The Effect of a Kettlebell Complex Program according to the Support Surface on Lower Extremity Muscle Activity and Balance in Baseball Players

Purpose@#The purpose of this study was to investigate the effect of a kettlebell complex program according to the support surface on the lower extremity muscle activity and balance of baseball players. @*Methods@#The participants were divided into two groups; unstable support surface group 1 (11 people) performed the kettlebell complex program on an unstable support surface, and stable support surface group 2 (10 people) performed the kettlebell complex program on a stable support surface. Muscle activity was measured by surface electromyography. Dynamic balance was measured with a balancemeasuring equipment. A paired t-test was used to compare groups before and after the experiment. An independent t-test was performed to determine the difference in the degree of change between the two groups before and after the experiment. @*Results@#The intragroup comparison between stable support surface group 1 and 2 showed significant differences in muscle activity and sense of balance. In the comparison between the groups, the difference in muscle activity in unstable support surface group1 was significant in the biceps femoris and rectus femoris muscles, and significant differences were also found in the sense of balance. @*Conclusion@#These results suggest that a kettlebell exercise on an unstable support surface is more effective in improving muscle activity and sense of balance than a kettlebell exercise on a stable support surface.

The Effect of Shoulder Stabilization Exercise through Visit Rehabilitation on Muscle Activity and Postural Alignment, Self-Efficacy in Rural Elderly People with Round Shoulders

Purpose@#This study covered the effect of shoulder stabilization exercise on muscle activity, postural alignment and self-efficacy of the elderly people with round shoulders by visiting village hall in rural area. @*Methods@#40 elderly people with round shoulders were recruited for this study (experimental group: 20 subjects and control group: 20 subjects). The experimental group was asked to perform shoulder stabilization exercise 60 minutes per one time for 8 weeks and three times in a week and the control group was asked to receive education related to pain management for the initial one time. Before and after the experiment, we measured the subjects’ muscle activity of upper trapezius, serratus anterior, infraspinatus, pectoralis major and the lower trapezius, then postural alignment of craniovertebral angle and round shoulder posture. In addition, self-efficacy is measured through the questionnaire. @*Results@#Compared to the control group, the experimental group showed significant differences in the muscle activity of all muscles, posture alignment of the craniovertebral angle. round shoulder posture, and improvement of self-efficacy. @*Conclusion@#We found that shoulder stabilization exercise is effective in muscle activity, postural alignment and self-efficacy of the elderly people through visit-rehabilitation service. This study can be used for improving the physical and mental abilities through active visit-rehabilitation service for areas where have poor medical benefits. It is considered that systematic visit rehabilitation service should have institutional framework ultimately.

The Effect of Shoulder Stabilization Exercise through Visit Rehabilitation on Muscle Activity and Postural Alignment, Self-Efficacy in Rural Elderly People with Round Shoulders

Purpose@#This study covered the effect of shoulder stabilization exercise on muscle activity, postural alignment and self-efficacy of the elderly people with round shoulders by visiting village hall in rural area. @*Methods@#40 elderly people with round shoulders were recruited for this study (experimental group: 20 subjects and control group: 20 subjects). The experimental group was asked to perform shoulder stabilization exercise 60 minutes per one time for 8 weeks and three times in a week and the control group was asked to receive education related to pain management for the initial one time. Before and after the experiment, we measured the subjects’ muscle activity of upper trapezius, serratus anterior, infraspinatus, pectoralis major and the lower trapezius, then postural alignment of craniovertebral angle and round shoulder posture. In addition, self-efficacy is measured through the questionnaire. @*Results@#Compared to the control group, the experimental group showed significant differences in the muscle activity of all muscles, posture alignment of the craniovertebral angle. round shoulder posture, and improvement of self-efficacy. @*Conclusion@#We found that shoulder stabilization exercise is effective in muscle activity, postural alignment and self-efficacy of the elderly people through visit-rehabilitation service. This study can be used for improving the physical and mental abilities through active visit-rehabilitation service for areas where have poor medical benefits. It is considered that systematic visit rehabilitation service should have institutional framework ultimately.

