• Clinical Pain
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• v.20 no.1
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• pp.49-52
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• 2021

Bertolotti's syndrome (BS) refers to chronic low back pain (LBP) associated with lumbosacral transitional vertebrae (LSTV). Many studies suggest that the anomalous articulation alters biomechanics, resulting in discomfort on the ipsilateral side. Herein, we present an unusual case of BS presenting pain on the non-articulated side. A 46-year-old man visited our clinic with history of chronic LBP, refractory to treatment of analgesics, modalities and manual therapies. Electrodiagnostic studies showed no evidence of lumbosacral radiculopathy. Radiographies noted unilateral pseudoarticulation of L5~S1 vertebrae, on the contralateral side of his pain. The pain improved dramatically after sacroiliac joint block and facet joint block with iliolumbar ligament infiltration on the non-articulated side. Clinicians should be cautious that the unaffected joint in BS may serve an important role in altered lumbopelvic biomechanism, since it might eventually lead to intractable chronic LBP when overlooked.

• Journal of Convergence for Information Technology
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• v.10 no.5
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• pp.188-197
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• 2020

This study was to investigate the effects of joint mobilization with two different electrotherapy methods on shoulder external rotation range of motion and pain in mastectomy patients. Thirty mastectomy patients were divided into STMG (joint mobilization+pain scrambler therapy, n=15) and TENMG (joint mobilization+transcutaneous electrical nerve stimulation, n=15). The measurements were performed shoulder external rotation range of motion (ROM), pain (VAS). In both groups, there was a significant difference in the shoulder external rotation ROM, pain after intervention (p <.05). STMG was more decrease in VAS score than TENMG (p <.05). There was no significant difference in shoulder external rotation ROM between the two groups. In order to decrease the pain of mastectomy patients, it was confirmed that STMG was more effective than TENMG.. It is thought that a control group is added to confirm various differences, and more subjects are needed.

• Physical Therapy Rehabilitation Science
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• v.9 no.1
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• pp.25-35
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• 2020

Objective: To compare the effects of joint mobilization, gym ball exercises, and breathing exercises on breathing pattern disorders and joint position sense in persons with chronic lower back pain. Design: Three-group pretest-posttest design. Methods: Thirty-six individuals with chronic low back pain who were undergoing a postural correction and vertebral movement at a rehabilitation center participated in this study. The subjects were randomly divided into the joint mobilization group (n=12), gym ball exercises group (n=12), and the breathing exercises group (n=12). The exercises were applied for 40 minutes a day, twice a week for a total of 12 weeks. Measurement tools included the end-tidal CO₂ (ETCO₂), respiration rate (RR), breath hold time, Nijmegen Questionnaire (NQ), excursion, and joint position error (JPE). Results: The groups showed significant differences in the ETCO₂, RR, NQ, Excursion and JPE test before and after the intervention (p<0.05). The differences between the groups were significant in the group that received the gym ball and breathing exercises in ETCO₂ and RR (p<0.05). The differences between the groups were most significant in the group that received breathing exercises in NQ and excursion (p<0.05). The differences between the groups were significant in the group that received the gym ball and breathing exercises in JPE Lt. and Rt. (p<0.05). Conclusions: All three interventions had a significant impact on the biomechanical changes, respiratory variables, and joint position sense in participants with chronic lower back pain. Breathing exercises were found to be particularly effective in improving respiratory parameters.

• Journal of Oral Medicine and Pain
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• v.44 no.2
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• pp.59-64
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• 2019

Purpose: The aim of this study was to analyse and evaluate the morphology of the articular eminence of temporomandibular joint in young Korean adults using cone-beam computed tomography (CBCT). Methods: One hundred seventy-one subjects (59 males, 112 females) in the 20s were examined using CBCT. Width and height of articular eminence, top-roof line angle, best-fit line angle, joint space were measured. For the group comparisons, independent t-test was used with the level of significance established at $p{\leq}0.05$. Results: In asymptomatic young Korean adults, average eminence width was $9.49{\pm}1.62mm$ in males and $9.33{\pm}1.36mm$ in females. Average eminence height was $7.23{\pm}1.81mm$ in males and $6.82{\pm}1.31mm$ in females. Average eminence inclination of measured by top-roof line angle was $37.09^{\circ}{\pm}7.74^{\circ}$ in males and $36.12^{\circ}{\pm}5.65^{\circ}$ in females. Average eminence inclination measured by best-fit line angle was $50.79^{\circ}{\pm}11.49^{\circ}$ in males and $48.43^{\circ}{\pm}9.05^{\circ}$ in females. Average joint space was $3.03{\pm}0.67mm$ in males and $2.63{\pm}0.68mm$ in females. Conclusions: Increasing age did not affect the morphology of the articular eminence in asymptomatic young Korean adults. Males had slightly larger eminence width, height, top-roof line angle, best-fit line angle and joint space, but no statistical significance (p>0.05) was observed only in the joint space (p=0.001). There was no side-to-side difference in morphology (p>0.05).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.1
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• pp.50-58
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• 2022

