• Journal of Biomedical Engineering Research
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• v.43 no.5
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• pp.361-368
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• 2022

The purpose of this study was to develop a hand rehabilitation training system for hemiplegic patients. We also tried to find out five hand postures (WF: Wrist Flexion, WE: Wrist Extension, BG: Ball Grip, HG: Hook Grip, RE: Rest) in real-time using multi-channel EMG-based deep learning. We performed a pre-processing method that converts to Spider Chart image data for the classification of hand movement from five test subjects (total 1,500 data sets) using Convolution Neural Networks (CNN) deep learning with an 8-channel armband. As a result of this study, the recognition accuracy was 92% for WF, 94% for WE, 76% for BG, 82% for HG, and 88% for RE. Also, ten physical therapists participated for the usability evaluation. The questionnaire consisted of 7 items of acceptance, interest, and satisfaction, and the mean and standard deviation were calculated by dividing each into a 5-point scale. As a result, high scores were obtained in immersion and interest in game (4.6±0.43), convenience of the device (4.9±0.30), and satisfaction after treatment (4.1±0.48). On the other hand, Conformity of intention for treatment (3.90±0.49) was relatively low. This is thought to be because the game play may be difficult depending on the degree of spasticity of the hemiplegic patient, and compensation may occur in patient with weakened target muscles. Therefore, it is necessary to develop a rehabilitation program suitable for the degree of disability of the patient.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.28 no.3
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• pp.89-99
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• 2022

Background: The purpose of this study was to investigate the effects of physical therapy intervention with local vibration on the physical function of patients with traumatic patella fractures. Methods: This study recruited 6 subjects who had suffered traumatic patella fractures. The study was conducted for an average of 12.8 weeks. Before the treatment (2 weeks post-surgery), they were evaluated using the numeric pain rating scale (NPRS), the Korean-version of the impact of event scale-revised (IES-R-K), pressure pain threshold (PPT), range of motion (ROM) of the knee joint, and the Korean knee injury and osteoarthritis outcome score (K-KOOS) and were reevaluated after 7 and 12 weeks, post-surgery. This study was conducted according to ORIF Patella Fracture Post-Operative Rehabilitation Protocol after applying local vibration. The protocol consists of Phases 1~5 and this study has been applied from phase 2. Results: A comparison of the performance of the participants before and after the intervention showed a decrease in NPRS (9.83±.41→4.83±.98), IES-R-K (68.67±2.73→23.83±2.40), and K-KOOS (Function, Daily living: 70.5±5.96→34.0±3.35, Function, Sports and Recreational activities: 22.83±2.32→10.77±1.37, Quality of Life: 19.33±7.33→7.33±.52) scores. And the ROM (Knee flexion: 30.0±4.47°→128.73±3.6°, Knee extension: -6.83±2.48°→-1.33±1.03°) and PPT (9.67±.52kg/cm²→22.44±2.33kg/cm²) scores increased. Conclusion: These results show that physical intervention with local vibration using a Blackroll® booster and head can help to improve pain, physical function, and psychological status. Also, it was possible to select interventions depending on the patient's condition and the desired goal, using physical intervention with the Blackroll® booster technique.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.1
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• pp.49-61
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• 2022

PURPOSE: This study compared the effects of proprioceptive sensation, subacromial space, and dynamic function according to proprioceptive neuromuscular facilitation (PNF), static stretching (SS), and complex rotational stretching (CRS). METHODS: Thirty students without any musculoskeletal disease who volunteered to participate were included in this study. The following metrics were measured to evaluate the function and stability under the normal conditions, with the PNF, SS, and CRS: special test and flexion, extension, abduction, adduction, internal rotation, external rotation (shoulder range of motion) and reaching distance on the medial (ME), superolateral (SL), inferolateral (IL), and subacromial space and proprioceptive sensation were evaluated. All measures were analyzed using one-way ANOVA and repeated measures of ANOVA. RESULTS: A clear difference in adduction in the range of motion was observed in all groups (p < .05). Significant differences could not be identified in all values in the error test, except for Ab (p < .05). Significant differences in reach were noted in all directions of the SS and PNF in the Me, SL, and IL (p < .05). After the intervention, significant differences in the average values could be identified in all groups except for the SS group after rest (p < .05). After the intervention, there was a significant difference between the CRS and SS and PNF groups (p < .05). CONCLUSION: The application of CRS is as helpful as the existing SS and PNF for improving the joint range of motion improvement, shoulder balance, and subacromial space.

