• Title/Summary/Keyword: Physical Dysfunction

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Biomechanics of Sacroiliac Joint Dysfunction and Clinical Disease (엉치엉덩관절 통증과 임상 질환에 대한 생체역학)

  • Jeong, Seong-Gwan;Lee, Woo-Hyung;Kim, Kyung-Hwan
    • PNF and Movement
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    • v.8 no.1
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    • pp.41-50
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    • 2010
  • Pain originating from the sacroiliac joint(SIJ) has been associated with poor performance, yet specific diagnosis of sacroiliac dysfunction(SID) has been difficult to achieve. Clinical presentation of SID appears that pain and poor performance is responsive to local analgesia of periarticular structures with poorly defined pathology, and poor performance with bony pathological changes present as a result of chronic instability. Previous research indicates that physical examination cannot diagnose SIJ pathology. Earlier studies have not reported sensitivities and specificities of composites of provocation tests known to have acceptable inter-examiner reliability. Tests based on mechanics as manual provocation for SIJ pain have formed the basis of tests used to diagnose SIJ dysfunction. In this review summary, the purpose of this study was to describe the sacroiliac tests with a model of examination, diagnosis, and management of SID. Further research is warranted to determine whether SIJ tests is reliable means of evaluating innominate impairments.

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Literature Review on the Association Between a Cervical Dysfunction and the Change of Neuromuscular Control Activity (경추부 장애와 신경근 조절 활동 변화와의 관련성에 대한 고찰)

  • Kim, Suhn-Yeop;Lee, Hae-Jung
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.12 no.1
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    • pp.57-67
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    • 2006
  • Musculoskeletal neck dysfunction syndromes are common in outpatient musculoskeletal pain practice. The underlying musculoskeletal and neurologic causes of pain are variable. In the management of these patients, it is important to accurately identify and treat these pain generators to optimize patient outcome. It is the purpose of this review to discuss three main categories of functional anatomy, the role of superficial/deep muscular system and the scientific evidence for optimal physical therapy intervention for cervical dysfunction. Specifically there is evidence of lowered microcirculation in the upper trapezius muscle, morphological signs of disturbed mitochondrial function which appears to be limited to type I fibers and an increased cross-sectional area of type I muscle fibers despite a lower capillary to fiber area ratio. In acute neck pain syndrome, changes in muscle activity of painful muscles may result from segmental and supraspinal inhibitory effects. Muscle activation is closely related to the control of joint movements and postures and it is difficult to separate the influence of the two components. Both the altered muscle recruitment patterns and altered kinematics appear to be a poor adaptation for pain of the head - neck region, as they are likely to result in increased compressive loading in the cervical spine, affecting muscles, articular structures such as zygapophyseal joints, connective tissues and neural tissues which are all peripheral generators of referred pain. The rectus capitus posterior minor muscle shows that it is one of the most important muscles of the suboccipital region. In this article, i reviewed the anatomy, neurophysiology, function and dysfunction as well as the treatment of cervical dysfunction.

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Effect of Mulligan SNAGs on Pain, Neck Dysfunction, and Depression in patients with Cervicogenic headache (멀리건 SNAGs 기법이 경추성 두통 환자의 통증, 경부 기능 장애 및 우울증에 미치는 영향)

  • Park, Jae-myoung;Shin, Eui-joo;Hong, Hyun-pyo
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.28 no.2
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    • pp.25-34
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    • 2022
  • Background: Cervical headache (CGH) is a common condition that causes serious damage. Mulligan described a sustained natural apophyseal glides (SNAGs) as a manual therapy approach to treat this dysfunction. Although there have been several case studies to evaluate the effectiveness of SNAG, the efficacy of SNAG for cervical headaches is still controversial. Therefore, this study examined the effects of Mulligan's SNAG technique on cervical headache and pain intensity to present basic clinical data. Methods: Thirty-two subjects participated in this study, 16 each in the experimental and control groups. The experimental group applied Mulligan's SNAGs technique and the control group applied the placebo SNAGs technique. Results: Significant differences (p<.05) in the changes in pain, neck disability index (NDI) and Hamilton rating scale for depression (HRSD) were observed between the two groups. Conclusion: The application of Mulligan's SNAG technique to patients with cervical headaches effectively reduced headache, depression, and neck dysfunction. Based on this study, Mulligan's SNAGs technique can be used as an objective research method for additional studies targeting cervical headache patients in the future.

