• Archives of Plastic Surgery
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• v.49 no.6
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• pp.750-754
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• 2022

Trigger wrist, characterized by a clicking or snapping sensation around the wrist joint during finger or wrist motion, and bifid or trifid median nerve, which occurs in carpal tunnel syndrome along with anatomical variation of median nerve, are rare conditions. We report the case of a patient with a thickened tendon caused by severe tenosynovitis and flexor tendon subluxation to the hamate hook due to bowing of the flexor retinaculum, thereby resulting in trigger wrist as well as an anatomical median nerve variation (bifid median nerve in the right wrist and trifid median nerve in the left wrist). A 59-year-old housewife visited our hospital with bilateral fingertip numbness, tingling sensation, and aggravated severe night cramping that began 2 months ago. She also complained about trigger wrist during small finger flexion. Based on magnetic resonance imaging, ultrasonography, and nerve conduction study, trifid median nerve and bilateral severe median nerve neuropathy of the wrist were diagnosed; therefore, transverse carpal tunnel release and exploration under wide-awake anesthesia were planned. Intraoperative findings showed trifid and bifid median nerves in left and right wrists, respectively. Additionally, bowing of flexor retinaculum and severe flexor tendon tenosynovitis were observed. Tenosynovitis with thickened flexor sheath resulted in subluxation of the small finger flexor tendon above the hamate hook. After transverse carpal ligament release with antebrachial fascia release and tenosynovectomy, subluxation of the flexor tendon was resolved. At 6 months postoperatively, the tingling and dullness in fingertips also resolved, and no trigger wrist or any other complications were noted.

• Archives of Reconstructive Microsurgery
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• v.14 no.1
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• pp.63-69
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• 2005

Purpose: The purpose of this study was to analyze the clinical results after Steindler flexoplasty. Materials and Methods: We analyzed 6 cases who had nearly normal finger and wrist joint flexion function, but could not flex elbow joint actively because of upper arm type brachial plexus injury. We performed operation during the period from February 1997 to July 2003. There were 5 males and 1 female with mean age of 28 years (range: $19{\sim}51$ years) when Steindler flexoplasty was done. The average follow-up period was 3 years 11 months (range: 12 months${\sim}$7 years 4 months). We assessed active range of motion of elbow joint, muscle power and elbow function by Mayer & Green grade scale at last follow-up. We assessed how much they were favorable for Steindler flexoplasty and had improvement of upper extremity function and correction of deformity. Results: Postoperative, flexion range of elbow joint improved to average $111.7^{\circ}$ (range: $90{\sim}130^{\circ}$). $25.8^{\circ}$ (range: $15{\sim}45^{\circ}$) in flexion contracture and $16.6^{\circ}$ (range: $10{\sim}35^{\circ}$) in pronation contracture were remained. Range of motion of elbow joint improved to average $85.3^{\circ}$ (range: $45{\sim}105^{\circ}$). Flexion power of elbow joint improved to Grade 5 in all cases. Postoperatively on Mayer & Green grade scale, there were excellent in 3 cases(50%), good in 2 cases(33.3%), fair in 1 case(16.7%). On patient's own assessment of functional improvement, there were excellent in 4 cases(66.6%), good in 1 case(16.7%) and fair in 1 case(l6.7%). Conclusion: Steindler flexoplasty can reserve good clinical results with being improved to active flexion of elbow joint in cases who have functional hand and wrist, but paralysis upper arm muscle in brachial plexus injury.

• Physical Therapy Rehabilitation Science
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• v.10 no.2
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• pp.235-243
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• 2021

