Citations
Citations
Citations
To determine whether ACE insertion/deletion (I/D) polymorphism is associated with the ossification of the posterior longitudinal ligament (OPLL) of the spine in the Korean population.
A case-control study was conducted to investigate the association between I/D polymorphism of the angiotensin I converting enzyme (peptidyl-dipeptidase A) 1 (
The genotype and allele frequencies of ACE I/D polymorphism showed significant differences between the OPLL patients and the control subjects (genotype, p<0.001; allele, p=0.009). The frequencies of D/D genotype and D allele in the OPLL group were higher than those in the control group. In logistic regression analysis, ACE I/D polymorphism was associated with OPLL (dominant model; p=0.002; odd ratio, 2.20; 95% confidence interval, 1.33-3.65).
These results suggest that the deletion polymorphism of the
Citations
To investigate the short-term effects and advantages of sono-guided capsular distension, compared with fluoroscopically guided capsular distension in adhesive capsulitis of shoulder.
In this prospective, randomized, and controlled trial, 23 patients (group A) were given an intra-articular injection of a mixture of 0.5% lidocaine (9 ml), contrast dye (10 ml), and triamcinolone (20 mg); they received the injection once every 2 weeks, for a total of 6 weeks, under sono-guidance. Twenty-five patients (group B) were treated similarly, under fluoroscopic guidance. Instructions for the self-exercise program were given to all subjects, without physiotherapy and medication. Effects were then assessed using a visual numeric scale (VNS), and the shoulder pain and disability index (SPADI), as well as a range of shoulder motion examinations which took place at the beginning of the study and 2 and 6 weeks after the last injection. Incremental cost-effective ratio (ICER), effectiveness, preference, and procedure duration were evaluated 6 weeks post-injection.
The VNS, SPADI, and shoulder motion range improved 2 weeks after the last injection and continued to improve until 6 weeks, in both groups. However, no statistical differences in changes of VNS, SPADI, ROM, and effectiveness were found between these groups. Patients preferred sono-guided capsular distension to fluoroscopically guided capsular distension due to differences in radiation hazards and positional convenience. Procedure time was shorter for sono-guided capsular distension than for fluoroscopically guided capsular distension.
Sono-guided capsular distension has comparable effects with fluoroscopically guided capsular distension for treatment of adhesive capsulitis of the shoulder. Sono-guided capsular distension can be substituted for fluoroscopic capsular distension and can be advantageous from the viewpoint of radiation hazard mitigation, time, cost-effectiveness and convenience.
Citations
Objective: To compare intraarticular steroid injection with and without capsular distension in the treatment of adhesive capsulitis of the shoulder
Method: Fifty-five cases those were clinically diagnosed as adhesive capsulitis of the shoulder were randomly assigned to one of two treatment groups. 28 cases were treated by intraarticular steroid injection with capsular distension (group 1) and 27 cases by steroid injection alone (group 2). They were evaluated by visual analogue scales, Cyriax stages of arthritis, and active shoulder range of motion (flexion, abduction, external rotation and internal rotation). Follow up assessments were made one week and one month after injection.
Results: There were no statistically significant differences in Cyriax stages and VAS between two groups. But in the group 1, shoulder range of motion showed significant improvement in flexion and internal rotation at one week, and flexion at one month.
Conclusion: Intraarticular steroid injection with cspsular distension had no advantage over steroid injection alone in pain reduction, but can help the patients to achieve better range of motion, especially flexion and internal rotation, in treatment of adhesive capsulitis of the shoulder.
A 75-year-old woman presented a cauda equina syndrome with epiconus involvement from the compression fractures of T12, L1, and L3 vertebrae as a result of fall accident. Cystometrogram performed at three months after the injury showed a small bladder capacity and low compliance. Anticholinergic medications including intravesical instillation of oxybutynin solution failed to increase the bladder capacity or lower the intravesical pressure. Bladder distension therapy using normal saline infusion with a volume surpassing the previous measured maximal bladder capacity was per-formed. The procedures were repeated four times per day. At the fifth day of the distension therapy, the patient complained of acute low abdominal pain and gross hematuria. The cystogram revealed the extraperitoneal bladder rupture. The patient was treated successfully with antibiotics and continuous urinary drainage through the Foley catheter for 14 days. We report a case of extraperitoneal bladder rupture during the bladder distension therapy. (J Korean Acad Rehab Med 2002; 26: 355-357)
Objective: To evaluate working condition in way of measuring working posture and muscle tension using the desktop personal computer and notebook personal computer having different screen height.
