• 한국전문물리치료학회지
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• 제20권2호
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• pp.28-37
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• 2013

This study examined differences in the activity of upper limb muscles according to how an ultrasound head is gripped. Twenty-two adult males were participated in the study. Each participant was asked to apply ultrasound treatment on to a lump of pork meat by two different ultrasound head grip patterns: spherical and cylindrical grips. Muscle activity was measured in the extensor carpi radialis longus (ECRL), flexor carpi ulnaris (FCU), and pronator teres (PT), triceps brachii (TB), middle deltoid (MD), and upper trapezius (UT) muscles. There were no significant differences in the EMG signals of any muscle according to the ultrasound head grip pattern (p>.05). There were significant differences in the EMG signal of each type of muscle (p<.05). The EMG signal of UT was the lowest and that of TB was lower than ECRL and FCU. There were interactions between ECRL and FCU, between ECRL and PT, between FCU and ECRL, and between FCU and MD. The EMG signal of ECRL using the cylindrical head was low and that of FCU with the cylindrical head was high, while the opposite was the case with the spherical head ($p_{adj}$ <.05/15). The results of this study indicate that the wrist muscles worked actively when the participants applied ultrasound therapy using both spherical and cylindrical heads. A spherical head might induce imbalanced muscle activity among the wrist muscles, leading to deviation of the wrist joint. Therefore, the cylindrical head is recommended for ultrasound therapy because it produced a constant, repeated force.

• Clinics in Shoulder and Elbow
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• 제8권2호
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• pp.81-87
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• 2005

Epicondylitis, as a tendinopathy characterized by fibroblast and microvascular hyperplasia, is a common musculoskeletal problem especially related with repetitive hand and wrist motion. It has a prevalence of between 0.2% and 5% in general population depending on the amount of exposure to manual labor jobs. Although it is known that the pathological lesions lie in the flexor or extensor common tendons, there could be collateral ligament lesions and/or reactive synovitis accompanied, which may make a case unresponsive to the treatment aimed only at the tendinopathy. Epicondylitis is easy to diagnose with typical pain, tenderness, and positive provocation tests. However, many conditions can mimic epicondylitis that further imaging or electrodiagnostic studies should be undertaken to exclude other possible problems. Ultrasonography provides information about the existence and extent of tendinopathy with relatively high specificity. Magnetic resonance imaging is often required to rule out other problems and confirm the diagnosis of the cases intractable to long term treatment. Many options of treatment are available for epicondylitis while numerous conflicting evidences have been noted, debating one treatment method is better than the others. Since it was reported that over 80% of epicondylitis improved within a year no matter what was done as treatment, it is a challenge to make accurate diagnosis and combine effective therapeutic regimens for the 20% of intractable cases.

• 한국치위생학회지
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• 제4권2호
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• pp.225-236
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• 2004

It has been suggested in research results thai dental hygienists have high risk of carpal tunnel syndrome, mainly caused by the repeated motion of extensor and flexor or the use of vibration tools, compared to other occupations. To find out the situation of the carpal tunnel syndrome of dental hygienists, who are exposed to work-related musculoskeletal disorders, this study used 132 questionnaires given on May 22, 2004, the period of continuing education of the first half year in the Gwangju Jeonnam area, and obtained the following results. 1. Subjects worked at a dental ciinic(32.6%), a hospital(31.8%), and a public health center(35.6%). Age by work was under 24 in a clinic(17.4%) and a hospital(15.9%), and over 30 in a public health center(35.6%). 2. In practice conducted over one time a day, a scaling accounted for 90.7% in a doctor's office; 595% in a hospital; and 3.0% in a public health center, suggesting significant difference(p<0.01). Pit and fissure sealant accounted for 53.5% in a clinic; 53.2% in a hospital; and 95% in a public health center, also suggesting significant difference(p0.01). 3. Symptoms of carpal tunnel syndrome appeared in a wrist(12.1%), a right hand(14.4%), and a left hand(5.3%). 4. In case of temporary crown practice, symptoms appeared in a wrist(22.0%), a right hand(14.0%), and a left hand(4.0%), suggesting significant difference(p<0.01). The above results showed that 12.1% of dental hygienists was exposed to carpal tunnel syndrome. Thus, it is considered very important that dental hygienists should be given education of the danger of continuous work in certain motions and prevention education of improving repeated position, and make efforts to reinforce self-control ability.

