Contributions of age, gender, body mass index, and normalized arch height to hallux valgus: a decision tree approach.

BACKGROUND: Hallux valgus (HV) is a common toe deformity with various contributory factors. The interactions between intrinsic risk factors of HV, such as arch height, sex, age, and body mass index (BMI) should be considered. The present study aimed to establish a predictive model for HV using intrinsic factors, such as sex, age, BMI, and arch height based on decision tree (DT) model. METHODS: This is retrospective study. The study data were based on the fifth Size Korea survey, of the Korea Technology Standard Institute. Among 5,185 patients, 645 were excluded due to unsuitable age or missing data, and 4,540 (males = 2,236 and females = 2,304) were selected for inclusion in the study. Seven variables (i.e., sex, age, BMI, and four normalized arch height variables) were used to develop the prediction model for the presence of HV using a DT model. RESULTS: The DT model correctly classified 68.79% (95% confidence interval [CI] = 67.25-70.29%) of the training data set (3,633 cases). The predicted presence of HV based on the DT was verified against the testing data set (907 cases) and showed an accuracy of 69.57% (95% CI = 66.46-72.55%). CONCLUSIONS: The DT model predicted the presence of HV on the basis of sex, age, and normalized arch height. According to our model, women aged over 50 years and those with lower normalized arch height were at high risk of HV.

Avocado peel extract: The effect of radiation-induced on neuroanatomical and behavioral changes in rats.

Avocado (Persea americana) contains a variety of physiological active substances such as polyphenol, which has excellent antioxidant properties. This study investigated the radioprotective effect of avocado peel extract on congenital malformations and on the behavior of Sprague-Dawley (SD) rats. Experimental animals were randomly classified into four groups: NC Group, normal control; PA Group, oral administration with avocado peel extract (200 mg/kg/day); IR Group, irradiation; and PA+IR Group, irradiation after orally administered with avocado peel extract. For irradiation, 2 Gy of 6 MV X-ray was used once for the whole body. After that, congenital malformations, histopathological evaluation of the brain, and behavioral evaluation were performed in the obtained offspring. Although the body weight of the offspring was decreased by radiation exposure, it was confirmed that the decrease in weight was smaller when treated with PA. As the congenital malformations, hydrocephalus, loss of eyes, and abnormal rat tail occurred, and the result for the PA+IR Group was significantly lower than that of IR Group. Histopathologically, the length of the cerebral cortex of the PA+IR Group was similar to that of the non-radiation group. It was confirmed that emotional and behavioral disorders such as anxiety and depression were improved in the open field test (OFT) and elevated plus maze (EPM) test. And proved that working memory and cognitive ability were enhanced in the novel object recognition (NOR) test and spontaneous alternation Y-maze (SAY) test. Therefore, it was concluded that avocado peel extract can reduce the incidence of congenital malformations and improve growth disorders, memory and cognitive abilities. In the future, based on these results, we will conduct research on the hippocampus and amygdala, which are major regions of the brain, and additional research on cell biology.

Effects of sterilization methods on the survival of pathogenic bacteria in potting soil stored at various temperatures.

Fresh food products can be contaminated with pathogenic bacteria in various agricultural environments. Potting soil is sterilized by heat sterilization and then reused. This study evaluated the effects of three sterilization methods (non-sterilized, pasteurized, and sterilized) on the survival of pathogenic bacteria in potting soil during storage for 60 days at 5, 15, 25, and 35 °C. The reduction in Escherichia coli O157:H7, Salmonella Typhimurium, and Staphylococcus aureus in potting soil was higher at higher temperatures (25 and 35 °C) than at lower temperatures (5 and 15 °C). The population of pathogenic bacteria in pasteurized and sterilized potting soil was reduced below the detectable levels within 30 days at 35 °C. In contrast, the population of Bacillus cereus did not change in potting soil during storage for 60 days at all temperatures. These results indicate that sterilization and storage temperature of potting soil are critical factors influencing the survival of pathogenic bacteria.

