Reliability of the Supraspinatus Muscle Thickness Measurement by Ultrasonography

Tae Im Yi,In Soo Han,Joo Sup Kim,Ju Ryeon Jin,Jea Shin Han 대한재활의학회 2012 Annals of Rehabilitation Medicine Vol.36 No.4

Objective To assess the intrarater and interrater reliability of the supraspinatus thickness measured by ultrasonography (US) in normal subjects and to identify the relationship between the supraspinatus thickness measured by US and cross sectional area (CSA) of the supraspinatus muscle by magnetic resonance imaging (MRI) in hemiplegic patients.Method We examined 20 shoulders of normal subjects and 10 shoulders of hemiplegic patients. In normal subjects, one examiner measured the supraspinatus thickness twice by US at the scapular notch and another examiner measured the supraspinatus thickness several days later. The intrarater and interrater reliability of supraspinatus thickness measurements were then evaluated. In hemiplegic patients, the supraspinatus thickness at the scapular notch was measured by US in affected side and compared with CSA of the supraspinatus muscle at the scapular notch and the Y-view of MRI.Results One examiner’s supraspinatus thickness measurement average was 1.72±0.21 cm and 1.74±0.24 cm, and the other examiner’s supraspinatus thickness measurement average was 1.74±0.22 cm in normal subjects. Intraclass correlation coefficients of intrarater and interrater examination were 0.91 and 0.88, respectively. For hemiplegic patients, the supraspinatus thickness measured by US was 1.66±0.13 cm and CSA by MRI was 4.83±0.88 cm2 at the Y-view and 5.61±1.19 cm2 at the scapular notch. The Pearson Correlation Coefficient between the supraspinatus thickness at the scapular notch and the CSA at the Y-view was 0.72 and that between the supraspinatus thickness and CSA at the scapular notch was 0.76.Conclusion The supraspinatus thickness measurement by US is a reliable method and is positively correlated with the CSA of the supraspinatus muscle in MRI in hemiplegic patients. Therefore, supraspinatus thickness measurement by US can be used in the evaluation of muscle atrophy and to determine therapeutic effects in hemiplegic patients.

Motor Axonal Neuropathy Associated With Idiopathic CD4+ T-Lymphocytopenia

Tae Im Yi,Bo Ra Kim,In Soo Han,Bo Kyoung Kim 대한재활의학회 2013 Annals of Rehabilitation Medicine Vol.37 No.1

Idiopathic CD4+ T-lymphocytopenia is a rare immune disorder characterized by an unexplained deficit of CD4+ T cells and results in various opportunistic infections. Herein, we report a case of new onset weakness in a 10-year-old boy secondary to motor axonal neuropathy associated with idiopathic CD4+ T-lymphocytopenia. The patient was referred to rehabilitation for an evaluation of progressive weakness involving all four limbs. A subsequent nerve conduction study and needle electromyography identified motor axonal neuropathy. At that time, laboratory studies specific to the differential diagnosis of motor axonal neuropathy were performed; however, the abnormality noted was a decreased CD4+ T-lymphocyte count. Motor axonal neuropathy represents an uncommon manifestation of idiopathic CD4+ T-lymphocytopenia and is probably associated with an underlying immune process.

The Relationships Between Determination of Treatment Success and Emotional Factors in Patients With Chronic Musculoskeletal Pain

Tae Im Yi,Bo Kyoung Kim,Seung A Ha,Ji Young Lim 대한재활의학회 2014 Annals of Rehabilitation Medicine Vol.38 No.1

Objective To investigate the relationship of the patient’s criteria of successful treatment to emotional factors in patients with chronic musculoskeletal pain.Methods Patients who visited our outpatient hospital due to chronic musculoskeletal pain were evaluated using a questionnaire survey. Patients were evaluated with the Patient-Centered Outcomes Questionnaire (PCOQ) to investigate their expectation and criteria for success regarding treatment of chronic musculoskeletal pain. Beck Depression Inventory and State-Trait Anxiety Inventory were used to check for psychological variables. Correlations among each of the variables were evaluated statistically.Results Patients with higher levels of depression and anxiety needed larger improvements to consider the treatment as a success in the pain domain (depression, r=0.398, p=0.04; anxiety, r=0.447, p=0.02) and emotional distress domain (depression, r=0.617, p=0.001; anxiety, r=0.415, p=0.03), but had lower level of expectation of the treatment in the pain domain (depression, r=-0.427, p=0.01; anxiety, r=-0.441, p=0.004), emotional distress domain (depression, r=-0.454, p=0.01; anxiety, r=-0.395, p=0.04), and interference of daily activities domain (depression, r=-0.474, p=0.01; anxiety, r=-0.396, p=0.04). Patients were classified into 3 clusters based on the importance rating of each domain via a hierarchical analysis. The cluster of the patients with the higher rating of importance across all domains (importance of pain domain, 9.54; fatigue domain, 9.08; emotional distress domain, 9.23; interference of daily activities domain, 9.23) had the highest level of depression and anxiety.Conclusion Consideration of psychological factors, especially in patients who require larger improvements in all treatment domains, may be helpful for the successful treatment of chronic musculoskeletal pain.

