• Physical Therapy Rehabilitation Science
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• v.10 no.2
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• pp.235-243
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• 2021

Objective: This study aimed to investigate the short-term effects of flexion-distraction spinal manipulation on intervertebral height, pain, spine mobility in patients with lumbar degenerative disc disease. Design: Randomized controlled trial with a pretest-posttest control group design Methods: A total of 96 participants with degenerative disc disease participated in the study and were randomly divided into two groups. Both groups received intervention for 3-5 minutes a day. The experimental group (n=48) underwent flexion-distraction spinal manipulation for 3-5 minutes, and the control group (n=48) was maintained in the same position as the experimental group for 5 minutes without any intervention. The intervertebral height was measured by computed tomography, pain was assessed using visual analog scale, and the spine in flexion mobility was measured using the finger-to-floor distance test and passive straight leg raise test. Pre-test and post-test measurements were obtained. Results: The experimental group showed significant improvement in intervertebral height, degree of pain, and spinal mobility (p<0.05). The intervertebral height increased from 6.32±1.90 to 6.93±1.85 mm (p<0.05), lower back pain decreased from 69.17±13.35 mm to 48.48±12.20 mm (p<0.05), lumbar spine mobility changed from 17.37±4.49 to 12.69±4.34 cm (p<0.05), and passive straight leg raise test range increased from 46.94±13.05° to 56.01±12.20° (p<0.05). Conclusions: This study suggests that flexion-distraction spinal manipulation could be an effective treatment for decreasing pain and improving function in patients with degenerative disc disease.

• Clinical Pain
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• v.19 no.2
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• pp.90-96
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• 2020

Objective: To investigate the diagnostic accuracy of two physical examinations (straight leg raise [SLR] and Bragard test) and electromyography (EMG) in patients with lumbosacral monoradiculopathy in acute and chronic state on confirmation of different diagnostic criteria (MRI vs MRI and diagnostic selective nerve root block [DSNRB]). Method: We identified 297 participants retrospectively from the departmental database. MRI evidence of L5 or S1 nerve root compression and a positive result in diagnostic SNRB served as reference standards. They were divided into two groups by the symptom duration: lasting more than 12 weeks in the chronic group and less than 12 weeks in the acute group. The diagnostic value of clinical tests and EMG were compared. Results: The clinical tests (SLR and Bragard test) done in acute stage on detection by MRI and DSNRB had the highest sensitivity (68%) compared to the chronic stage (63%), but sensitivity was low (57%) on confirmation of MRI alone. However, there was no significant difference on sensitivity and specificity of EMG regardless of reference standards and symptom duration. Electromyography was a significant predictor of neuropathic abnormalities on both acute (OR, 6.3; 95% CI, 2.4 to 16.7; p<0.01) and chronic (OR, 6.8; 95% CI, 2.9 to 16.3; p<0.01). Conclusion: In general, individual physical tests are easy to do and a combination of those tests could be a sensitive indicator of L5 or S1 radiculopathy. Furthermore, the use of provocation tests could provide useful information, especially in proceeding therapeutic selective nerve root block.

• Biomedical Engineering Letters
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• v.8 no.4
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• pp.345-353
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• 2018

This study suggested a new EMG-signal-based evaluation method for knee rehabilitation that provides not only fragmentary information like muscle power but also in-depth information like muscle fatigue in the field of rehabilitation which it has not been applied to. In our experiment, nine healthy subjects performed straight leg raise exercises which are widely performed for knee rehabilitation. During the exercises, we recorded the joint angle of the leg and EMG signals from four prime movers of the leg: rectus femoris (RFM), vastus lateralis, vastus medialis, and biceps femoris (BFLH). We extracted two parameters to estimate muscle fatigue from the EMG signals, the zero-crossing rate (ZCR) and amplitude of muscle tension (AMT) that can quantitatively assess muscle fatigue from EMG signals. We found a decrease in the ZCR for the RFM and the BFLH in the muscle fatigue condition for most of the subjects. Also, we found increases in the AMT for the RFM and the BFLH. Based on the results, we quantitatively confirmed that in the state of muscle fatigue, the ZCR shows a decreasing trend whereas the AMT shows an increasing trend. Our results show that both the ZCR and AMT are useful parameters for characterizing the EMG signals in the muscle fatigue condition. In addition, our proposed methods are expected to be useful for developing a navigation system for knee rehabilitation exercises by evaluating the two parameters in two-dimensional parameter space.

