• Strategy21
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• s.38
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• pp.221-249
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• 2015

The Royal United Services Institute(RUSI) was founded in the middle of the 19th century in Britain. It was developed through 'Naval Historical Revitalization Movement' in that time. Many celebrities and people who were interested in the Navy participated in the activities of the RUSI. For example, the forums and lectures were held by prestigious persons, like Sir Garnet Wolseley and the Duke of Cambridge. It also became the milestone for guiding the flow of the Royal Navy's thought with the Naval Intelligence Department and the Naval Records Society. The forum of the RUSI was the place for debating naval hot issues. The journal of the RUSI was the space for suggesting an idea and gathering public opinions for developing Britain's sea power. Therefore, the RUSI was the public sphere for the Royal Navy in the 19-20th Century. And especially, the paper prize contest of the RUSI was the culmination of the RUSI's activities for the Royal Navy. Naval prize essays gave messages to the Royal Navy about the changing situation of European naval powers. Also, they made many meaningful debates for the Royal Navy to overcome the difficult situations in that time. Those essays were reflecting the issues of the Royal Navy and leading the way for getting over it. Besides, some people appeared through the contest and they played important roles for making the contingency and planning the war. The contest reflected the past, anticipated the future, and selected the talented persons to shape the future. This developing aspects of the RUSI could apply to the Korea Institute for Maritime Strategy(KIMS). The KIMS already carries out the role of the RUSI very similarly. If the KIMS changes to the way for open-door policy to more people, it will work more efficiently for their goal. In this respect, the messages of the RUSI will be very useful for improving the activities of the KIMS.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.4
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• pp.81-90
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• 2015

PURPOSE: The purpose of this study was to compare the muscle architecture of serratus anterior and lower trapezius using rehabilitative ultrasound imaging (RUSI) in affected and unaffected side of chronic stroke patients. METHODS: The participants were thirty five patients with stroke hemiplegia in this study. RUSI was used to measure the muscle thickness of the serratus anterior and lower trapezius muscles. We compared the muscle thickness according to affected side and sex, determined the reliability of the measurement image. Independent t-test, intra-class correlation coefficient (ICC) and standard error of measurement (SEM) were used for statistical analysis. RESULTS: Significant difference in muscle thickness of serratus anterior was observed between affected and unaffected side (p<.001). Muscle thickness according to gender showed a significant difference in unaffected side of serratus anterior (p<.05). Compare asymmetry ratio of serratus anterior and lower trapezius muscle thickness showed a significant difference (p<.001). ICC for intra-reliability was .944~.962 in serratus anterior and .873~.925 in lower trapezius muscle thickness, respectively. SEM was .001~.004 in serratus anterior and .002~.008 in lower trapezius muscle. CONCLUSION: This study, using RUSI, showed significant difference in muscle thickness of serratus anterior in affected and unaffected side of stroke patients. RUSI is a practical tool for measuring soft-tissue thickness in the scapular region muscle of stroke.

• Physical Therapy Rehabilitation Science
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• v.6 no.3
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• pp.152-157
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• 2017

Objective: The aim of this study was to determine the intra-rater and inter-rater reliability of the dual rehabilitative ultrasound imaging (D-RUSI) when simultaneously measuring muscle thickness changes at rest and during co-contraction of the biceps brachii (BB) and triceps brachii (TB). Design: Cross-sectional study. Methods: This study included 36 healthy participants (23 men, 13 women). The participants sat on a chair in a comfortable position with a cushion placed under their elbow to maintain a 90-degree elbow flexion angle. The muscle thickness of the biceps brachii and triceps brachii was measured twice using the D-RUSI by two examiners during resting and co-contraction states. One week later, the same procedure was performed once again. Results: The intra-class correlation coefficients (ICCs) for intra-rater reliability ranged from 0.887 to 0.989 and the confidence interval was within an acceptable range of 0.778 to 0.994. The standard error of measurement (SEM) values ranged from 0.303 to 0.866 and the minimal detectable change (MDC) values ranged from 0.84 to 2.40. The ICCs for inter-rater reliability ranged from 0.758 to 0.925. The SEM values ranged from 0.702 to 1.486 and the MDC values ranged from 1.95 to 4.12. Conclusions: The use of the D-RUSI of the BB muscle had a very good intra-rater reliability and very good inter-rater reliability at the resting state, and a, good inter-rater reliability at the co-activation state. ICC values showed very good intra-reliability and inter-reliability for the TB muscle. the D-RUSI is a useful tool for simultaneously measuring the thickness of two muscles when the BB is an agonist and the TB is an antagonist during co-activation of the upper arm.

