• 대한정형외과스포츠의학회지
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• 제2권1호
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• pp.56-61
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• 2003

본연구는슬관절과견관절의초기재활과정에서관절운동범위와스트레칭, 그리고유산소성운동프로그램에대한논문이다. 만약관절이손상후장기간동안고정된다면관절이굳어지고 근육은위축이 될것이다. 그러므로본 프로그램은다양한운동기술을포함하고있다. 즉관절의경직을예방하기위한운동범위확보와근육의이완을위한스트레칭, 심폐기능의감소를예방하기위한심혈관훈련(수영, 상체자전거, 고정식자전거)을포함하고있다. 초기재활과정에서는임상운동전문가와환자사이의상호관계를형성하는것이매우중요하다. 또한임상운동전문가는환자의통증과운동적응도, 체력수준, 프로그램의진행등에관해스포츠의학전문의와상의하는것이권장된다.

• 재활치료과학
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• 제2권1호
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• pp.24-35
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• 2013

본 연구에서는 거울치료가 뇌졸중 환자의 상지 운동기능 향상에 미치는 효과를 문헌고찰을 통해 알아보고 임상적 효용성을 확인하고자 하였다. 또한, 그간 밝혀진 정보를 종합하여 거울치료를 통해 발생하는 중재효과를 분석하고 거울치료의 신경학적 기전을 알아보고자 하였다. 거울치료는 뇌졸중 환자들의 손과 팔의 운동기능을 향상시키고, 일상생활 수행기능회복과 통증경감에 효과가 있다. 하지만 시각 무시에 대해서는 효과를 입증할 수 있는 근거가 아직 분명치 않다. 거울치료는 전운동영역의 신경학적 회복을 유도한다. 전운동영역은 운동 조절의 핵심적인 역할을 하는 부위로서 거울치료에 의해 활성화되면 손상된 일차운동영역의 활성도를 증가시켜 기능회복을 유발한다. 일차운동영역이 완전히 손상된 경우에는 신경 재조직화를 통해 일차운동영역의 기능을 전운동영역이나 보완운동영역이 대체하여 수행한다. 선행연구의 고찰 결과, 거울치료의 효과나 이에 대한 신경학적인 원인에 대한 증거가 아직 부족한 실정이었다. 거울치료의 효과와 신경학적 기전이 명확히 규명된다면 거울치료는 임상에서 보다 효용성 있는 치료로서 구축될 것이라 사료된다.

• Physical Therapy Rehabilitation Science
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• 제4권1호
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• pp.11-16
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• 2015

Objective: Prone bridge exercise is one of the core strengthening exercise for improving abdominal, lower and upper extremity muscles. In addition, coactivation of the trunk muscles and extremities is important for treatment of low back pain. This study aimed to investigate the correlation between the thickness, cross-sectional area of the target muscle, and endurance during prone bridge exercise. Our hypothesis was that an increase in muscle thickness is positively related to the hold time for the static prone bridge exercise. Design: Cross-sectional study. Methods: Fourteen healthy university students (8 men and 6 women) voluntarily participated in the study at Sahmyook University. Hold time for the prone bridge with one and both legs was measured. The resting and contracted thickness of the lateral abdominal, rectus femoris, and triceps muscles was measured using rehabilitative ultrasound imaging. The correlation between muscle thickness and endurance for maintenance time was evaluated. Results: The prone bridge with both legs and the contraction thickness of the triceps muscle showed a positive correlation (r=0.692, p<0.05); the prone bridge with one leg and the contraction thickness of the internal oblique and transversus abdominis muscles showed a positive correlation (r=0.545, 0.574, p<0.05, 0.05, respectively). Conclusions: Endurance for the prone bridge exercise with a stable support surface is correlated with the contraction thickness of arm muscles; the prone bridge exercise with an unstable support surface is correlated with the contraction thickness of the deep abdominal muscles.

• Journal of Acupuncture Research
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• 제32권2호
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• pp.229-240
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• 2015

Objectives : The purpose of this report is to show the effect of complex traditional Korean medical care focused on warm needling(WN) and bee venom(BV) injection for a patient suffering from traumatic brachial plexus injury(BPI). Methods : A 51-year-old female patient with BPI was suffering from paresis and hypoesthesia with upper-extremity impairment. The patient had been treated once a day from 4 Feb to 11 Apr of 2015 mainly with WN and BV injection on the acupoints near the distribution of the brachial plexus. Improvement of the symptoms was measured by range of motion(ROM), manual muscle test(MMT) grip strength, and with the numeric rating scale(NRS) of tactile and pain sensitivity. Results : After 67 days of treatment, all obtained results showed remarkable improvement. The patient's satisfaction declaration was recorded through an interview at the end of the treatment. Conclusions : The results suggest that anatomically concerned WN and BV treatment can be a valuable option in reducing or normalizing pains from traumatic BPI.

