• Journal of Chest Surgery
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• v.27 no.12
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• pp.1008-1014
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• 1994

Increased interest in alternative approach to thoractomy has developed because of the considerable morbidity associated with the standard posterolateral thoracotomy[ST]. Muscle sparing thoracotomy is appeared as excellent alternative because of less postoperative pain and morbidity than standard posterolateral one. Vertical axillary muscle sparing thoracotomy[VM] is the newly revised modified muscle sparing thoracotomy that overcomes the disadvantages of previous lateral muscle sparing thoracotomy such as seroma, cosmetic problems, and need of subcutaneous drains. We conducted a prospective study of 45 consecutive patients to compare postoperative pain, muscle strength of serratus anterior and latissimus dorsi, and range of motion of the shoulder girdle between ST and VM group. There were no difference in preoperative status, surgical procedure, morbidity, mortality and hospital stay between two groups. But there were significant less postoperative narcotics requirements, more preserved latissimus dorsi and serratus anterior muscle strength, nd larger range of motion of shoulder girdle [ especially flexion and internal rotation in VM group. The opening time was prolonged[p<0.01] but closing time was less in VM group [p<0.01]. The sum of opening and closing time was not different in two group. The length of incision line was shorter in VM group. The vertical skin incision was concealed by the upper arm.In conclusion vertical axillary muscle sparing thoracotomy is good alternative for various intrathoracic procedures with less postoperative pain, well preserved muscle strength,increased range of motion of the shoulder girdle and impressive cosmetic outcome.

• Physical Therapy Korea
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• v.16 no.2
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• pp.1-8
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• 2009

Anticipatory postural adjustments is an example of the ability of the central nervous system to predict the consequence of the mechanical effect of movement on posture and helps minimize a forth coming disturbance. The aim of this study was to evaluate the sequence of activation of the trunk muscles during the performance of hip and shoulder movement and to determine the relationship between anticipatory activity and subjects' motor and functional status in subjects with hemiplegia post stroke. Twenty-four poststroke hemiparetic patients enrolled in this study. Electromyographic activity of the lumbar erector spinae, latissimus dorsi, and of the obliquus internus muscles was recorded bilaterally during flexion of both arm and from the rectus abdominis, obliquus externus, and obliquus internus muscles during flexion of both hip. Onset latencies of trunk muscles were partially delayed in the subjects with hemiplegia post stroke (p<.05). With upper limb flexion, the onset of erector spinae muscle and latissimus dorsi muscle activity preceded the onset of deltoid on both side respectively (p<.05). A similar sequence of activation occurred with lower limb flexion. Also the onset of external oblique muscle and rectus abdominis muscle activity preceded the onset of rectus femoris muscle on both side (p<.05). Major impairments in the activity of trunk muscles in hemiparetic subjects were manifested in delayed onset between activation of pertinent muscular pairs. These problems were associated with motor and functional deficits and warrant specific consideration during physical rehabilitation of post stroke hemiparetic patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.1
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• pp.1-16
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• 1996

There are various defects caused by trauma or resection of maignant tumor in the orofacial region, which can be reconstructed with various regional and pararegional flaps. Among these defects, it is very difficult to reconstruct palatal and midfacial defects after maxillectomy and patients have problems in speaking and swallowing of food. Therefore it is very important for surgeons to reconstruct these defects functionally and esthetically and to return the patients to the normal social activity. These defects are usually obturated with prosthodontic appliances to assist the phonation and swallowing. But nowadays surgical reconstruction by various flaps was considered and performed for better rehabilitation. For this purpose the forehead flap, the nasolabial flap, the tongue flap, the sternocleidomastoideous flap, the temporal flap, the latissimus dorsi flap, the scapular flap etc. are used. We reconstructed small-sized plalatal defects with tongue flap, medium-sized palatal and maxillary defects after maxillectomy with temporal myofascial flap and large midfacial defects including eyeball exenteration with latissimus dorsi myocutaneous flaps. Here we are to report 5 cases of these flaps used for the reconstruction of palatal and midfacial defects and consider the versatility, reliability and limitation in use of these flaps.

