Objectives: The purpose of this study was to compare the difference of Lumbar Lordosis Angle (LLA)between patients with Low Back Pain (LBP) and control groups. Methods: Questionnaires were completed by 40 adults LBP patients seeking physical therapy services and by 40 controls at the department of Physical Therapy, SaeJong Neurosurgical Clinic in Taegu city, South Korea from October 1999 to March 2000. LLA was measured on lateral x-ray films with standing position. The angle between a line parallel to tile top of the first Lumbar (Ll) and the top of the fifth Lumbar (L5) was defined LLA. Results: LLA of 29.88$^{\circ}$ for LBP patients was statistically significant decrease from that of 35.31$^{\circ}$ for controls in the difference of lumbar lordosis (p<0.01). There were statistically significant differences between genders in patients groups. Females(32.22$^{\circ}$) had significantly greater angles than males (27.32$^{\circ}$) (p<0.05), while 36.63$^{\circ}$ for female was also greater than 34.12$^{\circ}$ for male in the controls. No significant difference was found between age. In patient groups, 27.95$^{\circ}$ for below age 40 was a smaller than 32.32$^{\circ}$ for above, however, 35.82$^{\circ}$ for below age 40 was a little greater than 34.27$^{\circ}$ for above in controls. Patients in sitting posture had greater LLA (31.35$^{\circ}$). than those standing (28.93$^{\circ}$), however. values for controls were similar to each other. Conclusions: Results from this study indicate that distinct difference exist among patients and controls and gender, whereas little difference exists in age and working posture.
The Axes and Adzes are the oldest tools since the beginning of human history which is used to cut the tree and make part of architecture such as boards, square timber etc. Nowadays, these old woodworking tools especially "Jagui(자귀)" (adze) has been almost disappeared at the working site of residential and cultural properties. It is necessary to study Korean traditional woodworking tools to keep Korean traditional skill and technology. It has been reviewed the change of shape of "Jagui(자귀)" (adze) from before Samhan (삼한) period to Joseon Dynasty through excavated relics and paintings and summarize as follows: Based on excavation relics of Dahori, both plate type blade and pocket type blade are used for "Tokki(도끼)" (axe) and "Jagui(자귀)" (adze). The excavated "Jagui(자귀)" (adze) from Jeongbaikri 356 tomb, near Pyongyang is prototype of "Jagui(자귀)" (adze) used nowdays which has almost same shape as well as the insert method of blade and handle. The auxiliary handle is inserted to blade and the main handle is inserted to the auxiliary handle which is different from the method of Chinese and Japanese "Jagui(자귀)" (adze). The length of handle of "Jagui(자귀)" (adze) until late Joseon Dynasty is short by which we assume it is used for a sitting position as hand held Jagui and from that time long handle has been introduced for a standing position which is called "Sunjagui(선자귀)". "Jagui(자귀)" (adze) has been used since the beginning of human history but it is almost disappeared at the most of woodworking site which is the crisis of Korean traditional architecture and we have to do something to keep it.
Background: Shoulder external rotation exercises are commonly used to improve the stabilizing ability of the infraspinatus. However, during exercise, excessive activation of the posterior deltoid compared to the infraspinatus causes the humeral head to move anteriorly in an abnormal position. Many researchers have emphasized selective activation of the infraspinatus during shoulder external rotation exercise. Objects: This study aims to delineate the optimal exercise method for selective activation of infraspinatus by investigating the muscle activities of the infraspinatus and posterior deltoid according to the four shoulder exercise methods and two forearm positions. Methods: Thirty healthy individuals participated in this study. The participants were instructed to perform shoulder external rotation exercises following four exercise methods: sitting external rotation (SIER); standing external rotation at 90° abduction (STER); prone external rotation at 90° abduction (PRER); side-lying external rotation (SLER), and two forearm positions (neutral, supinated). The electromyography (EMG) signal amplitude was measured during each exercise. Surface EMG signals were recorded from the posterior deltoid, infraspinatus, and biceps brachii. Results: EMG results of the infraspinatus and posterior deltoid in PRER, were significantly higher than that of the other exercises (p < 0.01). The EMG ratio (infraspinatus/posterior deltoid) in SIER was significantly higher than that of the other exercises. EMG activation of the posterior deltoid in SIER, PRER, and SLER was significantly higher in neutral than in supinated (p < 0.01). Furthermore, the EMG of the infraspinatus in SIER was significantly higher in neutral than in supinated (p < 0.01). The EMG ratio (infraspinatus/ posterior deltoid) in SIER was significantly higher in neutral than in supinated (p < 0.05.) Contrarily EMG ratios in PRER and SLER were significantly higher in supinated than in neutral (p < 0.05). Conclusion: The results show that clinicians should consider these exercise methods and forearm positions when planning shoulder external rotation exercises for optimal shoulder rehabilitation.
