUG) test, and gait velocity were recorded both before and after the training sessions for both groups. The EG's results in gait velocity, the FRT and the TUG test improved after training (p<.05). The PROM of ankle dorsiflexion improved both in the EG and the CG (p<.05), the EG demonstrated a significantly higher increase (p<.05) than that of the CG. The results of this study suggest that increased joint mobilization positively affects balance and gait velocity of hemiplegic patients. Further studies with a greater sample size are necessary in order further prove the accuracy of the results of this study.
Seo, Min-A;Jeong, Kyu-Na;Kim, Yu-Jin;Lee, Yu-Jin;Hwang, Young-In
Physical Therapy Korea
/
v.29
no.1
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pp.70-78
/
2022
Background: Individuals with calf muscle shortening may have decreased dynamic balance. Objects: This study aimed to investigate the effect of mobilization with movement (MWM) and myofascial release (MFR) on kinematic changes in dynamic balance in individuals with calf muscle shortening. Methods: Thirteen participants were randomly assigned to the MWM or the mobilization with movement added myofascial release (MWM-MFR) group. The MWM group received treatment with only MWM, whereas the MWM-MFR group was treated with MWM and MFR. Pre- and post-intervention passive range of motion (PROM), maximum reaching lengths, and modified star excursion balance test (MSEBT) results were compared for all participants. Wilcoxon signed-rank test and Mann-Whitney U test were used for statistical analysis. Results: The results showed significant within-group differences in ankle PROM, but no significant between-group differences. The maximum reaching length in the MWM-MFR group in the posterolateral direction was significantly different before and after the intervention (p = 0.005). This group also showed significantly reduced ankle abduction in MSEBT during the posteromedial direction section 3 (p = 0.007) and posterolateral direction section 5 (p = 0.049) compared with the MWM group. Conclusion: Combined MWM and MFR intervention improves ankle stability in the coronal plane during the posteromedial and posterolateral forward movement in dynamic balance compared with only MWM in individuals with calf shortening.
Journal of the Korean Society of Physical Medicine
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v.15
no.4
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pp.111-119
/
2020
PURPOSE: In adults with hamstring tightness, stretching is considered a therapeutic exercise that improves flexibility. However, previous studies have reported efficacy of numerous methods, and are inconclusive in determining the most effective stretching techniques. This study aims to compare the outcomes of Evjenth-Hamberg stretching (E-HS), proprioceptive neuromuscular facilitation stretching (PNFS), and static stretching (SS), on muscle tone and flexibility. METHODS: A total of 30 subjects were assigned to each of the three stretching groups:; E-HS (n1 = 10), PNFS (n2 = 10), and SS (n3 = 10). Muscle tone of the hamstring muscle, active knee extension (AKE), and passive knee extension (PKE) were assessed by range of motion. RESULTS: After the intervention, statistically significant differences were obtained between groups for muscle tone (p < .05). The post hoc test, showed statistically significant differences in muscle tone between the E-HS and PNFS groups (p < .05), and PNFS and SS groups (p < .05). Post hoc test after intervention, also revealed statistically significant differences in flexibility (p < .05) between the E-HS and PNFS groups (p < .05), E-HS and SS groups (p < .05), and PNFS and SS groups (p < .05). Moreover, a statistically significant difference was observed in PKE scores between the E-HS and SS groups (p < .05), and PNFS and SS groups (p < .05). CONCLUSION: This study indicates that E-HS may be the most effective stretching technique for muscle tone and flexibility, in adults with hamstring tightness.
Purpose: To compare the clinical outcomes of single injection adductor canal block (SACB), continuous adductor canal block (CACB), and the concomitant use of transdermal buprenorphine after total knee arthroplasty (TKA). Materials and Methods: A total of 125 patients who underwent TKA were divided into three groups and the clinical results were retrospecitively compared. Group I was comprised of patients with pain controlled by SACB (n=41). Group II consisted of patients with pain controlled by both SACB and transdermal buprenorphine (10 ㎍/h) (n=44). Group III contained patients with pain controlled by CACB (n=40). The visual analogue scale (VAS) was used as the pain control indicator and the patients were measured on a VAS for resting on the bed (VAS-Rest) at 12 hours, 24 hours, and 48 hours after surgery. The VAS while doing continuous passive motion (VAS-CPM) on the first and second postoperative day was also measured. In addition, the total amount of medications used (Butopahn, Tridol, and Ketorac) for the intravenous patient controlled analgesia (PCA) was counted for 48 hours after surgery. As the indicator of the functional recovery outcome, the incidence of nausea and vomiting was observed for 48 hours after surgery. The maximum knee joint flexion range and maximum walking distance on the first and second postoperative day, and the total length of stay at the hospital were compared. Results: The VAS-Rest was similar in the three groups at 12 hours after surgery, but at 24 hours and 48 hours after surgery, group II and III a lower VAS-CPM and total amount of medications used for PCA than group I (p<0.05). The three groups showed a low incidence of nausea and vomiting, maximum knee joint flexion range, and similar walking distance and total length of stay at the hospital. Conclusion: The combination of SACB and transdermal buprenorphine has great pain control effect initially. On the other hand, it is not associated with catheter complications and it is convenient to use and safety toward the renal function. Therefore, the concomitant use of SACB and transdermal buprenorphine can be an effective pain control method after TKA.