Effectiveness of hamstring stretching using a pressure biofeedback unit for 4 weeks: A randomized controlled trial.

BACKGROUND: Stretching and length test of hamstring muscles have been performed commonly to manage lower back pain (LBP) in sports rehabilitation. Previous literatures addressed that stretching techniques and length test of hamstring muscles should be performed with the pelvic maintained in an anterior tilt position. However, there is no study to determine the effectiveness of pressure biofeedback unit (PBU) to maintain in anterior pelvic tilting (APT) on length test and stretching of hamstring muscles. OBJECTIVE: To determine the effectiveness of hamstring muscles stretching using a PBU. METHODS: Forty participants with shortness of hamstrings randomized into two groups. Participants performed the active knee extension (AKE) stretching without (control group) or with PBU (intervention group) for four weeks. AKE tests without and with PBU were administered three times before and after hamstrings stretching by each group. RESULTS: The AKE test without PBU showed a significant main effect of time ( p < 0 . 01 ) but not of group ( p = 0 . 55 ) on the AKE angle. The AKE test with PBU showed a significant increase in the AKE angle in the post-intervention compared to the pre-intervention assessments in both groups ( p < 0 . 01 ). The difference of AKE angle between the pre- and post-intervention results was significantly greater in the intervention group than in the control group ( p < 0 . 01 ). CONCLUSION: We recommend the use of a PBU to maintain the pelvic anterior tilting position when performing the AKE test or AKE stretching.

Trapezius and serratus anterior muscle strength in violinists with unilateral neck pain.

BACKGROUND: Weakness of the trapezius and serratus anterior (SA) muscle may be a risk factor for unilateral neck pain. OBJECTIVE: This study examined the trapezius (upper, middle, and lower) and SA muscle strength ipsilateral and contralateral to the painful side in violinists with unilateral neck pain. METHOD: Twenty-six female violinists with unilateral neck pain participated in this study. Participants reported the pain intensity and duration and completed the Neck Disability Index (NDI). The strengths of the upper (UT), middle (MT), and lower (LT) trapezius and SA muscles were measured using a handheld dynamometer. Paired t-test was used to compare the strength of the muscles between ipsilateral and contralateral to the painful side within subjects. The relationship between pain intensity, pain duration, and neck disability and strength deficit of the muscle was demonstrated by Pearson's correlation and Spearman's rank correlation. RESULTS: The strengths of the UT, MT, LT, and SA muscles were significantly decreased on the painful side compared with the contralateral side (P< 0.05). Except for correlations between pain intensity and percent strength deficit of the UT and between pain duration and percent strength deficit of the MT (P< 0.05), there were no significant associations between pain intensity, pain duration, or NDI and the percent strength deficit of the UT, MT, LT and SA muscles (P> 0.05). CONCLUSIONS: These results suggest that decreased UT, MT, LT, and SA muscle strength on the side of the pain should be considered in the rehabilitation of violinists with unilateral neck pain.

Effect of weight-bearing wrist movement with carpal-stabilizing taping on pain and range of motion in subjects with dorsal wrist pain: A randomized controlled trial.

STUDY DESIGN: Randomized control trial. INTRODUCTION: During weight-bearing wrist movement, potential stabilizing forces caused by carpal stabilizing taping (CST) may restrict movement of the carpal bones, allowing greater wrist joint extension. PURPOSE OF THE STUDY: The purpose of study was to investigate the effect of CST during weight-bearing wrist movement on pain intensity and range of motion (ROM) of wrist extension in subjects with dorsal wrist pain. METHODS: Thirty participants with dorsal wrist pain when weight bearing through the hand were randomly allocated into 2 groups: (1) a CST group using rigid tape and (2) placebo taping (PT) group using elastic tape. Subjects performed weight-bearing wrist movements with CST or PT in 6 sessions for 1 week. Active and passive ROM (AROM and PROM), and the visual analog scale (VAS) were assessed at baseline and after the intervention. RESULTS: The AROM and PROM of wrist extension increased significantly in both groups compared with preintervention values (P < .01). Comparing the PT and CST groups, the differences between preintervention and postintervention AROM (mean difference [MD] = +8.6°) and PROM (MD = +6.8°) were significantly greater in the CST group than in the PT group (P < .01). The CST group also showed greater improvement in VAS compared with the PT group (MD = -18 mm) (P < .01). CONCLUSION: We recommend CST during weight-bearing wrist movement as an effective intervention for both increasing wrist extension ROM and decreasing pain in patients with dorsal wrist pain during weight bearing through the hand.