Objectives : The purpose of this study was to present clinical utility of therapeutic exercise on the neck and shoulder parts based on the movement system impairment syndrome(MSIS) as Dong-Qi therapy of the Dong-Si Acupuncture and was to examine which Dong-Si acupoints were most effective and non-invasive when performing therapeutic exercise of the MSIS. Methods : Totally eight therapeutic exercises correspondent to eight neck and shoulder MSIS were summarized and tabulated from the Diagnosis and Treatment of Movement Impairment Syndrome and Movement System Impairment Syndromes Of The Extremities, Cervical and Thoracic Spines by Sahrmann SA. Together with the MSIS summaries, acupuncture points and Dong-Qi therapy were summarized and tabulated from Yangweijiequanji 1 and Yangweijiequanji 2 by Yangweijie. According to the posture and movement of the MSIS exercise, effective and non-invasive acupoints were selected. Thereafter, clinical pilot study which five normal volunteers participated in were performed to examine whether these acupoints resulted in any side effects of acupuncture therapy such as pain and distortion of the needle during the MSIS exercises. Results : Through clinical pilot study, ZhongZi, ZhongXian, ZhengJin, ZhengZong and MuLiu in a sitting position, and HuaGuYi, ZhongZi and ZhongXian in a supine position were finally determined as safe and non-invasive Dong-Si acupoints to treat cervical pain. In terms of shoulder pain, ZuQianJin, ZuWuJin, HuaGuEr and JianZhong in a supine position, SiHuaZhong, ZuQianJin, ZuWuJin, QuLing, JianZhong, ShenGuan and JiuLi in a standing position, and ZuQianJin, ZuWuJin, HuaGuEr, QuLing and JianZhong in a prone position were finally accepted as safe and non-invasive Dong-Si acupoints. Conclusion : It is concluded that Dong-Si acupoints can be safely and non-invasively used together with therapeutic exercises of the MSIS to treat cervical and shoulder pains.
The purpose of this study was to investigate the effects of diaphragmatic breathing on activation of trunk muscles of patients with low back pain. Diaphragmatic breathing may affect activation of trunk muscles. The assumptions are as follows: the crural diaphragm attatches to the lumbar vertebrae from L1 to L3, the voluntary downward pressurization of the diaphragm increases intra-abdominal pressure, and this increases the stiffness of the spine. Diaphragmatic breathing increases intra-abdominal pressure and the increased intra-abdominal pressure may contribute to the lumbar stability. Sixty patients with low back pain were randomly divided into two groups. Experimental group performed diaphragmatic breathing exercise with six breathing positions and control group performed only the breathing positions for five times per week during six weeks. % maximal voluntary contraction(% MVC) of trunk muscles on six breathing positions of experimental and control group was measured according to testing period of pre test, three weeks, and six weeks. The repeated measures of one-way ANOVA were used to analyze % MVC on trunk muscles of experimental and control group according to testing period. The results of this study were as follows: First, % MVC of right and left erector spinae in the right leg extension position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Second, % MVC of right and left erector spinae in all-four positions indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Third, % MVC of right and left erector spinae, external oblique in the sitting position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Fourth, % MVC of right and left erector spinae, external oblique in the standing position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Fifth, % MVC of right and left erector spinae, external oblique in the supine position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Sixth, % MVC of right and left erector spinae, external oblique in the lying on prone position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). In conclusion, as experimental group performed diaphragmatic breathing exercise according to the period of pre-test, post three weeks, and post six weeks, experimental group showed the greater significant effect on the activation of right, left erector spinae, and external oblique muscle. Diaphragmatic breathing exercise which resulted in activation of trunk muscles can be effective for managing the patients with back pain and should be utilized as the new therapeutic intervention.
