어깨뼈 뒤 당김 운동 방법에 따른 큰마름근과 중간등세모근의 근두께비의 비교 (Comparison of the Ratio of Thicknesses of the Rhomboid Major and Middle Trapezius Muscles While Performing Scapular Retraction Exercises)
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- 한국전문물리치료학회지
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- 제29권2호
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- pp.131-139
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- 2022
Background: Shoulder impingement syndrome, a major cause of shoulder pain, involves weakness of the scapular retractor muscles. The major scapular retractor muscles are the middle trapezius and rhomboid major muscles; however, the latter is excluded in most studies. Objects: We aimed to measure the thickness of the middle trapezius and rhomboid major muscles using an ultrasonic diagnostic imaging system while performing four different shoulder retraction exercises and comparing the thicknesses and ratio of the thicknesses of these muscles. Methods: The thickness of the middle trapezius and rhomboid major muscles was measured in 24 healthy adults using ultrasound. Muscle thickness was measured three times in the Reference posture and four times while performing four different exercises that involved scapular retraction. The averages and standard deviations of the measured muscle thicknesses were obtained and compared. The ratio of muscle thickness and rate of changes in muscle thickness between the reference posture and the four exercises were compared. Results: For both, male (n = 10) and female (n = 14), there was a significant difference in the thickness of the middle trapezius muscle between the reference posture and the four exercises (p < 0.05) and in the thickness of the middle trapezius and rhomboid major muscles between male and female (p < 0.05); however, there was no significant difference in the ratio of the thicknesses of these muscles. Although a significant difference in the rate of change in muscle thickness during the four exercises was noted, there was no significant difference in the ratio of change in muscle thickness. Conclusion: This study demonstrates the ratio of the thicknesses of the middle trapezius and rhomboid major muscles and the rate of change in their thickness during exercises involving scapular retraction in healthy people in their 20s-30s.
새로 개발된 조기 진단 장비들로는 laser fluorescence device(LFD), 초음파 진단 시스템, confocal laser scanning microscopy(CLSM), quantitative light-induced fluorescence(QLF) 시스템 그리고 digital imaging fiber-optic trans-illumination(DIFOTI) 시스템 등이 있다. 본 연구는 임상에서 사용되고 있는 DIFOTI시스템과 LFD를 이용하여 유치 교환 시기에 있는 환아 21명, 25개의 유치를 대상으로 각 치아당
Background: The purpose of this study was to investigate the effect of Plank exercise on unstable support surfaces on flexibility, abdominal muscle thickness and pain in patients with chronic back pain. Design: Randomized controlled trial. Methods: This study was performed on 16 patients with chronic back pain of ◯◯ military unit. Sixteen subjects were randomly assigned into two groups, an upper extremity trainer group (group I, n=8) and a lower extremity trainer group (group II, n=8). The subjects in group I carried out Flank exercise applying the stability trainer to their upper extremities and ones in group II carried out the same exercise applying the stability trainer to their lower extremities for 4 weeks. In order to ascertain the difference between two groups, flexibility, abdominal muscle thickness and pain were measured before and after the exercise. The flexibility was measured by sit and reach test, the thickness of the abdominal muscle was measured by using ultrasonic imaging equipment, and the pain was measured by the visual analogue scale. A paired t-test was utilized to compare changes in pain, abdominal muscle thickness and flexibility before and after flank exercise on unstable support surfaces. Analysis of Covariance (ANCOVA) was performed for ascertaining the significant differences between groups. The significance level was set by α=.05. Results: 1) The flexibilities of two groups were increased after the exercise (p<0.05). 2) In both groups, the thicknesses of rectus abdominis, external oblique abdominis, internal oblique abdominis, and transverse abdominis were all increased after the exercise (p<0.05). 3) The pains in both groups were decreased after the exercise (p<0.05). 4) In the comparisons of two groups, there were no differences in the flexibility, thickness of external oblique abdominis, internal oblique abdominis and transverse abdominis and pain (p>0.05). Whereas only thickness of Rectus abdominis was larger in the group I than in the group II (p<0.05). Conclusion: Plank exercise on the unstable support surface for 4 weeks resulted in increased flexibility, abdominal muscle thickness and pain reduction in patients with chronic back pain. Therefore, it is considered that performing flank exercise on the unstable supporting surface is suitable for the reduction of the pain in patients with chronic back pain. However, in this study, it is considered that continuous and diverse studies are needed because there was not a large difference between the groups when the upper or lower limbs are provided unstable support surfaces.
초음파 영상의 질은 진단에 많은 영향을 끼친다. 양질의 영상이 항상 일정하게 유지되기 위해서는 QA(Quality Assurance) 프로그램을 가지고 주기적인 관리가 이루어져야 할 것이다. 본 논문은 임상에서의 QA 상황을 파악하는 첫 번째 단계로 실제 병원의 초음파 영상의 질을 살펴보고자 하였다. 이를 위해 인간의 생체등가물질로 된 팬텀을 이용하여 정상 환자를 스캔할 때와 같은 기준 값에서 가상의 낭포 및 고반사 신호의 구조물들이 몇 개가 보이는지 convex probe와 linear probe를 측정하여 비교하였다. convex probe에서는 정상 간과 비슷한 0.5 dB에서 vertical group, cystic masses, high contrast masses에서는 대부분 잘 보였으며 지방간과 비슷한 조건인 0.7 dB에서는 vertical group이 중간레벨에서, cystic masses와 high contrast masses에서는 대체로 모두 잘 보였다. linear probe에서의 vertical group은 0.5 dB에서 중간레벨만 잘 보였고 cystic masses와 high contrast masses는 두 개에서 네 개 보이는 것들이 고루 분포되었으나 하나도 보이는 않는 경우가 11건수나 되었다. 0.7 dB에서는 vertical group이 6개 이하가 보이는 것이 대부분 이었고 cystic masses와 high contrast masses에서도 두개에서 네 개 보이는 것들이 고루 분포되었고 하나도 보이는 않는 경우도 40건 있었다. 이로서 지방간과 같은 조건하에서는 linear probe의 영상의 질이 대체로 좋지 않으므로 기준 설정 및 물리적인 조건들을 검사 시에 잘 조정하거나 probe의 교체가 필요하다고 판단된다. 많은 병원에서 초음파 장비를 잘 관리하고 있다고 하지만, 영상의 질은 아직도 미흡한 것을 알 수 있다. 초음파 장비의 설치에서부터 영상의 질을 평가하고 지속적이고 정기적인 관리와 평가가 이루어질 수 있는 프로그램이 필요하겠다.