• Physical Therapy Rehabilitation Science
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• v.7 no.3
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• pp.95-101
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• 2018

Objective: To determine if the provision of visual biofeedback using real-time rehabilitative ultrasound imaging (RUSI) enhances the acquisition and retention of diaphragm muscle recruitment during exercise. Design: Two group pretest posttest design. Methods: Thirty healthy subjects were randomly assigned to the verbal feedback group (VG, n=15) or the visual and verbal feedback group (VVG, n=15). The VG performed breathing exercises 10 times with verbal feedback, and the VVG also performed breathing exercises 10 times with verbal feedback and visual feedback with the use of RUSI to measure changes in diaphragm thickness (DT). For DT, the mid-axillary lines between ribs 8 and 9 on both sides were measured in standing, and then the chest wall was perpendicularly illuminated using a linear transducer with the patients in supine to observe the region between rib 8 and 9 and to obtain 2-dimensional images. DT was measured as the distance between the two parallel lines that appeared bright in the middle of the pleura and the peritoneum. After one week, three repetitions (follow-up session) were performed to confirm retention effects. Intra- and between- group percent changes in diaphragm muscle thickness were assessed. Results: In the VVG, the intervention value had a medium effect size compared to the baseline value, but the follow-up value decreased to a small effect size. In the between-group comparisons, during the intervention session, the VVG showed no significant effect on percent change of DT but had a medium effect size compared to the VG (p=0.050, Cohen's d=0.764). During the follow-up session, retention effect did not persist (p=0.311, Cohen's d=0.381). Conclusions: RUSI can be used to provide visual biofeedback and improve performance and retention in the ability to activate the diaphragm muscle in healthy subjects. Future research needs to establish a protocol for respiratory intervention to maintain the effect of diaphragmatic breathing training using RUSI with visual feedback.

• The Journal of Korean Physical Therapy
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• v.26 no.5
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• pp.324-330
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• 2014

Purpose: The aim of the current study was to compare the muscle architecture of lower extremity using rehabilitative ultrasound imaging (RUSI) in young adults in Seoul and Hanoi. Methods: The study design was a comparative study of muscle cross-sectional area of lower extremity. Sixty healthy young subjects (Seoul group: 30, Hanoi group: 30) participated in this study. Real-time B-mode RUSI with a 7.5MHz linear transducer was used for measurement of cross-sectional area, pennation angle, and muscle thickness of the rectus femoris, tibialis anterior, and medial gastrocnemius muscles. Independent t-test was used for statistical analysis. Results: Significant difference in cross sectional area of rectus femoris was observed between Korean young adults and Hanoi young adults (p<0.01). Muscle thickness and pennation angle of tibialis anterior in Korean young adults were greater than in Hanoi young adults (p<0.01). In addition, the muscle thickness and pennation angle of the medial part of gastrocnemius muscle were greater in Korean young adults than in Hanoi young adults (p<0.01). In addition, in the results for gender, men had larger muscle architectures than women in both groups (p<0.01). Conclusion: This study, using RUSI, showed significant difference in muscle architectures of lower extremity in a diverse group of young adults RUSI.

• Physical Therapy Rehabilitation Science
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• v.5 no.1
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• pp.47-52
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• 2016

Objective: This study surveyed the perceptions of physical therapists on muscle re-education through visual feedback obtained from rehabilitative ultrasound imaging (RUSI). Design: Survey. Methods: For this study, 500 physical therapists who participated in a refresher training held by the Seoul City Association in March 2015 were selected for a questionnaire-based survey. Subjects were randomly selected targets physiotherapists who participated in a refresher training.The questionnaire had 21 items in total. Questions 1 to 15 could be answered by everyone. However, questions 16 to 21 could be answered only by people who used RUSI. Results: The majority of respondents were aged 20 to 30 years. Respondents in their twenties, thirties, forties, and fifties accounted for 32.4%, 40.2%, 21.9%, and 5.6%respectively. Therapists with careers spanning one to 5 years accounted for 27.8%, while those with careers spanning 5 to 10 years and 10 to 15 years accounted for 34.6% and 17.0%, respectively. Those with careers over 20 years accounted for 9.2%. The types of work have not been various including work related to the nervous system (49.0%), the musculoskeletal system (41.5%), sports (0.7%), juvenile physical therapy (4.2%), and others (4.6%). Conclusions: In this study, we examined the perceptions of physical therapists on rehabilitation ultrasound imaging used in muscle re-education. We also examined how to use this technique. Many therapists who participated in the refresher training were found to be unaware of RUSI. In the future, further investigations on RUSI for muscle re-education are required through refresher training or training lectures at the national level.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.2
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• pp.45-52
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• 2021

PURPOSE: This study examined the imaging procedure of pectoralis minor muscle thickness and assessed the intra- and inter-rater reliability of the muscle thickness measured by two raters using rehabilitative ultrasound imaging (RUSI) in healthy individuals. METHODS: Fifteen participants (aged 21 - 28, seven females, and eight males) were involved in the study. The primary rater palpated the coracoid process and the fourth rib, defined as the width of the index finger lateral to the sternum to avoid breast tissues, and lined the two landmarks. The second examiner checked 1 / 3 (1st point) and 1 / 2 (2nd point) of the line length as measurement points. The two raters obtained right side muscle images of the participants at a standardized sitting position using RUSI with a 7.5 MHz linear transducer at 40mm depth. For intra-rater reliability, the principal rater took three images per point and tried to take one more with an interval. For the inter-rater reliability, the other rater performed the same tasks as the principal rater on the same day. The reliability was analyzed using the intra-class correlation coefficient (ICC), the standard error of the measurement (SEM), and Bland and Altman plots. RESULTS: The reliability at all points was excellent for the same rater (ICC_3,1 = .973 - .978, SEM = .042 - .046), and between raters (ICC_2,1 = .939 - .959, SEM = .059 - .097). CONCLUSION: These findings show that the RUSI could be reliable for examining the pectoralis minor muscle thickness in healthy individuals at all measurement sites.

