• Physical Therapy Korea
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• v.30 no.1
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• pp.50-58
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• 2023

Background: This study was carried out to determine whether non-face-to-face physical therapy would have similar exercise effects to face-to-face physical therapy. Hence, we developed an approach for patients, unable to visit hospitals due to circumstances such as the COVID-19 pandemic, to conduct physical therapy comfortably at home. Objects: This study aimed to compare the effects of a face-to-face and a non-face-to-face physical therapy treatment on improving a rounded shoulder posture. Methods: The participants with rounded shoulders were randomly divided into a face-toface group (n = 15) and a non-face-to-face group (n = 15), and each group performed exercises for four weeks. The exercise program consisted of the bare hands exercise, Thera-Band exercise, and foam roller exercise. The participants in the face-to-face group came to a designated place to perform their exercises, and those in the non-face-to-face group performed the exercises at their own home using Google Meet (Google). Acromial height, total scapular distance (TSD), shoulder pain and dysfunction index (SPADI), and pectoralis minor thickness were measured. Data analysis was performed using the R Statistical Software (R Core Team), and a normality test was performed using the Shapiro-Wilk test. Results: There were no significant differences between the face-to-face and the non-face-toface groups (p > 0.05). When comparing the differences before and after the exercises, both the face-to-face and the non-face-to-face groups showed significant differences in acromial height, SPADI, and pectoralis minor thickness (p < 0.05), and both groups showed no significant difference in TSD before and after the exercises (p > 0.05). Conclusion: The results of this study support the results of previous studies reporting that shoulder stabilization exercise and pectoralis minor stretching training improves round shoulders. In addition, this study revealed that both the face-to-face and the non-face-to-face physical therapy treatments had therapeutic effects.

• Journal of Dental Rehabilitation and Applied Science
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• v.16 no.2
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• pp.133-147
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• 2000

A well-planned, precise occlusal adjustment of natural teeth has some distinct advantages over other forms of occlusal therapy. It should be emphasized, however, that an occlusal adjustment is an irreversible procedure and has definite contraindications in some mouths. Generally, the treatment methods for the patients that has open-bite will be following as below. : (1) Use of removable orthopedic repositioning appliance, (2) Orthodontics, (3) Full or partial reconstruction of the dentition, (4) Orthognathic surgical procedure, (5) Occlusal adjustment of the existing natural teeth, (6) Any combination of the above. Above all, the advantages of occlusal adjustment of natural teeth are : (1) the patient is more able to adapt to the changes in jaw position and posture; (2) the phonetic or speaking ability of the patient is not significantly changed and usually is improved; (3) the esthetics of the natural teeth is not altered and often is better; (4) the hygiene of the individual teeth is easily maintained; and (5) the functional usage of the teeth as cutting and chewing devices is markedly improved. The objective of an occlusal adjustment, as with any form of occlusal therapy, is to correct or remove the occlusal interferences, or premature contacts, on the occluding parts of the teeth which prevent a centric relation closure of the mandible. A systematic, disciplined approach can be followed in treatment, the objectives should be listed. They are : (1) Centric relation occlusion of the posterior teeth. (2) Proper "coupling" of the anterior teeth. (3) An acceptable disclusive angle of the anterior teeth in harmony with the condylar movement patterns. (4) Stability of the corrected occlusion. (5) Resolution of the related symptoms. For the patient with open-bite on anterior and posterior teeth, this case report shows the treatment methods in combination the fixed prosthesis with the selective cutting of the natural teeth. Occlusal adjustment is no longer an elective procedure but a mandatory one for patients requiring restorations and those in treatment for TMD dysfunctions or those whose dentitions show signs of occlusal trauma. Occlusal adjustment is essential for all who do not display the above lists.