Effect of the scapula-setting exercise on acromio-humeral distance and scapula muscle activity in patients with subacromial impingement syndrome.

OBJECTIVES: The aim of present study was to investigate the effect of the scapula setting exercise on acromio-humeral distance (AHD) and the activity of scapula muscles in patients with subacromial impingement syndrome (SIS). STUDY DESIGN: Cross sectional study. SETTING: Pusan National University Yangsan Hospital in South Korea. PARTICIPANTS: Twenty-eight patients with SIS. MAIN OUTCOME MEASURES: We measured AHD by ultrasound and muscle activation of the serratus anterior (SA), upper trapezius (UT), middle trapezius (MT), and lower trapezius (LT) by surface electromyography and compared outcome measures between patients with and without the SSE. The SSE involved maintaining the scapula in upward rotation with posterior tilting in the resting position, and passive shoulder elevation at 60° in the scapula plane. RESULTS: The AHD (rest and 60°: P < 0.001), as well as muscle activity of SA (rest: P = 0.001, 60°: P = 0.004), MT (rest: P < 0.001, 60°: P = 0.001), and LT (rest: P = 0.001, 60°: P < 0.001), was significantly increased by SSE with the arm at rest and with passive 60° shoulder elevation. CONCLUSIONS: These findings suggest that the SSE could be used to increase the AHD and activity of the serratus anterior, middle trapezius, and lower trapezius muscles in patients with SIS. CLINICAL TRIALS: Gov identifier: KCT0002687.

Effect of feedback techniques for lower back pain on gluteus maximus and oblique abdominal muscle activity and angle of pelvic rotation during the clam exercise.

OBJECTIVES: This study was conducted in order to determine the effect of feedback tools on activities of the gluteus maximus (Gmax) and oblique abdominal muscles and the angle of pelvic rotation during clam exercise (CE). DESIGN: Comparative study using repeated measures. SETTING: University laboratory. PARTICIPANTS: Sixteen subjects with lower back pain. MAIN OUTCOME MEASURES: Each subject performed the CE without feedback, the CE using a pressure biofeedback unit (CE-PBU), and the CE with palpation and visual feedback (CE-PVF). Electromyographic (EMG) activity and the angles of pelvic rotation were measured using surface EMG and a three-dimensional motion-analysis system, respectively. One-way repeated-measures ANOVA followed by the Bonferroni post hoc test were used to compare the EMG activity in each muscle as well as the angle of pelvic rotation during the CE, CE-PBU, and CE-PVF. RESULTS: The results of post-hoc testing showed a significantly reduced angle of pelvic rotation and significantly more Gmax EMG activity during the CE-PVF compared with during the CE and CE-PBU. CONCLUSION: These findings suggest that palpation and visual feedback is effective for activating the Gmax and controlling pelvic rotation during the CE in subjects with lower back pain.

Effect of toe-spread-out exercise on hallux valgus angle and cross-sectional area of abductor hallucis muscle in subjects with hallux valgus.

