• Annals of Clinical Neurophysiology
• /
• v.21 no.2
• /
• pp.79-86
• /
• 2019

Background: Magnetic resonance (MR) images are useful for diagnosing myopathy. The purpose of this study was to determine the usefulness of lower-limb MR images in Korean patients with distal myopathy. Methods: We reviewed medical records in the myopathy database from January 2002 to October 2016. We selected 21 patients from 91 unrelated families with distal myopathy: four with GNE myopathy, 11 with dysferlinopathy, and six with ADSSL1 myopathy. Results: Ten (48%) of the 21 patients were men. The ages of the participants at symptom onset and imaging were $19.2{\pm}9.5$ and $30.4{\pm}9.0$ years (mean${\pm}$standard deviation), respectively. Their grade on the modified Gardner-Medwin and Walton grade was $3.3{\pm}1.7$. The strength grade of the knee extensors was not correlated with the Mercuri scale for the quadriceps (r = -0.247, p = 0.115). However, the Medical Research Council grades of the knee flexors, ankle dorsiflexors, and ankle plantar flexors were significantly correlated with the Mercuri scale ratings of the knee flexors (r = -0.497, p = 0.001), tibialis anterior (r = -0.727, p < 0.001), and ankle plantar flexors (r = -0.620, p < 0.001), respectively. T1-weighted MR images showed characteristic fatty replacement patterns that were consistent with the causative genes. Unsupervised hierarchical clustering of the Mercuri scale showed that the main factors contributing to the dichotomy were the causative gene and the clinical severity. Conclusions: This study is the first to reveal the usefulness of lower-limb MR images in the differential diagnosis of distal myopathy in Korea.

• The Journal of Korean Physical Therapy
• /
• v.24 no.2
• /
• pp.66-72
• /
• 2012

Purpose: The purpose of this study is to explore the importance of the image distortion correction in the cross sectional area measurement for the iliopsas muscle, tensor fasciae latae muscle, gluteus maximus muscle and the knee extensor muscles, by using (magnetic resonance imaging) MRI. Methods: This study was performed using an open 0.32T MRI system. To estimate the image distortion, T1 images for an AAPM homogeneity/linearity phantom were acquired, and the region in which the maximum geometric distortion was less than or equal to the pixel size (1.6 mm) of the images, it was defined as the distortion correction-free region. The T2 images for a human subject's pelvis and thigh in normal positions were obtained. Then, after the regions of interest in the pelvis and thigh were moved into the distortion correction-free region, T2 images for the pelvis and thigh were scanned with the same imaging parameters used in the previous T2 imaging. The cross-sectional areas were measured in the two T2 images that were obtained in the normal position, and the distortion correction-free region, as well as the area error caused by geometric image distortion was calculated. Results: The geometrical distortion is gradually increased, from the magnet center to the outer region, in axial and coronal plane. The cross-sectional area error of gluteus maximus muscle and the knee extensors was as high as 9.27% and 3.16% in before and after distortion correction, respectively. Conclusion: The cross-sectional area of the muscles that suffered from the geometrical distortion is necessary to correct for the estimation of the intervention.

• Journal of the Korean Academy of Clinical Electrophysiology
• /
• v.2 no.1
• /
• pp.19-37
• /
• 2004

The purpose of this study was to examine the effects of Progressive Resistive Exercise Program and Aqua Exercise Program on Lower extremity Muscle strength, Balance in Elderly old. The average age of elder female was 71.65 years. Subjects of the study were twenty older women living in daejon. The date were analyzed with frequency, independent t-test, paired t-test using SPSS PC(ver.10.0). The subjects were practiced with focusing on the Progressive Resistive Exercise Program and Aqua Exercise Program for 8 weeks, from 8, April 2002 to 1, June 2002. The results of this study were as follows: 1. After the Progressive Resistive Exercise Program, Balance ability by OLSTR, OLSTL was improved(p<0.05) on the soft surface with close eyes. 2. After the Aqua Exercise Program, the strength of the right knee flexors and extensors was improved(p<0.05). 3. After the Aqua Exercise Program, the strength of the left knee flexors was improved(p<0.01). 4. After the Aqua Exercise Program, Balance ability by OLSTR was improved(p<0.001) on the soft surface with open eyes, close eyes and by OLSTL was improved(p<0.05) on the hard surface with open eyes.