Objectives: Osteoarthritis (OA) is the most prevalent and disabling joint disease in the world. Temporomandibular joint (TMJ) exercise is a widely used treatment and could be a beneficial and long-term tool for treating TMJ OA. The present study aims to evaluate the effects of therapeutic exercise in the conservative treatment of TMJ OA. Materials and Methods: A single-group experimental pre-post test was performed. We included patients who met the diagnostic criteria for TMJ OA. Outcome variables were pain intensity (visual analogue scale), functionality (Helkimo index), and structural changes (ultrasound). Follow-up periods were at months 1, 3, and 6. The intervention included a home-based program with thermotherapy, manual therapy, and therapeutic exercise during the entire follow-up period. Results: We included 15 patients and 26 joints, all women with a median age of 57 years (range, 49-62 years). Median change in pain intensity on joint palpation, mouth opening, and at rest at the first month was 47.5 mm, 51 mm, and 60 mm, respectively, and 48 mm, 49.5 mm, and 42.5 mm, at six months (P=0.001). The Helkimo index showed significant improvement in medians from baseline severe dysfunction (17 points) to minimal dysfunction at three and six months (2 points) (P=0.001). Ultrasound showed improved disc position. Conclusion: This study demonstrated significant improvements in pain, function, and joint disc position and represents a valuable tool for the long-term treatment of patients with TMJ OA.

• Imaging Science in Dentistry
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• v.31 no.2
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• pp.73-84
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• 2001

Purpose: The purpose of this study was to find the relationship among the joint status, pain and effusion in patients with temporomandibular joint disorders. Materials and Methods: Materials included 406 patients (812 joints) with clinical records and bilateral TMJ MRIs in TMJ clinic, Yongdong Severance Hospital. All joints were classified in 4 groups in MR images according to the disc status of joint; normal disc position, disc displacement with reduction (DDcR), early and late stage of disc displacement without reduction (DDsR), and also 2 groups according to the bony status of joint; normal bony structure and osteoarthrosis. MR evidence of joint effusion was categorized in 4 groups according to its amount. To determine the relationship between joint pain and joint effusion, 289 patients with unilateral TMJ symptoms were selected from total materials. Result: Joint effusion was found 8.0% in normal disc position, 32.6% in DDcR, and 59.2% in DDsR (83.1 % in early state and 23.1 % in late stage). Joint effusion was found 39.7% in osteoarthrosis and 35.0% in normal bony structure. Joint effusion was more found in the painful joints (49.8%) than in the painless joints (22.4% )(p<0.001). Joint effusion in the early stage of DDsR only was more found significantly in painful joints (91.9%) than in painless joints (62.1 %) (p<0.001). Conclusion : MR evidence of joint effusion might be related to disc displacement regardless of the presence of osteoarthrosis, and the early stage of DDsR was found more frequently combined with joint effusion and joint pain.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.14 no.1_2
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• pp.146-153
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• 1992

In the outpatient clinic, we have many patients who suffer from temporomandibular joint disorders. These vary from MPD syndrome to osteoarthrosis, and many cases have tender spots or areas on the temporomandibular joint region and/or masticatory muscles. Further, they frequently have masticatory muscle pain when opening the jaw. This paper presents the results of our research on the differential diagnosis for tendernesses and pain on opening the jaw in the temporomandibular joint region and the masticatory muscles by joint cavity pumping with local anesthestic. The areas of tenderness and jae-opening paw in 65 patient suffering from temporomandibular joint disorder were examined and recorded before and after anesthetizing the upper joint cavity with 2% lidocaine. Maximum interincisal distance was similarly recorded. The results were as follows : In the area surrounding the upper joint cavity including the lateral pterygoid muscle, the tenderness and jaw-opening pain vanished almost entirely after anesthesia. This was considered a direct infiltrative effect of the local anesthesia. After the anesthesia, 86% of the tendernesses on the sternocleidomastoid muscles, and 66% of those on the posterior belly of the diagstric muscles vanished, while the disappearance rates on the masseter, temporal, and medial pterygoid muscles were 50~60%. Apart from the temporomandibular region, pain on opening the jaw was found on the masseter, temporal, posterior belly of the digastric muscles, and medial pterygoid muscles before anesthesia. The disappearance rates after anesthesia were 90~100% except for the pain of the posterior belly of the digastric muscles, for which the rate was 66%. These results suggest that more than 88% of the tendernesses on the sternocleidomastoid muscle, more than 60% of the tendernesses and jaw-opening pains on the digastric muscle, and more than half of the tendernesses and almost all of the jaw-opening pains in the jaw-closing muscles are referred pains from the temporomandibular joint. The tendernesses that had no change after anesthesia were considered to be derived from spasms of the muscles proper. Generally, maximum interincisal distance increased after anesthesia. The average distance was 34mm before anesthesia, but increased to 41mm after anesthesia. In a few cases, however little or no change was found in those distances. In these cases, pathological changes were found in the joint cavities arthrographically or arthroscopically.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.3
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• pp.61-66
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• 2018