• Journal of Biomedical Engineering Research
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• v.27 no.5
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• pp.210-217
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• 2006

Many types of interspinous distraction devices (IDDs) have been recently developed as an alternative surgical treatment to laminectomy and fusion with pedicle screws for the treatment of the lumbar spinal stenosis (LSS). They are intended to keep the lumbar spine in a slightly flexed posture to relieve pain caused by narrowing of the spinal canal and vertebral foramen. However, their biomechanical efficacies are not well known. In this study, we evaluated the kinematic behaviors and changes in intradiscal pressure (IDP) of the porcine lumbar spine implanted with IDD. For kinematics analysis, five porcine lumbar spines (L2-L6) were used and the IDD was inserted at L4-L5. Three markers (${\phi}{\le}0.8mm$) were attached on each vertebra to define a rigid body motion for stereophotogrammetric assessment of the spinal motion in 3-D. A moment of 7.5Nm in flexion-extension, lateral bending, and axial rotation were imparted with a compressive force of 700N. Then, IDD was implanted at L3-L4. IDPs were measured using pressure transducer under compression (700N) and additional extension moment (700N+7.5Nm). In kinematic behaviors, insertion of IDD resulted in statistically significant decrease 42.8% at the implanted level in extension. There were considerable changes in ROM at the adjacent levels, but statistically insignificant. In other motions, there were no significant changes in ROM as well regardless of levels. IDPs at the surgical level (L3-L4) under compression and extension moment decreased by 12.9% and 18.8% respectively after surgery (p<0.05). At the superiorly adjacent levels, IDPs increased by 19.4% and 12.9% under compression and extension, respectively (p<0.05). Corresponding changes at the inferiorly adjacent levels were 29.4% and 6.9%, but they were statistically insignificant (p>0.05). The magnitude of pressure changes due to IDD, both at the operated and adjacent levels, were far less than the previously reported values with conventional fusion techniques. Our experimental results demonstrated the IDDs can be very effective in limiting the extension motion that may cause narrowing of the spinal canal and vertebral foramens while maintaining kinematic behaviors and disc pressures at the adjacent levels.

• Journal of Korean Society of Spine Surgery
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• v.25 no.4
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• pp.185-195
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• 2018

Study Design: Literature review. Objective: Ultrasound-guided injections are a common clinical treatment for lower lumbosacral pain that are usually performed before surgical treatment if conservative treatment fails. The aim of this article was to review ultrasound-guided injections in the lumbar and sacral spine. Summary of Literature Review: Ultrasound-guided injections, unlike conventional interventions using computed tomography or C-arm fluoroscopy, can be performed under simultaneous observation of muscles, ligaments, vessels, and nerves. Additionally, they have no radiation exposure and do not require a large space for the installation of equipment, so they are increasingly selected as an alternative method. Materials and Methods: We searched for and reviewed studies related to the use of ultrasound-guided injections in the lumbar and sacral spine. Results: In order to perform accurate ultrasound-guided injections, it is necessary to understand the patient's posture during the intervention, the relevant anatomy, and normal and abnormal ultrasonographic findings. Facet joint intra-articular injections, medial branch block, epidural block, selective nerve root block, and sacroiliac joint injections can be effectively performed under ultrasound guidance. Conclusions: Ultrasound-guided injections in the lumbar and sacral spine are an efficient method for treating lumbosacral pain.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.6 no.1
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• pp.74-89
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• 1995