The relationship between stomatognathic habit and temporomandibular joint dysfunction (구강악습관과 측두하악관절 기능장애와의 관계)

  • Kim, Mun-Whan;Kim, Mi-Jin;Kim, Jae-Suen;Nam, La-Ju;Park, Joung-Ok;Sim, So-Young;Choi, Eun-Kyung;Kim, Suhn-Yeop
    • Journal of Korean Physical Therapy Science
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    • v.7 no.1
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    • pp.295-310
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    • 2000
  • The relationship between symptoms of temoromandibular joint dysfunction(TMJD) and stomatognathic habit was studied in 500 adolescents(mean age 22.45). The severity of TMJD was determined by using a self-reported anamnestic questionnaire composed of 10 questions regarding common TMJD. The index of oromandibular habit was determined by using a self-reported anamnestic questionnaire composed of 17 questions. There was a positive correlation(p<0.01) between the index of TMJD and index of stomatognathic habit. The most frequent symptoms were clicking sounds from the TMJ(37.4%) and a feeling of pain in the jaws(33.3%). The most frequent stomatognathic habit were a chin support(69.8%) and one side chewing(68.0%).

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Relationships of autonomic dysfunction with disease severity and neuropathic pain features in fibromyalgia: is it really a sympathetically maintained neuropathic pain?

  • On, Arzu Yagiz;Tanigor, Goksel;Baydar, Dilek Aykanat
    • The Korean Journal of Pain
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    • v.35 no.3
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    • pp.327-335
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    • 2022
  • Background: The pathophysiology of fibromyalgia (FM) involves many mechanisms including central nervous system sensitization theory, autonomic nervous system (ANS) dysfunction, and recently small fiber neuropathy. While the small fiber neuropathy itself can cause ANS dysfunction and neuropathic pain (NP), it is still unknown whether ANS problems have an association with severity of disease and NP in patients with FM. The aim of this study was to evaluate ANS dysfunction in FM patients and to explore possible associations of ANS dysfunction with disease severity and NP. Methods: Twenty-nine FM patients and 20 healthy controls were included in this cross-sectional study. Participants were tested using sympathetic skin responses (SSR) and R-R interval variation analyses for sympathetic and parasympathetic ANS dysfunction, respectively. Disease severity and somatic symptoms of patients with FM were evaluated using the ACR-2010 scales and Fibromyalgia Impact Questionnaire, and NP symptoms were evaluated using the Pain Detect Questionnaire and Douleur Neuropathique questionnaire. Results: FM patients were found to have ANS dysfunction characterized by increased sympathetic response and decreased parasympathetic response. SSR amplitudes were found to be correlated with a more severe disease. Although nonsignificant, NP severity tended to be associated with a decrease in sympathetic and parasympathetic activities. Conclusions: ANS dysfunction may play a role in the pathophysiology of FM. The trend of decreased ANS functions in FM patients exhibiting NP contradicts the notion that FM is a sympathetically maintained NP and may be explained with small fiber involvement.

Modified Sustained Natural Apophyseal Glides of Back Pain due to Combined Movement Dysfunction (복합운동 기능장애로 인한 요통의 수정된 SNAGs)

  • Park, Ji-Whan
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.8 no.1
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    • pp.25-30
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    • 2002
  • The main purpose of this article is to suggest a modified SNAGs manual method in based of Mulligan techniques. And this study aimed to resolve the back pain which has combined movement dysfunction in lumbar spine, in addition to upgrade of manual therapy technique in clinical field. The results of this study were as following; 1. The first introduction of SNAGs in Korea is the 'International Mulligan Concepts and Techniques Seminar' by Prof. Russell M. Woodman(Quinnipiac college, USA), 1998. SNAGs is defined a mobilization with movement manual therapy that facet joints of the lesion mobilized to anterior-superior direction according to the treatment plane in apophyseal joint of hypomobility. 2. A treatment mechanism of the SNAGs is, Mulligan say, HIVD which is the result of posterior disk bulging from a increased between intervertebral pressure due to hypo-mobile of facet joints in abnormal spine, so therapist should be necessary mobilization of zygophyseal joints especially in disk lesion. 3. Because Mulligan does not yet mentioned SNAGs techniques about a back pain with combined movements dysfunction, so we suggest a modified SNAGs method for manual therapy of back pain patients due to combined movement dysfunction at lumbar.

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Anatomy and Biomechanics of the Patellofemoral Joint (슬개대퇴관절의 해부학과 생체역학에 관한 문헌적 고찰)