Method: Seventeen healthy men performed wordprocessing task in three workstation: desktop PC on the conventional computer table (DPC (on)); desktop PC under the 'inside' type computer table (DPC (under)); notebook PC on the table (NPC). The viewing distance and angle, head and neck angle, thoracic bending and trunk inclination were measured. Muscle tension of right posterior neck muscle, upper trapezius, sternocleidomastoid (SCM), and upper back muscle was also measured by integrated electromyogram (IEMG).
Results: 1) The viewing distance was the longest in DPC (under). 2) The lower the screen height, the more downward viewing angle and more flexed position in upper neck. 3) The posterior neck muscle tension was the lowest in DPC (on). 4) Stooped position was most frequently seen in NPC and the highest tension of posterior neck muscle and upper back muscle was shown in NPC. 5) In relation between postural analysis and muscle tension, muscle tension decreased with increasing backward reclining position, and the neck and thorax became more erect with increasing in viewing distance.
Conclusion: These results suggest that the stooped posture was worst and most frequently seen in NPC. If neck flexion is avoided, DPC (under) position could lessen the visual and musculoskeletal problem. More Ergonomical study would be needed about working posture using computer.
Objective: This study was performed to evaluate the prevalence of new neuromuscular symptoms and disabilities and the psychological characteristics-depressioin, anxiety, type A behavior, loneliness, and also to determine any relationships between physical and neuropsychological characteristics in a group of post-polio syndrome (PPS).
Method: By 70 answered questionnaire, the polio survivors were grouped into PPS and Non- PPS. This questionnaire consisted of questions about acute polio problems; new health problems, fatigue severity scale, visual analog scale, weakness scale, Frenchay activity index, ambulation disability index; socio-economic problems; neuro-psychological inventories, Beck depression index, Spielberger state-trait anxiety inventory, revised UCLA loneliness scale, type A personality score.
Results: The median time from polio to the onset of new health problems was 27.6 years. Fatigue, muscle and/or joint pain, weakness in previously affected and unaffected muscles were most common newly appearing problems. The symptoms of PPS was consistent with the distribution of the anterior horn cell; spinal cord, brain stem, cerebral hemisphere, Reticular Activating System (RAS). Neuro-psychological evaluations revealed that fatigue scale was correlated with depression, type A personality.
Conclusion: In PPS group, pain, weakness, fatigue, autonomous symptoms, decreased concentration were more serious than in Non-PPS group. The fatigue in PPS group was correlated with type A personality, depression, sleep disturbance and concentration problem.
Objective: To evaluate the correlation of the cross-sectional areas (CSA) of paraspinal muscles (back extensors and psoas muscles) and full range-of-motion isometric lumbar extension strength in the individuals with low back pain.
Method: Twenty four subjects (14 men and 10 women) with low back pain completed a maximum isometric lumbar extension strength test at seven angles through a 72o range of motion (0, 12, 24, 36, 48, 60, 72 degrees of lumbar flexion). CSA of back extensors and psoas muscles were measured from standardized transaxial view by CT scanner.
Results: CSA of lumbar extensor and psoas were correlated with isometric lumbar extension strength from full flexion to extension in the low back pain patients. The greater the lumbar flexion angle, the greater the coefficient of determination (R2). The correlation coefficients of psoas muscles were greater than those of lumbar extensors.
Conclusion: Both back extensors and psoas muscles do their important role during isometric lumbar extension. Isometric lumbar extension strength of full lumbar flexion is well correlated with CSA of paraspinal muscles.
Method: Ten healthy adult volunteers were included. We attached surface markers at the corresponding skin surface of each lumbar vertebral bodies and measured lumbar segmental ROM in flexion-extension, right bending, left bending, axial rotation with 3-D motion analysis. We compared some of the results with radiologic segmental ROM measurements.
Results: In 3-D motion analysis, segmental ROM of flexion and extension, right bending, left bending, right rotation, left rotation were, respectively: 10.1o, 45o, 3.5o, 1.7o and 1.9o (L1-L2); 17.9o, 6.2o, 5.1o, 1.4o and 1.1o (L2-L3); 15.0o, 7.2o, 4.9o, 2.1o and 1.1o (L3-L4); 14.9o, 5.8o, 4.6o, 1.7° and 1.6° (L4-L5); 10.6o, 4.9o, 3.8°, 2.6° and 0.8° (L5-S1). There was no statistically significant difference in segmental ROM between 3-D motion analysis measurements and radiologic measurements except L5-S1 right bending, L2-L3 and L5-S1 left bending. No statistical significant difference in lumbar flexion and bending ROM was found between two methods.
