• The Journal of Korean Physical Therapy
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• v.25 no.2
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• pp.71-75
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• 2013

Purpose: Although use of a tilt table is recommended in clinical practice, there are no published guidelines regarding pressure and inclination for tilt table use. The aim of the current study was to assess the changes of pressure on sacrum and buttock according to different inclination of the tilt table in healthy subjects. Methods: Thirty two healthy subjects participated in this study. Subjects were positioned supine on the tilt table and safety straps were secured across the chest, pelvic, and knee with sufficient tension to prevent the subjects from falling. Pressure and peak pressure of sacrum and buttock were measured using pressure mapping system with the tilt table standing at $0^{\circ}$, $15^{\circ}$, $30^{\circ}$, $45^{\circ}$, $60^{\circ}$, $75^{\circ}$, and $85^{\circ}$ inclination. Results: A significant decrease in the pressure of sacrum and buttock was achieved by increasing tilt table inclination (p<0.05): $0^{\circ}{\sim}15^{\circ}$ (8.16%), $15^{\circ}{\sim}30^{\circ}$ (8.02%), $30^{\circ}{\sim}45^{\circ}$ (11.61%), $45^{\circ}{\sim}60^{\circ}$ (16.18%), $60^{\circ}{\sim}75^{\circ}$ (16%), and $75^{\circ}{\sim}85^{\circ}$ (11.48%). A significant decrease in the peak pressure was achieved by increasing tilt table inclination (p<0.05): $30^{\circ}{\sim}45^{\circ}$ (9.91%), $45^{\circ}{\sim}60^{\circ}$ (19.24%), $60^{\circ}{\sim}75^{\circ}$ (19.93%), and $75^{\circ}{\sim}85^{\circ}$ (11.48%). No significant peak pressure change was observed in $0^{\circ}{\sim}15^{\circ}$, $15^{\circ}{\sim}30^{\circ}$ tilt table inclination (p>0.05). Conclusion: The results of this study showed that the pressure of sacrum and buttock were decreased according to increasing tilt table inclination in healthy subjects. Guidelines are needed in order to optimize patient safety and overall outcome for tilt table standing.

• Journal of Acupuncture Research
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• v.26 no.4
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• pp.91-98
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• 2009

Objectives : The objective of this review is to introduce the basic concepts on the febrile disease in the Mongolian Traditional Medicine(MTM). Methods : We comprehensively reviewed related textbooks in Mongolian and articles searched from China National Knowledge Infrastructure(CNKI) on febrile disease about MTM and summarized the pathophysiologic basis of, and treatment principles in MTM. Results and Conclusions : 1. In MTM, there are basic concepts such as theory of Arga-Bilig, theory of five elements, theory of three elements(人體三素), theory of seven constitutions and three discharges(七元三濊). Most of all, theory of three elements, which is about the basic elements of human body in MTM, is important fundamental notions for explaining human physiology and pathology. In MTM, It is explained that the imbalance of three elements, namely khii, shar, bad-kan is the root of all disease. Especially, febrile disease is treated by suppressing activated shar and blood(血液), which have fire characters, and managing various additional symptoms by balancing three elements and eliminating miasma(邪氣), inappropriate substances such as bile water(shar yc, 黃水) or blood stasis(惡血) simultaneously. 2. In MTM, both of internal treatment modalities(various medicinal therapy) and external treatment modalities(physical therapy) have been used for febrile disease. Food therapy and life style modification also have been recognized as important treatment methods. These aspects correspond to wholism theory of Korean Traditional Medicine(KTM). Further studies about details of each treatment methods will discover new applicable treatment method and make broaden the external boundaries of the KTM.

• Physical Therapy Korea
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• v.3 no.2
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• pp.77-83
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• 1996

The purpose of this study was to determine the effect of transcutaneous electrical nerve stimulation(TENS) on sympathetic tone in healthy subjects. Stimulation in the conventional and burst modes was applied to the skin of the forearm overlying the median nerve. TENS was applied for 20 minutes at an intensity sufficient to produce a perceptible though not uncomfortable sensation and no muscle contracion of the forearm musculature. The change in sympathetic tone was measured with skin temperature. Skin temperature was measured at the index finger and on the volar surface of the forearm in the stimulated limb. The conventional and burst modes did not change the skin temperature at any of the two measurement sites. We conclude that TENS, as applied in this study, does not influence sympathetic tone. Further research is needed to assess the sympathetic effects of TENS on patient groups, long term treatment and other modalities.