Effect of Plank Exercise Combined with Breathing and Arm Exercises on Abdominal Muscle Thickness

PURPOSE: This study examined the effects of plank exercise combined with breathing and arm exercises on the external oblique, internal oblique, and transverse abdominal muscle thickness. METHODS: Thirty healthy adults consisting of 12 males and 18 females from K area were divided into a plank exercise combined with breathing and arm exercises group (n = 15) and a plank exercise only group (n=15). The changes in muscle thickness before the exercise and four and eight weeks after the exercise were analyzed using a two-way repeated analysis of variance (ANOVA). The significance level was set to α=0.05. Post-hoc t-tests were conducted to detect the interactions between the time and groups, and the significance level was set to α=0.01. RESULTS: According to the experimental results, the external oblique abdominal muscle showed significant differences over time (p<0.05). The internal oblique abdominal muscle also showed significant differences over time and in the interactions between the time and groups (p<0.05). The transverse abdominal muscle showed significant differences over time, in the interactions between time and groups, and in the changes between the groups (p<0.05). CONCLUSION: The results indicated that plank exercise combined with breathing and arm movement exercises led to increases in the abdominal muscle thickness. These types of exercises may be useful in lumbar stabilization rehabilitation treatment.

Effects of Transcranial Direct Current Stimulation on the Static Balance Ability of Patients with Back Pain

PURPOSE: This study examined the effects of transcranial direct current stimulation (tDCS) on the static balance ability of patients with back pain.METHODS: The subjects comprised of 30 males and females in their 20s, who were divided into two groups with and without tDCS. The balance posture ratio score was calculated to determine the changes in balance ability before and after the application of tDCS using balance equipment. A paired t-test was conducted to determine the changes over time, and an independent t-test was performed to determine the changes between the groups. The significance level was set to α=0.05.RESULTS: A significant difference in the changes in the static balance ability of CTDCSG between before and after applying tDCS was observed while the subjects' eyes were open (p<0.05). A comparison between the groups after the experiments revealed significantly increased changes in CTDCSG compared to STDCSE (p<0.05). The changes in static balance ability were not significant when the subjects' eyes were closed (p>0.05).CONCLUSION: The application of tDCS positively changed the static balance ability of patients with back pain. The results of this study showed that tDCS could be used as an intervention to increase the static balance ability of patients with back pain in the clinical field. The study results could be used further as foundational data for future studies on tDCS.

Effects of Active Vibration Exercise on Neck Pain, Disability Index, and Muscle Activity of Patients with Forward Head Posture

PURPOSE: The purpose of this study was to evaluate the impact of active vibration exercise on the neck pain, disability index, and muscle activity of patients with forward head posture. METHODS: A total of 24 patients were randomly assigned to an experimental group or a control group (n=12 each). The experimental group performed active vibration exercise using a flexi-bar for 20 minutes a day, five times a week for four weeks. The study measured patient neck pain using a visual analog scale, neck pain related disability using the neck disability index, and muscle activity using electromyography. RESULTS: The intragroup comparison showed significant differences in the visual analog scale score, neck disability index score and upper trapezius, lower trapezius and serratus anterior muscle activity values among patients in the experimental group. The intergroup comparison showed that differences in the visual analog scale score, neck disability index score and upper trapezius, lower trapezius and serratus anterior muscle activity values in the control group. CONCLUSION: This study showed that active vibration exercise was effective in improving the neck pain, disability index, and muscle activity of patients with forward head posture.

Effects of Proprioceptive Neuromuscular Facilitation and Treadmill Training on the Balance and Walking Ability of Stroke Patients

PURPOSE: The purpose of this study was to investigate the effects of combined training using proprioceptive neuromuscular facilitation (PNF) patterns and treadmills on the balance and walking ability of stroke patients. METHODS: Twenty-three stroke patients were randomized into a control group (n=11), receiving only treadmill training and an experimental group (n=12) receiving combined training. The use of both PNF exercise and treadmill were implemented in the combined training. Interventions were performed 5 times a week for 6 weeks. Balance ability was measured by a timed up and go (TUG) test. Walking ability was measured by a 10-meter walk test (10MWT) and a 6-minute walk test (6MWT). A paired t-test was used to compare differences between pre- and post-intervention and independent t-tests were used to compare between groups. RESULTS: Changes in TUG, 10MWT, and 6MWT before and after interventions were significantly different for both the experimental group and the control group (p < 0.05). In addition, within-group changes in the TUG, 10MWT, and 6MWT were more effective in the experimental group than in the control group (p < 0.05). CONCLUSION: Combined training using PNF techniques and treadmills may be useful in improving the balance and walking ability of stroke patients.

