• Clinical Pain
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• v.19 no.1
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• pp.1-7
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• 2020

Objective: A prospective, assessor-blinded, randomized controlled trial was conducted in patients with chronic low back pain to evaluate the efficacy of portable low power laser therapy (LPLT) and the effect when combined with exercise therapy on pain and functions. Method: 60 patients were recruited and 56 patients, excluding 4 dropouts, were randomly allocated to the LPLT group (Group 1: 19 patients), placebo laser therapy with exercise group (Group 2: 18 patients), and LPLT with exercise group (Group 3: 19 patients). Laser therapy and exercise was performed five times a week for 4 weeks. Visual analogue scale (VAS), Schober test, lumbar range of motion (ROM) measures (flexion, extension and lateral flexion), Oswestry Disability index (ODI) were measured at baseline, at 4 weeks after intervention, and at 6 weeks after 2 weeks of no intervention. Results: Statistically significant improvements were noted in all group by time interaction with respect to all outcome parameters (p<0.05). All parameters in each group improved not only in the period of treatment (4 weeks), but also in the final evaluation (6 weeks) 2 weeks after the end of treatment. Post-hoc analysis showed statistically significant difference between the LPLT with exercise group and the other groups in all outcome parameters except for the ODI at 4 weeks and at 6 weeks. Conclusion: Portable LPLT is effective treatment in reducing pain and improving lumbar ROM and with exercise is more effective than laser or exercise monotherapy for the chronic low back pain patients.

• The Journal of Korean Obstetrics and Gynecology
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• v.35 no.4
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• pp.161-173
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• 2022

Objectives: This study was conducted to evaluate the effectiveness of acupuncture in patients with primary menstrual difficulties taking NSAIDs. Methods: 30 women with primary menstrual difficulties with NSAIDs were assigned to treatment groups (n=15) and control groups (n=15). On their first visit, both groups were provided with a menstrual diary and were required to record the intensity of pain and the dosage of painkillers during each menstrual cycle. The treatment group received two acupuncture treatments per cycle during two cycles, and the control group did not receive acupuncture. Pain strength during menstruation was evaluated using Visual Analogue Scale (VAS), and the total number of painkillers taken during menstruation and the average number of painkillers taken during a single dose was measured. Results: The treatment group had significant pain relief compared to the pre-test group and significant differences from the control group. In addition, there was a significant difference between the treatment group and the control group in the frequency of taking painkillers during the menstrual period and the dose in the test group was significantly lower than before treatment. Conclusions: This clinical trial showed that this acupuncture can help alleviate primary menstruation and reduce the use of nonsteroidal anti-inflammatory drugs.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.28 no.1
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• pp.39-51
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• 2022

Background: The purpose of this study is to investigate the effect of neck and shoulder self-stretching exercise using audiovisual media on neck pain, postural alignment, and joint position error in women with chronic neck pain. Methods: The subjects included 20 women that gave consent to participate in the study voluntarily. They performed the self-stretching exercises using audiovisual media was carried out 20 minutes 5 times a week during 3 weeks. Neck disability index (NDI) and visual analogue scale (VAS) were used to measure the functional disability and pain, A pressure pain threshold was measured using an algometer, and a cervical range of motion (CROM) measurement tool was used to measure the range of motion and error of proprioceptive position sense of the cervical spine. To assess posture alignment, forward head angle (FHA), forward shoulder angle (FSA) were measured using image J software. Results: The neck pain intensity was statistically significantly within group (p<.05). Neck and shoulder functional disability were a statistically significant difference within group (p<.05). Splenius capitis and upper trapezius pressure pain threshold were statistically significant difference in within group (p<.05). The postural alignment was statistically significantly within group (p<.05). The cervical range of motion in neck extension, right and left lateral flexion were statistically significantly within group (p<.05). The joint position error in neck flexion, extension, right and left lateral flexion decreased statistically significantly within group (p<.05). Conclusion: Self-stretching exercise using audiovisual media increased the mobility of the neck, decreased neck pain and joint position error, and improved posture alignment. As a result, there was a positive effect by applying the self-stretching exercise using audiovisual media to people with neck pain. Based on this, it is thought that it can be used as the basis for research related to home training programs for healthy self-management.

• Journal of the Korean Orthopaedic Association
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• v.53 no.6
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• pp.522-529
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• 2018

Purpose: To compare the clinical outcomes of ultrasound-guided percutaneous repair (USPR) and open repair in a ruptured Achilles tendon. Materials and Methods: The outcomes of 12 patients with USPR (group A) and 18 patients with open repair (group B) from January 2015 to February 2017 were analyzed retrospectively. The postoperative clinical evaluations were performed using the Arner-Lindholm scale, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Achilles tendon total rupture score (ATRS), and visual analogue scale for the overall satisfaction and cosmetic satisfaction with the scar, and the starting time of single heel raises. The complications were also evaluated. Results: The Arner-Lindholm scale, AOFAS ankle-hindfoot score, ATRS, starting time of single heel raises were similar in both groups (all p>0.05). Group A showed a significantly higher overall patient's satisfaction and cosmetic satisfaction in than group B (all p<0.05). Two cases of Achilles tendon elongation were encountered in group A, and 1 case of re-rupture with deep infection and 1 case of superficial infection were experienced in group B. Conclusion: USPR showed good clinical outcomes and high satisfaction as well as a low rate of complications, such as sural nerve injury. Therefore, USPR can be considered as an effective surgical treatment option for Achilles tendon ruptures.