  • Choi, Byung-Ok
    • Journal of Korean Physical Therapy Science
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    • v.8 no.2
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    • pp.935-944
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    • 2001
  • The patellofemoral pint is formed by the articulation of the patella and femoral condyles in the trochlear groove. The complexity of the patellofemoral pint is magnified by the fact that the tibiofemoral pint works in conjunction with the patellofemoral pint. Additionally, other pints such as the subtalar pint., hip and sacroiliac pints indirectly contribute to the function of the patellofemoral pint. This pint has little bony stability, Soft tissue surrounds the pint to increase stability. The patellofemoral pint increases the mechanical advantage of the quadriceps muscles and resists mechanical loading. In patellofemoral dysfunction, patellofemoral contact pattern is disrupted. leading to excessive compression at the pint. When you treat the patellofemoral dysfunction, you should evaluate anatomic and biomechanic components and find factors of patellofemoral dysfunction. Hamstring tightness. weakness of VMO and tightness of lateral retinaculum lead to flexed knee and abnormal patella tracking and patellofemoral pint reaction force and patellofemoral dysfunction. A through understanding of the anatomy and biomechanics may assist the clinician in the recognition and treatment of patients with patellofemoral pain. Therefore physical therapists should apply modality as well as therapeutic exercise, stretching and strengthening. In this paper, I will discuss the germane anatomical structures and biomechanics of the patellofemoral pint.

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A Study on Low Back Pain with Sacroiliac Joint Dysfunction (요통과 천장관절기능이상에 대한 고찰)

  • Oh, Seung-Kil
    • Journal of Korean Physical Therapy Science
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    • v.5 no.3
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    • pp.697-706
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    • 1998
  • Motion at the sacroiliac joints(SIJ) has been reported in the medical literature since the mid-19th century. However, for many years authorities vie~d that no movement occurred at the sacroiliac joints and therefore were not clinically significant. Recent contributions from both the basic and clinical sciences caused a change in perception of the role of the sacroiloiac joint in low back pain(LBP). Movement within the sacroiliac joint is now generally recognized, although it is only a small amount. Controversy continues as to the type of motion available and the axes of motion, and continues as to the ability of a clinician to identify a significant sacroiliac dysfunction. Dysfunction of the pelvic girdle is complex and not easily understood. It is common to find serveral dysfunctions within the same pelvic girdle. Each needs to be individually diagnosed and appropriately treated. The diagnostic and therapeutic system designed by Philip E. Greenmam, D. O. allows the operator to deal with any combination of physical findings that are found within the pelvic girdle Restoration of pelvic girdle function within the walking cycle is a major therapeutic goal, particularly from the biomechanical postural-structural model.

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Diagnostic Value on the Orthopaedic Tests for Sacroiliac Joint Dysfunction (천장관절 기능부전에 대한 검사방법들의 진단적 가치 : 정형도수치료적 평가를 중심으로)

  • Yoon, Hong-Il;Sim, Hyun-Po
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.16 no.1
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    • pp.64-76
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    • 2010
  • The sacroiliac joint is difficult to appropriately examine and treat because it is extremely complex and also is difficult to distinguish dysfunctions from those of the spine and hip which are highly intergrated functionally. In addition generally traditional x-rays and CT scans also are not beneficial in detecting sacroiliac joint dysfunction. The manipulative physiotherapist should seek to establish a series of relevant finding that build into a case implicating the sacroiliac joint. When deciding to use these diagnostic tests, the examiner must determine if the test will give reliable and useful information that will help in the diagnosis and subsequent treatment. To be useful diagnostic tests must give reliable data and be valid and the most useful methods of determining whether a test is a good test for pathology under consideration are sensitivity and specificity. In the ideal world, one would want a test that has both high sensitivity and high specificity. The purpose of this review is to ascertain diagnostic value on the tests for sacroiliac joint dysfunction by literature.

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Effect of the Electro-acupuncture Stimulation into the Infraspinatus and the Teres Major for the Shoulder Function Improvement and Pain Reduction (극하근과 대원근에 적용한 전침이 견관절 기능 개선 및 통증 경감에 미치는 영향)

  • Jang, Won-Seok;Bae, Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.19 no.6
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    • pp.43-47
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    • 2007
  • Purpose: This study examined the effect of electro-acupuncture stimulation of the infraspinatus and teres major on the shoulder function reduction. The subjects consisted of 20 female patients with a shoulder dysfunction. Methods: The 20 female patients with shoulder dysfunction participated voluntary in this research. 10 minute electro-acupuncture stimulation (frequency: 5Hz, Intensity: below the pain threshold) with Infra-red therapy, 3 times per week given to the patients' Trigger point of the infraspinatus and teres major. The Visual Analog Scale (VAS), Apley's Scratch Test and Global Perceived Effect Scale (GPES) were examined before alter six applications. Results: There was a significant decrease in the VAS (p<0.05) and Apley's Scratch Test (p<0.05). In addition, there was statistically significant increase in the Global Perceived Effect Scale (p<0.05). Therefore, the infraspinatus and teres major is a very important muscle for the shoulder function. Conclusion: This data will be used to develop a treatment method for patients with a shoulder dysfunction. These results suggest that the electro-acupuncture stimulation into the infraspinatus and the teres major Trigger point is an effective intervention for patients with shoulder dysfunction and pain.

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