Effects of Knee Extension Exercise Using Blood Flow Restriction on the Thickness and Balance Ability of Tendons

PURPOSE: This study examined the effects of knee extension exercise using blood flow restriction on the changes in the thickness and static balance ability of the tendon of the rectus femoris muscle and achilles tendon. METHODS: A total of 30 subjects was were divided into two groups of 15 subjects each. The changes in the thickness and balance of their tendons were measured by ultrasonography and balance equipment. The measurements were taken three times: before the experiment, 4 weeks after, and 8 weeks after. The results were analyzed by repeated measure ANOVA, one-way ANOVA was conducted in cases where there were time-to-group interactions in the intra-individual effects test. RESULTS: Significant differences in the thickness of the tendon of the rectus femoris muscle and Achilles tendon were found between the groups, over time, and in the time-to-group interactions (p 0.05). CONCLUSION: Knee extension exercise using blood flow restriction leads to significant differences in the increase in tendon thickness and changes in balance, indicating that the results of this study can be utilized as basic data for future studies and for rehabilitation treatment at clinics.

Effects of Different Sizes of Blood Flow Restriction Areas on Changes in Muscle Thickness

PURPOSE: This study was conducted to examine the effects of different sizes of blood flow restriction areas on the thickness of the external oblique and biceps brachii. METHODS: The study subjects were 52 adults who were divided into four groups that performed plank exercises over a six-week period after blood flow restriction. Changes in the thickness of the external oblique and biceps brachii were measured using ultrasonography before the experiment, then three and six weeks after the experiment. The changes in each variable over time were evaluated by repeated-measures analysis of variance (ANOVA). RESULTS: The external oblique and biceps brachii showed significant differences in muscle thickness with regard to time and the interaction between time and each group (p0.05). CONCLUSION: A larger blood flow restriction area resulted in a statistically significant increase in muscle thickness. The results of this study may be used as the basis for future studies and for rehabilitation in clinical practice.

Effects of Respiratory Muscle Strengthening Exercise on Respiratory Function and Activities of Daily Living in Stroke Patients

PURPOSE: This study aimed to demonstrate reduction in stroke symptoms by analyzing the changes in respiratory function and activities of daily living (ADL) after respiratory muscle strengthening exercise in patients who had a stroke and thereby, propose an efficient exercise method. METHODS: Twenty patients with hemiplegic stroke were divided into two groups, with 10 patients in each. The control group (CG) received the traditional exercise therapy, and the experimental group (EG) received the traditional exercise therapy combined with expiratory muscle strengthening training. The training continued for 6 weeks, 5 days a week. Forced vital capacity (FVC) and forced expiratory volume at 1 second (FEV1) were measured with a spirometer, SpO₂ was measured with a pulse oximeter, and ADL were assessed by using the modified Barthel index (MBI). A paired t test was applied to compare the differences before and after the intervention, and an independent t test was used to compare the differences between the groups. The level of statistical significance was set as α=0.05. RESULTS: The changes in the FVC and FEV1 values within the group showed significant differences only in the EG (p<0.01). The between-group difference was statistically significant only for FVC and FEV1 in the EG (p<0.01). The changes in SpO₂ and MBI within the group showed significant differences only in the EG and CG (p<0.01). Between-group differences were statistically significant only for SpO₂ and MBI in the EG (p<0.05). CONCLUSION: The interventions with active patient involvement and combined breathing exercises had a positive impact on all the functions investigated in this study.

