Background and Purpose : The hemiplegic upper extremity is affected in many stroke patients, and recovery is often poor. The purpose of this study was to assess the efficacy of electroacupuncture (EA) in enhancing the upper extremity motor and functional recovery of ischemic stroke patients. Subjects and Methods : Forty ischemic stroke patients (the upper extremity Fugl-Meyer motor scale (FM) score lower than 46, lesion location within middle cerebral artery territory) within 2 weeks of stroke onset were randomly allocated to either an EA group that received EA treatment or a control group that received only routine ward care. The EA was applied at Quchi-Shousanli (LI11-LI10), Waiguan-Hegu (TE5-LI4) points on the hemiparetic side six times per week for 4 weeks. The frequency of stimulation was 25-50Hz and the intensity was set at a level sufficient to induce muscle contraction. EA treatment was given for 30 minutes and all patients of both groups received standard rehabilitation program. Outcomes were assessed, in a blind manner, before treatment began and at 4 weeks after treatment, with the FM, the Motor Power score (MP) for shoulder/elbow, and the subsection of the Modified Barthel Index (MBI) for drinking/feeding/dressing upper body/grooming. Results : These 2 groups had comparable clinical characteristics, lesion location, lesion size, and pretreatment impairment scores. By the end of treatment, the EA group showed significantly more improvement than the control group in the subsection of the FM for shoulder/elbow/coordination (6.4 vs. 3.7; P=0.047) and the MP for shoulder/elbow (5.3 vs. 3.3; P=0.008). The subsection scores of the MBI for drinking/feeding/dressing upper body/grooming were not significantly different between two groups. No adverse effects due to treatment were found Conclusion : These results suggest that EA enhances the upper extremity motor recovery of acute stroke patients. However, this study failed to demonstrate any significant functional benefit related with upper extremity. Future study should be carried out in a larger sample size and use the functional outcome measure that is more specific and sensitive to the upper extremity.
Purpose : The purpose of this study was to investigate effects of repetitive hand task on upper extremity proprioception and dexterity. Methods : Experimental group who had done hand task since last 1 year and young adult control group was recruited this study. Proprioception was measured positioning errors of elbow and wrist on three dimensional coordinate system by Winarm software(Zebris Medcal GmbH, Germany). And dexterity was measured by box and block test. Statistical analysis was used independent t -test. Results : When elbow moved from flexion to extension, there were significant difference on error of x axis in wrist location and erros of x, z axis in shoulder location(p<.05). When wrist moved from flexion to extension, there was significant difference on y axis in finger location error(p<.05). And there significant difference on dexterity(p<.05). Conclusion : In conclusion, repetitive hand task increase upper extremity proprioception and dexterity. The physical therapy in industrial workers should inhibit overuse injury.
Purpose: A large defect by fourth-degree burns in the upper limb requires flap reconstruction. Since severe vascular damage and decrease in blood circulation after vascular anastomosis can occur in defects caused by fourth-degree burns. Because of the disadvantages, it is difficult to apply free flap surgery to fourth-degree burns. We reconstructed a upper extremity using the pedicled Latissimus Dorsi (LD) flap in two stages. The purpose of our study is to review our experience and suggest two-staged pedicled Latissimus Dorsi (LD) flap in fourth-degree burns of upper extremities. Methods: A retrospective review was performed from 2016 to 2019, on a total of 12 fourth-degree burn patients undergone two-staged pedicled LD flap surgery as reconstruction of upper extremities in our hospital. We reviewed the location of the injury, etiology, TBSA (%), size of burns requiring flap surgery, period from 1st surgery to secondary division surgery, complications. Results: Using two-staged LD flap as a primary reconstruction, the outcome is satisfactory. This flap preserves the elbow joint and maintains the length of the forearm. We obtain low donor-site morbidity, simplicity and a small incision in the donor site. Conclusion: Using two-staged LD flap in fourth-degree burns of upper extremity is effective, such as preserving elbow joint and maintaining the length of the forearm. Successful reconstruction was achieved with excellent cosmetic results with reducing a postoperative scar, donor-site morbidity. Due to these advantages, two-staged pedicled LD flap can be an optimal option for reconstruction of fourth-degree burns in the upper limb.