Conclusion: 3-D motion analysis is a useful method when measuring the lumbar segmental range of motion and it has an advantage to analyze segmental lumbar motion with three directions simultaneously. (J Korean Acad Rehab Med 2003; 27: 424-432)
Method: Sixty healthy adult men performed five maximal isokinetic knee extension-flexion contractions in each of two contralateral leg stabilization conditions at different angular velocities. In the "Front condition", the test was done with a bar in front of the ankle joint of the non-testing leg. In the Fix condition", the non-testing leg was strapped and induced reciprocally to perform isometric contractions with respect to the testing leg. From the measured values, we calculated the strength difference ratio ([Peak Torque (PT) of "Fix condition"-PT of "Front condition"]⁓100/PT of "Front condition") at each angular velocity.
Results: By comparing the extensor strength, greater PTs were measured at the "Fix condition" in all tested angular velocities (p＜0.01). For the flexor, the PTs of both conditions were similar. The strength difference ratio decreased as angular velocity increased (r=0.48, p＜0.01) in the extensor.
Conclusion: We could infer the crossed extension-flexion reflex is more apparent in the lower angular velocity than in higher one. (J Korean Acad Rehab Med 2003; 27: 255-259)
Objective: The purpose of this study was to titrate the nerve block effect of phenol with different concentrations of phenol solution by electrophysiological and mechanical measurements.
Method: Right tibial nerves of twenty three adult rabbits were blocked by phenol solution with different concentrations (3%, 5%). Nerve conduction study for compound muscle action potential (CMAP), tension by electrical stimulation, and stiffness (slope) of stretch reflex of the triceps surae were performed after nerve block (4 weeks, 8 weeks, 16 weeks). The ratios of each values of right limb to those of left limb were used to evaluate the nerve block effect.
Results: The ratios of CMAP amplitude, tension, and slope of 3% group were 0.36, 0.55, and 0.56 at 4 weeks and those of 5% group were 0.21, 0.25, and 0.58. There were statistically significant differences of the CMAP amplitude and tension ratios, however there was no statistically significant difference of the slope ratio between two groups at 4 weeks. The ratios of CMAP amplitude, tension, and slope of 5% phenol group were increased with time.
Conclusion: Nerve block effects by 5% phenol solution were greater than 3%. These data suggest that nerve block effect can be titrated with concentration of phenol solution.
Traumatic spinal cord injury causes profound changes in blood pressure, pulse rate and cardiac rhythm. Because the cardiovascular system is highly dependent on autonomic influences, acute spinal cord trauma might interfere with the complex mechanisms involved in cardiovascular homeostasis. These abnormalities has been generally attributed to autonomic instability. However, relatively little attention has been paid to the acute aspects of autonomic dysfunction in humans.
Therefore, this study was performed retrospectively on 62 patients with acute spinal cord injuries to evaluate incidence, time course and severity for cardiovascular instability. In this study, the incidence of persistent bradycardia and hypotension in the cervical injury group was significantly higher than that of the thoracolumbar injury group. These signs occurred earlier in the cervical group than the thoracolumbar group and also lasted longer in the cervical group. This study suggests that there is a direct correlation between the level of spinal cord injury and the incidence of cardiovascular problems.