• PNF and Movement
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• v.20 no.3
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• pp.451-459
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• 2022

Purpose: Temporomandibular disorder (TMD) is a common musculoskeletal problem that causes pain in and disability of masticatory muscles, the temporo-mandibular joint (TMJ), and related structures. The purpose of this study was to compare pressure pain thresholds (PPTs) of masticatory muscles, cervical ranges of motion (ROM), and pelvic mobility during gait of subjects with or without TMD. Methods: In this study, pain thresholds and changes in the mobility of the cervical vertebrae and pelvis were measured in 25 patients with TMD and 25 healthy controls. Using a pressure algometer, the pressure pain thresholds (PPTs) of the masseter and temporalis muscles were measured in both groups. A gyroscope sensor with a mobile application was used to determine cervical ROM in the frontal and sagittal planes. A 3D-motion analysis system was used to evaluate pelvic mobility in the sagittal, frontal, and transverse planes during gait. Results: The TMD group showed significantly decreased PPTs of masseter and temporalis muscles compared with the control group (p < 0.05). Cervical ROM in flexion, extension, and lateral bending were significantly decreased in the TMD group compared with the control group (p < 0.05). In addition, antero-posterior pelvic tilt was significantly decreased in the TMD group (p < 0.05). Conclusion: The results of the current study suggest that there are close anatomical and functional relationships between TMD and muscle chains related to the cervical spine and pelvis. Therefore, more comprehensive body posture assessments, especially of painful areas, should be undertaken when studying TMD patients.

• Physical Therapy Korea
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• v.30 no.1
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• pp.15-22
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• 2023

Background: Delivery workers repeatedly get in and out of trucks and walk or run to deliver packages during work. Iliotibial band syndrome (ITBS) is a well-known non-traumatic overuse injury of the lateral side of the knee caused by frequent knee flexion and extension. Hip muscle strength is among the factors that prevent lower extremity injuries. Although many studies have examined the relationship between ITBS and hip muscle strengths, there was no study comparing hip muscle strength and ratio between delivery workers with and without ITBS. Objects: This study aimed to compare hip muscle strength and hip internal/external rotator and adductor/abductor strength ratios between delivery workers with and without ITBS. Methods: Fourteen delivery workers with ITBS matched inclusion criteria in the present study among 20 participants. Because total sample size was required 28 subjects by G*power program (ver. 3.1.9.4; University of Trier), 14 delivery workers without ITBS were recruited. Hip muscle strengths were measured in a side-lying position using a Smart KEMA pulling sensor (KOREATECH Co. Ltd.). An independent t-test was used to compare hip muscle strengths and hip internal/external rotator and hip adductor/abductor strength ratios between delivery workers with and without ITBS. Results: The adductor/abductor strength ratio was significantly greater in delivery workers without ITBS than in those with ITBS (p < 0.05). The strengths of the hip abductor, hip adductor, hip internal rotator, hip external rotator, and the ratio of internal/external rotator strengths were not significantly different between the delivery workers with and without ITBS (p > 0.05). Conclusion: This study's findings showed that delivery workers with ITBS had significantly lesser adductor/abductor strength ratio, while the strengths of the hip abductor and adductor muscles did not differ significantly. These results suggest that adductor/abductor strength ratio should be considered when evaluating and treating ITBS in delivery workers.

• PNF and Movement
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• v.21 no.1
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• pp.37-45
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• 2023

Purpose: Whiplash-associated disorder is often caused by external impact, such as a car accident, and it involves acceleration and deceleration of the flexion and extension of the neck. The purpose of this study is to determine whether the combination of cyrotherapy and a joint mobilization intervention in patients with acute whiplash-associated disorder is effective for pain, cervical range of motion (ROM), and muscle tone in the neck muscles. Methods: In this study, 20 patients with acute whiplash-associated disorder were randomly assigned to two groups. Group A was treated with cyrotherapy for 5 minutes, while group B was treated with cyrotherapy and a joint mobilization intervention. In both groups, visual analogue scale (VAS), neck disability index (NDI), cervical ROM, and muscle tone values were measured pre- and post-intervention. Results: According to the VAS values, both groups showed significant differences pre- and post-intervention (p<0.05), and in both groups, NDI was significantly decreased pre- and post-intervention (p<0.05). Finally, in terms of muscle tone, both groups showed significant changes before and after the intervention (p<0.05). Conclusion: These results showed that cryotherapy and joint mobilization can be effective interventions in patients with whiplash-associated disorder. In addition, to improve the ROM of the cervical joint and reduce NDI, the combination of cryotherapy and joint mobilization is considered more effective than the single intervention of cryotherapy.

• Physical Therapy Rehabilitation Science
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• v.11 no.4
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• pp.414-420
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• 2022

Objective: In this study, the test-retest reliability and validity were presented to evaluate the usability of isokinetic rehabilitation equipment for the knee joint. Design: Cross-sectional design, reliability & validity study. Methods: Thirty healthy adults participated in the study. A CSMI dynamometer was used as a standardized measuring device to present the validity of the equipment. It was measured based on the dominant leg. The average peak torque value was selected as the measurement variable. After the measurement, a questionnaire was conducted on safety, satisfaction, and performance through the usability evaluation questionnaire. Results: The knee joint isokinetic rehabilitation equipment showed high reliability with Intraclass Correlations Coefficients (ICC) =0.883~0.956. In order to check the validity of the equipment, the 95% confidence interval of the mean difference limit was confirmed by the Bland & Altman plot. As a result, all three angular velocities showed a smaller confidence interval in the flexion than in extension. There were less than 10 plots that were not included in 2 Standard Deviation (SD) between all measurements. As a result of the usability evaluation questionnaire, the average of the safety domain(4.9±0.4), satisfaction domain(4.1±0.8), performance domain(4.3±0.8). Conclusions: If the product is improved by supplementing the items identified in the usability evaluation process, it is judged that it can be used as a useful device in various knee joint rehabilitation fields.

