The Effects of Rehabilitative Training in the Treatment of Patellofemoral Pain Syndrome

Objective Inappropriate neural control of the quadriceps femoris muscle group has been implicated in patellofemoral pain syndrome (PFPS) and the methods of biomechanical assessment of PFPS has been developed recently. The aims of the present investigation were to evaluate the effects of therapeutic exercise in the alleviation of PFPS and to develope objective clinical test for PFPS. Method We investigated the onset time of the isometric contraction of vastus medialis oblique muscle (VMO) and the vastus lateralis muscle (VL) under four different conditions: knee flexion and extension in weight bearing (standing) and non-weight bearing (sitting on chair) situations. For each condition, onset times of EMG activities and onset times for VMO and VL were determined from five trials of isometric contraction. In addition, we compared knee flexor and extensor torques in control group and subjects with PFPS. To evaluate the effects of the exercise we compared the onset time difference (onset time of VL-onset time of VM) and quadriceps muscle torque at pre- and post- exercise in PFPS groups. Results In PFPS group, onset time of VMO during knee extension was significantly longer than the onset time of VL and the knee extensor torque was considerably weaker in comparison with normal group. Although onset time difference was not changed after exercise program, there were significant increase in knee extensor torque in subjects with PFPS. Conclusion The role of exercise in the rehabilitation of quadriceps functions is to reduce the pain, to strengthen the knee extensor, and further accurate diagnostic tools and methods for the result of therapeutic exercise in PFPS are needed.ope

The Patterns of Spinal Deformity in Duchenne Muscular Dystrophy

Objective: To investigate the relationships between scoliosis and kyphotic or lordotic posture in Duchenne muscular dystrophy (DMD) patients, this study explored the factors influencing the development of spinal deformity. Method: Twenty five DMD patients with scoliosis were conducted to roentgenographic study to obtain Cobb's angle. In addition, rotation grade of the spine, as well as the degree of kyphotic and lordotic postures were obtained using the Moe pedicle method, kyphotic index and lumbosacral angle respectively. The data were assessed for the correlations among spinal deformities as well as the evaluation of functional state. After comprehensive rehabilitation programs for six months including scoliosis correction exercise, breathing exercise and thoracolumbosacral spinal orthosis, the effects of spinal deformity and pulmonary function were analyzed. An age-matched control group of 15 male patients with scoliosis were analyzed and compared with the experimental group. Results: In the experimental group, the scoliosis angles were negatively correlated with kyphotic index (r=⁣0.80, p＜ 0.01). In the control group, no correlations of statistical significance were detected among different types of spinal deformity. In addition, the rotation grade was found to be positively correlated with the scoliosis angle in the experimental group (r=0.89, p＜0.01). Furthermore, the larger the scoliosis angle, the patients functional state was found to be poorer (r=0.56, p＜0.01). Conclusion: In DMD patients, a strong correlation was found between the scoliosis and kyphotic posture. For the prevention of kyphotic posture, further study on the relevant therapeutic approach would be needed.ope

Utility of Quantitative Electromyography in the Evaluation of Carpal Tunnel Syndrome

Objectives: The purpose of this study is to evaluate quantitative electromyography (QEMG) of carpal tunnel syndrome. Methods: Thirty six healthy controls and 24 patients who were diagnosed having carpal tunnel syndrome were included in this study. The quantitative EMG study of abductor pollicis longus (APB) muscles were performed in both control and patients group. Turns, activity, mean amplitude, envelop amplitude and number of small segments (NSS) were obtained automatically. Results: Mean amplitude and envelop amplitude were likely to be located in left-upper quadrant of normal cloud and NSS were in right lower quadrant in some cases. However the differences were not statistically significant. Disease duration and unit residue of each parameter (mean amplitude, envelop amplitude and NSS) did not have close correlation. Conclusion: In this study, quantitative EMG has limited value in the diagnosis of carpal tunnel syndrome.ope