Objective: This study aimed to investigate the short-term effects of flexion-distraction spinal manipulation on intervertebral height, pain, spine mobility in patients with lumbar degenerative disc disease. Design: Randomized controlled trial with a pretest-posttest control group design Methods: A total of 96 participants with degenerative disc disease participated in the study and were randomly divided into two groups. Both groups received intervention for 3-5 minutes a day. The experimental group (n=48) underwent flexion-distraction spinal manipulation for 3-5 minutes, and the control group (n=48) was maintained in the same position as the experimental group for 5 minutes without any intervention. The intervertebral height was measured by computed tomography, pain was assessed using visual analog scale, and the spine in flexion mobility was measured using the finger-to-floor distance test and passive straight leg raise test. Pre-test and post-test measurements were obtained. Results: The experimental group showed significant improvement in intervertebral height, degree of pain, and spinal mobility (p<0.05). The intervertebral height increased from 6.32±1.90 to 6.93±1.85 mm (p<0.05), lower back pain decreased from 69.17±13.35 mm to 48.48±12.20 mm (p<0.05), lumbar spine mobility changed from 17.37±4.49 to 12.69±4.34 cm (p<0.05), and passive straight leg raise test range increased from 46.94±13.05° to 56.01±12.20° (p<0.05). Conclusions: This study suggests that flexion-distraction spinal manipulation could be an effective treatment for decreasing pain and improving function in patients with degenerative disc disease.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.4
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• pp.685-692
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• 2010

Purpose : The purpose of this study was to investigate effects of repetitive hand task on upper extremity proprioception and dexterity. Methods : Experimental group who had done hand task since last 1 year and young adult control group was recruited this study. Proprioception was measured positioning errors of elbow and wrist on three dimensional coordinate system by Winarm software(Zebris Medcal GmbH, Germany). And dexterity was measured by box and block test. Statistical analysis was used independent t -test. Results : When elbow moved from flexion to extension, there were significant difference on error of x axis in wrist location and erros of x, z axis in shoulder location(p<.05). When wrist moved from flexion to extension, there was significant difference on y axis in finger location error(p<.05). And there significant difference on dexterity(p<.05). Conclusion : In conclusion, repetitive hand task increase upper extremity proprioception and dexterity. The physical therapy in industrial workers should inhibit overuse injury.

• Journal of Korea Multimedia Society
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• v.19 no.1
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• pp.68-79
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• 2016

Electromyographic (EMG) signals have been widely used as motion commands of prosthetic arms. Although EMG signals contain meaningful information including the movement intentions of human body, it is difficult to predict the subject's motion by analyzing EMG signals in real-time due to the difficulties in extracting motion information from the signals including a lot of noises inherently. In this paper, four Ag/AgCl electrodes are placed on the surface of the subject's major muscles which are in charge of four upper arm movements (wrist flexion, wrist extension, ulnar deviation, finger flexion) to measure EMG signals corresponding to the movements. The measured signals are sampled using DAQ module and clustered sequentially. The Fuzzy C-Means (FCMs) method calculates the center values of the clustered data group. The fuzzy system designed to detect the upper arm movement intention utilizing the center values as input signals shows about 90% success in classifying the movement intentions.

• Archives of Plastic Surgery
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• v.45 no.4
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• pp.363-366
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• 2018

Background Camptodactyly refers to permanent flexion contracture at the proximal interphalangeal joint. Most cases are limited to fifth-finger involvement. Although common, the treatment of camptodactyly is controversial. Many published studies have emphasized conservative treatment, while others have described surgical procedures. The problem with this deformity is that it presents in several forms, which means that there is no single model for effective treatment. The aim of this paper is to present the difficulties encountered with this condition and the management thereof on an individual basis. Methods This is a case series of 14 patients (nine males, five females) who underwent surgical treatment. The results were classified using the method from Mayo Clinic as excellent, good, fair, and poor. Results Fourteen patients with 15 fingers underwent surgery, and the results achieved were as follows: excellent, 0; good, 1; fair, 6; poor, 8. The treatment of camptodactyly still remains controversial, and hence proper planning individualized to each patient is needed to achieve the maximal improvement with realistic goals. Conclusions Although we performed individualised surgery, our careful follow-up was not able to identify any method as superior over another with respect to gain in extension and loss of flexion. We therefore propose that the extensor mechanism should not be disturbed during surgery to treat camptodactyly cases.