• Physical Therapy Rehabilitation Science
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• v.12 no.2
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• pp.92-104
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• 2023

Objective: The purpose of this study was to investigate the effect of spinal mobilization with leg movement (SMWLM) and neural mobilization (NM) in patients with lumbar disc herniation (LDH) accompanied by radiating pain. Design: Three-group pre-test-post-test control group design. Methods: We enrolled 48 participants, whom we randomly assigned to three groups. The SMWLM group (n=16) underwent 20 min of conventional physical therapy (CT) and 20 min of SMWLM. The NM group (n=16) underwent 20 min of CT and 20 min of NM. The control group (n=16) underwent 20 min of CT. These interventions in all the groups were performed three times a week for 4 weeks. Numeric pain rating score (NPRS), body grid chart score (BGCS), passive straight leg raise (PSLR), active lumbar flexion range of motion (ALFROM), korean version oswestry disability index (KODI), and korean version fear avoidance beliefs questionnaire (KFABQ) were measured pre- and post-intervention. Results: In all three groups, the NPRS, PSLR, KODI, and KFABQ scores were significantly different pre- and post-intervention (p<0.05). Significant differences were observed in BGCS and ALFROM in the SMWLM and NM groups pre- and post-intervention (p<0.05). The SMWLM group showed more improvement in the NPRS of leg pain, ALFROM, and KFABQ score than that exhibited by the NM and control groups (p<0.05). Conclusions: Both SMWLM and NM were effective for improving back and leg pain, centralization of symptoms, mechanical sensitivity, lumbar mobility, lumbar functional disability, and psychosocial functioning in patients with LDH with radiating pain.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.4
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• pp.113-121
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• 2018

PURPOSE: This study was conducted to identify a more effective intervention in sling and resistance exercise for chronic low back pain patients. METHODS: Seventy (70) subjects were randomly divided into the sling group (SG) and resistance exercise group (REG). Muscular activity of the internal oblique (IO), external oblique (EO), rectus abdominis (RA), and pelvic rotation angle during active straight leg raise (ASLR), a pressure pain threshold (PPT) and a visual analog scale (VAS) were measured. Sling and resistance exercises were conducted for 12 weeks. Intermediate measurements were taken after 8 weeks and final measurements were taken after 12 weeks. RESULTS: Both groups showed significantly decreased RA muscle activity and significantly increased IO muscle activity (p<.05). Additionally, EO muscle activity was significantly decreased in the REG, but significantly increased in the SG (p<.05), while the pelvic rotation angle and VAS were significantly decreased in the SG (p<.05). The pressure pain threshold was significantly increased in both groups (p<.05). CONCLUSION: Based on the results of this study, a 12-week intervention seems to be effective at improving back pain in both groups. However, a lower VAS was seen in the sling group after 8 weeks of intervention. Therefore, it is recommended that the sling be applied first when establishing a chronic back pain treatment program to shorten the treatment period and reduce the pain period.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.15 no.2
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• pp.63-73
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• 2020

Objectives The purpose of this study was to investigate the possibility of spinal mobilization with leg movement (SMWLM) using Korean Medicine treatment on acute lower limb muscle weakness through four case studies. Methods SMWLM, with other Korean Medicine treatments, was performed on four patients who underwent treatment at OOOO Korean Medicine Hospital from August 2017 to July 2018. Additionally, results of the Numerical Rate Scale(NRS), EuroQol-FiveDimensions(EQ-5D),Oswestry lowback pain disability questionnaire(ODI), Straight Leg Raise(SLR) test, and Manual Muscle Test(MMT) were evaluated. Results There was a significant increase in NRS, ODI, and EQ-5D scales with im-rovements of SLR angle and MMT figures to a normal range. Conclusions This study suggested that Korean Medicine treatment combined with SMWLM may affect treating acute lower limb muscle weakness. Further clinical studies are needed to establish a definite conclusion.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.11
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• pp.7439-7446
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• 2015