The purposes of this study were to measure the normal value of peak torque of lumbar extensors at various degrees of lumbar flexion and to compare this with the chronic low back pain patient. 100 normal subjects, 70 men(age, 49.0±5.3) and 30 women(age, 48.1±7.4), completed isometric lumbar extension strength test. 26 low back pain subjects, 9 men(age, 35.3±14.7) and 17 women(age, 42.6±10.1), completed isometric lumbar extension strength test. Normal male peak torques of lumbar extensors were 125±38 Ft-lbs at 0 degree, 164±43 at 12 degree, 200±43 at 24 degree, 221±46 at 36 degree, 241±50 at 48 degree, 257±50 at 60 degree, and 262±51 at 72 degree of lumbar flexion. Normal female peak torques of lumbar extensors were 78±24 at 0 degree, 105±27 at 12 degree, 120±38 at 24 degree, 135±35 at 36 degree, 142±37 at 48 degree, 151±40 at 60 degree, and 157±41 at 72 degree of lumbar flexion. Normal peak torques of lumbar extensors increase as degrees of lumbar flexion increase. Body weight is more correlated with peak torque than body mass index. Male peak torques of lumbar extensors with low back pain were 91±47 Ft-lbs at 0 degree, 129±46 at 12 degree, 156±57 at 24 degree, 178±61 at 36 degree, 197±54 at 48 degree, 217±61 at 60 degree, and 218±52 at 72 degree of lumbar flexion. Female peak torques of lumbar extensors with low back pain were 45±24 at 0 degree, 73±28 at 12 degree, 98±32 at 24 degree, 117±44 at 36 degree, 130±40 at 48 degree, 138±41 at 60 degree, and 148±36 at 72 degree of lumbar flexion. Peak torques of lumbar extensors with low back pain increase as degrees of lumbar flexion increase. Comparison of the normal male peak torque of lumbar extensors with low back pain group revealed statistical differences at 48 and 72 degree of lumbar extensors. And the female group revealed statistical difference at 0, 12, and 24 degree of lumbar flexion.
Objective: To determine the changes of posterior bulging of the lumbar intervertebral discs with flexion and extension movement of the spine in patients with central disc bulges or disc degeneration.
Method: Twenty patients with low back pain were studied. Nine patients had central type disc bulging and eleven patients had disc degeneration only. The spines were scanned in neutral, flexion, and extension positions in a vertically open 0.5T MR scanner. Degree of posterior bulging of the lumbar intervertebral disc of the pathological level was measured.
Results: In the patients with disc bulge, posterior bulging of the disc decreased in all of the patients by 0.8⁑0.6 mm with flexion of the spine and increased in 77.8% of the patients by 1.0⁑0.8 mm with extension of the spine. In the patients with disc degeneration, posterior bulging decreased with flexion in 36.7% of the patients. With extension, posterior bulging increased in 55.6% of the patients.
Conclusion: This study found that patients with low back pain and central disc bulges have consistent and marked discrepancies in posterior bulging with flexion-extension in comparison with our previous study with asymptomatic patients with normal MRIs.
Objective: To delineate the role of antidiuretic hormone (ADH) in relation to nocturnal polyuria, and to identify the factors influencing on the diurnal antidiuretic hormone level.
Method: The ADH was measured by radioimmuoassay at daytime (2:00 PM) and at nighttime (2:00 AM) with nocturnal polyuria group (11) and without nocturnal polyuria group (8). Urine volume, serum osmolarity, urine osmolarity, and blood pressure were also measured at the same time.
Results: 1) The ADH at 2:00 AM did not increase in nocturnal polyuria group, although it increased in no-symptom group. 2) There was a statistically significant correlation between wheelchair ambulation time and daytime ADH level. 3) The difference of ADH level between daytime and nighttime showed decrease in orthostatic hypotension group.
Conclusion: There was relationship between nocturnal polyuria and diurnal variation of ADH level. The ADH concentration seems to be influenced by the postural factors and sympathetic factors.
Objective: To define arthrographic findings in patients with frozen shoulder and to evaluate the therapeutic effect of arthrographic capsular distension and rupture.
Method: Thirty patients who were clinically diagnosed as frozen shoulder were enrolled. During a trial of intra-articular injection of 35 mL of fluid which contained 8 mL of 1% lidocaine, 2 mL of prednisolone (80 mg) and 25 mL of radiocontrast material, arthrographic findings and the occurrence of iatrogenic capsular tear were observed. Passive range of shoulder motion (percent of normal, %) at flexion, abduction, internal rotation, and external rotation was measured at pre- and 1 week post-injection. The therapeutic effect of the procedure was statistically analyzed by paired Student's t-test.
Results: Mean age of the subjects was 57-years-old (range: 40∼76 years) and mean duration of the symptom was 6 months (2∼42 months). A decreased joint volume of less than 10 mL (100%), poor or absent filling of the axillary recess or subscapular bursa (75.9%), nonfill of the biceps tendon sheath (37.9%), and irregularity of capsular insertion (31.0%) were typical abnormal arthrographic findings. In one week after arthrographic distension and rupture, the passive range of shoulder motion was significantly (p＜0.05) increased at flexion, abduction and external rotation, of which the range of external rotation was the most remarkably increased (mean, 23.9%).
Conclusion: Distension arthrography was useful for increasing shoulder motion in frozen shoulder, especially at flexion, abduction and external rotation.
First
Prev