• The Korean Journal of Pain
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• v.35 no.2
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• pp.152-159
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• 2022

Background: Subjects with frozen shoulder (FS) might not be comfortable with vigorous physical therapy. Clinical trials assessing the effect of graded motor imagery (GMI) in FS are lacking. The aim of this study was to determine the effect of GMI as an adjunct to conventional physiotherapy in individuals with painful FS. Methods: Twenty subjects aged 40-65 years having stage I and II of FS were randomly divided into two study groups. The conventional physiotherapy group (n = 10) received electrotherapy and exercises while the GMI group (n = 10) received GMI along with the conventional physiotherapy thrice a week for 3 weeks. Pre- (Session 1) and post- (Session 9) intervention analysis for flexion, abduction, and external rotation range of motion (ROM) using a universal goniometer, fear of movement using the fear avoidance belief questionnaire (FABQ), pain with the visual analogue scale, and functional disability using the shoulder pain and disability index (SPADI) was done by a blinded assessor. Results: Statistically significant difference was seen within both the groups for all the outcomes. In terms of increasing abduction ROM as well as reducing fear of movement, pain, and functional disability, the GMI group was significantly better than control group. However, both groups were equally effective for improving flexion and external rotation ROM. Conclusions: Addition of GMI to the conventional physiotherapy proved to be superior to conventional physiotherapy alone in terms of reducing pain, kinesiophobia, and improving shoulder function for stage I and II of FS.

• The Korean Journal of Pain
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• v.34 no.3
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• pp.315-321
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• 2021

Background: Pillar pain may develop after carpal tunnel release surgery (CTRS). This prospective double-blinded randomized trial investigated the effectiveness of extracorporeal shock wave therapy (ESWT) in pillar pain relief and hand function improvement. Methods: The sample consisted of 60 patients with post-CTRS pillar pain, randomized into two groups. The ESWT group (experimental) received three sessions of ESWT, while the control group received three sessions of sham ESWT, one session per week. Participants were evaluated before treatment, and three weeks, three months, and six months after treatment. The pain was assessed using the visual analogue scale (VAS). Hand functions were assessed using the Michigan hand outcomes questionnaire (MHQ). Results: The ESWT group showed significant improvement in VAS and MHQ scores after treatment at all time points compared to the control group (P < 0.001). Before treatment, the ESWT and control groups had a VAS score of 6.8 ± 1.3 and 6.7 ± 1.0, respectively. Three weeks after treatment, they had a VAS score of 2.8 ± 1.1 and 6.1 ± 1.0, respectively. Six months after treatment, the VAS score was reduced to 1.9 ± 0.9 and 5.1 ± 1.0, respectively. The ESWT group had a MHQ score of 54.4 ± 7.7 before treatment and 73.3 ± 6.8 six months after. The control group had a MHQ score of 54.2 ± 7.1 before treatment and 57.8 ± 4.4 six months after. Conclusions: ESWT is an effective and a safe non-invasive treatment option for pain management and hand functionality in pillar pain.

• Asian Oncology Nursing
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• v.12 no.3
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• pp.195-203
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• 2012

Purpose: To summarize and review the methodological quality of the evidence from trials examining the effectiveness of physical exercise in patients undergoing allogeneic hematopoietic stem cell transplantation (Allo-HSCT). Methods: Six randomized clinical trials (RCTs) were identified, reviewed for substantive results, and assessed for methodological quality. Results: Six trials met all methodological criteria on the modified Jadad score above 3 out of 5 points. Failure to blind the outcome assessor, and failure to describe the method of blinding of outcome assessor appropriately were the most prevalent methodological shortcomings. Various exercise modalities have been applied, differing in content, frequency, intensity, and duration. Positive results have been observed in part for a diverse set of outcomes, including physical and psychological performance. Conclusion: The trials reviewed in this study were of moderate methodological quality. They suggest that exercise in patients undergoing Allo-HSCT may be safe and feasible, and in part patients benefit from increased physical performance both during and after transplantation. Future RCTs should use larger samples, appropriate comparison groups, and a standard of outcome measures, and examine what kind of exercise intervention (aerobic vs. resistance vs. combined) is the most effective for Allo-HSCT patients. It would be necessary to define contraindication for exercise to guarantee its safety.

• The Korean Journal of Pain
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• v.31 no.3
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• pp.155-173
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• 2018

Chronic postsurgical pain (CPSP) is an unwanted adverse event in any operation. It leads to functional limitations and psychological trauma for patients, and leaves the operative team with feelings of failure and humiliation. Therefore, it is crucial that preventive strategies for CPSP are considered in high-risk operations. Various techniques have been implemented to reduce the risk with variable success. Identifying the risk factors for each patient and applying a timely preventive strategy may help patients avoid the distress of chronic pain. The preventive strategies include modification of the surgical technique, good pain control throughout the perioperative period, and preoperative psychological intervention focusing on the psychosocial and cognitive risk factors. Appropriate management of CPSP patients is also necessary to reduce their suffering. CPSP usually has a neuropathic pain component; therefore, the current recommendations are based on data on chronic neuropathic pain. Hence, voltage-dependent calcium channel antagonists, antidepressants, topical lidocaine and topical capsaicin are the main pharmacological treatments. Paracetamol, NSAIDs and weak opioids can be used according to symptom severity, but strong opioids should be used with great caution and are not recommended. Other drugs that may be helpful are ketamine, clonidine, and intravenous lidocaine infusion. For patients with failed pharmacological treatment, consideration should be given to pain interventions; examples include transcutaneous electrical nerve stimulation, botulinum toxin injections, pulsed radiofrequency, nerve blocks, nerve ablation, neuromodulation and surgical management. Physical therapy, cognitive behavioral therapy and lifestyle modifications are also useful for relieving the pain and distress experienced by CPSP patients.