• Korean Journal of Applied Biomechanics
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• v.13 no.1
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• pp.95-108
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• 2003

The purposes of this study were to analyze the muscle activities and the characteristics of muscle recruiting patterns of upper trunk for Ssirum dutguri technique using three top-ranked elite Ssirum players. The EMG technique was used to record muscle activities of both right and left sides of latissimus dorsi, biceps brachii, and erector spinae. Six surface electrodes were placed on the surface of the selected muscles and one ground electrode was also attached on the back of neck(C7). One video camera was also used to record the Ssirum motion to define 4 events and 3 phases for further analysis. The raw EMG data were filtered with band pass filter (50-400 Hz) to remove artifacts and then low pass filtered (4 Hz) to find the linear envelope which resemble muscle tension curve. This filtered EMG data were normalized to MVIC for the purpose of comparion between the subjects. The results were indicated that each subject with different physical characteristics showed very different muscle activity patterns. Although Ssirum dutguri is considered as foot technique the player grasped opponent's satba(belt) with both hands when they play. Because of this reason, activities of upper trunk muscles were relatively high. However, direct comparison between upper and lower body muscles was not possible due to the lack of the data in present study. Interestingly, all threes subjects showed that erector spinae muscle activity was comparatively higher than those of latissimus dorsi and biceps brachii. This implies to reinforce back muscle as a routine of training to improve performance or to prevent back injury.

• Archives of Plastic Surgery
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• v.48 no.5
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• pp.528-533
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• 2021

Bladder acontractility affects several thousand patients in the United States, but the available therapies are limited. Latissimus dorsi detrusor myoplasty (LDDM) is a therapeutic option that allows patients with bladder acontractility to void voluntarily. Our goal was to conduct a systematic review of the literature to determine whether LDDM is a better option than clean intermittent catheterization (CIC) (standard treatment) in patients with bladder acontractility. On January 17, 2020, we conducted a systematic review of the PubMed/MEDLINE, Cochrane Clinical Answers, Cochrane Central Register of Controlled Trials, Embase, and ClinicalTrials.gov databases, without time frame limitations, to identify articles on the use of LDDM for bladder acontractility. Of 75 potential articles, 4 fulfilled the eligibility criteria. The use of LDDM to treat patients with bladder acontractility was reported in four case series by the same group in Europe. Fifty-eight patients were included, and no comparison groups were included. The most common cause of bladder acontractility was spinal cord injury (n=36). The mean (±standard deviation) operative time was 536 (±22) minutes, postoperative length of hospital stay ranged from 10 to 13 days, and follow-up ranged from 9 to 68 months. Most patients had complete response, were able to void voluntarily, and had post-void residual volume less than 100 mL. Although promising outcomes have been obtained, evidence is still weak regarding whether LDDM is better than CIC to avoid impairment of the urinary tract among patients with bladder acontractility. Further prospective studies with control groups are necessary.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.3
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• pp.39-45
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• 2019

PURPOSE: We investigated the most effective way to activate the posterior oblique sling muscles by performing prone hip extension exercises. METHODS: An electromyography system was used to measure the activation of the posterior oblique sling muscles (latissimus dorsi, gluteus maximus, multifidus, and biceps femoris) in three different prone hip extension exercises of in 12 healthy individuals (6 men and 6 women): 1) prone hip extension, 2) prone hip extension with internal rotation and extension of the arm, and 3) prone hip extension with internal rotation and extension of the arm with a 1-Ib dumbbell. RESULTS: The overall muscular activation of the posterior oblique sling muscles was more increased when performing 1) prone hip extension with internal rotation and 2) prone hip extension with internal rotation and extension of the arm with a 1-Ib dumbbell as compared with that during prone hip extension except for the biceps femoris activation. There was a statistically significant difference in the activities of the contralateral multifidi among all three exercises; of the ipsilateral multifidi in PHE1) prone hip extension alone, PHE2) prone hip extension with internal rotation and extension of the arm and PHE3) prone hip extension with internal rotation and extension of the arm with 1-Ib dumbbell; and of the ipsilateral gluteus maximus among all the prone hip extension exercises. There was no significant difference in the activity of the biceps femoris among the three exercises. CONCLUSION: Prone hip extension with internal rotation and with internal rotation and extension of the arm with 1-Ib dumbbell can activate the posterior oblique sling muscles and so prevent back pain in healthy people.