Objectives The purpose of this study was to observe effectiveness of ultrasound-guided Soyeom pharmacopuncture therapy at acromioclavicular joint of shoulder in patients with anterior shoulder pain. Methods We analyzed medical records of 9 patients hospitalized with anterior shoulder pain who had admitted to Department of Korean Rehabilitation Medicine, College of Korean Medicine, Daejeon University from March 1, 2021 to June 13, 2021. 9 patients were treated the treatment of Soyeom pharmacopuncture therapy on acromioclavicular joint under ultrasonic guidance with Korean medicine treatment (such as herbal medicine, acupuncture, moxabustion, etc). The study was conducted as a retrospective observation study which analyze the patient's medical records. We used numeric rating scale (NRS) to evaluate pain reduction and the shoulder range of motion (ROM) to evaluate function improvement twice (before pharmacopuncture treatment and 5 days later treatment). Statistical analysis was performed using the IBM SPSS Statistics version 25 program (IBM Co., Armonk, NY, USA). Results The average of numeric rating scale reduced statistically significantly from 5.56±1.13 to 3.11±1.36 (p=0.004). The average of shoulder flexion ROM increased statistically significantly from 166.67±8.17° to 175.00±8.37° (p<0.05). And the average of shoulder abduction ROM increased statistically significantly from 158.57±20.35° to 172.86±12.53° (p<0.05). Both NRS and shouler ROM showed statistically significantly improve after treatment. Conclusions This study shows ultrasound-guided Soyeom pharmacopuncture therapy at acromioclavicular joint of shoulder has a meaningful clinical effect on the improving shoulder pain and ROM especially on flexion and abduction.
본 논문은 초음파 검사 및 판독에 사용되는 CRT, LCD 모니터에서 영상검사와 판독 시 적절한 시각화에 대한 최적의 주변 조도 수준을 제안하고자 하였다. 평가자들은 4그룹 20명(Ultra-sonographer 20명(4 groups; ultra-sonographer 1~5 years 5명, ultra-sonographer 6~10 years 5명, ultra-sonographer 11~15 years 5명, ultra-sonographer 16~20 years 5명)을 대상으로 하였으며, 문항수는 32문항이었다. 평가방법은 10, 25, 100 Lux 3가지 주변광 조도에서 초음파 soft copy 영상을 1문항 당 30초간 영상 평가하였으며, 평가 결과를 6점 척도로 1점=Normal (Definitely no lesion), 2점=possibly not a lesion, 3점=probably not a lesion, 4점=possibly a lesion, 5점=probably a lesion, 6점=Definitely a lesion으로 나타내었다. 본 연구에서 주변광에 따른 초음파 영상들에 대한 병변 감지에 사용되는 소프트 카피(soft copy) 영상 판독 ROC분석 결과는 10 Lux에서 높은 민감도, 특이도, 곡선하면적 결과를 나타내었다. 주변광 조도로 10 Lux를 이용한다면 초음파(ultrasound) 소프트 카피(soft copy) 영상의 병변 탐지에 있어 최적의 효과를 얻을 수 있음을 알 수 있었다. 추후 연구 자료를 기초로 하여 초음파 영상 검사실 및 판독실의 주변광 조명밝기를 설계하면서 기초자료로 제시될 것으로 생각한다.
미만성 갑상샘질환은 그 진단 기준이 모호하고 숙련자의 주관적인 진단에 따라 오류가 많이 발생한다. 또한 갑상샘 결절의 초음파 영상에 관한 연구는 활발히 이루어졌지만 미만성 갑상샘질환에 관한 연구 사례는 미흡한 실정이다. 본 연구에서는 정상과 미만성 갑상샘질환의 영상에 GLCM 알고리즘을 적용하여 영상의 특징을 추출하고 추출된 특징값을 파라미터를 이용하여 정량적인 분석을 하였다. W 병원에서 진단한 환자의 갑상샘 초음파 영상을 대상으로 GLCM 알고리즘을 이용하여 정상 199증례, 경도 132증례, 중등도 99증례 총 영상 430증례에 관심영역(50×50 pixel)을 설정하고, 각 영상에서 Autocorrelation, Sum of squares, Sum average, Sum variance, Cluster prominence, Energy 6가지 파라미터를 이용하여 분석하였다. Autocorrelation, Sum of squares, Sum average, Sum variance 4가지 파라미터에서 Normal, Mild, Moderate를 구분하는데 90%이상의 높은 인식률을 보였다. 미만성 갑상샙질환의 초음파영상에서 GLCM 알고리즘을 이용하여 미만성 갑상샘질환의 심각도 정도를 분류하는 기준으로서 가치가 있다. 이러한 파라미터를 적용하여 갑상샘질환의 진단에 있어 육안 판독에 따른 오류를 감소시키고 미만성 갑상샘질환 진단의 2차적인 수단으로 활용 가능할 것으로 기대된다.
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70