Rectal Somatosensory Evoked Potential in Normal Subjects

Objectives : To investigate the afferent pathways for signaling of visceral sensation in response to anorectal electrical stimulation. Methods : The study population consisted of healthy 28 males and 22 females. The stimulus was applied via anal probe equipped with bipolar surface stimulating electrode, and the probe was postioned 10 cm above anus. Cerebral evoked response were recorded from 1 cm posterior to vertex (Cz´, international 10~20 system) by needle electrode. Results : We found recognizable and reproducible evoked potentias in 23 subjects. The 13 male and 10 female subjects had an series of successive peaks and troughs. The first component of response had negative peak potentials, 97.2±4.2 msec mean peak latency for men and mean peak latency of 89.2±3.1 msec for women. Conclusion : We demonstrated the feasibility of methods to study visceral afferent nervous system from anorectum. There is some evidence that cortical evoked potentials may be obtained after electrical stimulation of anal canal.ope

Effects of Therapeutic Exercise on Patients with Osteoarthritis of Knee

Objective To investigate the effect of therapeutic exercise on patients with osteoarthritis of knee in view of functional capacity. Method The subjects were 80 patients with osteoarthritis of knee. Patients were randomly allocated to exercise or no exercise (control) group. Osteoarthritis was diagnosed on the base of clinical features, X ray findings. Therapeutic exercise was consisted of quad-setting exercise, isokinetic exercise, squatting exercise. Effects of therapeutic exercise were evaluated by muscle function, functioal performance and degree of pain. Results In exercise group, muscle function such as torque and endurance of extensor and flexor of knee were increased significantly compaired with control group (p＜0.05). Increment was more apparent in extensor. In both group, pain was decreased but more apparent in exercise group (p＜0.05). Functional performance was assessed in terms of dependency, difficulty and amount of pain. Exercise group showed improvement of functional performance in walking inside, climbing stairs (p＜0.05) but control group did not show improvement. Seventy percent of patients with osteoarthritis of knee showed increment of body weight above 10 kg compaired with their twenties. Conclusion When we manage the osteoarthritis of knee, therapeutic exercise should be included in the treatment regimen as well as physical and medical therapy.ope

A Study on Usage of Classroom Desks and Chairs by Teenagers

Objectives: To evaluate the compatability of high school students' desks and chairs to the fittness of their physique, to examine the factors related the posture and pain while they use the classroom desks and chairs, and to analyze the curvature of spine in sitting position. Method: Measurements of the dimensions of desks and chairs and a written survey to question students' habits regarding to the usage of classroom desks and chairs along with the physical examinations of spine including the analysis of spine curvature in sitting position with an electrogoniometer. Results: Seven hundred forty nine among 831 male students, and 1,017 among 1,074 female students, complained of discomforts associated with the usage of classroom desks and chiairs. An examination of spine in sitting position using an electrogoniometer showed that both male and female subjects displayed the spine curvatures in the order of thoracic kyphosis, lumbar lordosis, and scoliosis. All subjects displayed pain in the order of low back(38.8%), posterior neck(23.9%), shoulder and elbow joints(15.8%), and buttock(15.7%). Conclusion: The study revealed an urgent need for the adaptation of classroom desks and chairs according to the growing physique of the adolescents. A majority of the teenaged subjects experienced the discomfort from the use of improper funiture and a poor posture. Authors highly recommend a formal education to the students regarding the importance of proper posture and the usage of adjustable desks and chairs.ope

Change in Epidemiologic Characteristics of the Patients with Neck and Back Pain

Objective: The purpose of this study was to investigate the associated symptom aggravating factors and epidemiologic characteristics in patients with neck and back pain. Method: The demographic characteristics and the total number of patients who visited the Department of Rehabilitation Medicine, Yong-dong Severance Hospital for the management of neck and back pain were evaluated. A total of 2800 patients sampled from this group of patients and the possible influential factors such as symptom aggravating factors were evaluated. The back school attendants were analyzed for the effectiveness of education on prevention and management of neck and back pain. Results: The most common age group with neck and back pain were 5th decade (21.4%) and 6th decade (24.8%). The proportion of patients in acute stage were increased yearly. Of the aggravating factors, sports injury, driving and weight gain increased annually. In patients with neck pain, aggravation by typing and computer work was remarkable. The patients with desk type of job were increased each year and the patients in teenage group were also increased annually. Conclusion: Understanding of the current epidemiologic characteristics and the influential factors will be helpful for providing objective standards for assessment, management and preventioin of neck and back pain.ope

