Jeong-hui Kim;Ye-seul Park;Ju-yeon Song;Ho-ryong Yoo;In-chan Seol;Yoon-sik Kim
The Journal of Internal Korean Medicine
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v.44
no.3
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pp.544-554
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2023
Background: Postural hypotension refers to a drop in systolic blood pressure of 20 mmHg or diastolic blood pressure of 10 mmHg or more within three minutes after standing up from lying down. Symptoms of postural hypotension not only include dizziness and blurred vision but also fatigue, cognitive decline, leg weakness, headache, and, in severe cases, fainting. Postural hypotension is a phenomenon that occurs in about 6% of the total population, and in Korea, the number of patients with postural hypotension is continuously increasing. Both pharmacological and non-drug therapies, which are treatment methods for this disease, do not show a satisfactory symptom improvement effect. Case summary: A 65-year-old male patient who visited the hospital complaining of dizziness and paresthesia due to postural hypotension was treated with acupuncture, moxibustion, and herbal medicine. For symptom evaluation, the numeric rating scale (NRS) of each symptom was used, and blood pressure change according to posture was measured. After treatment, the NRSs of dizziness and dysesthesia were decreased, and blood pressure changes according to posture was improved. Conclusion: This case report suggests that Korean medicine treatment, including acupuncture, electro-acupuncture, moxibustion, and herbal medicine, can be an effective treatment for dizziness with postural hypotension.
The right hip abductor musculature has been reported to demonstrate "stretch weakness" attributable to chronic elongation imposed by standing posture common to right-handed healthy persons. Kendall and associates have described the concept of "stretch weakness",. The purpose of this study was to assess isometric hip abduction torque and surface electromyographic activity (using MYOMED 432) in a sample of 40 healthy right-handed persons (20 male, 20 female), all of whom agreed to participate in the study, and compare side difference in the hip abductor musculature. In order to assure the statistical significance of the results, the paired t test was applied at the .05 level of significance. The results were as follows: 1) The difference in apparent leg length of right and left legs was significant at the .05 level. 2) There was a significant difference between right and left pelvic height (standing position) at the 05 level measurements, and scapula height at the .05 level. 3) Power measurements and action potentials of right hip abductor were greater than the left hip abductor regardless of the range of joint motion (inner range, outer range) 4) The difference in muscle power and action potentials according to inner or outer range of both hip abductor were significant at the .05 level. 5) In supine during active left hip abduction, the appearance of action potentials in the right hip abductors is indicative of contra-lateral effect (p<.05) These results suggest: In healthy right-handed persons, the apparent leg length on the right is longer than on the left, and pelvic height is elevated on the right side. Muscle those and muscle action potentials of the right hip abductor are higher than those of the left hip abductor in the lengthened position. Therefore, the results in this study are contrary to Kendall's. This type of study should be carried out in many physical therapy departments.
To develop baseball catcher leg guards, 3-dimensional (3D) methodologies, which are 3D human body data, reverse engineering, modeling, and printing, optimized guard design for representative positions. Optimization was based on analysis of 3D body surface data and subjective evaluation using 3D printing products. Reverse engineering was used for analysis and modeling based on data in three postures: standing, $90^{\circ}$ knee flexion, and $120^{\circ}$ knee flexion. During knee flexion, vertical skin length increased, with the thigh and knee larger in anterior area compared to the horizontal dimension. Moreover, $120^{\circ}$ knee flexion posture had a high radius of curvature in knee movement. Therefore, guard designs were based on increasing rates of skin deformation and numerical values of radius of curvature. Guards were designed with 3-part zoning at the thigh, knee, and shin. Guards 1 and 2 had thigh and knee boundaries allowing vertical skin length deformation because the shape of thigh and knee significantly affects to its performance. Guard 2 was designed with a narrower thigh and wider knee area than guard 1. The guards were manufactured as full-scale products on a 3D printer. Both guards fit better in sitting than standing position, and guard 2 received better evaluations than guard 1. Additional modifications were made and an optimized version (guard 3) was tested. Guard 3 showed the best fit. A design approach based on 3D data effectively determines best fitting leg guards, and 3D printing technology can customize guard design through immediate feedback from a customer.
