• Physical Therapy Korea
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• v.12 no.2
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• pp.73-80
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• 2005

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.

• Journal of Korean society of Dental Hygiene
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• v.4 no.2
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• pp.225-236
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• 2004

It has been suggested in research results thai dental hygienists have high risk of carpal tunnel syndrome, mainly caused by the repeated motion of extensor and flexor or the use of vibration tools, compared to other occupations. To find out the situation of the carpal tunnel syndrome of dental hygienists, who are exposed to work-related musculoskeletal disorders, this study used 132 questionnaires given on May 22, 2004, the period of continuing education of the first half year in the Gwangju Jeonnam area, and obtained the following results. 1. Subjects worked at a dental ciinic(32.6%), a hospital(31.8%), and a public health center(35.6%). Age by work was under 24 in a clinic(17.4%) and a hospital(15.9%), and over 30 in a public health center(35.6%). 2. In practice conducted over one time a day, a scaling accounted for 90.7% in a doctor's office; 595% in a hospital; and 3.0% in a public health center, suggesting significant difference(p<0.01). Pit and fissure sealant accounted for 53.5% in a clinic; 53.2% in a hospital; and 95% in a public health center, also suggesting significant difference(p0.01). 3. Symptoms of carpal tunnel syndrome appeared in a wrist(12.1%), a right hand(14.4%), and a left hand(5.3%). 4. In case of temporary crown practice, symptoms appeared in a wrist(22.0%), a right hand(14.0%), and a left hand(4.0%), suggesting significant difference(p<0.01). The above results showed that 12.1% of dental hygienists was exposed to carpal tunnel syndrome. Thus, it is considered very important that dental hygienists should be given education of the danger of continuous work in certain motions and prevention education of improving repeated position, and make efforts to reinforce self-control ability.

• Physical Therapy Korea
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• v.10 no.1
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• pp.51-62
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• 2003

The purpose of this study was to compare the relative accuracy of a range of computer-based analysis with respect to EMG onset determined visually by an experienced examiner. Ten healthy students (6 male, 4 female) were recruited and three times randomly selected trials of isometric contraction of wrist flexion and extension were evaluated using four technique. These methods were compared which varied in terms of EMG processing, threshold value and the number of samples for which the mean must exceed the defined threshold, and beyond 7% of maximum amplitude. To identify determination of onset time, ICCs(Intraclass Correlation Coefficients) was used and inter-rater arid intra-rater reliability ranged good in visually derived onset values. The results of this study present that in wrist flexion and extension, the reliability of the inter and intra-examiner muscle contraction onset times through visual analysis showed beyond .971 with ICCs. The reliability of the muscle contraction onset time decision through visual reading, tested with computer analysis, showed a relationship of all the selected analysis methods with ICCs .859 and .871. The objective computer-based analysis comparing with visual reading at the same time is the effective and qualitative data analysis method, considering the specificity of each study method.

• The Journal of Korean Physical Therapy
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• v.32 no.5
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• pp.307-311
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• 2020

Purpose: This study examined the effects of changes in the intensity of Functional Electrical Stimulation (FES) on CorticoMuscular Coherence (CMC) during action observation. This paper presents a neurophysiological basis for the effective intensity of FES. Methods: Twenty-seven healthy volunteers were asked to observed a video with FES. The FES was provided with a sensory stimulation level, nerve stimulation level, and motor stimulation level. Simultaneously, an electroencephalogram (EEG) of the sensorimotor cortex and electromyogram (EMG) from the wrist extensor muscle were recorded. The peak CMC and average CMC were analyzed to compare the differences caused by the FES intensity. Results: The peak CMC showed a significant increase in the alpha band during motor stimulation (p<0.05). The average CMC showed a significant increase in the beta band during motor stimulation (p<0.05). Conclusion: The intensity of FES, which causes actual movement, increased the CMC during action observation. These results show that the intensity of the FES can affect the functional connection between the sensorimotor cortex and muscle.