• Journal of the Korean Society of Clothing and Textiles
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• v.47 no.3
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• pp.577-592
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• 2023

In this study, nanofiber-based textile sensors were developed for motion detection and monitoring. Poly(vinylidene fluoride) (PVDF) nanofibers containing zinc oxide (ZnO) nanoparticles and silver nanowires (AgNW) were fabricated using electrospinning. PVDF was chosen as a piezoelectric polymer, zinc oxide as a piezoelectric ceramic, and AgNW as a metal to improve electric conductivity. The PVDF/ZnO/AgNW nanocomposite fibers were used to develop a textile sensor, which was then incorporated into an elbow band to develop a wearable smart band. Changes in the output voltage and peak-to-peak voltage (V_p-p) generated by the joint's flexion and extension were investigated using a dummy elbow. The β-phase crystallinity of pure PVDF nanofibers was 58% when analyzed using Fourier transform infrared spectroscopy; however, the β-phase crystallinity increased to 70% in PVDF nanofibers containing ZnO and to 78% in PVDF nanocomposite fibers containing both ZnO and AgNW. The textile sensor's output voltage values varied with joint-bending angle; upon increasing the joint angle from 45° to 90° to 150°, the V_p-p value increased from 0.321 V_p-p to 0.542 V_p-p to 0.660 V_p-p respectively. This suggests that the textile sensor can be used to detect and monitor body movements.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.18 no.2
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• pp.1-8
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• 2023

Objectives This study aimed to propose biomarkers for diagnosing Chuna manual therapy (CMT) based on X-ray images in the thoracic and lumbar spines. Methods Through a literature review and expert consensus process, diagnostic biomarkers for CMT were selected based on the listing system in thoracic and lumbar radiograph anterior-posterior (AP) and lateral views. Results 1. Diagnostic biomarkers were derived from four points on the outer contour of the vertebral body in the thoracic and lumbar spine radiograph lateral view, enabling the diagnosis of flexion and extension malposition. 2. Additional diagnostic biomarkers were identified in the thoracic and lumbar radiographAP view, utilizing points on the outer contour of the vertebral body. These biomarkers facilitate the diagnosis of lateral bending. Moreover, biomarkers derived from the innermost point of the pedicle contour allow for the diagnosis of rotation malposition. 3. Furthermore, through the biomarkers proposed in this study, all malpositions of the thoracolumbar spines and complex Type I and II malpositions can be diagnosed in CMT. Conclusions The biomarkers reported in this study consist of minimal points to determine the position of the vertebral body, providing the advantage of simplicity while minimizing potential errors during the CMT diagnostic process. Further clinical research and the development of related programs should be pursued to expand the evidence for CMT.

• Journal of Korean Neurosurgical Society
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• v.66 no.6
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• pp.703-715
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• 2023

Objective : This retrospective study investigated the factors that affect cage obliquity angle despite orthogonal maneuvers performed during oblique lateral interbody fusion (OLIF) and assessed the relationship between cage obliquity angle and radiological outcomes post-surgery. Methods : Twenty-nine males who underwent L4-L5 OLIF for lumbar degenerative disease between 2019 and 2021 with a followup duration greater than 12 months were analyzed. Radiological parameters were measured including psoas muscle volume, total psoas area index (total psoas muscle area [cm²]/height squared [m²]), distance from the iliac artery to the origin of the psoas muscle (DIAPM), angle between the origin of the psoas muscle and the center of the vertebral disc (APCVD), iliac crest height, disc height, lumbar flexibility (lumbar flexion angle minus extension angle), cage location ratio, cage-induced segmental lumbar lordosis (LL) (postoperative index level segmental LL minus used cage angle), foraminal height changes, fusion grade. Results : DIAPM, APCVD, iliac crest height, postoperative index level segmental LL, and cage-induced segmental LL were significantly correlated with OLIF cage obliquity angle. However, other radiological parameters did not correlate with cage obliquity. Based on multiple regression analysis, the predictive equation for the OLIF cage obliquity angle was 13.062-0.318×DIAPM+0.325×1APCVD+0.174×iliac crest height. The greater the cage obliquity, the smaller the segmental LL compared to the cage angle used. Conclusion : At the L4-L5 level, OLIF cage obliquity was affected by DIAPM, APCVD, and iliac crest height, and as the cage obliquity angle increases, LL agnle achievable by the used cage could not be obtained.