Selective mutism is a childhood condition defined by persisten failure to speak in specific social situation when speaking is expected, dispite preserved ability to comprehend spoken language and speak. Present study is to investigate clinical characteristics, treatment method and outcome of 23 children who were diagnosed as selective mutism by DSM-IV criteria at the child psychiatry ouptatient department of SNUH. The results were as follows : 1) The Sex ratio was 1: 4.8, female dominant Mear age of onset was 33 years old and mean age of first referral was 7.7 years old. 2) 22% of subjects had perinatal problem such as low birth weight, preterm birth, 26% of the subjects have history of delayed language development. There are subjects who had been separated with mam caretaker before 3 years old(26%) and who experienced physical or psychological trauma before 3 years old(26%). A few subjects had enurests(30%) and encoprests(4%). 3) Many subjects(65%) had symbiotic relationship with their mother. These families consist of dominant, verbally aggressive mother and passive father. Parents of 39% of all subjects were judged to have definite psychopathology(social phobic, depression, hysterical trait or alcohol problem) 26% of all subject, were reported physically abused. 4) The personality trait of the subjects were frequently described as follows(in order of frequency) ; Shy(100%), anxious(83%), stubborn(83%)m rigid and tense posture(78%), immature(65%) overdependent(65%), irritable(52%), manipulative(39%), depressive(39%). 5) The mean performance IQ of 16 subjects by KEDI-WISC was 88.3 Among them, the subjects with IQ below 69 were seven and those with IQ above 70 were nine. When comparing these two group(Mental retardation group vs Normal IQ group), we could find some difference in language development, personality trait, family dynamics and treatment outcome. 6) Among several treatment methods for selective mutism, play therapy was the most frequently used method(65%). Other commonly used treatment methods were pharmacotherapy(21%), behavioral therapy(8%), combined therapy(play therapy+pharmacotherapy+family therapy+behavioral therapy)(12%), 7) Regarding the outcome of treatment 8.6% was evaluated as Excellent, 30.4% as Good, 52% as Fair, 8.7% as Poor at the tinic of treatment. At follow up interview 21.7% was evaluated Excellent, 13% as Good, 21.7% as Fair, 34.8% as Poor. 8) We classified all subjects by Havden's 4 subtype. Symbiotic mutism was most common(65%) and other subtypes are Speech phobic mutism(8.6), Reactive mutism(13%) and Passive-aggressive mutism(30%).

• Journal of Korean Physical Therapy Science
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• v.6 no.3
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• pp.125-143
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• 1999

The purpose of this study was to investigate the need and understanding about the physical therapy. The subjects of this study were 101 licensee nurses who was taking the home nursing trainers. The results were as follows: 1. The home nursing trainers(97.1%) were required the need for home physical therapy service. The reasons which requires the home physical therapy were 'the increased elderly patients(97.0%)', 'the early leaving of the hospital(96.0.%)', 'the lack of caretakers(96.0%)', and 'the increased chronic patients(96.0%)'. 2. The ratio of affirmation of home physical therapy system was 97% of the home nursing trainers, the reasons which were helped the patients was 'the saved time(97.0%)'. 'the decreased psychological stress(95.0%)' 'the continuing treatment after discharge(93.0%)' and 'the teaching patients and caretakers(93.0%)'. 3. The main center which was organized the home physical therapy service was 'the department of home physical therapy arid the home nurse(42.6%)', 'the department of home nurse(22.8%)', and 'the department of home physical therapy(1l.9%)'. 4. The home nursing trainers wanted to learn the home physical therapy methods for chronic patients(95.0%). The contents of home physical therapy methods was 'the therapeutic exercise for preventing deformity(15.4%)', and 'maintenance of normal posture and howe to change body position(12.4%)'. 5. Statistically significant difference in the teams (the home physical therapy, the home nurse, and the home physical therapy with the home nurse) was found between the age groups, and statistically significant difference in the teams was found between the educational degree groups.

• Physical Therapy Korea
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• v.23 no.2
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• pp.75-83
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• 2016

Background: Several studies have discussed diverse exercise methods considered to be useful for the selective contraction of the vastus medialis oblique (VMO) muscle for the treatment of patellofemoral pain syndrome. Some studies have reported that exercise methods, including hip adduction, in closed kinetic chain exercises are more effective in terms of the muscle activation of the VMO and the timing of the muscle's initial contraction. We focused on isometric contraction during a closed kinetic chain exercise with hip adduction. Objects: The purpose of this study was to examine muscle activation in the VMO and the vastus lateralis (VL) and the onset time difference between their initial contractions via closed kinetic chain isometric quadriceps femoris exercises including hip adduction. Methods: In total, 36 healthy subjects adopted two hip positions during isometric contraction of the quadriceps femoris in a closed kinetic chain exercise (hip neutral and hip adduction position). Statistical analyses were conducted using a paired t-test (${\alpha}=.05$). Results: Isometric contraction of the quadriceps femoris in a closed kinetic chain exercise caused a greater increase in VMO muscle activity in the hip adduction position [$52.68{\pm}22.21$ percentage of maximal voluntary isometric contraction (%MVIC)]than the hip neutral position ($43.43{\pm}19.85%MVIC$). The onset time difference (VL-VMO) decreased more in the hip adduction position ($-82.14{\pm}34.2ms$) than the hip neutral position ($73.94{\pm}2.94ms$). Conclusion: We recommend this exercise as a clinically useful therapeutic method for patients with patellofemoral pain syndrome due to weakening of the VMO muscle and lateral inclination of the patella.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.6 no.1
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• pp.69-79
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• 2008