• Journal of Korean Physical Therapy Science
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• v.13 no.2
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• pp.17-26
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• 2006

The purpose of this study was to evaluate effect of balance control therapy on low back pain patient's pain and flexibility. The subjects were consisted of 45 patients (15 males, 30 females) who had limited flexion range of motion of full spine with low back pain. All patients were one time treated the balance control therapy. Visual Analogue Scale(VAS) and Finger-to-Floor test(F-T-FT) were measured at pre-treatment, post-treatment and next day. VAS was used to measure subjective pain level. F-T-FT was used to measure forward flexion range of motion of full spine of low back pain patients. The results of this study were summarized as follow: 1. The VAS was significantly reduced between pre-treatment, post-treatment and next day (p<0.001). 2. The F-T-FT was significantly reduced between pre-treatment, post-treatment and next day (p<0.001). 3. The changes of pain decrease were related with pain duration(p<0.05), satisfaction for previous treatment(p<0.001). 4. The changes of flexibility increase were related with satisfaction for previous treatment(p<0.05).

• Journal of the Korean Society of Physical Medicine
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• v.10 no.1
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• pp.1-7
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• 2015

PURPOSE: The aim of this study was to investigate the effects of distal movement on shoulder muscle activation during diagonal pattern of exercises. METHODS: Seventeen healthy male participants volunteered to participate. Five muscles of shoulder were investigated during standing performance of diagonal shoulder exercises with and without visual trace. Two patterns of the diagonal exercises were used as diagonal 1 flexion and extension (D1F-E), and diagonal 2 flexion and extension (D2F-E). Two way repeated measures analysis of variance was used, which the factor was the presence of distal movement and exercise variations. RESULTS: The average muscle activity values of the lower trapezius and anterior deltoid are higher with the D2F-E, compared to the D1F-E (p<.05). The distal movement effect was observed within included all muscles except the lower trapezius, which the values are significantly greater in exercise with distal movement (P<.05). All significant increase of the muscles during the exercise with distal movement condition showed over 0.9 for the observed power in present study. CONCLUSION: Present result suggested that the diagonal pattern of exercise with distal movement has additional advantages of activating the scapulothoracic muscle as well as glenohumeral muscles. In addition, the D2F-E exercise pattern is effective for activating lower trapezius and anterior deltoid muscles.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.16 no.1
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• pp.50-56
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• 2010

Purpose : To evaluate effects of joint mobilization on the range of motion of chronic low back pain patients. Methods : The subjects were consisted of sixty patients who had non specific chronic low back pain(10 females. 10 males; mean aged 36.5). All subjects received modalities treatment with therapeutic massage for 10minutes and joint mobilization or manipulation for 10minutes per day and three times a week during 4 weeks period. The Multilevel Roland-Morris Disability Questionnaire(MR-MDQ) was used to measure functional disability level. Visual Analogue Scale(VAS) was used to measure subjective pain level. Remodified Schober test(RST) was used to measure forward flexion range of motion of lumbar segment. Finger-to-Floor test(F-T-FT) was used to measure forward flexion range of motion of full spine of low back pain patients. All measurements of each patients were measured at pre-treatment and 4 week post-treatment. Results : The MR-MDQ, VAS, RCT and F-T-FT were significantly different within-subjects(p<.05), Conclusion : The manual therapy included therapeutic massage and joint mobilization found that improved chronic low back pain patients. Further studies are needed to including more subjects on long-term outcomes.

• Journal of Applied Reliability
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• v.16 no.2
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• pp.147-154
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• 2016

Purpose: To evaluate statistical differences among three measurements of range of motion (ROM) with Rapael Smart Glove (RSG) group 1, 2 and manual goniometer group. To investigate reference value of the kinematic analysis for range of motion (ROM) of distal upper extremity with Rapael Smart Glove (RSG). Methods: Sixteen normal persons without limitation of motion (LOM) enrolled in the study. The study was performed at two separate times and by two investigators on 16 normal adults. We compared ROM with RSG for measuring joint angles. We compared degrees of forearm supination/pronation, wrist flexion/extension and radial deviation/ulnar deviation during ROM of 16 participants using RSG. After one week, degrees of each motion were measured in the same way by other investigator to evaluate the reliability. Results: Statistical differences among three groups were showed. Most results of paired t-test between two RSG groups were over 0.05 and exceptions are supination, extension, and finger %. Conclusion: Our findings demonstrate that ROM of normal persons obtained by kinematic analysis with RSG are not valid as normal reference value for distal upper extremity motion. But, the reliability of between two RSG groups was showed with paired t-test and Pearson's correlation except supination, extension and finger %.