• Physical Therapy Rehabilitation Science
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• v.7 no.3
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• pp.95-101
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• 2018

Objective: To determine if the provision of visual biofeedback using real-time rehabilitative ultrasound imaging (RUSI) enhances the acquisition and retention of diaphragm muscle recruitment during exercise. Design: Two group pretest posttest design. Methods: Thirty healthy subjects were randomly assigned to the verbal feedback group (VG, n=15) or the visual and verbal feedback group (VVG, n=15). The VG performed breathing exercises 10 times with verbal feedback, and the VVG also performed breathing exercises 10 times with verbal feedback and visual feedback with the use of RUSI to measure changes in diaphragm thickness (DT). For DT, the mid-axillary lines between ribs 8 and 9 on both sides were measured in standing, and then the chest wall was perpendicularly illuminated using a linear transducer with the patients in supine to observe the region between rib 8 and 9 and to obtain 2-dimensional images. DT was measured as the distance between the two parallel lines that appeared bright in the middle of the pleura and the peritoneum. After one week, three repetitions (follow-up session) were performed to confirm retention effects. Intra- and between- group percent changes in diaphragm muscle thickness were assessed. Results: In the VVG, the intervention value had a medium effect size compared to the baseline value, but the follow-up value decreased to a small effect size. In the between-group comparisons, during the intervention session, the VVG showed no significant effect on percent change of DT but had a medium effect size compared to the VG (p=0.050, Cohen's d=0.764). During the follow-up session, retention effect did not persist (p=0.311, Cohen's d=0.381). Conclusions: RUSI can be used to provide visual biofeedback and improve performance and retention in the ability to activate the diaphragm muscle in healthy subjects. Future research needs to establish a protocol for respiratory intervention to maintain the effect of diaphragmatic breathing training using RUSI with visual feedback.

• Physical Therapy Rehabilitation Science
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• v.5 no.3
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• pp.155-161
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• 2016

Objective: This study aimed to investigate the reliability and validity of a personal computer-based muscle viewer (PC-BMW) compared with that of a portable ultrasound (P-US) for measuring upper trapezius (UT) and transversus abdominis (TrA) muscle thickness at rest and during contraction. Design: Observational inter-rater reliability study. Methods: Fifty-five healthy participants (25 men, 30 women) participated in this study. PC-BMW and P-US were randomly measured at the UT and TrA muscles. Two examiners randomly obtained the images of all participants in 3 test sessions lasting 2 days. Intra-class correlation coefficients (ICCs), standard error of measurement, contraction ratio, and correlation were used to estimate reliability and validity. Pearson's correlation coefficients were used to analyze the relationship between muscle thickness measures taken from PC-BMW and P-US. Results: The intra-rater reliability ICCs of UT and TrA muscle thickness for the PC-BMW were >0.995, indicating excellent reliability. Inter-rater reliability ICCs for the PC-BMW ranged from 0.963 to 0.987. The P-US also exhibited high reliability. A high correlation was found between the measurements of the two muscles in PC-BMW and P-US (p<0.01). Conclusions: PC-BMW provides clear and excellent images, is pocket-sized and less expensive than a conventional ultrasound imaging system. PC-BMW can be utilized variously and has the advantage of rehabilitative ultrasound imaging. More research is needed to evaluate the utility of PC-BMW for rehabilitation.

• Physical Therapy Rehabilitation Science
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• v.8 no.4
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• pp.218-224
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• 2019

