• Clinical Pain
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• v.20 no.2
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• pp.141-144
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• 2021

There are some cases of myofascial pain syndrome (MPS) with chronic upper back pain that does not respond to dry needling or trigger point injection, well-known treatments for MPS. A 67-year-old female developed a stabbing upper back pain with trigger point at left T7~8 levels 10 years ago. She complained of the pain with Numeral Rating Scale (NRS) 8 points. Myofascial release technique and trigger point injection had no effect. Under ultrasound guidance 20 ml of 1% lidocaine was injected into thoracic paravertebral space. Immediately, the pain was reduced to NRS 4 points. One week later, the second block was performed in the same way as the first, and the pain was reduced to NRS 2 points. The stabbing pain disappeared, and oral opioids were discontinued. Ultrasound guided thoracic paravertebral space block is an effective and safe treatment for refractory MPS with chronic upper back pain.

• Clinical Pain
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• v.18 no.2
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• pp.92-96
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• 2019

Torticollis is an abnormal, asymmetric head or neck position which usually caused by imbalance of paracervical muscles. The traumatic torticollis can be caused by following events; atlantoaxial rotatory subluxation, atlantoaxial dislocation, cervical vertebral fractures, and injury to the cervical musculature. Especially, acute traumatic atlantoaxial rotatory subluxation usually presents limitation of cervical range of motion without pain or neurologic deficit. We report a case of a 58 year-old man who developed the acute atlantoaxial rotatory subluxation right after the chiropractic therapy, which induced the limitation of cervical range of motion to 52.5% of normal range. The magnetic resonance image revealed the facture of the odontoid process and the partial injury in transverse ligaments of the atlas. He underwent intramuscular botulinum toxin injection and 10 days of continuous cervical traction 15 hours a day using a 5 kg weight. The range of the cervical motion restored up to 90.2% of normal range.

• Clinical Pain
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• v.18 no.1
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• pp.8-15
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• 2019

Objective: To determine the relationship between cervical sagittal parameters and the degree of the cervical disc degeneration at each cervical level by using cervical plain radiographs and disc degeneration grading. Method: This study analyzed 110 patients with posterior neck pain. Cervical radiographic measurements included the occipito-cervical (O~C2) angle; sagittal Cobb angles of C1~C2, C2~C7; and sagittal vertical axis (SVA) of C1~C7 and C2~C7. The degenerations of cervical discs at each level were evaluated through Pfirrmann grading system by magnetic resonance images of the cervical spine. The correlations between the cervical sagittal measurements and the disc degeneration at each level were analyzed by Spearman's correlation. Results: A significant correlation was found for the C2~C7 angle with disc degenerations at C2~C6 levels. O~C2 angle was correlated significantly with disc degenerations at C2~C4 and C5~C7 levels. There was significant correlation between C1~C2 angle and disc degeneration at C6~C7 level. No significant relationship was found between the cervical SVA and the cervical disc degeneration at all cervical levels. Conclusion: Cervical sagittal parameters representing cervical angles (C2~C7, O~C2, and C1~C2 angles) were significantly correlated with the degree of the cervical disc degeneration. These findings suggest that the loss of the natural cervical lordosis rather than loss of natural SVA could be correlated with progression of the cervical disc degeneration.

• Clinical Pain
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• v.18 no.2
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• pp.65-69
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• 2019

Objective: This study aims to evaluate the efficacy of high-voltage microcurrent therapy in patients with herniated lumbar disc (HLD) presenting radicular or back pain. Method: This is a retrospective study with 33 patients who are complaining pain with HLD findings on magnetic resonance image. Microcurrent therapy was applied to leg or paralumbar area. Treatment was conducted for seven minutes with 250~1000 uA intensity as high as the patients could tolerate via stimulating probe with roller type and the frequency was 60 Hz with a sine wave pulse. The visual analogue scale (VAS) was measured just before and after the treatment. Results: The degree of pain reduction (△VAS) was 1.6 points after treatment on average. The △VAS according to the diagnosis, stenosis, dermatome area, medication, pain site and caudal epidural block was not statistically significant. However, the △VAS according to the number of treatments (< 3, ≥ 3 times) showed a statistically significant difference (p=0.04). Conclusion: High-voltage microcurrent therapy may help reduce lumbar or lumbosacral radiating pain after the procedure. The effect was better when microcurrent was applied three times or more. This result suggests that the microcurrent would have cumulative effect on reducing radicular or back pain in patients with HLD.

• PNF and Movement
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• v.22 no.1
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• pp.71-80
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• 2024

Purpose: The purpose of this study is to compare the effects of proprioceptive neuromuscular facilitation (PNF) stretching, based on ballistic stretching and the contract-relax technique, on hip joint flexibility and muscle tone in adults with shortened rectus femoris muscles. Methods: The study involved 40 adults with shortened rectus femoris muscles, identified using the modified Thomas test. Participants were randomly divided into two groups: PNF stretching, employing the contract-relax technique, and ballistic stretching. Measurements included muscle tension, hip joint range of motion, and muscle characteristics. The rectus femoris muscle shortening effect was confirmed by the modified Thomas test, while the flexibility effect was assessed through hip joint motion range. The muscle tension effect was determined using Myoton-PRO. Results: Both stretching methods resulted in significant improvements in modified Thomas test angles and frequency, with the PNF stretching group showing notably greater changes. However, neither stretching method significantly affected decrement or stiffness measurements. These findings suggest that PNF stretching may be more effective for certain outcomes compared to ballistic stretching. Conclusion: In summary, both stretching methods positively influenced flexibility and muscle tension, with PNF stretching showing a greater impact. These findings highlight the importance of selecting the appropriate stretching technique for achieving functional improvements in muscles, which could serve as valuable indicators for preventing and treating muscle injuries in both sports and daily activities.