We studied the effect of vibratory stimulations of different leg muscles, tibialis anterior(TA) and triceps surae(TS), and plantar zones in ten healthy subjects during 1) quiet standing, 2) forward lean of body, 3) backward lean of body, 4) right lean of body, and 5) left lean of body. The experiments were performed on the force platform. The effect of vibration were measured by monitoring the area of COP(Center of pressure) sway. The subjects wore a vibratory stimulation system on foot and ankles and were given the instruction not to resist against the applied perturbations. The results show that all vibratory stimulations to lower limb muscles and plantar zones reduced the COP sway area. This reduction of the COP sway area occurred also in partial vibratory stimulations during quiet standing. In forward lean of body, vibratory stimulations to TA reduced the COP sway area. During backward lean of body, vibratory stimulations to TS reduced the COP sway area. When the subject was tilted right, vibratory stimulations to left plantar zone reduced the COP sway area. During left lean of body, vibratory stimulations to right plantar zone reduced the COP sway area. Thus, the influence of vibratory stimulations to leg muscle and plantar zones differed significantly depending on the lean of body. We suggest that the vibration stimuli from leg muscles and plantar zones could be selectively used to help maintaining postural balance stable.
Objective: The purpose of this study was to perform a muscle function path analysis of muscle function on myofascial meridians. Method: Seven male students (mean age: $22{\pm}3.46years$; mean mass: $72.71{\pm}8.19kg$; mean height: $174{\pm}4.39cm$) without a history of musculoskeletal system symptoms or injuries were recruited for this study. The measurement muscle of the myofascial line was selected along with the muscle presented in "anatomy trains (Thomas W. Myers. 2014)", and the attachment of the surface EMG (Telemyo 2400T G2, USA) pad was determined according to "EMG analysis (Kim Tae Wan et al., 2013)". The subjects underwent maximum volumetric contraction of their fascia line end muscles three times in lying and standing postures and were subjected to the maximum number of contractions of the myofascial line muscle three times in the lying and standing postures. The sampling rate of the EMG signal was set to 1,000 Hz, and the bandwidth was 20 to 350 Hz. The activity of each muscle was quantitated using the Pearson correlation coefficient, and SPSS 22.0 was used for data analysis. Results: In myofascial meridians, a positive correlation in the myofascial connection and a negative correlation in the mechanical connection were observed. Conclusion: Muscles that show significant contract correlations with one another may be expected to be used as an effective clinical marker in muscle strengthening or relaxation therapy, and rehabilitative training. In this study, the correlation of total myofascial meridians may differ without consideration of functional posture. Future studies need to consider these points.
Asymmetrical stance posture, balance, and gait disturbance are common problems in hemiplegic patients. Posterior leaf springs (PLS) are frequently prescribed to correct these problems. Recently, anterior leaf springs (ALS) have also been prescribed, but only limited studies have been performed to investigate the effects of ALS. The purpose of this study was to compare the effects of three conditions, i.e., wearing an ALS, wearing a PLS, and not wearing an AFO (ankle foot orthosis),: on 1) the distribution of weight bearing on the affected side, 2) standing balance, and 3) the gait patterns of hemiplegic patients. Eleven hemiplegic patients (10 men and 1 woman) participated in this study. The data were analyzed by the Friedman test. The results were as follows: 1) More weight bearing on the affected leg was observed in the ALS and PLS conditions than in the condition without an AFO. No significant difference between the ALS and PLS conditions was found. 2) There were statistically significant differences in the composite equilibrium scores (CES) among the three conditions. The CES in the PLS condition was significantly higher than in the ALS condition or the condition without an AFO. 3) Gait patterns improved significantly in the ALS and PLS conditions. No statistically significant difference between the ALS and PLS conditions was found. These results suggest that both ALS and PLS effectively improve the distribution of weight bearing on the affected side, standing balance, and gait patterns of hemiplegic patients. Further study using three-dimensional kinematic analysis and dynamic electromyography is needed to support these findings.
Kim, Hyung-Gon;Shin, Dong-Ah;Kim, Hyoung-Ihl;Yoo, Eun-Ae;Shin, Dong-Gyu;Lee, Jung-Ok
Journal of Korean Neurosurgical Society
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v.46
no.4
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pp.333-339
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2009
Objective : Few studies on the clinical spectrum of automated pressure-controlled discography (APCD)-defined positive discs have been reported to date. Thus, the present study was undertaken to analyze clinical parameters critical for diagnosis of discogenic pain and to correlate imaging findings with intradiscal pressures and pain responses in patients with APCD-positive discs. Methods : Twenty-three patients who showed APCD-positive discs were selected for analysis. CT discogram findings and the degrees of nuclear degeneration seen on MRI were analyzed in comparison to changes of intradiscal pressure that provoked pain responses; and clinical pain patterns and dynamic factors were evaluated in relation to pain provocation. Results : Low back pain (LBP), usually centralized, with diffuse leg pain was the most frequently reported pattern of pain in these patients. Overall, LBP was most commonly induced by sitting posture, however, standing was highly correlated with L5/S1 disc lesions (p<0.01). MRI abnormalities were statistically correlated with grading of CT discogram results (p<005); with most pain response observed in CT discogram Grades 3 and 4. Pain-provoking pressure was not statistically correlated with MRI grading. However, it was higher in Grade 3 than Grade 4. Conclusion : APCD-positive discs were demonstrated in patients reporting centralized low back pain with diffuse leg pain, aggravated by sitting and standing. MRI was helpful to assess the degree of nuclear degeneration, yet it could not guarantee exact localization of the painful discs. APCD was considered to be more useful than conventional discography for diagnosis of discogenic pain.