• Physical Therapy Korea
• /
• v.8 no.2
• /
• pp.1-16
• /
• 2001

This study was designed to identify the effects of foot position on electromyographic (EMG) activity of the quadriceps femoris during maximum voluntary contraction (MVC) in standing. Twenty young adults who had not experienced any knee injuries were recruited. Their Q-angles were within a normal range. They were asked to stand in five different foot positions ($40^{\circ}$ externally rotated, $30^{\circ}$ internally rotated, neutral, $20^{\circ}$ plantarflexed, and $10^{\circ}$ dorsiflexed foot position). The EMG activities of the vastus lateralis (VL), rectus femoris (RF), and vastus medialis oblique (VMO) were recorded in standing by surface electrodes and normalized by MVC EMG values derived from manual muscle test. The normalized EMG activity levels (%MVC EMG) of muscles in the five foot positions were compared using repeated measures ANOVA. The EMG activity levels of the VL, RF, and VMO were the highest when foot was externally rotated. The EMG activity levels of the VL and RF were significantly different among the foot positions (p<.05). However, EMG activity levels of the VL, RF, VMO, and VMO/VL ratio did not show significant differences in each foot position (p> .05). The results suggest that the quadriceps femoris may be effectively activated by performing MVC at an externally rotated foot position. Therefore, the externally rotated foot position can be considered as an effective foot position for quadriceps femoris strengthening exercise. Further studies are needed to identify whether there are differences in the effects of foot position on muscle strength after MVC exercise of quadriceps femoris in standing.

• The Journal of Korean Physical Therapy
• /
• v.32 no.5
• /
• pp.302-306
• /
• 2020

Purpose: The purpose of this study was to investigate comparisons of vastus medialis (VMO) and vastus lateralis (VL) muscle activities according to different heights during drop landing in flatfooted adults. Methods: Fifteen subjects with a flat foot arch and 15 subjects with a normal feet arch were participated. Subjects performed a double limb drop landing task from 20, 40, and 60 cm heights. Surface electromyography was used to measure the muscle activities of the VMO and VL during drop landing. Results: There were significant differences of muscle activities in the VMO, VL, and the VMO and VL ratio between groups. The electromyography values of VMO, VL, and the VMO and VL ratio in the normal group were significantly greater than in the flat foot group, and muscle activities and the VMO and VL ratio significantly increased with landing heights in the both groups. Conclusion: Our results indicated that muscle activity patterns of VOM and VL in the flat foot group were lower at heights than in the normal group, so calf tightness was negative effects on balance and gait ability, so assessment of muscle activation patterns in the knee extensors should be considered during exercise and treatment of flat feet.

• Korean Journal of Applied Biomechanics
• /
• v.17 no.4
• /
• pp.57-64
• /
• 2007

The purpose of this study was to investigate comparative analysis of the vertical ground reaction force variables during landing from vertical jump blocking in volleyball through GRF analysis system. The subjects participated in this study were 6 male university volleyball player and 6 male acted as a control group. The results are as follows: 1. The skilled group was longer than the unskilled group in flight time during vertical jump blocking. 2. The skilled group was faster than the unskilled group in tFz2 during landing from vertical jump blocking. 3. The skilled group was higher than the unskilled group in Fz2 during landing from vertical jump blocking. 4. The skilled group was higher than the unskilled group in Fz2LR during landing from vertical jump blocking. 5. The skilled group was higher than the unskilled group in impulse during landing from vertical jump blocking. Consequently, during landing from vertical jump, the landing strategy of the skilled group was found as a form of a stiff landing. Therefore, this landing strategy will be required to strengthen of hip and knee extensors and ankle plantar flexors for injury prevention.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.15 no.2
• /
• pp.1-7
• /
• 2009

Purpose : to investigate change of isokinetic muscle strength and isokinetic muscle endurance of quadriceps femoris and hamstring after application of taping and static stretching. Methods : For this study, 14 male members of college soccer team participated in this research. Participants were divided into two groups: seven was assigned to a taping group(n=7) and the others were assigned to a static stretching exercise group(n=7). Main outcome was measured by using biodex. The isokinetic muscle strength test was processed at the speed of the $60^{\circ}$/sec five times, and isokinetic muscle endurance was processed at the speed of $180^{\circ}$/sec ten times. Results : From the outcomes of the measurement, the results show that there is a more significant difference in the taping group than in a static stretching exercise group. Conclusion : These results will be utilized for the preliminaries in the future.