• International Journal of Contents
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• v.7 no.4
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• pp.98-102
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• 2011

In this study, we investigated the effects of neuromuscular electrical stimulation (NMES) on the treatment of 20 acute stroke patients with dysphagia. For both the treated and control groups, the basic facial stimulation training was conducted for 30 minutes, five times a week, for four weeks. NMES was performed on the treated group only, for 30 minutes each time. Both groups were evaluated according to the functional dysphagia scale (FDS) using a videofluoroscopic swallowing study (VFSS). After the treatment was performed for four weeks, the FDS results of the treated group showed a significance difference in oral transit time in the oral phase and in the triggering of pharyngeal swallow fluid, laryngeal elevation and epiglottic closure, nasal penetration, residue in valleculae, coating of pharyngeal wall after swallow fluid, and pharyngeal transit time in the pharyngeal phase. In addition, the treated group showed a significant difference in laryngeal elevation and epiglottic closure, nasal penetration, and pharyngeal transit time in the pharyngeal phase after the treatment compared to the control group. The results of this study showed that neuromuscular electrical stimulation may be an effective method of treating dysphagia in acute phase stroke patients.

• Physical Therapy Korea
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• v.4 no.2
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• pp.66-76
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• 1997

The purpose of this study was to compare the integrated electromyographic activity ratios of vastus lateralis(VL); rectus femoris lateral portion (RFL); rectus femoris medial portion(RFM); and vastus medialis(VM) muscles of 30 healthy subjects under three proprioceptive neuromuscular facilitation(PNF) techniques. Each subject was randomly assigned to one of 3 PNF techniques groups : slow reversal(SR), slow reversal hold(SRH) and rhythmic stabilization (RS). Each person was positioned in supine with the right hip flexed to $45^{\circ}$ and the knee fully extended and received a total of 6 sessions. Each technique was applied to the right lower extremity in two diagonal patterns while electrical activity was monitored from the ipsilateral muscles VL, RFL, RFM, and VM, respectively. Comparison of normalized mean EMG magnitudes from VL, VM showed that RS demonstrated significantly greater activity than that of SR or SRH and that RFL and RFM did not demonstrate any greater relative EMG activity with the three PNF techniques than did VL or VM.

• The Transactions of the Korean Institute of Electrical Engineers P
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• v.64 no.3
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• pp.175-181
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• 2015

In this paper, the neuromuscular electrical stimulation medical devices for non-implantable incontinence treatment other than vaginal insertion type was developed and commercialized. The structure of medical devices for electrical stimulation based on the anatomy of the pelvic floor muscle designed. Then, the optimum parameters that may be effective in pelvic floor muscle electrical stimulation was set. The circuit system based on the optimum parameters were designed and manufactured. The frequency of the pulse voltage for electrical stimulation is 75[Hz], the pulse width is 300[${\mu}s$], the development of medical devices was to have seven program functions to the various treatments. The circuit system of medical devices was composed of microcontroller, comparator and converter. The performance of the developed circuit system in KTC(Korea Testing Certification) were carried out medical equipment inspection test. Test results, test specifications were satisfied with the medical device, the performance was verified to be commercialized as a medical device. The development of medical devices were validated risk assessment and product performance through a software validation. Commercialization of medical equipment was acquired to enable the certification standards of the international standard IEC 60601-1.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.3
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• pp.141-150
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• 2018

PURPOSE: This study was conducted to understand the adaptive responses of different modes of physical exercises utilizing skeletal muscle and the comprehensive relevance of AMPK signaling that can be activated by physical exercise as a potential molecular target in human health problems such as neuromuscular disorders (NMDs). METHODS: Most of the contents in this review article are based on recent publications concerning the main topics of interest. The reference literatures cited were obtained by basic searches of overseas academic databases such as PubMed and ScienceDirect using EndNote X7.8. RESULTS: The phenotypic adaptive responses of skeletal muscle during endurance- and resistance-based exercise training (ET and RT respectively) appear to be distinct. To explain the adaptive responses in each single mode of exercises (ET, RT) along with combined exercise training (CT), AMPK signaling is proposed as an important molecular link among those differential modes of exercise and a promising molecular target of NMDs. CONCLUSION: Based on the available evidence, intracellular AMPK signaling activated by diverse stimuli including physical exercise can be a potential and promising therapeutic target for the prevention, amelioration or cure of various human health problems including NMDs and may also be beneficial for physical rehabilitation and emergency situations that may elicit acute metabolic stresses.

• Physical Therapy Korea
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• v.22 no.1
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• pp.79-92
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• 2015

The effects of Proprioceptive Neuromuscular Facilitation (PNF) and elastic band exercise on the physical functions and blood lipids of obese elderly women were investigated. The experimental group ($n_1=16$) patients underwent PNF for 12 weeks, and the control group ($n_2=15$) patients performed elastic band exercises. SPSS 21.0 was used to compute the means and standard deviations. After the 12-week PNF, both the experimental and control groups showed statistically significant differences in the physical functions (cardiovascular endurance, strength of the lower extremity, muscular endurance, flexibility, balance, and agility) (p<.05), but the difference in the experimental group was more significant than that in the control group (p<.05). In terms of the changes in the blood lipid levels (total cholesterol, triglycerides, high-density lipoprotein, and low-density lipoprotein), the experimental group showed significant changes (p<.05). In conclusion, PNF was confirmed as more effective than elastic band exercise in improving the physical functions and blood lipid levels of obese elderly women.