The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.7
no.1
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pp.51-66
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2001
Objective: The purpose of study was to compare physical therapy duration in relation tohealth care organization system in patients with low back pain. Subjects: Subjects of this study were 759 patients who are receiving physical therapy at 56 health care organization. Methods: Data were collected by questionnaire that had been completed by patients and physical therapist for two months. Physical therapy procedures consisted of modality application, manual therapy, active therapeutic exercise, and patient education. Physical therapy session duration was investigated for each physical therapy procedure. Data were analyzed in relation to the university hospital, hospital, and clinic. Results: The mean age of subjects was $42.84{\pm}15.46$. There were no significant differences in age among three groups. The number of patients diagnosed with herniated disc were 244(32.15%) and with mechanical low back pain was 187(24.64%). The mean treatment duration per day was 53.22 minutes, and the longest treatment duration was 61.28 minutes at the university hospitals (p<0.001). The mean modality application duration was 42.17 minutes, and the longest application duration was 46.26 minutes at the university hospitals (p<0.001). The mean duration for manual therapy was 5.11 minutes, and the longest treatment duration was 5.97 minutes at clinics. The mean duration for active therapeutic exercise was 4.16 minutes. It was 7.60 minutes at the university hospitals, and 2.48 minutes at clinics. There was a significant difference in active therapeutic exercise duration between university hospitals and clinics(p<0.001). For modalities, hot packs(89.33%) and interferential current therapy(60.87%) were mostly applied. For manual therapy, Soft tissue mobilization(32.93%) and manipulation(14.10%) were mostly applied. In general, treatment application duration was longer at University hospital (p<0.05). For therapeutic exercise, exercise without equipment(18.84%) and muscle strengthening (16.73%) were mostly performed. The longest treatment duration for therapeutic exercise was 7.60 minutes at the university hospital(p<0.05). Conclusion: physical therapy session duration for low back pain was 53.22 minutes. Modality application constitutes 79%, manual therapy 10%, active therapeutic exercise 8% of total treatment duration. It is concluded that patients do not participate actively in treatment procedures.
Objective: This study was conducted to investigate the effect of high-intensity laser therapy(HILT), transcutaneous electrical nerve stimulation(TENS), and ultrasound(US) treatment on pain, grip strength, and hand function in patients who had undergone carpal tunnel syndrome surgery. Design: A randomized controlled trial. Methods: Thirty patients who had undergone carpal tunnel syndrome surgery were randomly assigned to receive either TENS combined with HILT, US combined with HILT, or only HILT as the control group. Treatments were applied around the surgical site, and pre- and post-treatment changes were evaluated. Pain was assessed using NPRS, hand symptoms using CTS-6 and BCTQ-SSS, grip strength with an electronic dynamometer, and hand function using BCTQ-FSS. Treatments were administered seven times over two weeks. Results: The pain and symptoms were significantly reduced(p<0.05) and grip strength and hand function were significantly increased(p<0.05) after treatment compared to before treatment for all subjects. Pain was significantly reduced(p<0.05) and grip strength was significantly increased(p<0.05) in the TESN+HILT group and US+HILT group compared to the Control group. Hand symptoms were significantly reduced(p<0.05) and hand function significantly increased(p<0.05) in the TENS+HILT group compared to the Control group. Conclusions: TENS combined with HILT was found to be more effective than US combined with HILT in reducing pain and symptoms and improving grip strength and hand function in patients following carpal tunnel syndrome surgery. These findings suggest that these treatment modalities can be beneficially applied in clinical practice.
Purpose: It remains controversial for the effect of daily functioning and quality of life on therapeutic exercise after stroke. The purpose of this study was to describe the effects on daily functioning and QOL. Methods: Outcome measures of daily functioning included, such as the Functional Independence Measure (FIM), Barthel index. Outcome measures of QOL included, such as Stroke Impact Scale(SIS) and the Medical Outcomes Study short-form 36-item questionnaire(SF-36). Results: 125 stroke patients were recruited, who were in or outpatients. The average age was 55.4 years. 64.8% were male. The mean Bathel index and FIM score was 63.7 and 87.5. The mean SIS score were higher in communication and mean SF-36 score were higher in physical pain. In/out patients are associated with SIS (communication, emotion) and SF-36(social function, energy or fatigue). Sex are associated with SF-36 (physical function). Other disease state are associated with SIS(hand function) and SF-36 (physical function). Paralysis portion are associated with SIS(communication, daily activity). Barthel index are associated with SIS(communication, mobility) and SF-36(social function, physical function, role limits due to emotional problems). Conclusion: These findings may provide the useful with rehabilitation professionals, who specilalized in the importance of QOL in designing treatment modalities.
