• Journal of Integrative Natural Science
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• v.13 no.4
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• pp.121-127
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• 2020

To investigate the effects of wearable near-infrared ray-emitting knee pads on knee pain among elderly adults in Korea. Randomized controlled trial evaluating the effects of near-infrared rays (NIR) on knee pain in Korean elderly adults. Five community-based research facilities (two welfare centers, a senior citizen center, and two churches). Forty-seven participants aged 65 years and older who had experienced knee pain. The experimental group (n = 25) wore NIR-emitting knee pads for one month at nighttime while sleeping. The control group (n = 22) wore knee pads without NIR. Demographic characteristics, intensity and duration of knee pain, amount of analgesic medication used, range of motion, gait speed, and health-related quality of life were collected using questionnaires. The experimental group showed decreased intensity (t = -6.17, p < 0.001) and duration (t = -3.34, p = 0.002) of knee pain and reduced analgesic use (t = -2.30, p = 0.026) compared to the control group. NIR may be an effective non-pharmacological option for relieving knee pain in elderly adults.

• International Journal of Heart Failure
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• v.6 no.3
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• pp.107-116
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• 2024

Frailty is highly prevalent among patients with heart failure (HF) and independently predicts adverse outcomes. However, optimal frailty definitions, assessments, and management in HF remain unclear. Frailty is common in HF, affecting up to 80% of patients depending on population characteristics. Even pre-frailty doubles mortality risk versus robust patients. Frailty worsens HF prognosis through systemic inflammation, neurohormonal changes, sarcopenia, and micronutrient deficiency. Simple screening tools like gait speed and grip strength predict outcomes but lack HF-specificity. Comprehensive geriatric assessment is ideal but not always feasible. Exercise, nutrition, poly-pharmacy management, and multidisciplinary care models can help stablize frailty components and improve patient-centred outcomes. Frailty frequently coexists with and exacerbates HF. Routine frailty screening should guide supportive interventions to optimize physical, cognitive, and psychosocial health. Further research on HF-specific frailty assessment tools and interventions is warranted to reduce this dual burden.

• Journal of Korean Neurosurgical Society
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• v.58 no.6
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• pp.571-577
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• 2015

Direct removal of beak-type ossification of posterior longitudinal ligament at thoracic spine (T-OPLL) is a challenging surgical technique due to the potential risk of neural injury. Slipping off the cutting surface of a high-speed drill may result in entrapment in neural structures, leading to serious complications. Removal of T-OPLL with an ultrasonic osteotome, utilizing back and forth micro-motion of a blade rather than rotatory-motion of drill, may reduce such complications. We have applied the ultrasonic osteotome for posterior circumferential decompression of T-OPLL for three consecutive patients with beak-type OPLL and have described the surgical techniques and patient outcomes. The preoperative chief complaint was gait disturbance in all patients. Japanese orthopedic association scores (JOA) was used for functional assessment. Scores measured 2/11, 5/11, 2/11, and 4/11 for each patient. The ventral T-OPLL mass was exposed after posterior midline approach, laminotomy and transeversectomy. The T-OPLL mass was directly removed with an ultrasonic osteotome and instrumented segmental fixation was performed. The surgeries were uneventful. Detailed surgical techniques were presented. Gait disturbance was improved in all patients. Dural tear occurred in one patient without squeal. Postoperative JOA was 6/11, 10/11, 8/11, and 8/11 (recovery rate; 44%, 83%, 67%, and 43%) respectively at 18, 18, 10, and 1 months postoperative. T-OPLL was completely removed in all patients as confirmed with computed tomography scan. We hope that surgical difficulties in direct removal of T-OPLL might be reduced by utilizing ultrasonic osteotome.

• Journal of International Academy of Physical Therapy Research
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• v.3 no.1
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• pp.370-377
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• 2012

This study examines the effects of different environments on the application of hemiplegia patients circuit balance training. Group 1 performed circuit balance training without any auditory intervention Group 2 performed training in noiseless environments and Group 3 performed training in white noise environments. First, among lower extremity muscular strength evaluation items, maximum activity time(MAT) was not significantly different(p>.05). Maximum muscle strength(MMS) increased significantly in Group 3(p<.01), there was no significant difference in MMS among the groups. Average muscle strength(AMS) indexes also significantly increased in Group 3(p<.01), there was no significant difference in AMS among the groups. Second, among balancing ability evaluation items, Berg's balance scale(BBS) scores significantly increased in all groups(p<.05), BBS scores were significantly difference among the groups. Based on the results, Group 1, 2 and Group 1, 3 showed significant increases (p<.05). Functional reach test(FRT) values significantly increased in Group 2, 3(p<.05), and there was no significant difference in FRT values among the groups. Timed up and go(TUG) test values significantly decreased in Group 2, 3(p<.05), and there was no significant difference in TUG test values among the groups. Third, among walking speed evaluation items, the time required to walk 10m significantly decreased in all groups(p<.05), and there was no significant difference in the values among the groups. Average walking speeds showed significant increases in Group 1, 3(p<.05), and there was no significant difference in the values among the groups. Based on the results of this study, noise environments should be improved by either considering auditory interventions and noiseless environments, or by ensuring that white noise environments facilitate the enhancement of balancing ability.