Effect of Kettle Bell Swing Exercise on the Body Composition and Lower Limb Muscular Activity

PURPOSE: This study examined the effect of Kettle bell swing exercise on the body composition and lower limb muscular activity. METHODS: As subjects, 26 normal adults in their twenties were divided randomly into the experiment group (n=13), in which Kettle bell exercise was applied, and the control group (n=13), in which bar exercise was applied. Both groups participated in the interventions for eight weeks with three sessions per week. Each group was assessed before training and four and eight weeks into the training to determine the effects of training intervention within and between the groups. The body composition was measured with a body composition analyzer. The changes in muscle activity were measured with a surface electromyography. An independent t-test was conducted to test the significance between the groups according to the measurement points and Repeated measured ANOVA was performed to compare the groups according to the periods with the statistical significance level set to α=0.05. RESULTS: No significant changes to the main effects of time and the interactions of time according to the measurement points were observed in the Kettle bell and control groups in the body composition (p>0.05). The muscular activity of both muscles were significantly different between the Kettle bell and control groups according to the measurement points with the exception of the right lateral gastrocnemius muscle (p<0.05). CONCLUSION: These findings suggest that Kettle bell swing exercise can have positive effects on the development of lower limb muscles.

Effect of Sling Exercise on Muscle Activity and Pain in Patients with Rotator Cuff Repair

PURPOSE: This study was conducted to determine the effects of sling exercise on muscle activity and pain in patients with rotator cuff repair. METHODS: This research evaluated 20 rotator cuff repair patients, divided randomly between 10 controls and 10 in an experimental group who performed a sling exercise. Both the experimental and control groups underwent transcutaneous electrical nerve stimulation and performed continuous passive motion. Muscle activity was measured with a surface electromyograph and pain was measured with the visual analogue scale. The paired t-test was used to compare groups before and after the experiment. The independent t-test was conducted to assess differences in the degree of change between the two groups before and after the experiment. RESULTS: Within-group comparison of both the experimental and control group showed significant differences in muscle activity and pain. Comparison of the groups revealed significant differences in muscle activity between groups group, but not in pain. CONCLUSION: These results indicate that sling exercise is effective for improving muscle activity of rotator cuff repair patients.

Superficial Dosimetry for Helical Tomotherapy / 대한방사선종양학회지

PURPOSE: To investigate the feasibility of helical tomotherapy on a wide curved area of the skin, and its accuracy in calculating the absorbed dose in the superficial region. MATERIALS AND METHODS: Two types of treatment plans were made with the cylinder-shaped 'cheese phantom'. In the first trial, 2 Gy was prescribed to a 1-cm depth from the surface. For the other trial, 2 Gy was prescribed to a 1-cm depth from the external side of the surface by 5 mm. The inner part of the phantom was completely blocked. To measure the surface dose and the depth dose profile, an EDR2 film was inserted into the phantom, while 6 TLD chips were attached to the surface. RESULTS: The film indicated that the surface dose of the former case was 118.7 cGy and the latter case was 130.9 cGy. The TLD chips indicated that the surface dose was higher than these, but it was due to the finite thickness of the TLD chips. In the former case, 95% of the prescribed dose was obtained at a 2.1 mm depth, while the prescribed does was at 2.2 mm in the latter case. The maximum dose was about 110% of the prescribed dose. As the depth became deeper, the dose decreased rapidly. Accordingly, at a 2-cm depth, the dose was 20% of the prescribed dose. CONCLUSION: Helical tomotherapy could be a useful application in the treatment of a wide area of the skin with curvature. However, for depths up to 2 mm, the planning system overestimated the superficial dose. For shallower targets, the use of a compensator such as a bolus is required.

Prediction of Target Motion Using Neural Network for 4-dimensional Radiation Therapy / 의학물리

Studies on target motion in 4-dimensional radiotherapy are being world-widely conducted to enhance treatment record and protection of normal organs. Prediction of tumor motion might be very useful and/or essential for especially free-breathing system during radiation delivery such as respiratory gating system and tumor tracking system. Neural network is powerful to express a time series with nonlinearity because its prediction algorithm is not governed by statistic formula but finds a rule of data expression. This study intended to assess applicability of neural network method to predict tumor motion in 4-dimensional radiotherapy. Scaled Conjugate Gradient algorithm was employed as a learning algorithm. Considering reparation data for 10 patients, prediction by the neural network algorithms was compared with the measurement by the real-time position management (RPM) system. The results showed that the neural network algorithm has the excellent accuracy of maximum absolute error smaller than 3 mm, except for the cases in which the maximum amplitude of respiration is over the range of respiration used in the learning process of neural network. It indicates the insufficient learning of the neural network for extrapolation. The problem could be solved by acquiring a full range of respiration before learning procedure. Further works are programmed to verify a feasibility of practical application for 4-dimensional treatment system, including prediction performance according to various system latency and irregular patterns of respiration.