[Purpose] This study investigated whether the toe-spread-out exercise affects the hallux valgus angle, the cross-sectional area of the abductor hallucis muscle, and the hallux valgus angle during active abduction. [Subjects and Methods] Twenty-four subjects with hallux valgus were randomly assigned to orthosis and orthosis plus toe-spread-out exercise groups. The orthosis group wore the orthosis for 8 weeks, while the orthosis plus toe-spread-out group also performed the toe-spread-out exercise. The hallux valgus angle, the cross-sectional area of the abductor hallucis muscle, and the hallux valgus angle during active abduction were measured initially and after 8 weeks by radiography and ultrasonography. [Results] While there were no significant changes in the three parameters in the orthosis group, there were significant differences in the orthosis plus toe-spread-out exercise group after 8 weeks. In addition there were significant differences in the three measures between the two groups. [Conclusion] The toe-spread-out exercise reduces the hallux valgus angle and hallux valgus angle during active abduction, and increases the cross-sectional area of the abductor hallucis muscle. The toe-spread-out exercise is recommended for patients with mild to moderate hallux valgus.

Comparison of muscle activities of abductor hallucis and adductor hallucis between the short foot and toe-spread-out exercises in subjects with mild hallux valgus.

BACKGROUND AND OBJECTIVE: Muscle imbalance between the abductor hallucis (AbdH) and adductor hallucis (AddH) has been demonstrated in hallux valgus (HV). Clinically, the short-foot (SF) is performed for strengthening foot intrinsic muscle. The toes-spread-out (TSO), the newly introduced, was devised to correct HV deformity. However, there was no study to determine which exercise is effective in balancing the ratio of activation between AbdH and AddH muscles. The purpose of this study was to compare the muscle activities of the AbdH and AddH between SF and TSO exercises in subjects with mild HV. METHODS: Eighteen subjects with mild HV participated. The muscle activity of AbdH and AddH and the angle of first metatarsophalangeal (MTP) joint in the horizontal plane were measured during the SF and TSO exercises. Values of dependent variables were compared using a paired t-test between the SF and TSO exercises. RESULTS: The TSO exercise showed significantly greater activation of the AbdH than did the SF exercise (mean difference=44.96% of maximum voluntary isometric contraction; p< 0.001). There was no significant difference between the SF and TSO exercises in activating the AddH (mean difference=8.28% of maximum voluntary isometric contraction; p=0.271). The ratio of AbdH to AddH muscle activity was significantly higher in the TSO exercise than in the SF exercise (mean difference=0.54; p=0.001). The angle of the first MTP joint in the horizontal plane during the TSO was significantly greater than that in the SF exercise (mean difference=9.60°; p<0.001). CONCLUSIONS: These results suggest that the TSO exercise can be recommended for preventing or correcting HV deformity at an early stage.

Comparison of electromyographic activity of the lower trapezius and serratus anterior muscle in different arm-lifting scapular posterior tilt exercises.

OBJECTIVE: To determine the most effective exercise to specifically activate the scapular posterior tilting muscles by comparing muscle activity generated by different exercises (wall facing arm lift, prone arm lift, backward rocking arm lift, backward rocking diagonal arm lift). DESIGN: Repeated-measure within-subject intervention. PARTICIPANTS: The subjects were 20 healthy young men and women. MAIN OUTCOME MEASURES: Lower trapezius (LT) and serratus anterior (SA) muscle activity was measured when subjects performed the four exercises. RESULTS: Muscle activity was significantly different among the four exercise positions (p<0.05). The backward rocking diagonal arm lift elicited significantly greater activity in the LT muscle than did the other exercises (p<0.05). The backward rocking arm lift showed significantly more activity in the SA muscle than did the other exercises (p<0.05). CONCLUSIONS: Clinicians can use these results to develop scapular posterior tilting exercises that specifically activate the target muscle.

Effect of foot orthoses and short-foot exercise on the cross-sectional area of the abductor hallucis muscle in subjects with pes planus: a randomized controlled trial.