The purpose of this study was to find the risk factors of injury by FMS and to investigate the effects of 12-weeks' combined training program on body imbalance, physical fitness, muscle strength and FMS score in woman rugby players of the national team. Fourteen subjects were woman rugby national players to participate in the 17th Incheon Asian Games. These players tested FMS and performed 12 weeks' (May~Aug, 2014) combined training program (4days, 120min${\geq}$). Statistical evaluation was undertaken using paired t-test (pre vs. post). The results of this study were as follows; Frist, the score of FMS test on Deep Squat, Hurdle Step, Active Straight Leg Raise, and Trunk Stability Push up were significantly increased after 12 weeks' combined training program (p<.05), and also Inline Lunge (p<.01) and Rotary Stability (p<.001) were significantly increased. However, Shoulder Mobility was not significantly increased(p=.104) although the tendency of increased was FMS score. Second, the sum of the entire item was significantly increased after combined training(p<.001). These results suggest that 12-weeks' combined training program has effect of improving FMS score and low-injury risk in woman rugby national players. Therefore, we consider that FMS have effect on prevention of athletic injury and improvement of athletic performance in woman rugby national players.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.1
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• pp.336-343
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• 2013

The purpose of the present study was to determine the effect of 4 weeks course of motorized spinal decompression delivered via SpineMT(mobilization & traction) combined with therapeutic modalities on the treatment of patients with lumbar radiculopathy(LRP). A total of 15 patients with LRP (mean age, 36.63 years; age range 20-50years) participated in this study. 4 weeks course of spinal decompression delivered via SpineMT combined with therapeutic modalities was delivered to the patients for 6 days per week for the first two weeks, and four times per week for two additional weeks. The entire treatment consisted of 20 visits over 4 week period. Comparisons of changes in the muscle strengthening (MS), straight leg raise (SLR), and Oswestry disability index (ODI) at pre-intervention, after 10 treatment sessions, and at discharge (after 20 treatment sessions) were analyzed. There were significant improvements in the outcome measures of MS test, SLR test, and ODI score after 10 and 20 sessions of spinal decompression treatment combined with therapeutic modalities as compared with the pre-intervention(p<0.05). Spinal decompression treatment combined with therapeutic modalities appears to be a safe and efficacious, noninvasive treatment modality for patients with LRP.

• Journal of Korean Neurosurgical Society
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• v.52 no.2
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• pp.156-158
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• 2012

Intervertebral intradural lumbar disc herniation (ILDH) is a quite rare pathology, and isolated intradural lumbar disc herniation is even more rare. Magnetic resonance imaging (MRI) may not be able to reveal ILDHs, especially if MRI findings show an intact lumbar disc annulus and posterior longitudinal ligament. Here, we present an exceedingly rare case of an isolated IDLH that we initially misidentified as a spinal intradural tumor, in a 54-year-old man hospitalized with a 2-month history of back pain and right sciatica. Neurologic examination revealed a positive straight leg raise test on the right side, but he presented no other sensory, motor, or sphincter disturbances. A gadolinium-enhanced MRI revealed what we believed to be an intradural extramedullary tumor compressing the cauda equina leftward in the thecal sac, at the L2 vertebral level. The patient underwent total L2 laminectomy, and we extirpated the intradural mass under microscopic guidance. Histologic examination of the mass revealed a degenerated nucleus pulposus.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.3
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• pp.45-53
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• 2021

PURPOSE: The current case study focuses on identifying the effects of the independent application of TECAR therapy and physiotherapeutic intervention using TECAR therapy on pain self-awareness and hip joint function in patients with hip impingement syndrome caused by nonstructural changes. Subjects: The research subject was a 34-year-old woman struggling with acute pain in her left hip, difficulty in actively moving the hip, and a problem in its overall function. METHODS: The subject's pain awareness and hip joint function were measured using a Visual Analog Scale (VAS) and passive range of motion (PROM), respectively. The experimental intervention was carried out in 24 sessions of 16 minutes each, three times a week, for eight weeks. RESULTS: The VAS score decreased to 0 cm on the post-test from 4.3 cm, 6.5 cm, and 7.2 cm in the pre-test at the rest, standing, and gait positions, respectively. The index of PROM measured hip joint flexion, extension, abduction, adduction, internal rotation, external rotation, and passive straight leg raise. The values increased to 122.5°, 24.5°, 78°, 33°, 65°, 42°, and 96.5° in the post-test compared to 88.5°, 15°, 39°, 21.5°, 23°, 22°, and 46.5° in the pre-test, respectively. CONCLUSION: TECAR therapy and physiotherapeutic intervention using TECAR can help reduce pain and enhance the hip joint function in patients with hip impingement syndrome.