• 한국전문물리치료학회지
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• 제10권1호
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• pp.51-62
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• 2003

The purpose of this study was to compare the relative accuracy of a range of computer-based analysis with respect to EMG onset determined visually by an experienced examiner. Ten healthy students (6 male, 4 female) were recruited and three times randomly selected trials of isometric contraction of wrist flexion and extension were evaluated using four technique. These methods were compared which varied in terms of EMG processing, threshold value and the number of samples for which the mean must exceed the defined threshold, and beyond 7% of maximum amplitude. To identify determination of onset time, ICCs(Intraclass Correlation Coefficients) was used and inter-rater arid intra-rater reliability ranged good in visually derived onset values. The results of this study present that in wrist flexion and extension, the reliability of the inter and intra-examiner muscle contraction onset times through visual analysis showed beyond .971 with ICCs. The reliability of the muscle contraction onset time decision through visual reading, tested with computer analysis, showed a relationship of all the selected analysis methods with ICCs .859 and .871. The objective computer-based analysis comparing with visual reading at the same time is the effective and qualitative data analysis method, considering the specificity of each study method.

• 한국전문물리치료학회지
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• 제16권2호
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• pp.67-76
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• 2009

In order to prevent upper extremity musculoskeletal disorders, effective keyboard selection is an important consideration. The aim of this study was to compare upper extremity muscle activity according to transverse plane angle changes during vertical keyboard typing. Sixteen healthy men were recruited. All subjects had a similar typing ability (rate of more than 300 keystrokes per minute) and biacromion and forearm-fingertip lengths. Four different types of keyboard (vertical keyboard with a transverse plane angle of $60^{\circ}$, $96^{\circ}$, or $120^{\circ}$, and a standard keyboard) were used with a wrist support. The test order was selected randomly for each subject. Surface electromyography (EMG) was used to measure upper extremity muscle activity during a keyboard typing task. The collected EMG data were normalized using the reference contraction and expressed as a percentage of the reference voluntary contraction (%RVC). In order to analyze the differences in EMG data, a repeated one-way analysis of variance, with a significance level of .05, was used. Bonferroni correction was used for multiple comparisons. There were significant differences in the EMG amplitude of all seven muscles (upper trapezius, middle deltoid, anterior deltoid, extensor carpi radialis, extensor carpi ulnaris, flexor carpi radialis, and flexor carpi ulnaris) assessed during the keyboard typing task. The mean activity of each muscle had a tendency to increase as the transverse plane angle increased. The mean activity recorded during all vertical keyboard typing was lower than that recorded during standard keyboard typing. There was no significant difference in accuracy and error scores; however, there was a significant difference between transverse plane angles of $60^{\circ}$ and $120^{\circ}$ with regard to comfort. In conclusion, a vertical keyboard with a transverse plane angle of $60^{\circ}$ would be effective in reducing muscle activity compared with vertical keyboards with other transverse plane angles.

• Archives of Reconstructive Microsurgery
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• 제13권1호
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• pp.14-23
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• 2004

Introduction: The hand and wrist are particularly susceptible to electrical burn. Skin defect with damage or exposure of underlying vital structure requires coverage by skin flap especially in case of the need for late reconstruction. We are reporting 4 cases of electrical burned hand treated by posterior tibial arterial free flap. The commonly used skin flaps such as scapular flap or groin flap are too bulky so that they are not satisfactory in function and cosmetic appearance. So we tried to cover them with a more thin skin flap. Materials and Method: From January 2002 to June 2003, four cases of hand and wrist electrical burn were covered using posterior tibial arterial free flap. All the cases were due to high voltage electrical burn. Age ranged from 31 years to 38 years old and all the cases were male patients. Recipient sites were 2 wrist, one thenar area and one knuckle of 2.3rd MP joint. Additional procedures were flexor tenolysis (simultaneous), FPL tenolysis and digital nerve graft (later) and extensor tendon reconstruction (later). Result: All the flap have survived totally without any complication including circulatory concern about the donar foot. Posterior tibail arterial free flap was so thin that debulking procedure was not required. Conclusion: For skin coverage of the hand & wrist region, posterior tibial arterial free flap have many advantages such as reliable anatomy, easy dissection and easy anastmosis with radial or ulnar artery and possibility of sensory flap. The most helpful advantage for hand coverage is its thinness. So we think this flap is one of the very useful armamentarium for reconstructive hand surgery.

