• Title/Summary/Keyword: Physical modality

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Is conventional radiofrequency ablation of the superolateral branch, one of the three genicular nerves targeted as standard, necessary or not? A non-inferiority randomized controlled trial

  • Osman Albayrak;Canan Sanal Toprak;Osman Hakan Gunduz;Savas Sencan
    • The Korean Journal of Pain
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    • v.37 no.3
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    • pp.264-274
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    • 2024
  • Background: Radiofrequency ablation is an effective treatment modality in the symptomatic treatment of knee osteoarthritis. Our aim was to compare the efficacy of radiofrequency ablation of the superomedial and inferomedial genicular nerves (2 branches) with the superolateral, superomedial, and inferomedial genicular nerves (3 branches) and to show whether the 2-branch procedure is inferior to the 3-branch procedure. Methods: This study is a prospective, randomized, single-blind clinical study. Eligible participants were randomized into 2 groups: group A, which applied the procedure to the superomedial and inferomedial genicular nerves, and group B, which applied it to the superomedial, superolateral and inferomedial genicular nerves. Pain was evaluated with the numerical rating scale, quality of life with the Short Form-36 (SF-36), and disability with the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index before, and at 1 and 3 months after the procedure. Results: A total of 41 patients were included. There were no differences between the groups except for the SF-36 physical health sub-score at baseline. A significant improvement was seen in the numeric rating scale (NRS) score, SF-36 sub-scores, WOMAC Index total, as well as pain and physical function scores in both groups, though no significant difference was detected between the groups during follow-up. Conclusions: Although we were unable to establish the noninferiority of conventional radiofrequency ablation (CRFA) applied to 2 branches to CRFA applied to 3 branches, in this trial, significant and similar improvement was observed in NRS, WOMAC total, pain, and physical function and SF-36 scores in both groups.

Change of Cerebral Motor Area Activity by Anodal Transcranial Direct Current Stimulation (tDCS) (양극 경두개직류자극에 의한 운동관련피질전위의 변화)

  • Lim, Young-Eun;Kim, Su-Hyon;Yang, Dae-Jung;Kim, Tae-Youl
    • The Journal of Korean Physical Therapy
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    • v.21 no.4
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    • pp.65-71
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    • 2009
  • Purpose: Transcranial direct current stimulation (tDCS) is a useful method for modulating the brain activity. This study compared the effect of continuous and interrupted tDCS using the change in the movement related cortical potential. Methods: Thirty healthy participants (male: 18 and female: 12) were assigned randomly to three groups; sham tDCS, continuous tDCS, which the current continuously flowed for 10 minutes, and interrupted tDCS, which the interrupted current flowed for 10 minutes (repetition: 4sec stimulation and 5sec rest) at an intensity of 1mA with anodal polarity. The effect of tDCS on the right primary motor area was measured from the movement related cortical potential (MRCP) before and after the experiment. MRCP consisted of the bereitshaftspotential (BP) and negative slope potential (NS) at Cz and C4. Results: Continuous and interrupted tDCS showed a significant difference in the changes in the BP, NS at Cz and C4 compared to the sham tDCS. However, there was no significant difference between the continuous tDCS and interrupted tDCS. Conclusion: The change in cortical activity by continuous and interrupted tDCS results from an improvement in the MRCP. An interrupted tDCS may be a safe and useful modality for stimulating the cortical region.

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The Effects of Joint Mobilization on Neck Pain (관절가동운동이 경부통에 미치는 영향)

  • Kim Hyun-Jung;Bae Sung-Soo;Jang Chel
    • The Journal of Korean Physical Therapy
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    • v.15 no.3
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    • pp.65-90
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    • 2003
  • To identify the effects of joint mobilization on the functional improvement of patients with neck pain, the present research investigated 60 neck pain patients, dividing them into a group doing joint mobilization, a group doing Mckenzie exercise and a group using modalities. This study examined patients degree of recovery from neck pain by comparing their neck pain before and after the treatment, and compared three groups to find difference in the degree of recovery from neck pain. The results of this study are as follows : 1. For the joint mobilization group, the visual analogue scale (VAS) decreased significantly for three weeks treatment, and the range of motion (ROM) of cervical vertebrae increased significantly(p<.05). 2. For the Mckenzie exercise group, the visual analogue scale decreased significantly for three weeks treatment, and the range of motion cervical vertebrae increased significantly(p<.05). 3. For the modality using group, the visual analogue scale decreased significantly for three weeks treatment, and the range of motion of cervical vertebrae increased significantly(p<.05). 4. In the comparison of VAS and ROM of the three groups before and after the treatment, significant differences were found among the three groups in VAS after three weeks' treatment, and in ROM before the treatment(p<.05). 5. In all the three groups, VAS decreased and the ROM of cervical vertebrae increased after the treatment, and in particular, the decrease of VAS and the increase of the ROM of cervical vertebrae were remarkable in the joint mobilization group.