Purpose : This study aimed to examine the relationships among five clinical measures for functional alignment of the lower extremity. Methods : Thirty healthy subjects (15 males and 15 females) were recruited for the study. The five clinical measures of functional alignment of the lower extremity included navicular drop, quadriceps angle, internal rotation of hip, and anterior and lateral pelvic tilt angles. The level of navicular drop was calculated by the difference between the height of the navicular bone in the sitting (non-weight bearing) and standing (weight bearing) positions. The quadriceps angle and internal rotation of hip were measured using a standard goniometer with photographic markers while the subjects were lying in a prone position on a table with their knee at $90^{\circ}$ flexion. Anterior and lateral pelvic tilt angles were determined using a inclinometer. Results : Correlation and a simple linear regression analysis were used to assess relationships between the clinical measures. There were significant correlations between navicular drop and quadriceps angle (p<.05), between navicular drop and internal rotation of hip (p<.05), and between quadriceps angle and internal rotation of hip (p<.01). In simple linear regression analysis, the navicular drop appeared to be a factor affecting the quadriceps angle and internal rotation of hip (p<.05). The findings suggest that navicular drop has a great impact on lower extremity alignment. Conclusion : This study might help us to examine lower extremity function and clarify its role as a potential injury risk factor.
Purpose: The study compared the muscle activity and ratio of upper trapezius (UT) to lower trapezius (LT) activity between acute and chronic whiplash-associated disorder (WAD) patients. Methods: Twelve healthy (male: 7), 14 acute WAD (male: 7), and 11 chronic WAD (male: 3) volunteers participated in this study. Electromyography using a surface EMG recorded the activity of the upper trapezius and lower trapezius of both shoulders (dominant and non-dominant) during $120^{\circ}$ elevation when standing and shoulder depression when sitting. The testing order was selected randomly. Subjects were asked to maintain each experimental position for 5 seconds at end range. EMG activity was normalized using the maximal voluntary isometric contraction (MVIC) elicited using a manual muscle-testing technique. One-way repeated measures analysis of variance (ANOVA) was used to compare the average root mean square (RMS) value of EMG activity for each condition. Results: The EMG activity of the dominant UT for chronic WAD subjects was significantly higher than for acute WAD subjects during $120^{\circ}$ elevation (p<.05). The EMG activity of the dominant LT for acute WAD subjects was significantly lower than for the control group (p<.05) during $120^{\circ}$ elevation. The EMG activity of the dominant LT for WAD patients was significantly lower than for the control group during shoulder depression (p<.05), and the chronic WAD patients scored significantly the lowest (p<.01). The dominant UT/LT for chronic WAD patients was significantly higher than the ratio for acute WAD subjects during shoulder depression (p<.05); this result was higher than for the control group (p<.01). The non-dominant UT/LT (ratio) for chronic WAD patients was significantly higher than the ratio for acute WAD subjects during shoulder depression (p<.05). Conclusion: The UT for chronic WAD subjects was hyperactive when compared to the acute WAD subjects, and the was hypoactive for both acute and chronic patients, therefore intra-trapezius imbalance was more prevalent during shoulder depression.