OBJECTIVE: To prevent overuse injuries related to excessively pronated feet, the strengthening of the foot intrinsic muscles has been recommended. The purpose of this study was to examine the effects of foot orthoses and a short-foot exercise intervention on the cross-sectional area (CSA) of the abductor hallucis (AbdH) muscle and strength of the flexor hallucis (FH) in subjects with pes planus. METHODS: Twenty-eight subjects with pes planus were randomly assigned to the foot orthosis (FO) group or the combined foot orthosis and short-foot exercise (FOSF) group for an 8-week intervention. The CSA of the AbdH muscle and the strength of FH were assessed before and after intervention. Data were analyzed using a mixed-model ANOVA. RESULTS: Significant group by intervention interaction effects were observed in CSA of the AbdH (p=0.009) and strength of the FH (p=0.015). The results of the post hoc paired t-test showed that that the CSA of the AbdH muscle and the strength of the FH significantly increased after the intervention in both groups (p=0.000). The mean CSA of the AbdH muscle and the strength of FH were significantly greater in subjects in the FOSF group compared with subjects in the FO group (mean difference of FO vs. FOSF=13.61 mm(2) in CSA of AbdH muscle; 0.90 kgf in strength of FH; p=0.008). CONCLUSIONS: Results from this study demonstrate that foot orthoses combined with short-foot exercise is more effective in increasing the CSA of the AbdH muscle and the strength of FH compared with foot orthoses alone. Therefore, foot orthoses combined with short-foot exercise are recommended for improving strength of AbdH muscle in subjects with pes planus.

A comparison in the muscle activity of the abductor hallucis and the medial longitudinal arch angle during toe curl and short foot exercises.

OBJECTIVE: To compare the muscle activity of the abductor hallucis (AbdH) and the medial longitudinal arch (MLA) angle during toe curl (TC) and short foot (SF) exercises while sitting or in one-leg standing position. DESIGN: Two-way repeated-measures ANOVA was used to analyze the effects of exercise type and position on the muscle activity of the AbdH and the MLA angle. PARTICIPANTS: Twenty subjects with normal feet participated in this study. MAIN OUTCOME MEASURES: The muscle activity of the AbdH and the MLA angle were measured during TC and SF exercises while sitting or in one-leg standing position. RESULTS: The EMG activity of AbdH in SF exercise was significantly greater than during TC exercise in both exercise postural positions (p < 0.001). During the SF exercise, the EMG activity of the AbdH in the one-leg standing position was significantly higher than that while sitting (p < 0.001). The MLA angle in SF exercise was significantly smaller than during TC exercise in both postural positions (p < 0.001). CONCLUSIONS: These results suggest that SF exercise is a more useful strengthening exercise than TC exercise in activating the AbdH muscle.

Effect of medial arch support on displacement of the myotendinous junction of the gastrocnemius during standing wall stretching.

STUDY DESIGN: Controlled laboratory study. OBJECTIVES: To examine the effects of standing wall stretching with and without medial arch support (WMAS versus WOMAS) on the displacement of the myotendinous junction (DMTJ) of the medial gastrocnemius, rearfoot angle, and navicular height in subjects with neutral foot alignment and pes planus. BACKGROUND: Standing wall stretching is often prescribed to increase ankle dorsiflexion range of motion for sports fitness and rehabilitation. However, the effect of standing wall stretching WMAS on DMTJ is unknown. METHODS: Fifteen subjects with neutral foot alignment and 15 subjects with pes planus performed standing wall stretching under WMAS and WOMAS conditions. Measurements of DMTJ and rearfoot position were performed using ultrasonography and video imaging. Navicular height was measured using a ruler. Dependent variables were examined with a 2-way mixed-design analysis of variance. The 2 factors were foot type (neutral foot versus pes planus) and stretching condition (WMAS versus WOMAS). RESULTS: There were significant interactions of medial arch support by foot type for DMTJ, rearfoot angle, and navicular drop (P<.001). A post hoc paired t test showed that standing wall stretching in the WMAS condition significantly increased the DMTJ, compared to stretching in the WOMAS condition, in subjects with neutral foot (mean +/- SD, 9.6 +/- 1.6 versus 10.5 +/- 1.6 mm; difference, 0.9 mm; 99% CI: 0.4-1.4 mm) and in those with pes planus (10.0 +/- 1.8 versus 12.7 +/- 2.0 mm; difference, 2.7 mm; 99% CI: 1.9-3.5 mm) (P<.001). When comparing WOMAS and WMAS, the difference in DMTJ (1.8 mm; 99% CI: 0.9-2.7 mm) was significantly greater in subjects with pes planus than in those with neutral foot (P<.001). CONCLUSION: Standing wall stretching with medial arch support maintained subtalar joint neutral position and increased the length of the gastrocnemius in subjects with pes planus. When prescribing standing wall stretching, clinicians need to emphasize the use of medial arch support to effectively stretch the gastrocnemius in subjects with pes planus.

