Kim, Jong-Gun;Kim, Jin-Hong;Do, Kwang-Sun;Yim, Jongeun
Physical Therapy Rehabilitation Science
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v.5
no.3
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pp.138-142
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2016
Objective: The purpose of this study was to investigate how light touch with a finger affects balance ability when a posture is maintained in the condition of visual information blockage and to provide a fundamental material for developing balance ability in the process of rehabilitation treatment. Design: Cross-sectional study. Methods: The study subjects were 17 healthy men and women in their twenties and thirties who were studying at S University in Seoul. The system was comprised of an equilateral triangular force platform. Subjects were asked to step on the foot position of the force platform (Good Balance, Finland) barefooted for 30 seconds, with eyes closed, hands hanging down loosely, and feet comfortably apart. It was connected to a laptop by using Bluetooth technology. An experiment was conducted in the following three circumstances: 1) no-touch trial, 2) light touch to the back (T7 area), and 3) light touch to the middle finger of the left hand. Each subject was given a 10-minute break between consecutive measurements. The experimental circumstances were performed randomly. Anteroposterior sway (APSV), mediolateral sway velocity (MLSV), and velocity moment (VM) were measured. Results: The APSVs (mm/s) were $9.32{\pm}3.37$ and $5.45{\pm}2.98$; the MLSVs (mm/s), $6.39{\pm}3.35$ and $3.31{\pm}2.48$; and VM ($mm^2/s$), $17.13{\pm}11.75$ and $6.76{\pm}8.31$ in the first and second experimental circumstances, respectively. APSV, MLSV, and VM values were significantly improved with the 1) no-touch trial and 2) light touch to the back trail conditions compared with the 3) light touch to the middle finger of the left hand condition (p<0.05). Conclusions: This study revealed that the balance ability for maintaining a body posture was influenced more by light touch to the back (T7) than by light touch with the sensitive fingertip and body sway diminished after visual information was blocked.
This study investigated activation of cerebral cortex in patients with hemiplegia that was caused by neural damage. Key-point control movement therapy of Bobath was performed for 9 weeks in 3 subjects with hemiplegia and fMRI was used to compare and analyze activated degree of cerebral cortex in these subjects. fMRI was conducted using the blood oxygen level-dependent(BOLD) technique at 3.0T MR scanner with a standard head coil. The motor activation task consisted of finger flexion-extension exercise in six cycles(one half-cycles = 8 scans = $3\;sec{\times}\;8\;=\;24\;sec$). Subjects performed this task according to visual stimulus that sign of right hand or left hand twinkled(500ms on, 500ms off). After mapping activation of cerebral motor cortex on hand motor function, below results were obtained. 1. Activation decreased in primary motor area, whereas it increased in supplementary motor area and visual association area(p<.001). 2. Activation was observed in bilateral medial frontal gyrus, middle frontal gyrus of left cerebrum, inferior frontal gyrus, inter-hemispheric, fusiform gyrus of right cerebrum, superior parietal lobule of parietal lobe and precuneus in subjedt 1, parahippocampal gyrus of limbic lobe and cingulate gyrus in subject 2, and inferior frontal gyrus of right frontal lobe, middle frontal gyrus, and inferior parietal lobule of left cerebrum in subject 3 (p<.001). 3. Activation cluster extended in declive of right cellebellum posterior lobe in subject 1, culmen of anterior lobe and declive of posterior lobe in subject 2, and dentate gyrus of anterior lobe, culmen and tuber of posterior lobe in subject 3 (p<.001). In conclusion, these data showed that Key-point control movement therapy of Bobath after stroke affect cerebral cortex activation by increasing efficiency of cortical networks. Therefore mapping of brain neural network activation is useful for plasticity and reorganization of cerebral cortex and cortico-spinal tract of motor recovery mechanisms after stroke.
Background: The study aimed to determine if ultrasonography of masseter can be used to evaluate the outcome of transcutaneous electrical nerve stimulation (TENS) in subjects with temporomandibular disorders (TMDs) such as myositis and myofascial pain. Methods: Fifteen TMD subjects with myofascial pain/myositis who satisfied the RDC/McNeil criteria were included in the study. All the subjects were administered TENS therapy for a period of 6 days (30 minutes per session). The mouth opening (in millimeters) and severity of pain (visual analogue scale score) and ultrasonographic thickness of the masseter (in millimeters) in the region of trigger/tender areas was assessed in all the subjects both prior and post TENS therapy. A comparison of the pre-treatment and post-treatment values of the VAS score, mouth opening and masseter thickness was done with the help of a t-test. Results: There was a significant reduction in the thickness of masseter muscle (P = 0.028) and VAS scores (P < 0.001) post TENS therapy. There was also a significant improvement in the mouth opening (P = 0.011) post TENS therapy. Conclusions: In the present study, ultrasonography was found to be an effective measuring tool in the assessment of TENS therapy in subjects with myositis and myofascial pain.