• 척추신경추나의학회지
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• 제2권1호
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• pp.99-114
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• 2007

Objectives : The purpose of this study was to introduce the Chuna Manual Therapy (CMT) using Bong (a type of stick which is called 'bong') as a part of Oriental Medicine. Methods : We searched several traditional methods of CMT using Bong, either individual contact to specialist of CMT using Bong or referred to publications, and summarized briefly for introduction. Authors also made a comparative study between existing CMT and CMT using the bong. Results & Conclusions : The indications of Bong CMT are regarded as acute or chronic pain syndrome, whiplash associated disorders, facet syndrome, vertebral misalignment, chronic fatigue syndrome, obesity and also lower extremity length difference caused by malalignment of vertebrae and pelvic bone. The Meridian Muscle Therapy by pressing down using the Bong can be carried out on the imbalances of the muscle by shortening and lengthening contraction. CMT with Bong is considered more effective than other existing CMT in terms of effectiveness. In the case of pelvic correction which needs a tremendous amount of force, it can reduce the force required effectively. This fact can be inferred by the theory of composition and decomposition of force during the transmission of power. We can perform Bong CMT feeling less fatigued subsequently than general CMT. Pressing down with flexed fingers to grip bong acts on the contraction of flexor digiti and extensor digiti muscle, this protects the $doctor^{\circ}{\emptyset}s$ wrist joints from injury. The bong which acts as a tool between the doctor and the patient, while being given treatment, absorbs and spreads out the direct impact from the patient to the doctor. CMT with Bong is able to apply to both existing massage therapies with the hand. The bong appliance can be used in all applications, particularly, but not limited to; Orthopedic and Manual Correction Therapy, Meridian Muscle Pressing, Exercise Therapy, and Meridian Point Manual Pressing Therapy. CMT with Bong belongs to the category of oriental rehabilitation and Chuna manual medicine.

• The Journal of Korean Physical Therapy
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• 제24권6호
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• pp.409-413
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• 2012

Purpose: Rehabilitative devices are used to enhance sensorimotor training protocols, for improvement of motor function in the hemiplegic limb of patients who have suffered a stroke. Sensorimotor integration feedback systems, included with these devices, are very good therapeutic frameworks. We applied this approach using electrical stimulation in stroke patients and examined whether a functional electric stimulation-assisted biofeedback therapy system could improve function of the upper extremity in chronic hemiplegia. Methods: A prototype biofeedback system was used by six subjects to perform a set of tasks with their affected upper extremity during a 30-minute session for 20 consecutive working days. When needed for a grasping or releasing movement of objects, the functional electrical stimulation (FES) stimulated the wrist and finger flexor or extensor and assisted the patients in grasping or releasing the objects. Kinematic data provided by the biofeedback system were acquired. In addition, clinical performance scales and activity of daily living skills were evaluated before and after application of a prototype biofeedback system. Results: Our findings revealed statistically significant gradual improvement in patients with stroke, in terms of kinematic and clinical performance during the treatment sessions, in terms of manual function test and the Purdue pegboard. However, no significant difference of the motor activity log was found. Conclusion: Hemiplegic upper extremity function of a small group of patients with chronic hemiparesis was improved through two weeks of training using the FES-assisted biofeedback system. Further research into the use of biofeedback systems for long-term clinical improvement will be needed.

• 재활치료과학
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• 제9권4호
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• pp.7-20
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• 2020

목적 : 본 연구는 뇌졸중 환자들의 상지기능 개선을 위해 말초신경감각자극과 과제지향적 훈련의 동시적용하여 효과를 알아보는 것이다. 연구방법 : 본 연구는 29명의 편마비 환자를 대상으로 수행하였다. 말초신경감각자극과 과제지향적 훈련을 동시에 적용한 실험군은 14명, 과제지향적 훈련만 실시한 대조군은 15명으로 주5회, 회기당 30분씩, 총 4주간 진행하였다. 결과측정은 손목과 어깨근육의 자발적 근수축 비율과 상자와 나무토막 검사, 잡기와 쥐기의 근력, Action Research Arm Test를 사용하여 중재 전·후로 측정하였다. 결과 : 4주간의 중재 후 짧은노쪽손목폄근, 노쪽손목굽힘근의 근 활성도와 잡기 근력, Action Research Arm Test에서 실험군은 대조군 보다 유의한 개선을 나타냈다. 결론 : 말초신경감각자극과 과제지향적 훈련의 동시적용은 과제지향적훈련만 하는 것보다 뇌졸중 환자의 상지기능 개선에 보다 효과적이었다.