• Sleep Medicine and Psychophysiology
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• v.21 no.2
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• pp.69-73
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• 2014

Objectives: This study was designed to assess the change of heart rate variability (HRV) at resting, upright, and psychological stress in anxiety disorder patients. Methods: HRV was measured at resting, upright, and psychological stress states in 60 anxiety disorder patients. We used visual analogue scale (VAS) score to assess tension and stress severity. Beck depression inventory (BDI) and state trait anxiety inventories I and II (STAI-I and II) were used to assess depression and anxiety severity. Differences between HRV indices were evaluated using paired t-tests. Gender difference analysis was accomplished with ANCOVA. Results: SDNN (Standard deviation of normal RR intervals) and low frequency/high frequency (LF/HF) were significantly increased, while NN50, pNN50, and normalized HF (nHF) were significantly decreased in the upright position compared to resting state (p < 0.01). SDNN, root mean square of the differences of successive normal to normal intervals, and LF/HF were significantly increased, while nHF was significantly decreased in the psychological stress state compared to resting state (p < 0.01). SDNN, NN50, pNN50 were significantly lower in upright position compared to psychological stress and nVLF, nLF, nHF, and LF/HF showed no significant differences between them. Conclusion: The LF/HF ratio was significantly increased after both physical and psychological stress in anxiety disorder, but did not show a significant difference between these two stresses. Significant differences of SDNN, NN50, and pNN50 without any differences of nVLF, nLF, nHF, and LF/HF between two stresses might suggest that frequency domain analysis is more specific than time domain analysis.

• Clinics in Shoulder and Elbow
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• v.10 no.1
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• pp.65-72
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• 2007

Purpose: To evaluate the relationship between the clinical outcome and the cuff integrity following open repair in large and massive rotator cuff tears using ultrasonography as an imaging modality. Material and Methods: From November 2001 to April 2005, 17 cases(16 patients) who had open repair of tear measuring more than 3cm were assessed with minimal follow-up of 12 months in this study. 6 cases had a large tear and 11 cases a massive tear. There were 6 men and 11 women with a mean age of 52 years at surgery (range, 33 to 72 years). The evaluation consisted of the preoperative and postoperative shoulder scores according to UCLA shoulder scoring system and Visual analogue scale (VAS). Ultrasonography was performed by a experienced musculoskeletal physician at a minimum of 12 months postoperatively to evaluate the postoperative cuff integrity. Results: Retear were detected in four of seventeen cases. Regardless of the presence of recurrent tear, 14 cases had UCLA score of more than 29 points (good grade). All 17 had an improvement in the functional score, which increased from an average of 15.1 to 31.2 points. All cases showed pain relief and five cases had no pain. Sixteen cases except one had the range of motion of forward elevation above $90^{\circ}$. Conclusion: Open rotator cuff repair in large and massive tears showed low retear rate. At a minimum of twelve months follow-up, all cases had improvement on UCLA score, pain relief, increased range of motion of the shoulder regardless of retear. And the correlation between recurrent tear and function score was not statistically significant.

• Journal of Oral Medicine and Pain
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• v.32 no.4
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• pp.403-411
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• 2007

This investigation was carried out to evaluate the effect of Transcutaneous Electric Nerve Stimulation (TENS) to experimentally induced masticatory muscle pain and muscular fatigue. Twenty-nine healthy volunteers (18 men and 11 women, aged $26.1{\pm}4.7$ years) without past history or present symptoms of temporomandibular disorders were participated in this study. All of the subjects were randomly assigned to experimental group and control group, after at least 3 days interval, two groups were reassigned conversely. Subjects assigned to experimental group were received TENS and others assigned to control group were received sham-TENS therapy for 45 minutes, respectively. The changes of Visual Analogue Scale (VAS), Pressure Pain Threshold (PPT), and EMG power spectrum were measured on the masseter muscle both before and after sustained fatiguing contraction in each group. The major findings of this study are as follows : 1. PPTs and median frequencies of masseter muscles were significantly decreased after sustained isometric contraction resulting in muscular fatigue. 2. In experimental group received TENS therapy, PPTs measured both before and after occurrence of experimentally induced muscular fatigue were significantly increased. 3. In experimental group received TENS therapy, the changes of PPTs during sustained isometric contraction resulting in muscular fatigue were significantly decreased. 4. In experimental group received TENS therapy, VAS measured after occurrence of experimentally induced muscular fatigue was significantly decreased. 5. Although there were not statistical significances, endurance time was increased in experimental group received TENS therapy and decreased in control group received sham-TENS therapy. 6. In experimental group received TENS therapy, the changes of median frequencies were the less decreased and the slope of median frequency shift was the more increased during endurance time than in control group, however, there were not statistical significances.