In this paper, the effects of the external-rotation exercise on the gait of hemiplegia was investigated. 26 patients with hemiplegia due to cerebrovascular accident participated in this study. Subjects were randomly assigned to experimental group(n=12) and control one(n=14). 12 subjects of the experimental group were received the external rotation reducing exercise on the mat with seating and supine posture after the general therapeutic exercise for hemiplegia. 14 subjects of the control group were received only general therapeutic exercise. The effects of external rotation reducing exercise were evaluated by measurements of gait velocity, cadence, stride length, step length and foot angle using ink-foot prints. The collected data were analyzed statistically based on Wilcoxon, Mann-Whitney and correlation analysis. After treatment of three weeks, it turned out that external rotation reducing exercise has the significant effect on foot angle(p<0.01). However the exercise has no statistically significant direct effect on the gait velocity, cadence, stride length and step length.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.1
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• pp.1-10
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• 2014

PURPOSE: The purpose of this study was to investigate the effects of flexible derotator of femur orthosis (FDO) during treadmill gait training on the quadriceps-angle (Q-angle), lateral pelvic tilt, gait speed, and number of steps in children with cerebral palsy. METHODS: Seven children with cerebral palsy who had rotational deformity of the lower extremities participated in this study. We used single group repeated measure design. The procedure consisted of baseline phase, intervention phase, and post-intervention phase. The baseline phase consisted of stretching and strengthening exercise and treadmill gait training without FDO. The treatment phase not only included the same procedures as those for baseline, but also included FDO during treadmill gait training. Postural alignment of the lower extremities was assessed with the Q-angle, and lateral pelvic tilt using the Dartfish software program. A 10-m walk test was used to evaluate gait speed and number of steps. RESULTS: For postural alignment, there was significant differences after the application of FDO (p<.05). For gait ability, there was significant differences in all phases (p<.01). CONCLUSION: These finding suggest that the application of FDO during treadmill gait training had a positive effect on the improvement of postural alignment and gait ability in children with cerebral palsy having rotational deformity.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.1
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• pp.63-68
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• 2014

PURPOSE: The purpose of this study was to examine the position changes with tilt table on autonomic nervous system using heart rate variability analysis. METHODS: Fourty healthy adult males volunteered in this study. The low frequency, high frequency and low frequency/high frequency ratio and mean heart rate, standard deviation of all normal R-R intervals, root mean square of successive differences, heart rate variability index were measured at the tilt table angle of $0^{\circ}$, $45^{\circ}$ and $90^{\circ}$ with pulsoximeter. Data were analyzed one-way ANOVA and LSD post hoc test. RESULTS: The mean heart rate, low frequency and low frequency/high frequency ratio increased significantly at higher angle of tilt table(p<.05). The root mean square of successive differences, heart rate variability index decreased significantly at lower angle of tilt table(p<.05). The standard deviation of all normal R-R intervals, high frequency decreased at higher angle of tilt table did not show significant difference. CONCLUSION: The symphathetic activity increased significantly at higher angle of tilt table. The parasymphathetic activity decreased at higher angle of tilt table, but the difference were not significant. The autonomic adaptation, balance and heart rate variability decreased significantly at higher angle of tilt table. Based on these results, in the treatment of patients with a change in posture precedence should be carefully treated. Further studies are necessary to determine the most safety and effective methods.