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The Effects of Microcurrent Electrical Neuromuscular Stimulation on Delayed Onset Muscle Soreness, Serum Creatine Kinase, and Maximal Voluntary Isometric Contraction: A Preliminary Report (미세전류신경근자극이 Delayed Onset Muscle Soreness, 혈청 Creatine Kinase, 최대 수의적 등척성 수축에 미치는 영향)

  • Kim, Tae-Youl;Choi, Eun-Young;Yoon, Hee-Jong
    • Journal of Korean Physical Therapy Science
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    • v.2 no.3
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    • pp.587-598
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    • 1995
  • The purpose of this study was to test the microcurrent electrical neuromuscular stimulation on muscle soreness, serum creatine kinase levels and force deficits evident following a high-intensity eccentric exercise bout. 10 volunteer male subjects were randomly assigned to a treatment group or to a control group. Exercise consisted of high-intensity eccentric contractions of the elbow flexors. Resistance was reduced as subjects fatigued, until they reached exhaustion. Muscle soreness rating was determined using a visual analog scale. Serum creatine kinase levels were analyzed using a blood sample. Force deficits were determined by measures of maximal voluntary isometric contraction at $90^{\circ}$ of elbow flexion on a Orthotron II dynamometer. Muscle soreness rating, serum creatine kinase levels and maximal voluntary isometric contraction were determined at the before exercise and again at 24 and 48 hours postexericse. Treatments were applied immediately following exercise. The control group subjects rested following their exercise bout. Statistical analysis showed significant increases in muscle soreness rating and significant decreases in maximal voluntary isometric contraction when the before exercise was compared with 24 and 48 hour measures(p<0.01). No significant effects were observed between groups in muscle soreness rating and maximal voluntary isometric contraction(p>0.05). Highly significants differences in serum creatine kinase levels were found using on Analysis of variance(ANOVA) repeated measures between groups for each time cycles(p<0.001). This modality may have benefits when used early stage in the muscle damage.

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Aerobic and Graduated Treadmill Exercise Decreases Blood Glucose Levels, Lipid Levels and Oxidative Stress in an Animal Model of Type 1 Diabetes Mellitus

  • Kim, Eun-Jung;Kim, Gye-Yeop
    • The Journal of Korean Physical Therapy
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    • v.22 no.6
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    • pp.65-70
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    • 2010
  • Purpose: Exercise has been shown to be a simple and economical therapeutic modality that may be considered as an effective aid for diabetic mellitus. For example, exercise training increases insulin sensitivity in type 2 diabetes. But we found no reported of how exercise affect type 1 diabetes. This study investigated the impact of aerobic and graduated treadmill exercise regimens on body weight, glucose and insulin concentrations, lipid profiles, and oxidative stress indicators in rats with streptozotocin (STZ) induced diabetes. Glycosylated hemoglobin ($HbA_{1c}$) was determined as an indicator of glucose control during exercise. Methods: In our study, a total of 40 rats were used. Three groups of 10 rats each were given STZ to induce diabetes. The remaining 10 rats became the normal group. After 28 days we determined biochemical parameters such as glucose, glycosylated hemoglobin ($HbA_{1c}$), insulin concentration, serum total cholesterol (TC), triglycerides (TG), and high-density lipoprotein (HDL). Superoxide dismutase (SOD) and catalase activities were also measured. Results: Concentrations of blood glucose and $HbA_{1c}$ in the moderated exercise groups were significantly decreased after 28 days compared with the control group (p<0.05). There was a significant reduction in serum TC and TG in the experimental groups. The activity of SOD increased significantly by 17.70% and 48.25% respectively. Conclusion: These results indicate that physical training and exercise training affects body weight, fasting blood glucose, $HbA_{1c}$, insulin, lipid profiles, and antioxidant status in rats with streptozotocin-induced diabetes. We suggest that graduated treadmill exercise may have therapeutic, preventative, and protective effects against diabetes mellitusby improving glycemic control, oxidant defenses, and lipid metabolism.