• Physical Therapy Korea
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• v.24 no.2
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• pp.27-36
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• 2017

Background: Research efforts to improve the pulmonary function of people with limited chest function have focused on the diaphragmatic ability to control breathing pattern. Real-time ultrasonography is appropriate to demonstrate diaphragmatic mechanism during breathing. Objective: The purpose of this study was to investigate the effects of diaphragmatic breathing training using real-time ultrasonographic imaging (RUSI) on the chest function of young females with limited chest mobility. Methods: Twenty-six subjects with limited chest mobility were randomly allocated to the experimental group (EG) and control group (CG) depending on the use of RUSI during diaphragmatic breathing training, with 13 subjects in each group. For both groups, diaphragmatic breathing training was performed for 30-min, including three 10-min sets with a 1-min rest interval. An extra option for the EG was the use of the RUSI during the training. Outcome measures comprised the diaphragmatic excursion range during quiet and deep breathing, pulmonary function (forced vital capacity; FVC, forced expiratory volume in 1-sec; FEV1, tidal volume; TV, and maximal voluntary ventilation; MVV), and chest circumferences at upper, middle, and lower levels. Results: The between-group comparison revealed that the diaphragmatic excursion range during deep breathing, FVC, and middle and lower chest circumferences were greater at post-test and that the changes between the pretest and post-test values were greater in the EG than in the CG (p<.05). In addition, the subjects in the EG showed increased post-test values for all the variables compared with the pretest values, except for TV and MVV (p<.05). In contrast, the subjects in the CG showed significant improvements for the diaphragmatic excursion range during quiet and deep breathings, FVC, FEV1, and middle and lower chest circumferences after the intervention (p<.05). Conclusion: These results indicate that using RUSI during diaphragmatic breathing training might be more beneficial for people with limited chest mobility than when diaphragmatic breathing training is used alone.

• PNF and Movement
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• v.9 no.2
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• pp.9-19
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• 2011

Purpose : To provide the understanding of abdominal hollowing exercise, this study reviewed literatures related with TrA and AHE. Methods : We reviewed the prior studies related with TrA and AHE. Results : Crook lying is easier to facilitate isolated contraction of TrA from EO than the others. The contraction of the TrA is shown to be the highest muscle activity in prone lying. Additionally, wall support standing(or standing) is shown a higher contraction of entire abdominal muscle than the others. However, learning and teaching correct AHE have innate difficulties in four positions. Conclusion : We have to consider that Rehabilitative Ultrasonic Imaging(RUSI) can facilitate accurate AHE. In the country, physical therapists will be necessary more training and efforts to use ultrasound because very few use ultrasound in clinical field. It will be necessary to study the effects of RUSI feedback and examine effects of exercises in combination with AHE.

• Physical Therapy Rehabilitation Science
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• v.6 no.1
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• pp.7-13
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• 2017

Objective: The aim of this study was to investigate the inter-rater and intra-rater reliability of rehabilitative ultrasound imaging (RUSI) for measurement of muscle thickness with changes in angles of the gluteus maximus (GM) at rest and during contraction. Design: Cross-sectional study. Methods: Twenty-two healthy men volunteered for this study. GM muscle images were obtained in the resting position and during prone hip extension with knee flexion at hip abduction angles of $0^{\circ}$ and $30^{\circ}$, respectively. Two examiners randomly measured the thickness of the GM twice in three different positions. The first position was a comfortable prone position. The second position was prone hip extension with knee flexion (PHEKF) to $90^{\circ}$. The third position was achieved by hanging a 1-kg weight on the ankle of the lifted leg during PHEKF with the angle of the lifted leg the same as the second position. Intra-class correlation coefficients (ICCs), standard error measurements, and minimal detectable changes were used to estimate reliability. Results: The intra-rater reliability ICCs (95% confidence interval) of the GM were >0.870, indicating good reliability. Inter-rater reliability ICCs ranged from 0.668 to 0.913. The reliability of measurements of muscle thickness at each position was similar to the reliability of the angle change. Differences in muscle thickness and ratios for each position with $0^{\circ}$ and $30^{\circ}$ of hip abduction were not statistically significant. Conclusions: In the present study, the intra-rater reliability of muscle thickness measurements of the GM was good, and the inter-rater reliability was moderate to good. Reliable RUSI measurements of wide and large muscles, such as the GM muscle at rest and during contraction, are feasible. Further investigation is required to establish the reproducibility of the protocols presented in this study.