• Physical Therapy Korea
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• v.3 no.2
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• pp.29-35
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• 1996

The purpose of this study was to compare acupuncture-like transcutaneous electrical nerve stimulation(ALTENS) with conventional transcutaneous electrical nerve stimulation(C-TENS) for crossover effect in healthy subjects. Forty subjects recieved ALTENS(20 persons), C-TENS(20 persons) to one upper extremity. Each technic was applied to the motor point of the wrist extensor muscle group for twenty-minutes. With the subject placed in supine the technics were applied at 80 Hz, 2-10 mA(ALTENS) and 10 Hz, 4-12 mA(C-TENS). Results revealed: (1) a significant difference between the pretreatment and posttreatment in each group(p<.05) (2) no significant difference between ALTENS and C-TENS(p>.05). In conclusion, there was no difference between ALTENS and C-TENS for crossover effect.

• Journal of Korean Physical Therapy Science
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• v.19 no.1
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• pp.47-54
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• 2012

Purpose : This study is to know the effect on muscle activity when people use mouse aid or not in computer working environment. Method : 11 people of both sex in their twentieth were tested. As a independent variable, the condition without mouse aid and the condition with movable mouse aid were selected, and as a dependent variable, MVC(%) on four muscles and inconvenience degree(RPE scale) on three body part(wrist, forearm, shoulder) were measured. Result : Analyzing the research, MVC(%) of extensor muscle of finger had notably higher muscle activity than other muscles, and there wasn't notable difference in muscle activity before and after using mouse aid. In case of using mouse aid, we tested by giving RPE questionnaire which segmentalized mental fatigue degree into hand, forearm, and shoulder, and resultingly, there wasn't notable differences perspectively. However, people felt less tiredness subjectively after they use the mouse aid. Conclusion : The usage of mouse aid seems to give comfort to computer users.

• Clinics in Shoulder and Elbow
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• v.8 no.2
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• pp.81-87
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• 2005

Epicondylitis, as a tendinopathy characterized by fibroblast and microvascular hyperplasia, is a common musculoskeletal problem especially related with repetitive hand and wrist motion. It has a prevalence of between 0.2% and 5% in general population depending on the amount of exposure to manual labor jobs. Although it is known that the pathological lesions lie in the flexor or extensor common tendons, there could be collateral ligament lesions and/or reactive synovitis accompanied, which may make a case unresponsive to the treatment aimed only at the tendinopathy. Epicondylitis is easy to diagnose with typical pain, tenderness, and positive provocation tests. However, many conditions can mimic epicondylitis that further imaging or electrodiagnostic studies should be undertaken to exclude other possible problems. Ultrasonography provides information about the existence and extent of tendinopathy with relatively high specificity. Magnetic resonance imaging is often required to rule out other problems and confirm the diagnosis of the cases intractable to long term treatment. Many options of treatment are available for epicondylitis while numerous conflicting evidences have been noted, debating one treatment method is better than the others. Since it was reported that over 80% of epicondylitis improved within a year no matter what was done as treatment, it is a challenge to make accurate diagnosis and combine effective therapeutic regimens for the 20% of intractable cases.

• Physical Therapy Korea
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• v.16 no.2
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• pp.67-76
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• 2009

In order to prevent upper extremity musculoskeletal disorders, effective keyboard selection is an important consideration. The aim of this study was to compare upper extremity muscle activity according to transverse plane angle changes during vertical keyboard typing. Sixteen healthy men were recruited. All subjects had a similar typing ability (rate of more than 300 keystrokes per minute) and biacromion and forearm-fingertip lengths. Four different types of keyboard (vertical keyboard with a transverse plane angle of $60^{\circ}$, $96^{\circ}$, or $120^{\circ}$, and a standard keyboard) were used with a wrist support. The test order was selected randomly for each subject. Surface electromyography (EMG) was used to measure upper extremity muscle activity during a keyboard typing task. The collected EMG data were normalized using the reference contraction and expressed as a percentage of the reference voluntary contraction (%RVC). In order to analyze the differences in EMG data, a repeated one-way analysis of variance, with a significance level of .05, was used. Bonferroni correction was used for multiple comparisons. There were significant differences in the EMG amplitude of all seven muscles (upper trapezius, middle deltoid, anterior deltoid, extensor carpi radialis, extensor carpi ulnaris, flexor carpi radialis, and flexor carpi ulnaris) assessed during the keyboard typing task. The mean activity of each muscle had a tendency to increase as the transverse plane angle increased. The mean activity recorded during all vertical keyboard typing was lower than that recorded during standard keyboard typing. There was no significant difference in accuracy and error scores; however, there was a significant difference between transverse plane angles of $60^{\circ}$ and $120^{\circ}$ with regard to comfort. In conclusion, a vertical keyboard with a transverse plane angle of $60^{\circ}$ would be effective in reducing muscle activity compared with vertical keyboards with other transverse plane angles.