Clinical manifestations and treatment outcomes of pulmonary aspergilloma.

BACKGROUND: Pulmonary aspergilloma usually results from the ingrowth of colonized Aspergillus from a damaged bronchial tree, a pulmonary cyst, or from the cavities of patients with underlying lung diseases. In the present study, we analyzed the clinical features, diagnostic methods, and managements of 36 patients with pulmonary aspergilloma. METHODS: Thirty-six patients were diagnosed as having pulmonary aspergilloma at Chung-Ang University Hospital between February 1988 and February 2000. Their medical records were reviewed retrospectively. RESULTS: The age of patients (median +/- SD) was 53.3 +/- 11.8 years, the male to female ratio was 2.36:1, and the most frequent symptom was hemoptysis, which occurred in 24 patients (65%). The most common underlying disease was pulmonary tuberculosis (81%), and the upper lobes of both lungs were the most frequently involved sites. Nine patients received a chest CT in the prone position and seven of these showed a movable fungus ball. Eleven patients were positive for the precipitin antibody to A. fumigatus. Twenty patients underwent surgical resection, and post-operative complications were reported in seven cases. The post-operative mortality was 5.6% (2/36). CONCLUSION: Pulmonary aspergilloma usually develops in the patients with underlying lung diseases. Resectional lung surgery is considered the mainstay of therapy for pulmonary aspergilloma. However, this operation is associated with significant complications and death in some cases. Therefore, it is necessary to develop reasonable criteria for selection of candidates for such surgery.

Effects of ankle exercise combined with deep breathing on blood flow velocity in the femoral vein.

Ankle exercises are commonly used to facilitate venous return in the lower extremity and to prevent deep vein thrombosis. Moreover, the respiratory cycle affects venous return. This study examined the effects of ankle exercise combined with deep breathing on the blood flow velocity in the femoral vein. Twenty healthy males (mean age 21.3 years), who had no medical history of lower extremity disease, were recruited for this study. The blood flow velocity in the femoral vein was measured while performing four exercise protocols: quiet breathing while resting (QR), deep breathing (DB), ankle exercise with quiet breathing (AQB), and ankle exercising combined with deep breathing (ADB). Using a Doppler ultrasound with an 8 MHz probe, peak blood flow velocities were collected for a 20 second period at the start of the inspiration phase in each protocol, three times. There were statistically significant differences in the peak blood flow velocity in the femoral vein with the four protocols (p lt 0.001). The mean (SD) peak blood flow velocity in the femoral vein was as follows: QR 10.1 (4.2) cm/sec, DB 15.5 (3.9) cm/sec, AQB 20.7 (6.6) cm/sec, and ADB 26.5 (9.4) cm/sec. Post hoc analyses revealed significant differences between each of the four protocols (p(adj) lt 0.01). The mean peak blood flow velocity in the femoral vein was greatest with the ADB protocol, which implies that the ADB protocol may be useful to prevent the blood stasis in patients at risk of deep vein thrombosis.