• Physical Therapy Korea
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• v.21 no.2
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• pp.8-17
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• 2014

The purpose of this study was to examine the effects of hip joint mobilization (HJM) on walking ability, balance ability, and the joint range of motion in stroke patients to minimize the problems of the musculoskeletal system in patients with central nervous system diseases. All volunteers were randomly assigned to the HJM group ($n_1=14$) and the general neurodevelopment therapy (NDT) group ($n_2=16$). The HJM procedure involved applying Maitland mobilization techniques (distraction, lateral gliding, inferior gliding, and anterior gliding) by grade 3 to both hip joint. The mobilization process included mobilization and NDT for 15 min/day, 3 days a week for 4 weeks. The outcome measures were evaluated, including the hip joint passive range of motion (ROM) test and femur head anterior glide test (FHAG) using prone figure four test, dynamic and static balance abilities [timed up and go (TUG) test and center of pressure (COP) analysis], and walking ability [10-meter walking test (10MWT) and 6-min walking test (6MWT)]. Both the groups showed significant post-training differences in the hip joint ROM (FHAG and degree of hip extension) and 10MWT. The post-training improvements in the TUG test were significantly greater in patients of the HJM group than in the NDT group; however, there were no post-training improvements in COP in both groups. Patients in the HJM group showed post-training improvement in the 6MWT; however, statistically significant differences were not observed. Patients in the NDT group showed post-training improvements in the 6MWT. These results suggest that HJM improves hip joint ROM, dynamic balance ability, and walking speed in stroke patients. However, further studies are required to evaluate the long-term therapeutic efficacy of HJM in stroke patients.

• The Journal of Korean Physical Therapy
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• v.27 no.4
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• pp.228-233
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• 2015

Purpose: Gait is the most basic element when evaluating the quality of life with activities of daily living under ordinary life circumstances. Symmetrical use of the lower extremities requires complicated coordination of all limbs. Thus, this study examined asymmetry of muscle activity quadriceps femoris and tibialis anterior as a baseline for training during over-ground walking and stair walking of stroke patients. Methods: Subjects were 14 stroke patients included as one experimental group. Gait speed used in this study was determined by the subject. Low extremity paretic and non-paretic EMG was compared using the surface EMG system. Results: The low extremity EMG difference was statistically significant during over-ground walking and stair walking (p<0.05). The result of low extremity EMG substituted symmetry ratio formula was compared to EMG symmetry ratio in both legs during over-ground walking and stair walking. The average symmetry ratio of quadriceps femoris during over-ground walking was 0.65, and average symmetry ratio of quadriceps femoris during stair walking was 0.47, with significant difference (p<0.05). Conclusion: EMG data was higher in stair walking than over-ground walking. However, in the comparison of symmetry ratio, asymmetric EMG of quadriceps femoris was significantly increased during stair walking. These findings suggested that application of stair walking for strengthening of both legs can be positive, but the key factor is maintaining asymmetrical posture of both legs. Therefore, physical therapists should make an effort to reduce asymmetry of quadriceps femoris power during stair walking by stroke patients.

• Korean Journal of Applied Biomechanics
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• v.27 no.1
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• pp.53-58
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• 2017

Objective: The purpose of this study was to compare the accuracy of stride time and stride length provided by a commercial APDM inertial sensor system (APDM) with the results of three dimensional motion capture system (3D motion) during treadmill walking. Method: Five healthy men participated in this experiment. All subjects walked on the treadmill for 3 minutes at their preferred walking speed. The 3D motion and the APDM were simultaneously used for extracting gait variables such as stride time and stride length. Mean difference and root mean squared (RMS) difference were used to compare the measured gait variables from the two measurement devices. The regression equation derived from the range of motion of the lower limb was also applied to correct the error of stride length. Results: The stride time extracted from the APDM was almost the same as that from the 3D motion (the mean difference and RMS difference were less than 0.0001 sec and 0.0085 sec, respectively). For stride length, mean difference and RMS difference were less than 0.1141 m and 0.1254 m, respectively. However, after correction of the stride length error using the derived regression equation, the mean difference and the RMS difference decreased to 0.0134 m and 0.0556 m or less, respectively. Conclusion: In this study, we confirmed the possibility of using the temporal variables provided from the APDM during treadmill walking. By applying the regression equation derived only from the range of motion provided by the APDM, the error of the spatial variable could be reduced. Although further studies are needed with additional subjects and various walking speeds, these results may provide the basic data necessary for using APDM in treadmill walking.