Objective : The purpose of this study is to investigate the characteristics of patients with fracture admitted in oriental hospital. Methods : From october 1996 to october 2001, we retrospectively evaluated the simple radiographic proven 8441 patients with musculoskeletal pain in oriental hospital. The patients included 3899 men and 4542 women. All fractures were analyzed in terms of location, age and sex. Results : 1. The fracture rate of radiologic study was relatively high in foot, chest, upper extremity and hand. The frequent fractures were in spine (257 cases), foot (119 cases), upper extremity (83 cases). and chest (68 cases). 2. The male patients with fracture were significantly higher than female in 0-40 years group: in 0-20 years group(8.5 % vs 4.0 %, p<0.01), in 21-40 years group (4.1 % vs 2.6, p<0.05), while female patients with fracture were significantly higher than male patients in more than 60 years group( 10.1 % vs 15.4 %, p<0.01). 3. The incidence of fracture showed significant association with increased age except 0-20 years group(p<0.01). Spine and chest cage in mate, and upper extremity, pelvis, spine, ankle and chest cage in female were significantly higher on older age groups. Conclusion : The overall fracture rate of radiologic study was 6.6 % for patients with musculoskeletal problem admitted in oriental hospital. The distribution of fracture showed significant difference in terms of age, sex and site. So we believe the radiologic study is helpful to evaluate fracture in oriental hospital.
A free rectus abdominis flap can include a variable amount of muscle length depending on recipient site requirements. There is also great flexibility in flap design in terms of size, orientation of its axis, and the level of its location over the muscle. It is safe to design the skin island across the midline. Though skin islands designed over the most inferior portion of the abdomen have not always proved reliable when based on the superior epigastric artery, free flaps based on the inferior pedicle can be successfully designed in this area. As free flap based on the inferior epigastric vessels, this flap has been useful for large head and neck defects following ablative procedures, for facial contour restoration as a buried flap, for upper extremity defects, for lower extremity defects such as coverage of grade III tibial fractures and for breast reconstruction. A free rectus abdominis muscle or myocutaneus flap was used in 8 patients. The operations were performed between Sep. of 1994 and April of 1996. The patients were tongue cancer 1 case, chronic facial palsy 1 case, unilateral breast reconstruction 1 case, upper and lower extremity injury 5 cases. The free rectus abdominis muscle flaps were 4 cases and the free myocutaneous flaps were 4 cases. There was no failure of the flap, except one partial necrosis. One case of the skin grafts on the muscle flap was regrafted. One case of reoperation due to venous thrombosis was performed. In tongue cancer patient, a orocutaneous fistula was occurred, but conservative treatment and secondandry skin graft were done. In conclusion, a free rectus abdominis flap has many advantages such as a long and constant pedicle, easy dissection, enough soft tissue available, scar on the donor site to be hiddened, no need for changing position. So we think that this flap is the most useful one for small or moderate sized defects on the various sites.
PURPOSE: This study examined the incidence, location, and characteristics of sports injuries according to the position in Korean female national field hockey athletes. METHODS: Eighteen female national field hockey athletes (two goal keepers, five forwards, six midfielders, and five defenders) who trained at the national training center between January 2018 and December 2018 were enrolled. The event, position, and location of injury were recorded per IOC's daily injury reports form. The incidence of sports injuries was examined with the 95% confidence interval (CI), and the difference in the incidence of injury according to the position was presented as the rate ratio (RR). Moreover, differences in the location of sports injury according to the position were examined using χ2 tests. RESULTS: A total of 92 sports injuries occurred among field hockey players, with an incidence of 6.47 cases per 1,000 hours of training (95% CI 4.98-7.96). In addition, 29.12 cases of injuries occurred per 1,000 exposures (95% CI 23.17-35.07), and the incidence of injury was highest among the defenders, followed by forwards, midfielders, and goal keepers. The most common location of sports injury was the lower extremity, followed in order by the trunk, upper extremity, head, and neck, and there were significant differences in the location of the sports injury according to the position (p=.046). In addition, lumbar spine/lower back, thigh, ankle, lower leg, knee, and foot/toe were common sites of sports injury among female field hockey players. CONCLUSION: These results provide a baseline for predicting sports injuries in athletes during games, and would provide useful information for developing performance enhancement and injury prevention programs.