Feasibility Assessment of Physical Factors of Rectal Cancer Short-Course Chemoradiotherapy with Delayed Surgery

  • Koo, Jihye;Chung, Mijoo;Chung, Weon Kuu;Jin, Sunsik;Kim, Dong Wook
    • Progress in Medical Physics
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    • v.29 no.4
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    • pp.143-149
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    • 2018
  • To verify the correlations between the clinical outcomes and physical factors of short-course chemoradiotherapy (SCRT) and long-course chemoradiotherapy (LCRT) with delayed surgery in patients with rectal cancer. Seventy-two patients with rectal cancer were enrolled in this study. Nineteen patients were treated with SCRT (25 Gy, 5 fractions) by intensity-modulated radiation therapy (IMRT), and 53 patients were treated with LCRT (50.4 Gy, 28 fractions) by three-dimensional conformal radiation therapy (3DCRT). Various physical factors for the target and organs at risk (OARs) were calculated to compare the clinical outcomes. The organ equivalent dose (OED) and lifetime attributable risk (LAR) of bowels and bladders were similar between the SCRT and LCRT groups, whereas the values of femurs were higher in the LCRT group. The equivalent uniform dose and normal tissue complication probability were higher in the LCRT than the SCRT group for most organs. Treatment complications, including anastomotic leakage, bowel adhesion, and hematologic toxicity, were not significantly different between SCRT and LCRT groups. CIs were $0.84{\pm}0.2$ and $0.61{\pm}0.1$ for SCRT and LCRT, respectively. The CVIs were $1.07{\pm}0.0$ and $1.10{\pm}0.1$, and the HIs were $0.09{\pm}0.0$ and $0.11{\pm}0.1$ for SCRT and LCRT, respectively. The sphincter-saving rates were 89.5% and 94.3% for SCRT and LCRT, respectively. The complete pathologic remission rates were 21.1% and 13.2%, and the down-staging rates were 47.4% and 26.4% for SCRT and LCRT, respectively. SCRT with IMRT is comparable to conventional LCRT in both physical indexes and clinical outcome. The preoperative SCRT, compensated by IMRT, is an effective and safe modality.

Immediate Effect of Neuromuscular Electrical Stimulation on Balance and Proprioception During One-leg Standing

  • Je, Jeongwoo;Choi, Woochol Joseph
    • Physical Therapy Korea
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    • v.29 no.3
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    • pp.187-193
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    • 2022
  • Background: Neuromuscular electrical stimulation (NMES) is a physical modality used to activate skeletal muscles for strengthening. While voluntary muscle contraction (VMC) follows the progressive recruitment of motor units in order of size from small to large, NMES-induced muscle contraction occurs in a nonselective and synchronous pattern. Therefore, the outcome of muscle strengthening training using NMES-induced versus voluntary contraction might be different, which might affect balance performance. Objects: We examined how the NMES training affected balance and proprioception. Methods: Forty-four young adults were randomly assigned to NMES and VMC group. All participants performed one-leg standing on a force plate and sat on the Biodex (Biodex R Corp.) to measure balance and ankle proprioception, respectively. All measures were conducted before and after a training session. In NMES group, electric pads were placed on the tibialis anterior, gastrocnemius, and soleus muscles for 20 minutes. In VMC group, co-contraction of the three muscles was conducted. Outcome variables included mean distance, root mean square distance, total excursion, mean velocity, 95% confidence circle area acquired from the center of pressure data, and absolute error of dorsi/plantarflexion. Results: None of outcome variables were associated with group (p > 0.35). However, all but plantarflexion error was associated with time (p < 0.02), and the area and mean velocity were 37.0% and 18.6% lower in post than pre in NMES group, respectively, and 48.9% and 16.7% lower in post than pre in VMC group, respectively. Conclusion: Despite different physiology underlying the NMES-induced versus VMC, both training methods improved balance and ankle joint proprioception.