• Journal of Oral Medicine and Pain
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• v.34 no.4
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• pp.379-385
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• 2009

The purpose of this study was to present basic data that is needed in comprehension of dysesthesia after mandibular nerve injury and grasp meaning. We analyzed medical records of 59 patients who were diagnosed as dysesthesia after mandibular nerve injury from January 2007 to July 2009. The results are summarized as follows. 1. The most frequent cause was implant surgery (59%) and the most frequent injured branch of mandibular nerve was inferior alveolar nerve(81%). 2. The period passed after nerve injury showed significant interrelationship with level of pain. Visual Analogue Scale(VAS) increased from 4.82 to 6.91 after 6 month. 3. The period passed after nerve injury did not show significant interrelationship with recovery of dysesthesia. But, when conservative treatment was offered at earlier stage, ratio of patients who showed recovery of symptom tended to increase. 4. In computed tomography, level of invasion into inferior alveolar nerve canal did not show significant interrelationship with level of pain and recovery of dysesthesia. Conclusively, in the patients with dysesthesia of mandibular nerve, inferior alveolar nerve injury by dental implant surgery dominated most significant problem. Although level of invasion into inferior alveolar nerve is the most important factor to initiation of dysesthesia, there are other various factors exert more influence on the level of pain or recovery of dysesthesia. Therefore, begining conservative therapy at earlier stage is encouraged. Also, because nerve injuries can occur without direct invasion into nerve canal, so leaving enough safe space from nerve canal is needed for prevention of indirect nerve injury.

• Journal of the Korean Orthopaedic Association
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• v.56 no.2
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• pp.157-163
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• 2021

Purpose: Xanthomatosis of the Achilles tendons is rare. In some patients, however, the lesions in the Achilles tendon need to be removed, which may be painful and disfiguring. While studies of successful surgical outcomes for the total resection and reconstruction of the Achilles tendon have been reported, reconstruction surgery has a technical challenge, and extended surgical exposures are required. This study analyzed five cases of bilateral xanthoma of the Achilles tendon, which was treated surgically using a wedge-shaped tendon-sparing approach to eliminate the need for tendon reconstruction. Materials and Methods: From July 2010 to May 2018, five patients with xanthomatosis in both Achilles tendons underwent wedge-shaped tendon preserving surgery. The average age was 49 years (range, 40-55 years), and the follow-up period was 21.4 months (range, 12-31 months). The patients consisted of three males and two females. Complications related to surgery were recorded. The outcome measures included the range of motion of the ankle joint, American Orthopaedic Foot and ankle Society (AOFAS) ankle/hindfoot score, and visual analogue scale (VAS) for overall satisfaction at the last follow-up. The availability of a single-limb heel raise and returning time to work were also measured. Results: Wound dehiscence that did not require secondary surgery was noted in one patient. At the last follow-up, the range of motion of the ankle joint was normal in all patients. The mean AOFAS ankle/hindfoot score was 91 (range, 85-96) and the VAS for the overall satisfaction ranged from 8 to 10. The average time between surgery and return to work was 27.6 days (range, 17-58 days) and all patients could perform a single-limb heel raise test. Conclusion: The tendon-sparing technique, which can preserve the anatomical functioning of the Achilles tendon, could be an excellent surgical approach because it has very promising functional and cosmetic surgical outcomes in patients with Achilles tendon xanthomatosis.

• Journal of the Korean Orthopaedic Association
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• v.52 no.1
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• pp.1-6
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• 2017

Purpose: To retrospectively compare minimally invasive percutaneous plate osteosynthesis (MIPPO) with open plate fixation for the treatment of clavicle midshaft fracture. Materials and Methods: Between November 2011 to May 2014, 40 cases that were followed for more than 1 year-among all cases of MIPPO and open plate fixation-were analyzed. The study population was divided into two groups: group A included 20 cases of MIPPO and group B included 20 open plate fixation cases. The comparative analysis between the two groups was based on the operative time, bone union, functional evaluation (American Shoulder and Elbow Society score), incision length, pain relief (visual analogue scale, VAS), and complication. Results: The bone union was successful for all the cases, and the functional evaluation scores of the shoulder joint were satisfactory for both groups (p>0.05). The operative time was 47.5 minutes and 58.7 minutes for group A and B, respectively (p<0.05). The incision length for group A was 6.2 cm and that for group B was 10.7 cm with statistical significance (p<0.05). Pain relief (VAS) after surgery for group A showed a quick recuperation in the early stages. For complications, there were 2 cases of dysesthesia and 1 case of malunion due to metal fixation failure in group A. There were 6 cases of dysesthesia and 2 cases of cosmetic problem due to hypertrophic scar in group B. Conclusion: Surgical results of clavicle shaft fracture were satisfactory for both groups, but group A had advantages of shorter operative time, minimal incision length, and better pain relief in the early stages compared with group B. However, we need further evaluations with long-term follow-up results and complications, such as malunion and exposure on radiation.