Journal of Physiology & Pathology in Korean Medicine
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v.36
no.4
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pp.138-142
/
2022
This study aimed to evaluate the effectiveness of Korean rehabilitation treatement for patients with post-TKR. The medical records of inpatients undergoing Korean rehabilitation treatment after TKR from 2016.01.01. to 2021.12.31. during the admission, were analyzed retrospectively. The effect of treatment was evaluated by using a numeric rating scale(NRS) and range of motion(ROM) of knee. Statistical analysis was done using the IBM SPSS statistics 26 program. If the period of hospitalization was within 7 days or change of NRS and ROM was not recorded properly, the case was excluded. All inpatients received acupuncture treatment, Electro-acupuncture. Soyeom pharmaco-acupuncture were used at a high rate. Blood letting cupping therapy, dry cupping therapy, Interferential Current Therapy(ICT) continuous passive motion(CPM), cryotherapy were used at a high rate. A significant improvement was noted when comparing the NRS and knee ROM results at the time of admission and discharge. Korean medical rehabilitation can be effectively used for patients who have undergone TKR, to relieve pain and enable returning to daily activities. It is expected to be helpful in future studies of post-TKR in Korean Medicine. Also It can be used for medical treatment of post-TKR in Korean Medicine Hospital and clinic. However, further research with a high level of evidence is necessary to support this finding.
Purpose: To analyze the result of the accurate open reduction of acromioclavicular (AC) joint and pin fixation, coracoclavicular (CC) screw fixation without CC ligament repair for AC joint injuries. Materials and Methods: Between January 2000 and December 2003, seventeen cases with at least one year follow-up among twenty-one cases underwent operation for AC-CC ligament injuries. A transverse incision approximately 5 cm in length was made over the clavicle, and the AC joint was reduced accurately. Under the image intensifier, a cannulated screw and washer were inserted for the CC ligament. Two Steinman pins were inserted for the AC joint and the AC ligament was repaired with nonabsorbable suture. Gentle passive range of motion was begun postoperative 2 weeks. The pins were removed at $6{\sim}8$ weeks and the screw was removed at $10{\sim}12$ weeks. The results were evaluated by a distance between AC and CC joints on plain films and ASES score at last follow-up. Results: At the last follow-up, there was no limitation of motion and average ASES score was 96($86{\sim}100$ points). There was no failure showing over 5 mm difference of distance compared to opposite side on the plain films. Seven cases had the skin damages and local infection due to pin migration and three cases showed the loosening of CC screw. Conclusion: We could have satisfactory results by accurate reduction of AC joint and simple pins and screw fixation for AC-CC ligament injuries.
Previous studies of the relationship of TMJ signs and symptoms in elderly people have provided inconsistent findings. The objective of this study was to retrospectively analyze the prevalence of signs and symptoms of temporomandibular disorders(TMD). Additionally, young subjects were examined as a control group. Forty old patients (28 female, 12 male, mean age: $65.2{\pm}2.5$ years) and forty young patients (30 female, 10 male, mean age: $23.3{\pm}2.6$ years) clinically diagnosed with TMD were screened. Patient records were analyzed regarding: pain on chief complain, amount of range of mouth opening, TMJ noises(clicking sounds, crepitus), pain on palpation of the TMJ and masticatory muscles and neck and upper back muscles. Differences between the groups were assessed using t-test and the chi-squared test. (SPSS v.17) P value <0.05 was considered statistically significant. Geriatric subjects more often exhibited crepitus on mouth opening (25%), muscular palpation pain of masseter muscles (82.5%) and temporal muscles(60%). In contrast, young subjects more frequently exhibited joint sounds (62.5%), more amount of range of passive mouth opening (p=0.043). It was found that the younger subjects (82.5%) and the older subjects (87.5%) suffered from subjective sign (orofacial pain on chief complain). There were not statistically significant relationships between orofacial pain (VAS) and the groups. Differences between the groups with respect to joint sounds, muscular palpation pain and mandibular range of motion were significant. Although older subjects more frequently exhibited objective signs (crepitus on opening, pain on muscular palpation) of TMD, younger subjects more frequently objective signs (clicking sound on mouth opening, amount of mandibular range of motion).
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