Objective: This reliability study examined the effects of applying varying induced inward pressures using a transducer placed at 0° neutral ankle position (NEU) and 15° ankle dorsiflexion (DF) on tibialis anterior (TA) muscle thickness using a custom-made device with a force indicator during rehabilitative ultrasound imaging. Design: Cross-sectional study. Methods: Twenty-four healthy subjects were recruited in this study. Two examiners measured the muscle thickness of the TA at 0° NEU and 15° DF in 3 conditions of inward pressures (1.0 N, 2.0 N, and 4.0 N) using a custom-made holder. The muscle thickness was measured three times for each of the conditions arranged in random order. For intra- and inter-rater reliability, the intraclass correlation coefficients (ICCs) with 95% confidence intervals, standard error of measurement, minimal detectable change, and coefficient of variation were analyzed. One-way repeated measures analysis of variance was conducted for investigating changes of TA muscle thickness according to the inward pressures of the transducers. Results: The intra-rater reliability of TA muscle thickness measurement was excellent (ICC_3,1: 0.92-0.96) for all conditions (at both ankle joint angles per varying inward pressure). Likewise, the inter-rater reliability of TA muscle thickness measurement was excellent (ICC_2,1: 0.89-0.97) under same conditions. The mean of TA thickness showed the trend of decreasing significantly with increased inward pressures at all ankle joint angles (p<0.05). Conclusions: Use of this custom-made device with a force indicator is useful to accomplish the high intra- and inter-rater reliability of TA muscle thickness measurement at both ankle joint angles in reducing the measurement error.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.4
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• pp.81-90
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• 2015

PURPOSE: The purpose of this study was to compare the muscle architecture of serratus anterior and lower trapezius using rehabilitative ultrasound imaging (RUSI) in affected and unaffected side of chronic stroke patients. METHODS: The participants were thirty five patients with stroke hemiplegia in this study. RUSI was used to measure the muscle thickness of the serratus anterior and lower trapezius muscles. We compared the muscle thickness according to affected side and sex, determined the reliability of the measurement image. Independent t-test, intra-class correlation coefficient (ICC) and standard error of measurement (SEM) were used for statistical analysis. RESULTS: Significant difference in muscle thickness of serratus anterior was observed between affected and unaffected side (p<.001). Muscle thickness according to gender showed a significant difference in unaffected side of serratus anterior (p<.05). Compare asymmetry ratio of serratus anterior and lower trapezius muscle thickness showed a significant difference (p<.001). ICC for intra-reliability was .944~.962 in serratus anterior and .873~.925 in lower trapezius muscle thickness, respectively. SEM was .001~.004 in serratus anterior and .002~.008 in lower trapezius muscle. CONCLUSION: This study, using RUSI, showed significant difference in muscle thickness of serratus anterior in affected and unaffected side of stroke patients. RUSI is a practical tool for measuring soft-tissue thickness in the scapular region muscle of stroke.

• The Journal of Korean Physical Therapy
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• v.30 no.5
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• pp.199-203
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• 2018

The number of reported cases with dual disability is increasing for the past few decades. Currently, dual disability of lower limb amputation and motor weakness after stroke became a strong issue in public concern. The functional levels of patients have shown in the wide range from independent community ambulation to non-ambulation. Thus, it indicates that favorable outcomes for dual disability may depend upon adopted rehabilitative strategies. We present the case of a man with left below-knee amputation and severe right-sided weakness following a huge putaminal hemorrhage. He had suffered from extreme pain and misfit of the prosthetic socket and the complicated residual limb for three years prior to the stroke. Forty days post-stroke, we performed a revision surgery to resolve the complications of bony overgrowth, verrucous hyperplasia, and neuroma and applied an ankle foot orthosis (AFO). Two years post-stroke, he was able to ambulate outside his home and negotiate stairs using a cane. This is the first case with the dual disability of lower limb amputation and contralateral hemiplegia to undergo revision surgery. The results suggest that an early revision surgery and use of an AFO are crucial for achieving a higher level of mobility in such cases.