Prediction of Target Motion Using Neural Network for 4-dimensional Radiation Therapy / 의학물리

Studies on target motion in 4-dimensional radiotherapy are being world-widely conducted to enhance treatment record and protection of normal organs. Prediction of tumor motion might be very useful and/or essential for especially free-breathing system during radiation delivery such as respiratory gating system and tumor tracking system. Neural network is powerful to express a time series with nonlinearity because its prediction algorithm is not governed by statistic formula but finds a rule of data expression. This study intended to assess applicability of neural network method to predict tumor motion in 4-dimensional radiotherapy. Scaled Conjugate Gradient algorithm was employed as a learning algorithm. Considering reparation data for 10 patients, prediction by the neural network algorithms was compared with the measurement by the real-time position management (RPM) system. The results showed that the neural network algorithm has the excellent accuracy of maximum absolute error smaller than 3 mm, except for the cases in which the maximum amplitude of respiration is over the range of respiration used in the learning process of neural network. It indicates the insufficient learning of the neural network for extrapolation. The problem could be solved by acquiring a full range of respiration before learning procedure. Further works are programmed to verify a feasibility of practical application for 4-dimensional treatment system, including prediction performance according to various system latency and irregular patterns of respiration.

Ankylosing Spondylitis associated with Plasmacytoma: a Case Report / 대한류마티스학회지

Plasmacytomas are tumors composed of plasma cells of variable maturity, which are histologically identical to those seen in multiple myeloma. Ankylosing spondylitis is a chronic inflammatory disease, probably resulting from the interaction of a genetic predisposition involving HLA-B27 with an environmental event such as enteric bacterial infection. Multiple myeloma has been intermittently reported in patients with ankylosing spondylitis. It has been proposed that the protracted stimulation of immunocytes by inflammatory lesions on the mucosal surfaces of the gastrointestinal, respiratory tracts may be implicated in the pathogenesis of multiple myeloma in some patients. We observed a 23 year old male patient with a history of plasmacytoma who subsequently developed ankylosing spondylitis. He was diagnosed as plasmacytoma 4 years ago and took a radiation therapy. There was no previous report of ankylosing spondylitis following plasmacytoma. The relationship between two diseases is uncertain until now and further study should be needed.

Bcl-2 Expression in Endometrial Hyperplasia and Carcinoma / 대한암학회지

PURPOSE: To speculate the role of bcl-2 protooncogene in endometrial carcinogenesis by determination of the expression of bcl-2 in endometrial hyperplasia and carcinoma. MATERIALS AND METHODS: We studied bcl-2 expression by an immunohistochemical method in the paraffin-embedded blocks of 78 patients with endometrial hyperplasia, 64 with simple hyperpasia, 9 with complex hyperplasia and 5 with atypical hyperplasia respectively, and 33 endometrial carcinoma treated at Asan Medical Center from June, 1989 to May, 1997. Intensity of bcl-2 staining was scored on a scale of 0 to 4, calibrated by comparison with stromal lymphocytes, which always received a score of 4. RESULTS: The results of this study showed that bcl-2 was relatively highly expressed in simple (n= 64), complex (n=9) and atypical hyperplasias (n=5) with mean staining scores of 2.95+/-1.09 (Mean+Standard Deviation), 2.78+/-1.20 and 3.60+/-0.89 respectively, which showed no difference among histologic types. In endometrial carcinoma, the expression of bcl-2 was significantly down regulated (mean score=1.76+/-1.35) compared with that of hyperplasia, and did not conelate with FIGO surgical stage. However, grade III tumor showed significantly lower expression that grade I or II tumor. CONCLUSION: Bcl-2 expression is down regulated in endometrial carcinoma than endo- metrial hyperplasia, and correlates with tumor grade, which suggest that bcl-2 expression might be the result of carcinogenesis or bcl-2 plays only an adjunctive role in the endometrial carcinogenesis.