• Korean Journal of Applied Biomechanics
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• v.26 no.1
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• pp.135-142
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• 2016

Objective: The purpose of this study was to investigate the acute effect of walking on high heels on the behavior of fascicle length and activation of the lower limb muscles. Methods: Twelve healthy inexperienced high heel wearers (age: $23.1{\pm}2.0yr$, height: $162.4{\pm}4.9cm$, weight: $54.4{\pm}8.5kg$) participated in this study. They walked in high heels (7 cm) and barefoot on a treadmill at their preferred speed. During the gait analysis, the lower limb joint kinematics were obtained using a motion analysis system. In addition, the changes in fascicle length and the level of activation of the medial gastrocnemius (MG) were simultaneously monitored using a real-time ultrasound imaging technique and surface electromyography, respectively. Results: The results of this study show that the MG fascicle operates at a significantly shorter length in high heel walking ($37.64{\pm}8.59mm$ to $43.99{\pm}8.66mm$) in comparison with barefoot walking ($48.26{\pm}9.02mm$ to $53.99{\pm}8.54mm$) (p < .05). In addition, the MG fascicle underwent lengthening during high heel walking with relatively low muscle activation while it remained isometric during barefoot walking with relatively high muscle activation. Conclusion: Wearing high heels alters the operating range of the MG fascicle length and the pattern of muscle activation, suggesting that prolonged wearing of high heels might induce structural alterations of the MG that, in turn, hinder normal functioning of the MG muscle during walking.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.1
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• pp.53-61
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• 2019

PURPOSE: This study examined the dynamic range of motion (ROM) of the hip, knee, and ankle joint when wearing different shoe sole lifts, as well as the limb asymmetry of the range according to the leg length discrepancy (LLD) during normal speed walking. METHODS: The participants were 40 healthy adults. A motion analysis system was used to collect kinematic ROM data. The participants had 40 markers attached to their lower extremities and were asked to walk on a 6 m walkway, under three different shoe lift conditions (without an insole, 1 cm insole, and 2 cm insole). Visual3D professional software was used to coordinate kinematic ROM data. RESULTS: Most of the ROM variables of the short limbs were similar under each insole lift condition (p>.05). In contrast, when wearing a shoe with a 2 cm insole lift, the long limbs showed significant increases in flexion and extension of the knee joint as well as; plantarflexion, dorsiflexion, pronation, eversion, and inversion of the ankle joint (p<.05). Of the shoes with the insole lifts, significant differences in all ROM variables were observed between the left and right knees, except for the knee internal rotation (p<.05). CONCLUSION: As the insole lift was increased, more ROM differences were observed between the left and right limbs, and the asymmetry of the bilateral lower limbs increased. Therefore, appropriate interventions for LLD are needed because an artificial mild LLD of less than 2.0 cm could lead to a range of musculoskeletal problems of the lower extremities, such as knee and ankle osteoarthritis.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.2
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• pp.105-113
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• 2022

Purpose: The purpose of this study is to investigate the effect of non-invasive transcranial direct current stimulation (tDCS) on muscle activity, including 10 m WT, TUG, and BBS, in hemiplegic stroke patients. Methods: This study was conducted on 42 inpatients diagnosed with hemiplegia due to stroke at hospital B in Daejeon for more than 6 months. Walking training was conducted for six weeks, five times a week for 30 minutes, with a general walking group (14 people), tDCS walking group (14 people), and tDCS (sham) walking group (14 people). Results: As a result of the study, the change in the muscle activity before and after tDCS intervention was significantly increased in the tibialis anterior muscle in the CG group. In the EG group, the erector spine (lumbar), rectus femoris, and tibialis anterior muscles significantly increased. In the SEG group, significant increases were observed in the rectus femoris and tibialis anterior muscles. Significant differences were found in the rectus femoris and tibialis anterior muscles in the comparison between groups after intervention according to tDCS application. Also, 10 m WT, TUG, and BBS were significantly increased in the CG, EG, and SEG groups after intervention, and there were significant differences in 10 m WT, TUG, and BBS in comparison between groups after intervention according to tDCS application. Conclusion: As a result, tDCS is an effective in improving the walking ability of stroke patients, and in particular, it effectively increases the muscle activity of the rectus femoris and tibialis anterior muscles, which act directly on walking, and also improves the speed and stability of walking. It is considered being an effective method to increase the gait of stroke patients by combining it with the existing gait training.