• The Korean Journal of Pain
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• v.35 no.3
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• pp.280-290
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• 2022

Background: This study aimed to determine the impact of complex decongestive therapy applications on upper extremity function in breast cancer patients who developed adhesive capsulitis after lymphedema. Methods: Thirty patients who developed adhesive capsulitis due to lymphedema were divided into two groups as study (n = 15) and control (n = 15) groups. Both groups received 20 minutes of exercise five days a week for three weeks using a Biodex isokinetic dynamometer, as well as a hot pack and TENS (Transcutaneous Electrical Nerve Stimulation) treatment to the shoulder joint. The study group received 45 minutes of intensive decongestive therapy along with the adhesive capsulitis treatment. The visual analogue scale was used to assess pain, circumference, and volumetric measurements were used to assess edema, and the Arm, Shoulder, and Hand Problems Questionnaire (DASH: Disabilities of the Arm, Shoulder, and Hand) was used to assess upper extremity functionality. The shoulder range of motion was evaluated. Results: Both groups had improvements in pain (P < 0.001), shoulder joint range of motion (P < 0.001), and upper extremity functionality (P < 0.001) after the treatment. There was a significant decrease in circumference and volumetric measurements in the study group (P < 0.001). However, no differences were seen in measurements in the control group. Conclusions: The results showed that complex decongestive therapy was beneficial in reducing lymphedema in breast cancer patients who acquired adhesive capsulitis due to lymphedema. Consequently, the authors believe that supplementing conventional physiotherapy with complex decongestive therapy will benefit patients.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.4
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• pp.615-621
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• 2010

Purpose : The purpose of this study was to compare chronic LBP patients and asymptomatic subjects on measures of multifidus size (cross-sectional area;CSA, thickness) and symmetry (proportional difference of relatively larger side to smaller side). Methods : Data were obtained from 12 asymptomatic subjects without a prior history of LBP (8 females, 4 males), and a retrospective audit was undertaken of records from 12 chronic low back pain patients (8 females, 4 males). CSA and Thickness of the lumbar multifidus muscles was measured from axial T1-weighted magnetic resonance images(MRI). Results : The results of the analysis showed that chronic LBP patients had significantly smaller multifidus CSA and thickness than asymptomatic subjects at L4-5 vertebral levels(p<.05). The asymmetry between sides was seen at L4- L5 vertebral level in patients with chronic low back pain presentations(p<.05). Conclusions : MRI provided a quantitative measure of change between asymptomatic subjects and chronic low back pain patients of multifidus muscle. MRI identified significant differences in cross-sectional area and thickness and helps to evaluate clinically and plan the treatment modalities of LBP.

• Archives of Plastic Surgery
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• v.49 no.5
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• pp.633-641
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• 2022

Introduction In chronic facial palsy, synkinetic muscle overactivity and shortening causes muscle stiffness resulting in reduced movement and functional activity. This article studies the role of multimodal therapy in improving outcomes. Methods Seventy-five facial palsy patients completed facial rehabilitation before being successfully discharged by the facial therapy team. The cohort was divided into four subgroups depending on the time of initial attendance post-onset. The requirement for facial therapy, chemodenervation, or surgery was assessed with East Grinstead Grade of Stiffness (EGGS). Outcomes were measured using the Facial Grading Scale (FGS), Facial Disability Index, House-Brackmann scores, and the Facial Clinimetric Evaluation scale. Results FGS composite scores significantly improved posttherapy (mean-standard deviation, 60.13 ± 23.24 vs. 79.9 ± 13.01; confidence interval, -24.51 to -14.66, p < 0.0001). Analysis of FGS subsets showed that synkinesis also reduced significantly (p < 0.0001). Increasingly, late clinical presentations were associated with patients requiring longer durations of chemodenervation treatment (p < 0.01), more chemodenervation episodes (p < 0.01), increased doses of botulinum toxin (p < 0.001), and having higher EGGS score (p < 0.001). Conclusions This study shows that multimodal facial rehabilitation in the management of facial palsy is effective, even in patients with chronically neglected synkinesis. In terms of the latency periods between facial palsy onset and treatment initiation, patients presenting later than 2 years were still responsive to multimodal treatment albeit to a lesser extent, which we postulate is due to increasing muscle contracture within their facial muscles.