The purpose of the study was to obtain the basic data on the self-adjusting ability of the support panty stockings. Ten healthy women in the twenties were selected as subjects and clothing pressure of 9 support panty stockings made of single covered yarn (SCY) and double covered yarn (DCY) were measured under the standard environmental condition for the study. Data was analysed statistically according to body postures, sides, and parks. The results were as follows: Clothing pressure according to body posture was order of 'sitting-on-a-chair', 'stepping-up-a-stair', and 'standing'. High clothing pressure was obtained in the parts of calf ($9.4gf/cm^2$) in 'standing' and knee (9.7 and $16.5gf/cm^2$) in both 'stepping-up-a-stair' and 'sitting-on-a-chair', respectively. The order of clothing pressure with body sides was 'front', 'side', and 'back'. The highest clothing pressure was knee ($18.8gf/cm^2$) on the front, thigh ($8.8gf/cm^2$) on the side, and calf ($6.4gf/cm^2$) on the back. Clothing pressure of DCY at abdomen and knee was a little higher than those of SCY 3. In terms of material structure variation, clothing pressure of thigh, calf and ankle with SCY was a little higher than those with DCY, while clothing pressure of abdomen and knee with DCY was a little higher than those with SCY.
Purpose: This study examined the effect on postural control during the stimulation of haptic touch with fingertip on the stable surface at quiet standing posture, squat flexion stage, 60 degrees squat stage and squat extension stage. Methods: The postural sway was measured on the force platform, while 30 subjects were squatting, under three different haptic touch conditions (No Touch [NT], Light Touch [LT], Heavy Touch [HT]), above the touch pad in front of their body midline. Three different haptic touch conditions were divided into 1) NT condition; squatting as right index fingers held above the touch pad, 2) LT condition (<1N); squatting as the touch pad was in contact with right index fingers pulp with a pressure not exceeding 1N and 3) HT condition; squatting as subjects were allowed to use the touch pad for mechanical support by transmitting onto it with as much force, choosing with their index fingers. Results: There was significant decrease in LT, rather than that of NT (p<0.01), and in HT, rather than that of LT (p<0.01), as the results of the distance and velocity of center of pressure (COP) in mediolateral direction at quiet standing position. In anteroposterior direction, the distance and velocity of COP in LT and HT showed significant decrease, when compared to that of the data of NT (p<0.01). There was no significant difference between the 3 conditions (NT, LT, and HT), with respect to the distance and velocity of COP in mediolateral direction, during dynamic balance (squat flexion stage, squat extension stage) (p>0.05). In anteroposterior direction, the results of the distance and velocity of COP in HT showed significant decrease when compared to that of the data of NT (p<0.05). Conclusion: Light touch, during the task, decreased the postural sway at static balance. The results suggest that haptic touch should be applied, appropriately, because it varies the effects according to different conditions.
Background: Many studies have reported positive results of the various mirror training and virtual reality games in improving dynamic standing balance and posture adjustment in chronic stroke patients. However, no systematic study has been conducted to compare the effects of virtual reality games and the mirror balance training. Objects: The purpose of this study was to compare the effectiveness of Wii balance games and Mirror Self-Balancing Exercises in improving proprioception of knee joint and standing balance of people with chronic stroke. Methods: Twenty patients with chronic stroke volunteered for this study. The subjects were randomly divided into a Wii balance games group and a Mirror Self-Balancing Exercises group with 10 patients in each group. Each training was performed for 30 mins a day for 4 days. In addition to the balance training, 30 mins neuro-developmental-treatment based routine physical therapy was given to both groups. Proprioception was measured using two continuous passive motion devices, and static balance was measured using a Wii balance board. Dynamic balance assessment tools included the Berg Balance Scale, Dynamic Gait Index, and Timed Up-and-Go test. Results: All measured variables before and after the experimental results showed a significant improvement in both groups (p<.05). Only the improvement of the affected knee proprioception appeared to be significantly greater in the Wii balance game group (p<.05). However, other variables did not differ between the groups (p>.05). Conclusion: The findings suggest that both Wii balance games and Mirror Self-Balancing Exercises may be helpful for improving the proprioception of knee joint and the balance of patients with chronic stroke.
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