• 한국전문물리치료학회지
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• 제9권2호
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• pp.43-50
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• 2002

This study was designed to identify the effects of walking conditions (normal walking vs. toe-walking) on electromyographic (EMG) activity of gastrocnemius, tibialis anterior, and soleus muscle. Seven healthy adult males participated in this study. The exclusion criteria were orthopedic or neurologic disease, congenital anomaly or acquired deformity, or pain in low back or lower extremities. The maximal voluntary isometric contraction for each muscle was used for the reference contraction, and EMG activity of each muscle during normal walking and toe-walking was expressed as a percentage of reference contraction. The gait cycle was determined with two foot switches, and gait was normalized as 100% gait cycle for each condition. The maximal values of EMG activity in terminal stance (30~50% of gait cycle) of each condition were compared for data analysis. No significant differences were found in EMG activity of the tibialis anterior and soleus (p>.05), whereas significant decrement was found in EMG activity of gastrocnemius during toe-walking compared to normal walking (p<.05). There is a limitation to generalize the results of this study, because small number of subjects participated for this study and only EMG was used for data collection. The treatment methods should be developed to improve gait efficiency by substituting the weakened muscles secondary to upper motor neuron, or by strengthening the distal muscles in lower extremity.

• Archives of Plastic Surgery
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• 제34권4호
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• pp.531-534
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• 2007

Purpose: Plastic surgeons are responsible for the management of spinal cord injury patients with upper and lower extremity reconstruction, pressure sore, and wounds. Derailment of autonomic nervous systems caused by injury to the spinal cord may result in fatal autonomic dysreflexia. Autonomic dysreflexia is a syndrome of massive imbalance of reflex sympathetic discharge occurring in patients with spinal cord lesion above the splanchnic outflow(T6). It is characterized by a sudden onset and severe increase in blood pressure and is potentially life threatening. The other classic symptoms are headache, chest pain, sweating, and bradycardia. In order to lower the blood pressure, it is important to remove the noxious stimulus for autonomic dysreflexia. If such symptoms last for more than 15 minutes despite conservative interventions, antihypertension drugs are recommended. Methods: In this case study, we report an autonomic dysreflexia case that developed in a 45 year-old tetraplegia patient with sacral pressure sore. When he got bladder irrigation, his blood pressure went up very high and his mentality became stuporous. He was sent to ICU for his blood pressure and mental care. ICU care made his vital sign stabilized and his mentality alert. Results: After the patient underwent proper treatment like inotropic agent, he was transferred to the general ward and his pressure sore on sacral area was coveraged with gluteus maximus myocutaneous advancement flap. Conclusion: If treatment is not effective, the patients have to undergo sudden, severe hypertension, which can cause stroke or death. To provide safe and effective care, plastic surgeons should be able to recognize and treat autonomic dysreflexia.

• Archives of Plastic Surgery
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• 제38권4호
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• pp.498-500
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• 2011

Purpose: Neurilemoma is benign tumor of the nerve sheath which arises from Schwann cells. It is usually formed along the path of a peripheral nerve but is rarely separate from normal nerve fascicles. We experienced a patient with an isolated neurilemoma localized in the palmaris longus tendon with no connection to the major nerve trunk, which was in an unusual location and has never been reported. We report our case with the review of the literature. Methods: A 23-year-old female visited our clinic with mild pain on the mass at the flexor area of the right wrist which had been present for about one year. The physical examination revealed a $1{\times}1cm$ sized subcutaneous mass at the flexor area of the right wrist. Sonography and computed tomography showed an ovoid, superficial solid mass on the palmaris longus tendon. Upon surgical excision, a $1{\times}0.5cm$ sized mass attached to the palmaris longus tendon was found. The tumor had no connection with the median nerve and was detached easily from the palmaris longus tendon. Results: Histological examination demonstrated the mass to be a neurilemoma, which consists of spindle shaped cells with oval elongated nuclei arranged fascicles. No sensory dysfunction or evidence of recurrence was found during the 12 months of postoperative follow-up. Conclusion: We experienced a rare case of neurilemoma attached to the palmaris longus tendon with no connection to the major nerve trunk. We wish to emphasize its unusual location through our case and hope to expand our spectrum in exploring the upper extremity mass.

• Journal of Acupuncture Research
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• 제38권1호
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• pp.72-78
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• 2021

Combined Western-Korean medicine treatments were given to a 67-year-old woman with late onset seizures who underwent surgical drainage of a subdural hematoma. Clonazepam and herbal medicine was prescribed. Acupuncture, moxibustion, cupping, chuna, and physical therapy were also performed. The frequency and intensity of seizures was assessed using the Chalfont Seizure Severity Scale. The seizure index score improved from 25 at admission to 0 at discharge. Pain in the right upper extremity reduced from 10 to 0 on the visual analogue scale and muscle strength increased from Grade 3 to 5 in Medical Research Council Scale for the Manual Muscle Test. At the time of hospitalization, the manual muscle strength tests for the affected shoulder, elbow, wrist, and grip strength were 30%, 60%, 10%, 5%, respectively, which improved almost 100% by discharge. Further studies using combined Western-Korean medicine for seizures after strokes are necessary to determine the most effective treatment.