PURPOSE: This study examined the incidence, location, and characteristics of sports injuries according to the position in Korean female elite handball athletes. METHODS: Thirty handball athletes, who trained at between January 2019 and December 2019 were enrolled. The event, position, and location of injury were recorded according to the IOC's Daily injury reports form. The incidence of sports injury was examined with the 95% confidence interval (CI), and the difference in the incidence of injury by position was presented as the rate ratio (RR). Moreover, differences in the location of the sports injury according to the position were examined using χ2 tests. RESULTS: A total of 148 sports injuries occurred in the handball players, with an incidence of 22.71 cases of injury per 1,000 exposures (95% CI 19.05 - 26.37) The incidence of injury was highest in the Competition group, followed by the Weights and Training groups. The most common location of sports injury was the lower extremity, followed by the upper extremity, trunk. No significant differences in the location of sports injuries were observed according to the position (p = .384). In addition, the knee, ankle, lumbar spine/lower back, shoulder/clavicle were common sites of sports injury among handball players. CONCLUSION: These results provide a baseline for predicting sports injuries occurring in athletes during games, and would provide useful information for developing performance enhancement as well as injury prevention programs.
The coverage of soft tissue defects around the knee joint or upper one third of lower leg presents a difficult challenge to the reconstructive surgeon. Various reconstructive choices are available depending on the location, size and depth of the defect. The authors present their clinical application of a medial sural artery perforator island flap as a useful alternative method for upper one third of lower leg and knee reconstruction. From 2002 to 2004, we operated total 4 patients (total 4 flaps) using the medial sural artey perforator island flap for coverage of the defect on upper one third of lower leg and knee, of 4 patients, 3 patients was men and one was woman. Average patient age was 54.6 years. The largest flap obtained was 10x8cm2. Postoperative follow up of the patients ranged from two to 33 months. In two cases, defects was located on upper one third of lower leg and in other two cases, defects were on the knee. All four cases had bone exposure open wound. In angiography, 2 cases had injured in the anterior tibial artery, 1 case had injured in the posterior tibial artery. There were no diabetes or other vascular disease. All 4 flaps were survived completely, without minor complications such as venous congestion and hematoma. Donor morbidity was restricted substantially to the donor linear scar. There were no functional impairment. As the main advantages of the medial sural perforator island flap, it ensures constant location and reliable blood supply without sacrificing any main source artery or damaging underlying muscle. This procedure is valuable extension of local flap for defect coverage with minimal functional deficit donor site and good aesthetic result on the defect. We consider it as one of the useful methods of the upper one third of lower leg and knee reconstruction.
PURPOSE: This study examined the incidence, location, and characteristics of sports injuries according to the position in Korean national Kabaddi athletes. METHODS: Twenty-four national Kabaddi athletes (12 males and 12 females) who trained at the national training center between January 2019 and December 2019 were enrolled in this study. The event, position, and location of injury were recorded on an IOC daily injury report form. The incidence of sports injury was examined with the 95% confidence interval (CI), and the difference in the incidence of injury by position was presented as the rate ratio (RR). Moreover, the differences in the location of sports injury according to position were examined using χ2 tests. RESULTS: One hundred and nine sports injuries occurred among Kabaddi players, with an incidence of 20.28 cases of injuries per 1,000 exposures (95% CI 16.47 - 24.08), and the incidence of injury was the highest among the competition, followed by training and weights. The most common location of sports injury was the lower extremity, followed by the upper extremity, trunk, head, and neck. In addition, no significant differences in the locations of the sports injuries were noted according to gender (p = .689). Furthermore, knee, ankle, lumbar spine/lower back, shoulder/clavicle were common sites of sports injury among Kabaddi players. CONCLUSION: These results provide a baseline for predicting sports injuries occurring in athletes during games, and would provide useful information for developing performance enhancement as well as injury prevention programs.
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