• Archives of Reconstructive Microsurgery
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• v.14 no.1
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• pp.1-13
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• 2005

Purpose: The purpose of this study is to present extended indications for the use of arterialized venous flaps in reconstructing soft tissue, tendon, nerve, blood vessel, and composite tissue defects of the hand of various sizes based on researches and clinical experiences of the authors. Moreover, procedures to achieve complete flap survival and postoperative results are presented. Materials & methods: This study is based on 154 cases of arterialized venous flaps performed to reconstruct the hand during the past 11 years. The most common cause of injury was industrial accidents with 125 cases. One hundred thirty patients or 84% of the cases had emergency operation within 2 weeks of the injury. The flaps were categorized depending on the size of the flap. Flaps smaller than $10\;cm^2$ were classified as small (n=48), those larger than $25\;cm^2$ classified large (n=42) and those in between medium (n=64). Classified according to composition, there were 88 cases (57.1 %) of venous skin flaps, 28 cases of innervated venous flaps, 15 cases of tendocutaneous venous flaps, which incorporated the palmaris longus tendon, for repair of extensor tendons of the fingers, and 17 cases of conduit venous flaps to repair arterial defect. There were 37 cases where multiple injuries to multiple digits were reconstructed. Moreover, there were 6 cases of composite tissue effects that involved soft tissue, blood vessels and tendons. The donor sites were ipsilateral forearm, wrist and thenar area, foot dorsum, and medial calf. The recipient sites were single digit, multiple digits, first web space, dorsum and palm of hand, and wrist. Results: There were seven cases (4.5%) of emergent re-exploration due to vascular crisis, and 3 cases of flap failure characterized by more than 50% necrosis of the flap. The survival rate was 98.1 % (151/154). In small flaps, an average of 1.01 afferent arteries and 1.05 efferent veins were microanastomosed, and in large flaps, an average of 1.88 afferent arteries and 2.19 efferent veins were anastomosed. In 8 cases where innervated flaps were used for reconstructing the palm of the hand, the average static two-point discrimination was $10\;(8{\sim}15)\;mm$. In 12 cases where tenocutaneous flaps were used, active range of motion at the proximal interphalangeal joint was 60 degrees, 20 degrees at the distal interphalangeal joint, and 75 degrees at the metacarpophalangeal joint. Conclusion: We conclude that the arterialized venous flap is a valuable and effective tool in the reconstruction of hand injuries, and could have a more comprehensive set of indications.

• The Journal of Korean Physical Therapy
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• v.24 no.6
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• pp.409-413
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• 2012

Purpose: Rehabilitative devices are used to enhance sensorimotor training protocols, for improvement of motor function in the hemiplegic limb of patients who have suffered a stroke. Sensorimotor integration feedback systems, included with these devices, are very good therapeutic frameworks. We applied this approach using electrical stimulation in stroke patients and examined whether a functional electric stimulation-assisted biofeedback therapy system could improve function of the upper extremity in chronic hemiplegia. Methods: A prototype biofeedback system was used by six subjects to perform a set of tasks with their affected upper extremity during a 30-minute session for 20 consecutive working days. When needed for a grasping or releasing movement of objects, the functional electrical stimulation (FES) stimulated the wrist and finger flexor or extensor and assisted the patients in grasping or releasing the objects. Kinematic data provided by the biofeedback system were acquired. In addition, clinical performance scales and activity of daily living skills were evaluated before and after application of a prototype biofeedback system. Results: Our findings revealed statistically significant gradual improvement in patients with stroke, in terms of kinematic and clinical performance during the treatment sessions, in terms of manual function test and the Purdue pegboard. However, no significant difference of the motor activity log was found. Conclusion: Hemiplegic upper extremity function of a small group of patients with chronic hemiparesis was improved through two weeks of training using the FES-assisted biofeedback system. Further research into the use of biofeedback systems for long-term clinical improvement will be needed.