• Journal of International Academy of Physical Therapy Research
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• v.3 no.2
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• pp.458-463
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• 2012

This study is to examine the effects of a feedback breathing device exercise and diaphragm breathing exercise on pulmonary functions of chronic strokes patients. The selection of 20 subjects was divided equally and placed into a experiment group and a control group and the intervention was applied four times per a week for five weeks. In each session, both groups received rehabilitative exercise treatment for 30 minutes, and a feedback breathing device exercise for 15 minutes. In addition, experimental group conducted a combination of diaphragm breathing exercise for 15 minutes. Prior to and after the experiment, patients' pulmonary functions were measured using a spirometer. The pulmonary function tests included FVC, FEV1, FEV1/FVC, PEF, VC, TV, IC, ERV, IRV. With respect to changes in the pulmonary functions of both groups, the experimental group significantly differed in FVC, FEV1, TV, ERV but did not in PEF, FEV1/FVC, VC, IRV. The control group did not significantly differ in any of the tests. There were significant differences in FEV1, FEV1/FVC, TV, ERV between the two groups, but no significant differences in FVC, PEF, FEV1/FVC, VC, IRV between them after the experiment. The experimental group, which conducted a combination of a feedback breathing device exercise and diaphragm breathing exercise, saw their respiratory ability increase more significantly than the control group. The breathing exercise was found to improve pulmonary function in chronic stroke patients.

• Journal of Acupuncture Research
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• v.17 no.4
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• pp.200-210
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• 2000

By process of treatment for a case which diagnosed as spinal cord infarction and admitted from the 18th, April, 2000 to the 29th, July, 2000, the result are as foilows. Method and Results : In the earlier days of admission, this patient was diagnosed as damp-heat(濕熱) and was dosed with Cheongjo-tang. In medication, weakness in upper and lower limbs of the patient was improving. After diagnosed as Taeyangin, the patient was dosed with Ogapijangchuk-tang and punctured with Taeyangin Taegeuk-chim and Sagae-chim. As the result, Weakness in upper and lower limbs are improved remarkably. Conclusion : The prognosis of patients diagnosed spinal cord infarction is not so good. But, in the case of this patient, power and sense of four limbs improved remarkably through oriental medical treatment with rehabilitative therapy.

• Journal of Korean Clinical Health Science
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• v.5 no.3
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• pp.936-942
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• 2017

Purpose. The purpose of this study was to determine the effect of cognitive based programs on cognitive functions in elderly people. Methods. The participants included a group of 9 elderly people in Changwon, from the period of May 2016 to July 2016. The test tools used were MMES-K. SADL. and GDS. The statistics used was the 20.0 version. Results. According to the results of this study, the MMSE, GDS mean scores improved after implentation of the program, but no significant improvement was shown with SADL. The MMSE of the correlation coefficient was 0.785, and the GDS of the correlation coefficient was 0.916. Both of these scores were significant in their correlation. Conclusion. In conclusion, cognitive based programs were effective among mildly cognitive-impaired elderly people, and that suitable programs must be developed on a case by case basis.

• Journal of Acupuncture Research
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• v.19 no.5
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• pp.247-257
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• 2002

By process of treatment for a case which diagnosed as spinal cord injury due to spinal arterio-venous malformation and admitted from the 19th, April, 2001 to the 15th, October, 2001, the results are as follows. Methods : The treatment of patient who is diagnosed as spinal cord injury due to spinal arterio-venous malformation by walking abreast of several kinds of oriental medical treatment with rehabilitative therapy. Results : The treatment was taken to the patient upgraded Frankel scale B to D and Cord motor index 61point to 88point.

• The Journal of Internal Korean Medicine
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• v.43 no.5
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• pp.1006-1017
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• 2022

Objectives: This study examined a clinical case of a recurrent polyarticular gout patient treated with Korean medicine. Methods: The patient was treated with Korean medicine (Gyejigagye-tang, Soshiho-tang-gami, Gyejigajakyak-tang, acupuncture, and moxibustion), Western medicine, and rehabilitative therapy. Their effects were evaluated using the Visual Analog Scale. Results: After receiving Korean medical treatment for two admission periods, the Visual Analog Scale score for joint pain improved or disappeared. Moreover, Korean medicine was able to manage the symptoms of the gout patient. Conclusions: Proper Korean medicine treatment could be effective in improving the symptoms of recurrent polyarticular gout pain.