Effect of Vibratory Stimulation on Recovery of Muscle function from Delayed Onset Muscle Soreness

  • Koh, Hyung-Woo;Kim, Cheol-Yong;Kim, Gye-Yoep;Kim, Kyung-Yoon;Kim, Soo-Geun;Lee, Hong-Gyun
    • Korean Journal of Exercise Nutrition
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    • v.16 no.1
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    • pp.43-50
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    • 2012
  • This study was designed to investigate the effect of vibratory stimulation on recovery of muscle function from delayed onset muscle soreness (DOMS). Volunteers performed 3 set of 70 % maximal voluntary eccentric muscle contraction and induced DOMS. volunteers were allocated to one of three treatment group after DOMS : group I (control), group II (ultrasound), group III (vibration). Maximal Voluntary Isometric Contraction (MVIC), Visual Analog Scale (VAS), Range Of Motion (ROM), Root Mean Square (RMS), Median frequency (MDF), Blood Serum Creatine Kinase (CK), Lactic dehydrogenase (LDH) were recorded at baseline, and 24, 48, 72 hours post-exercise. In MVIC measurement, there was a statistically significant difference in group III compared to group I (p < .05). In VAS measurements, there were a statistically significant difference in group II and III compared to group I (p < .05). In ROM measurement, there was a statistically difference in group II and III compared to group I (p < .05). In Muscle Volume with Ultrasonography measurement, there was no statistically significant difference in any groups (p > .05). In RMS and MDF measurement, there were a statistically significant difference in group II and III compared to group I (p < .05). In Blood samples of CK and LDH measurements, There were no statistically significant difference in any groups (p > .05). From the above result, Vibratory stimulation had a positive effect on recovery of muscle function from delayed onset muscle soreness. Further studies should be undertaken to ascertain the more effectiveness of vibratory stimulation and may be a promising treatment modality.

Effectiveness of exercise for improving physical and renal function in older adults with pre-dialysis chronic kidney disease: A systematic review and meta-analysis (운동중재가 투석 전단계 만성 신질환 노인의 신체기능 및 신기능 향상에 미치는 효과: 체계적 문헌고찰 및 메타분석)

  • Lee, Hyeon-Ju;Son, Youn-Jung;Jang, So Eun
    • Journal of Korean Critical Care Nursing
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    • v.16 no.3
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    • pp.34-47
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    • 2023
  • Purpose : Exercise may prevent the worsening of chronic kidney disease (CKD) and progression of cardiovascular diseases in patients with CKD. This review aims to identify the best type of exercise modality and summarizes the beneficial effects of exercise on physical and renal function among older adults with pre-dialysis CKD. Methods : A systematic search of PubMed, Embase, CINAHL, Cochrane Library, Web of Science, SCOPUS, and domestic database was performed for randomized controlled trials (RCTs) assessing the effect of exercise intervention on older adults with pre-dialysis CKD published until February 2023. A random-effects meta-analysis was conducted. The risk of bias was assessed using a Cochrane tool for assessing the risk of bias in RCTs (RoB 2.0). Results : The systematic review included 11 RCTs (n = 591, average age 60.2-76), of which 8 could be included for meta-analysis. Exercise was significant in increasing peak oxygen consumption and knee muscle strength among physical functions, and also in improving glomerular filtration rate among kidney functions. Conclusion : Exercise has beneficial effects on physical and renal function among older adults with pre-dialysis CKD. In the future, it is necessary to verify the effectiveness of exercise by subdividing it by type, intensity, duration, and delivery.

Clinical Study of Acupucture Effect on Microtraumatic Injuries of the Knee Joint (슬관절 미세손상환자의 침치료에 관한 임상적 고찰)

  • Woo, Young-Min;Lee, Jin-Heon;Kim, Jean-Moon;Nam, Young
    • Journal of Acupuncture Research
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    • v.17 no.4
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    • pp.88-99
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    • 2000
  • Objectives : This study was performed to evaluate the clinical effect of acupuncture on microtraumatic injuries of the knee joint. Methods : Among the outpatients with knee joint pain who visited to Department of Acupuncture & Moxibustion, National Medical Center from February 2000 to September 2000, we selected 15 cases that showed normal finding in both X-ray and neurological examination, and that were categorized into microtraumatic injuries by the physical examination based on the Cyriax's orthopedic medicine. During acupuncture therapy, the patients were ordered to move involved side actively. The effect was assessed through questionnaires of CNRS(Cincinnati Knee Rating System). Results : We investigated 11 female and 4 male patients. The most common distribution of age was 30's(40%). The most commom duration of symtoms was from 3 to 5 months(40%). The most common microtraumatic injury was pes anserinus bursitis(33.3%), and followed by iliotibial band friction syndrome(20%), and patellar tendinitis(20%). In the CNRS, the mean number of before treatment was 60.6 and after was 66.5. 10 cases among the 15 patients were improved(66.6%). Conclusions : These results suggest that the acupuncture therapy combined with active movements of involved side was effective treatment modality on microtraumatic injuries of the knee joint.

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