Objective : This study is designed in order to evaluate the therapeutic effect of venesection on acute low back pain. Methods : From Nov. 1st 2003 to Apr. 30th 2004, 40 cases of low back pain patients at acute stage were divided into 2 groups; one group(control group) took only acupuncture therapy, and the other group(test group) took acupuncture and venesection therapy. Pain rating score(PRS) was used to assess the pain for its intensity, frequency, duration, and aggravating factors. And visual analog scale(VAS) was used, too. PRS and VAS was checked twice, before the treatment and after the treatment. Treatment was done twice a day. Results : Both acupuncture therapy and acupuncture with venesection therapy showed good effect on low back pain of acute stage. And the latter group showed better effect on decreasing pain than former. It was proved by the difference between PRS and VAS checked before treatment and what checked after treatment. But it was not proved statistically. Conclusion : Only acupuncture and acupuncture with venesection can be recommended as a useful therapy to treat low back pain of acute stage.
Purpose: We measured the Oswestry Low Back Pain Disability Index (OLBPDI) and related factors in patients with low back pain. Methods: The sample consisted of 50 patients who received physical therapy at the physical therapy units of the Andong Seoul Sintong Clinic, St. Luke Clinic, and Yeongju Seoul Sintong Clinic in Andong and Yeongju city from October, 2007, to February, 2008. The OLBPDI questionnaire was administered by 5 physical therapists as a cross-sectional study. Student's t-test and analysis of variance (ANOVA/Tukey and Scheffe) were used to analyze OLBPDI score differences. We also used nonparametric statistic analysis (Wilcoxon rank sum test, Median test). Pearson correlation analysis (Spearman correlation analysis) was used to analyze the relationship between OLBPDI and the visual analogue scale (VAS). Multiple regression analysis was performed to determine the effects of independent variables on pain scores as defined by the OLBPDI. Results: The average patient age was 37.1 years (range: 18$\sim$78 years old), and time from onset was 21.7 months (1$\sim$180). OLBPD and VAS scores were 12.70 (3.0$\sim$28.0) and 5.14 (1$\sim$8), respectively. OLBPDI scores were 14.4 in patients taking medicine and 11.57 in those who did not. There was a statistically significant relationship between OLBPDI and VAS (r=0.54, p=0.0001; r=0.55, p=0.0001 by Spearman coefficient). Gender ($\beta$=6.14, p=0.0124), age ($\beta$=-2.01, p=0.0324), weight ($\beta$=0.31, p=0.0222), time from onset ($\beta$=1.54, p=0.0044), and VAS score ($\beta$=1.59, p=0.0004) were significantly associated with OLBPD by multiple regression analysis. Conclusion: Variables associated with OLBPD were gender, age, weight, time from onset, and VAS score. Collecting information on the pain index using OLBPDI was acceptable to patients with low back pain. Further research should explore the pain index by using larger sample sizes and longer follow-up periods.
The purpose of this study was to investigate the effect of the cold air application for release of inflamation and pain in patient with acute rheumatoid arthritis who had taken medication(NSAIDs, DMARDs, corticosteroids). The participants had knee joint pain and ESR score over the 30. They were randomly assigned to three groups with each 15. Control group(group I ) were applied cold air and medication, experimental group II were applied hot pack and medication. and experimental group III were applied only medication. They were evaluated from April 1, 2000 to september 1,2000 ,and it was examined by ESR and VAS(visual analoge scale) in Lee Bang Hoon rehabilitation medicine clinic in Jeju Korea. The result of this study were as follow: 1. It was found that group 1, group II and group III had the statistically significant reduction of the ESR score according to treatment time(p<.05). 2. There were not statistically significant differences in ESR change pattern of each group according to treatment time(p>.05). 3. There were not statistically significant differences in the change of ESR according to treatment time between group I and group II , group I and group III , and group II and group III (p<.05). 4. It was found that group I . group II and group III had the statistically significant reduction of the VAS(Visual Analoge Scale) score according to treatment time(p<.05). 5. There were statistically significant differences in VAS score according to treatment time between control group(group I ) and experimental groups(group II and group III)(p<.05), but there were not stsiistically significant differences between experimental groups(p>.05).
Multi-sensory systems, including the visual, somatosensory, and vestibular ones, are involved in maintaining standing balance. The organization of these sensory systems is as important as the efficiency of each individual system in maintaining optimal balance. The purpose of the present experiment was to investigate the developmental changes in static standing balance and sensory organization under altered sensory conditions. This study involved 64 children (from 4 to 15 years of age) and 17 young adults. The children were divided into four age groups: 4~6, 7~9, 10~12, and 13~15 years. Static standing balance was assessed with the one-leg standing test under four different sensory conditions: the children stood on a firm surface with (1) eyes open or (2) closed, and they stood on a foam surface with eyes (3) open or (4) closed. In balancing ability, the age groups exhibited significant differences. The function of sensory organization for balance control was poorer for the children than for the young adults. The functional efficiency of the somatosensory system of the children aged 7~9 years was at the young adults' level, and the visual function of the children aged 10~12 years had also reached the young adults' level. However, the functional efficiency of the vestibular system of children was significantly lower than that of the young adults, even at the age of 15 years. This may indicate that sensory organization and standing balance are still developing after the age of 15 years.