• 한국전문물리치료학회지
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• 제28권2호
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• pp.93-100
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• 2021

Background: Lateral epicondylitis (LE) is the most common chronic musculoskeletal conditions of the upper extremity with pain and wrist extension disability. The tendon which is most affected is the extensor carpi radialis brevis (ECRB). Previous study evaluated the effect of taping technique on patient with LE, but no study investigated the changes of electromyography (EMG) on ECRB when using dynamic taping (DT) technique. Objects: The aim of this study was to investigate the effect of DT technique using dynamic tape on muscle activity of ECRB during wrist isometric extension, isotonic extension and flexion. Methods: Twenty-one healthy subjects volunteered to participate in this study. Subjects were instructed to perform wrist isometric extension, isotonic extension and flexion without and with DT on origin area of ECRB. Wrist isometric extension was performed at 75%, 50% and 25% (%maximal voluntary contraction force), respectively, based on maximum contraction force. Isotonic extension and flexion test used dumbbell. EMG data was collected from ECRB. Results: EMG of ECRB were statistically significant decrease in wrist isotonic extension after DT (p < 0.05). Significant increase in wrist isometric extension during 25% and 50% force task (p < 0.05). Conclusion: This study applied DT technique to suppress the wrist extensor muscles in 21 healthy adults in their twenties. Change in muscle activity was compared in the ECRB muscle during wrist isometric extension, isotonic extension and flexion task. Based on the results of this study, the DT technique applied to the wrist and forearm area can reduce the load on the wrist extensors when the wrist performs various movements during daily life movements or repetitive tasks, and by using these effects, excessive stress is applied to tennis elbow patients.

• 한국환경보건학회지
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• 제17권2호
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• pp.78-94
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• 1991

The purpose of this study is to research the actual conditions of industrial accident patients and to produce worker satisfaction and a rational and effective counter measure pain. Direct interviews with 179 cases (in and out patients) were carried out during a three month period from April to July 1990, at six hospitals two general hospitals Sun Lin and Sung Mo in Po Hang, and four general hospitals in Taegu Kyung Pook University Hospital, Dong San Medical Center, Young Nam Medical Center and Catholic Hospital. The results of this study are summarized as follows: 1. Among the 179 cases, 51.6 % were male and 48.4 % were female. The two largest age groups were 30~39, 31.8 % and 20~29, 27.4 %. Among the 179 cases, 51.6% were married, the largest family number was 2 to 3, 41.1% and 4 to 5, 25.6%. Educationally, graduation from high school was the largest group, 46.4% among the patients, followed by middle school and primary school. The largest group income level was from 40~69만원, 45.2%. The largest group of patients who worked over 50 hrs. a week was 52.0%. The largest group of patients who worked less than 1 year was 44.7%, of the patients in work places of less than 100 people, 60.3% were injured and in work places of 100~299 people, 20.1% were injured. In manufacturing, the lagest group injured was 55.3%, the next group was transport, stroage, communication. The largest group of production workers injured was 40.2%. 2. The cause of injury in the largest group was facility problems, 33.5%. The next group was unsafe habits, 30.2% a lack of safety knowledge, 17.9% and insufficient supervision, 12.3%. The 30~39 year age group was head the highest number of injuries, 40.4% work places with more than 10 yeras of work, 44.4% work palces with more than 1000 people, 56.3% and mining accidents, 80.0%. Among these groups the highest cause of injury was due to facility problems. 3. The accident pattern showed machinery injuries 28.5% as the largest group, followed by falls & falling objects 17.3%, fire & electric 15.1%, struke by an object 14.5%, followed by overaction and vehicular accidents. The accident pattern showed 46.4 % among workers over the 50 year age group, workers in the 5~10 year group, 50.0 % places employing more than 1000 workers, 35.3 % : construction 73.7%, and construction workers 57.1%, among these fall & falling objects caused the greatest number of injuries. 4. The largest group of injuries was fractures 54.8%, trauma 14.5%, amputation 11.7%, open wound, and burns. The largest number of fractures occurred in people in the 30~39 year age group, 63.2 % over 10 years of work, 55.6% in work places of 300~400 people, 63.6% construction 63.2% and general workers 57.2 %. 5. The largest group of injuries was upper extremity 45.3%, lower extremity 24.0%, trunk 18.5 % and head or neck 12.2%. Of these groups, upper extremity injuries were the highest in those less 20 years old 75.0%, less than 1 years of work 59.5%, in work places of 500~999 people 60.0%, manufacturing 56.6 % and production workers 55.6%. 6. Periods of injury showed 34 people injured in September, to be the largest followed by October, 32 August, 22 people July, 19 people and the lowest December, 2 people. During the week, Friday had the largest group injured, 35 people followed by Saturday, 26 people and the lowest was Wednesday, 17 people, During the day 1400 hours had the largest group injured, 38 people followed by 800 hours, 31 people. 7. On a basis of 5 as the highest mark, the average, according to worker satisfaction showed facility safety 3.55, work environment 3.47, income 3.44, job 3.21 and treatment 2.98. 8. The correlation between general characteristics and injury showed that age was directly correlated to the duration of work(r=.2591) p<0.01, age was directly correlated to industry (r=2311) p<0.01, and the duration was directly correlated to occupation(r =.4372) p<0.001.