Purpose : Shoulder subluxation is a very common problem in patients with hemiplegia with stroke. Prevention of the low tone subluxed shoulder has been an issue for physical therapists working with neurological patients for many years. Methods : This study reviewed the literature to definite the management and a cause of shoulder subluxation with hemiplegia patients after stroke. Various modalities have been suggested for realigning the glenohumeral joint, but their use is controversial. The purpose of this paper is to review critically the evidence base in order to inform the clinical decision-making process for physiotherapists working in neurology. Results : Literature has identified supports, strapping and functional electrical stimulation(FES) in the management of low tone shoulders. Following review of this evidence it is suggested that there is a lack of reliable and valid research evidence on which to base conclusions. The modalities with the best supporting evidence for realigning the low tone subluxed glenohumeral joint are the triangular sling, Harris hemi sling and the Rolyan humeral cuff used in a standing position and the lap board and arm trough while the patient is sitting. However, due to soft tissue adaptation with associated lack of movement, over-correction and the need for careful patient positioning these supports need to be evaluated for each patient and should be used only in appropriate situations. Conclusion : Similarly, there is a lack of evidence on the effects of long-term use to this equipment. Electrical stimulation is also thought to have potential in the treatment to subluxed low tone shoulders but additional research is required to clarify the parameters for use and the long-term effects of these forms of management.
Purpose: This study examined the effects of sagittal spinopelvic alignment on the clinical parameters, motor symptoms, and respiratory function in patients with mild to moderate Parkinson's disease (PD). Methods: This study was a prospective assessment of treated patients (n=28, Hoehn and Yahr (H&Y) stage 2-3) in a PD center. Twenty-eight subjects ($68.5{\pm}5.7yrs$) participated in this study. The clinical and demographic parameters, including age, sex, symptoms duration, treatment duration, and H&Y stage, were collected. Kinematic analysis was conducted in the upright standing posture with a motion capture system. A pulmonary function test (PFT) was performed in the sitting position using a spirometer. The motor symptoms were assessed on part III of the movement disorder society sponsored version of the unified Parkinson's disease rating scale (MDS-UPDRS). SPSS 18.0 was used to analyze the collected data. Results: The exceeding 12 degrees group of the lower trunk showed significantly higher on the clinical parameters than the below 12 degrees group. In addition, the exceeding 12 degrees group of the lower trunk showed a significantly lower forced expiratory volume at one second (FEV1) / forced vital capacity (FVC) (%) and 25-75% forced mid-expiratory flow (FEF) (L/s) than in the below group. On the other hand, there was no difference in the upper trunk and the cervical pelvis between the groups. Conclusion: These findings suggest that the sagittal balance in the lower trunk is related to the clinical parameters and respiratory function, but not the motor symptoms in patients with mild to moderate PD.
감각장애는 뇌졸중에서 흔히 나타나며, 발에서 나오는 촉각의 감각정보는 균형을 위해 중추신경계에 중요한 정보를 제공한다. 본 연구의 목적은 뇌졸중 환자의 발바닥 감각역치와 균형의 상관관계를 연구하는 것이다. Semmes-Weinstein Monofilaments를 사용하여 발바닥의(엄지발가락과 뒤꿈치) 감각역치를 평가하였다. 균형은 버그균형척도와 MTD system을 이용하여 정적 선 자세와 앉은 자세에서 일어서기 동안의 마비쪽과 비마비쪽의 체중 분포 정도를 측정하였다. 정적 선 자세와 앉은 자세에서 일어서기 동안 체중 분포 정도는 비마비쪽보다 마비쪽에서 더 낮았다(P<0.05). 버그균형척도는 36.00±1.53이었다. 마비쪽의 엄지발가락 감각역치는 버그균형척도(r=-0.444, P<0.05), 정적 선 자세(r=-0.332, P<0.05), 앉은 자세에서 일어서기(r=-0.390, P<0.05)와 상관관계가 있었다. 마비쪽의 뒤꿈치 감각역치는 버그균형척도(r=-0.467, P<0.05), 정적 선 자세(r=-0.532, P<0.05), 앉은 자세에서 일어서기(r=-0.516, P<0.05)와 상관관계가 있었다. 이러한 결과는 발바닥의 높은 감각역치가 균형 능력 저하에 영향을 미칠 수 있음을 시사한다. 앞으로 뇌졸중 환자의 감각 역치에 대한 연구는 뇌졸중 환자의 재활과 감각 평가에 도움이 될 것이다.
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