PURPOSE: This study was conducted to determine the effects of taping on a home program of hip abductor exercise on pain and quadriceps muscle strength during knee joint osteoarthritis. METHODS: The subjects were 24 elderly women aged over 65 years with knee joint osteoarthritis. Twenty-four subjects were divided into two groups of 12. The intervention was conducted three times a week for six weeks. The control group underwent a home program of hip abductor exercise, while the experimental group underwent taping applied to a home program of hip abductor exercise. The measurement factors were knee joint pain and quadriceps muscle strength. Knee joint pain was measured using the VAS, while quadriceps muscle strength was measured using the 1RM method. RESULTS: Changes in pain following intervention were significantly reduced from $4.83{\pm}.72$ to $3.92{\pm}.67$ in the control group. In the experimental group, changes in pain following intervention were reduced significantly from $4.67{\pm}.78$ to $3.25{\pm}.45$. In the experimental group, the pain decreased significantly, while muscle strength increased significantly as in the control group. However, there were significant differences in pain and muscle strength between groups post intervention (p<.05). CONCLUSION: In the elderly women with knee osteoarthritis, the home program of hip abductor exercise will be a good intervention, and taping will be applied as an intervention program for better osteoarthritis.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.4
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• pp.85-92
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• 2022

PURPOSE: This study examined the effects of motion taping during combined lower extremity exercise application on pain, ROM, muscle strength, and WOMAC index in middle-aged women with osteoarthritis of the knee joint METHODS: The subjects were 26 middle-aged women with osteoarthritis in the knee joint. Twenty-six subjects were divided into two groups. Each group contained 13 subjects. Three subjects dropped out in the middle of the experiment. The intervention was six weeks, three times a week. The control group performed traditional physical therapy and lower extremity exercise. The experimental group was motion taping applied to the lower extremity exercise. The measurement factors were knee joint pain, quadriceps muscle strength, and WOMAC index. The pain was measured using the numeric pain scale instrument (NPSI). The quadriceps strength was measured using the 1RM method. RESULTS: In both groups, pain, muscle strength, and WOMAC index showed significant improvement according to the intervention (p < .05). In comparison between groups of the change values pre-post intervention, pain and WOMAC index showed statistically significant differences between the two groups. On the other hand, there was no difference in strength between the two groups. CONCLUSION: When performing a rehabilitation exercise program for middle-aged women with osteoarthritis of the knee, motion taping has a positive effect on pain and the WOMAC index.

• The Korean Journal of Pain
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• v.37 no.2
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• pp.164-177
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• 2024

Background: Neck and jaw pain is common and is associated with jaw functional limitations, postural stability, muscular endurance, and proprioception. This study aimed to investigate the effect of jaw and neck pain on cranio-cervico-mandibular functions and postural stability in patients with temporomandibular joint disorders (TMJDs). Methods: Fifty-two patients with TMJDs were included and assessed using Fonseca's Questionnaire and the Helkimo Clinical Dysfunction Index. An isometric strength test was performed for the TMJ depressor and cervical muscles. The TMJ position sense (TMJPS) test and cervical joint position error test (CJPET) were employed for proprioception. Total sway degree was obtained for the assessment of postural stability. Deep neck flexor endurance (DNFE) was assessed using the craniocervical flexion test. The mandibular function impairment questionnaire (MFIQ) was employed to assess mandibular function, and the craniovertebral angle (CVA) was measured for forward head posture. Results: Jaw and neck pain negatively affected CVA (R² = 0.130), TMJPS (R² = 0.286), DNFE (R² = 0.355), TMJ depressor (R² = 0.145), cervical flexor (R² = 0.144), and extensor (R² = 0.148) muscle strength. Jaw and neck pain also positively affected CJPET for flexion (R² = 0.116) and extension (R² = 0.146), as well as total sway degree (R² = 0.128) and MFIQ (R² = 0.230). Conclusions: Patients with painful TMJDs, could have impaired muscle strength and proprioception of the TMJ and cervical region. The jaw and neck pain could also affect postural stability, and the endurance of deep neck flexors as well as mandibular functions in TMJDs.