• Journal of muscle and joint health
• /
• v.10 no.1
• /
• pp.62-76
• /
• 2003

This study was a quasi-experimental study of non-equivalent control group pretest and posttest design. The purpose of this study was to determine the effect of Tai Chi exercise program on physical functions, psychological functions, and fall among the fall-prone elderly. The data were collected from September 19, 2001 to January 31, 2002. The study, conducted at two facilities located in Kwang-ju, was targeted to the ambulatory aged 60 years or older who had at least one of the key fall risk factors. Experimental group participated in Tai Chi exercise for 40 minutes per one time and three times a week for 12weeks at an auditorium. Fifty nine fall-prone elderly were assigned to 12-week Tai Chi exercise program (n=29) and control group (n=30). They underwent tests of lower muscle strength, time for chair stand, balance, flexibility, depression, falls efficacy, fear of falling, and numbers of fall at the baseline and at the 12th week. Numbers of fall and fall injuries were monitored for 16 weeks(12-weeks intervention plus 4-week follow-up periods) using fall calendar. Each participant was given a calendar to record the numbers of fall per day for a month. The calendars were collected at the last week of each month. 1. Tai Chi exercisers showed significant improvement in the strength of knee flexors, and ankle dorsiflexors and plantarflexors compared to the control group. The experimental group had improvement in the strength of knee extensors while the control group did not, with no statistical significance. 2. Tai Chi exercisers reported positive change in the average time of chair stand as compared to the control group. 3. Tai Chi exercisers had significant improvement in flexibility as compared to the control group. 4. There was no significant difference in the depression between the two groups, even though the Tai Chi exercisers maintained depression score in the same level while the others were increased. 5. Tai Chi exercisers showed significant improvements in the falls efficacy as compared to the control group. The falls efficacy was significantly improved among the experimental group while the opposite was identified among the control group. 6. The experimental group reported the significant reduction of the fear of fall, whereas control group reported the opposite. 7. Of the 59 subjects for 16weeks(12weeks intervention period and 4weeks follow up), 9 (31.0%) of the 29 in exercise group and 15 (50%) of the 30 in the control group fell (relative risk=0.62. 95% CI 0.32-1.19), even with no statistical difference. The results suggest that the Tai Chi exercise program can improve the strength of knee flexors, ankle dorsiflexors and plantarflexors, chair stand. flexibility, falls efficacy, and fear of falling for the fall-prone elderly.

• Physical Therapy Korea
• /
• v.10 no.1
• /
• pp.109-128
• /
• 2003

This study tested whether repeated measurement of median frequency (MDF)-related variables could express the muscle power changes during a 12-week DeLome strengthening program, by using consecutive overlapping FFT (Fast Fourier transformation) and integrated EMG (IEMG) from surface EMG data for isometric and isotonic exercise. To evaluate the effect of training, the following were recorded every 3 weeks for the elbow flexors and knee extensors of 5 healthy male volunteers: MVC, lRM, limb circumference, and surface EMG during isometric MVC or isotonic contraction at 10RM load. From the EMG data, IEMG and variables from a regression analysis between MDF and time were obtained. MVC, lRM, IEMG, and initial MDF increased linearly over the training period. The fatigue index and slope of the regression line increased temporarily until the 6th week and decreased thereafter. From these results, there appeared to be enhanced neural recruitment of fast twitch fibers in the first 6 weeks and continued enhancement in the recruitment and hypertrophy of fast twitch fibers, which led to increased fatigue resistance, over the last 6 weeks. Accordingly, the MDF and IEMG analysis technique could demonstrate the effect of the program detected significant changes in both isometric and isotonic contractions. EMG analysis methods can be used to estimate the electrophysiological and histological changes in skeletal muscles during a strengthening program.

• Physical Therapy Korea
• /
• v.9 no.2
• /
• pp.115-131
• /
• 2002

Functional electrical stimulation (FES) training of the knee extensors is a useful way to rehabilitate the ability to stand and walk. However, training using FES has not been able to solve the problem of fatigue; clinical application of FES quickly produces muscle fatigue, due to the continuous activation of the muscles of the lower extremity. Therefore, reduction of muscle fatigue is an important factor in increasing the effectiveness of FES training in paraplegia. Intermittent high frequency alternating stimulation is a method that combines the advantages of high frequency (leading to strong muscle contractions) and alternating stimulation (reducing muscle fatigue), thereby continuously strengthening muscles. It is not known whether low frequency simultaneous stimulation results in stronger muscle contraction than high frequency alternating stimulation. This study compared the effectiveness of high frequency alternating stimulation with low frequency synchronized stimulation. Muscle power using FES on the quadriceps of 20 normal subjects were compared. Intermittent high frequency alternating stimulation did not produce more powerful muscle contraction than intermittent low frequency synchronized stimulation, because the muscle characteristics differed individually. Significant individual variation according to muscle characteristics was founded when applying FES. Accordingly, when physical therapists use FES to treat patients, they must be aware of individual variation in muscle characteristics.