• Archives of Plastic Surgery
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• v.48 no.1
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• pp.15-25
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• 2021

Thoracodorsal artery (TDA) flaps, ranging from the vascular-pedicled thoracodorsal artery perforator (TDAP) flap, the propeller TDAP flap, and the muscle-sparing latissimus dorsi (MSLD) flap to the conventional latissimus dorsi (LD) flap and the extended LD flap, can all be used for breast reconstruction. The aim of this paper and review is to share our experiences and recommendations for procedure selection when applying TDA-based flaps for breast reconstruction. We describe the different surgical techniques and our thoughts and experience regarding indications and selection between these procedures for individual patients who opt for breast reconstruction. We have performed 574 TDA flaps in 491 patients: 60 extended LD flaps, 122 conventional LD flaps, two MSLD flaps, 233 propeller TDAP flaps, 122 TDAP flaps, and 35 free contralateral TDAP flaps for stacked TDAP breast reconstruction. All the TDA flaps are important flaps for reconstruction of the breast. The LD flap is still an option, although we prefer flaps without muscle when possible. The vascular-pedicled TDAP flap is an option for experienced surgeons, and the propeller TDAP flap can be used in most reconstructive cases of the breast, although a secondary procedure is often necessary for correction of the pedicle bulk. The extended LD flap is an option for women with a substantial body mass index, although it is associated with the highest morbidity of all the TDA flaps. The MSLD flap can be used if the perforators are small or if dissection of the perforators is assessed to be hazardous.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.1
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• pp.75-83
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• 2022

PURPOSE: This study was conducted to investigate the effect of the resistance respiratory muscle exercise with transcutaneous electrical nerve stimulation (TENS) on the respiratory muscle tone and pulmonary function of stroke patients. METHODS: Twenty stroke patients were divided into the TENS group (n = 7), placebo TENS group (n = 7), and control group (n = 6), and each intervention was performed on the three groups 5 times a week for 4 weeks. The assessment was carried out by measuring changes in the muscle tone of the latissimus dorsi and abdominal external obliques, and pulmonary function. RESULTS: In this study, the TENS group and the placebo TENS group had significant increases in the paretic side latissimus dorsi muscle tone, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and peak expiratory flow (PEF). There was no significant difference in changes in respiratory muscle tone between the three groups. The pulmonary function was significantly different between the three groups, and it was observed from the results of the post-hoc test that FVC showed a significant increase in the TENS group and the placebo TENS group compared to the control group. CONCLUSION: Through this study, it was found that the respiratory muscle resistance exercise was more effective as a method to increase respiratory muscle tone and pulmonary function in stroke patients than combined transcutaneous electrical nerve stimulation.

• Korean Journal of Applied Biomechanics
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• v.32 no.1
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• pp.31-36
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• 2022

Objective: The purpose of this study was to investigate muscle activation according to the four strap lengths in the TRX plank exercise to provide scientific and accurate data on effective training methods. Method: Twenty healthy men who had at least 6 months of weight training experience and could fully adjusted plank exercise, were participate in this study (age: 25.2 ± 3.7 yrs., height: 174.2 ± 3.9 cm., weight: 71.2 ± 9 kg). To pursue the study purpose, surface electrodes were attached to trunk muscles (pectoralis major, rectus abdominis, external oblique, internal oblique, erector spinae, latissimus dorsi) and lower extramity muscles (gluteus maximus, rectus femoris, gastrocnemius), and the muscle activity was measured using 11-channel electromyography equipment. In order to verify the muscle activation according to the four strap lengths during TRX plank exercise, an one-way ANOVA with repeated measure was used with statistical significance level set at as α=.05. Results: First, there were statistically significant differences in pectoralis major, rectus abdominis, external oblique, internal oblique, and erector spinae among TRX strap lengths. Second, there were statistically significant differences in gluteus maximus, rectus femoris, and gastrocnemius among TRX strap lengths. Third, even though no statistically significant difference found in latissimus dorsi, but increased muscle activation tendency was showed as the length of the strap increased. Conclusion: From the results of this study, it may be possible that TRX exercise prevent injuries and improve lower extremity muscle as well as trunk muscles by setting appropriate length of strap.

• Design Convergence Study
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• v.14 no.5
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• pp.157-169
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• 2015

In this study, three axillary crutches(Mobilegs, KM crutch, Pro In-motion) were tested with 12 healthy male subjects by measuring the EMG activity of the latissimus dorsi and gastrocnemius and the user-perceived levels focusing on the comfort and ease of use. The result showed that the EMG activity of the gastrocnemius was significantly reduced during ambulation using Mobilegs and Pro In-motion compared with the ambulation using KM crutch, a conventional crutch. However, no statistically significant difference was found for EMG activity of the latissimus dorsi. Subjects perceived the Mobilegs to be more comfortable and easy to use than the other crutches. Theses result may delivered mostly from the characteristics of spring-loaded axillary pad and ergonomic crutch handle. The results indicate that ambulation using the spring-loaded crutch is much easy with asking less exertion at gastrocnemius. In addition, the characteristics of crutch design, such as embedded spring, makes muscles to consume less energy. When the reasonable structure and form of the axillary pad and crutch handle are applied herein, the ambulation using the crutches are perceived to comfort.