Objective: Tension-type headaches usually occur with temporomandibular disorder, which increases the risk of the chronic tension-type headaches. This study was conducted to investigate the effect of additional temporalmandibular therapy compared to cerivcal joint therapy for tension-type headaches with pericranial tenderness. Design: Randomized controlled trial. Methods: Forty-one patients with chronic tension-type headaches and pericranial tenderness were randomized into the 3 groups, such as the temporomandibular joint therapy group (TMJT group, n=14), cervical manual therapy group (CMT group, n=14) and conservative therapy group (CT group, n=13). All patients were assessed at baseline and after each intervention during the three sessions. The participants in the TMJT group received the temporomadibular joint treatment and cervical manual therapy for 30 minutes, once a week, for 3 weeks. The participants in the CMT group received the cervical manual therapy, and those in the CT group received modalities during same time period. The outcome measurements used were the intensity of headaches measured on the Visual Analogue Scale (VAS), quality of life measured with the Headache Impact Test (HIT-6), and function of the cervical spine using the Neck Diability Index (NDI). Results: The TMJT group that received temporomandibular joint treatment and cervical manual therapy showed a significant decrease in VAS, HIT-6, and NDI compared with the other 2 groups (p<0.05). Conclusions: This study suggected that temporomandibular joint treatment combined with cervical manual therapy was more effective for the chronic tension-type headaches with pericranial tenderness than the usual cervical therapy alone.
We investigated the activation of the cerebral cortex during active movement, passive movement, and functional electrical stimulation (FES), which was provided on wrist extensor muscles. A functional magnetic resonance imaging study was performed on 5 healthy volunteers. Tasks were the extension of right wrist by active movement, passive movement, and FES at the rate of .5 Hz. The regions of interest were measured in primary motor cortex (M1), primary somatosensory cortex (SI), secondary somatosensory cortex (SII), and supplementary motor area (SMA). We found that the contralateral SI and SII were significantly activated by all of three tasks. The additional activation was shown in the areas of ipsilateral S1 (n=2), and contralateral (n=1) or ipsilateral (n=2) SII, and bilateral SMA (n=3) by FES. Ipsilateral M1 (n=1), and contralateral (n=1) or ipsilateral SII (n=1), and contralateral SMA (n=1) were activated by active movement. Also, Contralateral SMA (n=3) was activated by passive movement. The number of activated pixels on SM1 by FES ($12{\pm}4$ pixels) was smaller than that by active movement ($18{\pm}4$ pixels) and nearly the same as that by passive movement ($13{\pm}4$ pixels). Findings reveal that active movement, passive movement, and FES had a direct effect on cerebral cortex. It suggests that above modalities may have the potential to facilitate brain plasticity, if applied with the refined-specific therapeutic intervention for brain-injured patients.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.21
no.2
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pp.1-5
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2015
Background: The purpose of this study was to search the present state of physiotherapy and the development direction of a curriculum for physiotherapy educational program, especially in field of orthopedic manual therapy, in Swaziland. Methods: The developed curriculum is as follows: 1. Disease and Health State in Swaziland. 2. Medical Human Resources State of Swaziland. 3. Physiotherapy Services State in Swaziland. 4. Higher Education State in Swaziland. 5. Development Direction of a Curriculum for Physiotherapy Educational Program in Swaziland. Conclusions: There is no a physiotherapist in Swaziland and Swaziland government which has not a physiotherapy education programme in any university of whole country. So we need to the development direction of a curriculum for physiotherapy educational program for the future of Swaziland, especially in field of orthopedic manual therapy. The reason is firstly, most of people are obesity in this country, so many people complained a lot of joint and muscle pain. And secondly, also there are many musculoskeletal disease patients now a day in Swaziland because of HIV/AIDS. Lastly, Swaziland country is in a poor and developing state, so physiotherapist it is hard to make a purchase and setting physiotherapy modalities apparatus at Swaziland country.