Objective: The purpose of this study was to investigate the relationship between anticipatory postural adjustment (APA), single task, dual tasks and physical performances. The trunk muscles of APA consist of bilateral erector spinae (ES) and bilateral internal oblique (IO) adnominal muscles, during rapid stepping with the affected or unaffected leg in a sitting posture. Design: Cross-sectional study. Methods: In patients with chronic stroke, electrodes of surface electromyography (EMG) were attached on the bilateral erector spinae (ES), bilateral internal oblique adnominal (IO), and bilateral rectus femoris (RF) muscles. RF acts as the prime mover. The stroke patients performed hip flexion until $20^{\circ}$ as fast as possible at each leg in a sitting posture according to a visual cue. The visual cue unexpectedly appeared on monitor in front of the stroke patient. The single task was the Timed Up and Go (TUG) test. The dual tasks were the TUGconitive, which increased cognitive capacity, and the TUGmanual task, which had an external focus. Results: All EMG data showed earlier onset latency before the prime mover. In affected leg raising, the onset time of unaffected ES muscle of the stroke patients was correlated with the single and dual tasks (p<0.05). In unaffected leg raising, the onset time of the affected IO muscle was related to all the tasks (p<0.05). Gait speed showed a relationship with the unaffected ES muscle only. Conclusions: The trunk muscles of the bilateral ES and bilateral IO play an important role in APA. The single and dual tasks using TUG test were correlated with the APA s of ES and IO muscles. Dual task by the TUG test is a good measuring tool for reflecting the real life in patients with chronic stroke.
Journal of International Academy of Physical Therapy Research
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v.10
no.4
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pp.1921-1925
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2019
Background: Neurodynamic mobilization is divided into slider mobilization and tensioner mobilization. However, movement direction in neurodynamic mobilization has been overlooked in neurodynamic exercise program. Objective: To examine the effect of movement direction in neurodynamic mobilization on upper limb mobility and pain. Design: Quasi-experimental study Methods: Twenty-two adults positive for neurodynamic test for the median nerve were recruited for participation in this study. Twenty-two subjects were allocated to the applied neurodynamic mobilization at limited side group (ANTLS, n=7), the applied neurodynamic mobilization at contralateral limited side group (ANTCLS, n=7), and the applied neurodynamic mobilization at bilateral side group (ANTBS, n=8). Before the intervention upper limb limited was measured neurodynamic test for the median nerve, pain was measured using visual analogue scale (VAS), movement direction in neurodynamic mobilization was applied to each group, and then re-measured using neurodynamic test for the median nerve and VAS. Differences the Intra-groups before and between the intergroups after intervention were analyzed. Results: In the ANTLS and ANTBS groups, a statistically significant increase in ROM and decrease in VAS score in the population before and after intervention were indicated. Statistically significant differences in VAS and ROM from before to after intervention were found among the ANTLS, ANTCLS, and ANTBS groups. Conclusions: The results of the present study indicate that movement direction in neurodynamic mobilization must be considered within the limits of its selected range of the neurodynamic exercise program.
Background: Pillar pain may develop after carpal tunnel release surgery (CTRS). This prospective double-blinded randomized trial investigated the effectiveness of extracorporeal shock wave therapy (ESWT) in pillar pain relief and hand function improvement. Methods: The sample consisted of 60 patients with post-CTRS pillar pain, randomized into two groups. The ESWT group (experimental) received three sessions of ESWT, while the control group received three sessions of sham ESWT, one session per week. Participants were evaluated before treatment, and three weeks, three months, and six months after treatment. The pain was assessed using the visual analogue scale (VAS). Hand functions were assessed using the Michigan hand outcomes questionnaire (MHQ). Results: The ESWT group showed significant improvement in VAS and MHQ scores after treatment at all time points compared to the control group (P < 0.001). Before treatment, the ESWT and control groups had a VAS score of 6.8 ± 1.3 and 6.7 ± 1.0, respectively. Three weeks after treatment, they had a VAS score of 2.8 ± 1.1 and 6.1 ± 1.0, respectively. Six months after treatment, the VAS score was reduced to 1.9 ± 0.9 and 5.1 ± 1.0, respectively. The ESWT group had a MHQ score of 54.4 ± 7.7 before treatment and 73.3 ± 6.8 six months after. The control group had a MHQ score of 54.2 ± 7.1 before treatment and 57.8 ± 4.4 six months after. Conclusions: ESWT is an effective and a safe non-invasive treatment option for pain management and hand functionality in pillar pain.
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