Selective Removal of Fibroblast with Using Proline Analogue andCytosine Arabinoside in Myoblast Culture

Objective: The phenomenon of fibroblast overgrowth is one of the major problems encountered during long-term culture such as myoblast culture. The first goal of the study is to determine the effects of proline analogue and cytosine arabinoside to reduce fibroblasts in myoblast culture. The second goal is to investigate whether the chemicals influence the growth and differentiation of myoblast. Method: Muscle tissues were obtained from legs of healthy men, and then fibroblasts and myoblasts were isolated and cultured. Those mixed cells were divided into three groups; control group, proline analogue (cis-hydroxyproline) treated group and cytosine arabinoside (araC) treated group. We evaluated the effectiveness of cis-hydroxyproline and araC on selective removal of fibroblasts in culture. We have also determined if cis-hydroxyproline and araC could alter differentiation of myoblast in each group. Results: The treatment with araC was effective to eliminate fibroblasts comparing to the control group (p＜0.05) while there was no statistically significant difference between proline analogue and control group (p＞0.05). Myoblasts of all three groups were differentiated into myotube. Conclusion: Using araC, we could reduce a number of fibroblasts in myoblast culture where contamination and subsequent overgrowth with fibroblasts remained a problem.ope

Cognition Associated with Dystrophin Deletion in Duchenne Muscular Dystrophy

Objective: To find correlations between the deletion of dystrophin gene and cognitive status in Duchenne muscular dystrophy (DMD). Methods: Cognitive abilities of 49 DMD children with dystrophin deletion were tested. Korean Wechsler Intelligence Scale for children was used to evaluate the cognitive status in DMD. Gene deletion was classified into two groups according to the location of the rearrangement (proximal region: central and 3’ region of the gene). Results: Molecular study by multiplex PCR (Polymerase Chain Reaction) of dystrophin exons was performed to identify 49 deletions in the 110 DMD patients. 13 out of 49 DMD were mentally impaired. In patients with distal deletions, total IQ (Intelligence Quotient) score was lower than the those with proximal deletions; which was not statistically significant. And the difference of the verbal and performance intelligence scale was not statistically significant. But comparisons of molecular and neuropsychological features showed that deletions localized in the central and 3’ regions of the gene were preferentially associated with the mental impairement. Conclusion: We concluded that deletions in the distal portions of the gene were more related to the mental retardation, although deletions with variable locations might lead to cognitive impairmentsope

The Efficacy of Aspirin and Acetaminophen in the Management of Delayed Onset Muscle Soreness

Objective: To investigate the efficacy of commonly available analgesics in the management of delayed-onset muscle soreness (DOMS) over an 8-day period, and to compare the efficacy between aspirin and acetaminophen. Method: Forty-two subjects were recruited. DOMS was induced by using the isokinetic dynamometer (KinComⰒ) in standardized fashion in the nondominant knee extensor with subjects seated at 30 degree-angle velocity. Subjects were asked to extend their non-dominant knee with concentric method and to hold the knee with eccentric flexion force at 30 degree-angle velocity, with maximal efforts. On this way, they did 10 repetitions, and then 3 cycles. We categorized four groups (n=10, for each group), that were control group with no medication, placebo group with placebo medication (antacid tablets), aspirin group with medication of 900 mg of aspirin, and acetaminophen group with medication with 3,900 mg of acetaminophen. Visual Analogue Scale (VAS: twice a day, until on day 8). and McGill Pain Questionnaire (MPQ: on day 1 and 3) were measured. Results: We didn't find any significant difference of peak VAS score and relief time between four groups (P＞0.05), The score of MPQ was not different between four groups (P＞0.05). Conclusion: We concluded that the medication may not be beneficial, at least at the doses stated, in the management of DOMS.ope