Lee, Sang Hee;Han, Ji Hoon;Lee, Sung Jae;Cho, Hwi Young;Baek, Jung Heum;Kim, Jae Gyoon
Physical Therapy Rehabilitation Science
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v.8
no.1
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pp.22-31
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2019
Objective: For knee osteoarthritis (OA), there is a demand for alternative modalities in order to delay surgery and to avoid the side effects of medications. This study compared the effects of applying seaweed pack and mudpack for the treatment of knee OA. Design: Randomized controlled trial. Methods: Twenty-five patients with knee OA who satisfied the criteria were included. The patients were divided into two groups according to the treatment method: mudpack (n=12) and seaweed pack (n=13). The two groups were treated for 20 minutes, twice a day for five continuous days at the Ocean Healing Center at Wando Island, South Korea. Participants were assessed by clinical scores (Western Ontario and McMaster Universities Osteoarthritis Index, Hospital for Special Surgery Knee Score, Knee injury and Osteoarthritis Outcome Score and 36-Item Short Form Health Survey) and lab results (erythrocyte sedimentation rate, C-reactive protein, insulin-like growth factor-1 [IGF-1], tumor necrosis $factor-{\alpha}$ [$TNF-{\alpha}$]) during the follow-up period. Results: For the most part, clinical scores improved after therapy and maintained improvements for four weeks in both groups (p<0.05). In the seaweed group, $TNF-{\alpha}$ was significantly decreased at two weeks post-therapy (p<0.05). In both groups, IGF-1 was significantly increased immediately post-therapy (p<0.05). There were no statistically significant differences after therapy between the groups in clinical scores and labs. Conclusions: Seaweed packs and mudpacks had similar positive effects for knee OA. Additionally, the seaweed pack group showed decreased levels of $TNF-{\alpha}$ at two weeks post-treatment, which may explain the reduced inflammatory reaction. For rehabilitation therapy, use of seaweed packs may serve as an alternative modality for the treatment of knee OA.
Fibromyalgia syndrome(FMS) is a chronic pain disorder of unknown etiology characterized by widespread musculoskeletal aches and pains, stiffness, and general fatigue, disturbed sleep and sleepiness. Frequently misdiagnosed, FMS is often confused with myofascial pain syndrome, polymyalgia rheumatica, polymyositis, hypothyroidism, metastatic carcinoma, rheumatoid arthritis (RA), juvenile rheumatoid arthritis, chronic fatigue syndrome, or systemic lupus erythematosus, any of which may occur concomitantly with FMS. The management of FMS often begins with a thorough examination and a diagnosis from a physician who is formally trained in tender-point/trigger-point recognition. An initial diagnosis provides reassurance to the patient and often reduces the anxiety and depression patterns associated with FMS. The most common goals in the management of FMS are (1) to break the pain cycle, (2) to restore sleep patterns, and (3) to increase functional activity levels. Because FMS is a multifactorial syndrome, it is likely that the best treatment will encompass multiple strategies. Medication with analgesics and antidepressants and also physiotherapy, are often prescribed and give some relief. The other most effective intervention for long-term management of FS to date is physical exercise. Physical therapists can instruct patients in the use of heat at home (moist hot packs, heating pads, whirlpools, warm showers or baths, and hot pads) to increase local blood flow and to decrease muscle spasm and tension. Also instruct patients in the proper use of cold modalities (ice packs, ice massage, and cool baths) to anesthetize localized areas of pain (tender points) and break the pain cycle. Massage and tender-point massage also may promote muscle relaxation. To date, the two most important interventions for the long-term management of FS are patient education and physical exercise. Lately, is handling FMS and Chronic Fatigue syndrome(CFS) together, becuase FMS and CFS are poorly understood disorders that share similar demographic and clinical characteristics. Because of the clinical similarities between both disorders it was suggested that they share a common pathophysiological mechanism, namely, central nervous system dysfunction.
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.
Park, Hee Ung;Cho, Hangrae;Lee, Sang Ju;Cho, Han Kyoung
Medical Lasers
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v.10
no.4
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pp.242-245
/
2021
Acne vulgaris is a common inflammatory skin disease of the pilose-baceous unit. It appears as lesions consisting of comedones, papules, pustules, and nodules of varying shapes and severity. In general, the first-line treatment for acne vulgaris includes topical and oral medication. Recently, various physical modalities have also been investigated. The use of laser therapy is steadily increasing because of its fewer side effects, short procedure time, and rapid results. In particular, laser therapy assisted with carbon suspension application is effective for acne vulgaris but may sometimes result in discomfort due to odor and dust formation during the procedure. Herein, we report that acne vulgaris and enlarged facial pores can be safely and effectively treated with laser therapy assisted with diamond particle suspension and gold microparticle application, which can address the discomfort caused by the carbon suspension application.
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