The Effects of Modified Low-Dye Taping in the Patient with Heel Pad Atrophy

Tae Im Yi,Jae Won Shim,Hye Kyung, Ku,In Seok Seo,Won Seok Huh,Joo Sup Kim,Jun Sung Park 대한재활의학회 2011 Annals of Rehabilitation Medicine Vol.35 No.1

Objective To evaluate whether the change of heel pad thickness improves the pain after Modified Low-Dye Taping (MLDT) in the patient with heel pad atrophy. Method Thirty-five feet of 20 volunteers with heel pad atrophy were selected for the measurement of heel-pad thickness and compressibility index (CI) of the center of calcaneus bone using ultrasound. The subjects were laid in prone with the knees flexed to 90o, and an electronic body weight scale was inserted beneath the anterior surface of their knees to take measurements of both UHPT (unloaded heel pad thickness) and LHPT (6 kg-loaded heel pad thickness), which were repeated 3 times respectively. CI was calculated base on LHPT divided by UHPT. After MLDT, the same method was repeated. visual analogue scale (VAS) score was checked at first visit and followed up at second visit. Results Prior to MLDT, the average value of UHPT (cm), LHPT (cm) and CI value was 0.92±0.11, 0.25±0.06 and 0.27±0.04 respectively. After MLDT, the average was 1.24±0.17 for UHPT (cm) and 0.42±0.11, for LHPT (cm) while CI stood at 0.33±0.06. VAS before MLDT was 7.35±1.27 and after MLDT was 3.50±1.36, which presented 54% of decrease than initial. Conclusion It was confirmed that the average values of the heel-pad thickness, CI and VAS of patients with heel pad atrophy were improved for MLDT. Accordingly it is considered that application of MLDT is an efficacious treatment and thus further study is needed to develop foot orthoses for heel pad atrophy using the principle of MLDT.

Nutritional Status of Children with Cerebral Palsy

Tae Im Yi,Won Seok Huh,Hye Kyung Ku,In Seok Seo,Jae Won Shim,이가은,Joo Sup Kim,Jun Sung Park 대한재활의학회 2011 Annals of Rehabilitation Medicine Vol.35 No.1

Objective To determine the nutritional status of children with cerebral palsy (CP) and to compare their anthropometric and functional indices. Method Seventy children with cerebral palsy, were at class I (12), II (17), III (18), IV (9) and V (14) on Gross Motor Function Classification System (GMFCS). They varied by age from 25 to 130 months with a mean of 48 months, and consisted of spastic diplegic cerebral palsy (30), quadriplegia (28), triplegia (3), hemiplegia (4), athetoid (4) and hypotonia (1). Evaluation of weight, height, subcutaneous fat thickness, brachial circumference, Body Mass Index (BMI), level of albumin, lymphocyte and blood ferritn were conducted. To identify the factors affecting nutritional status, dietary status and symptoms of dysphagia were investigated. Results Low BMI percentile was in 23 children (32.9%) and obese condition in 3 children (4.3%). Low BMI percentile tends to frequently observed in groups III, IV, V of GMFCS. BMI percentile with subcutaneous fat thickness, Gross Motor Function Measure (GMFM) score were significantly related (p<0.05). Seen from the symptom of dysphagia, low BMI percentile was correlated with decreased tongue motion (p<0.05). Conclusion Cerebral palsy children with lower GMFM score, decreased tongue motion were significantly related with low BMI percentile. Subcutaneous fat thickness can be useful tool for evaluation of malnutrition of cerebral palsy children.

Clinical Characteristics of the Causes of Plantar Heel Pain

Tae Im Yi,이가은,In Seok Seo,Won Seok Huh,Tae Hee Yoon,Bo Ra Kim 대한재활의학회 2011 Annals of Rehabilitation Medicine Vol.35 No.4

Objective The objectives of this study were to investigate the causes of plantar heel pain and find diff erences in the clinical features of plantar fasciitis (PF) and fat pad atrophy (FPA), which are common causes of plantar heel pain, for use in differential diagnosis. Method This retrospective study analyzed the medical records of 250 patients with plantar heel pain at the Foot Clinic of Rehabilitation Medicine at Bundang Jesaeng General Hospital from January to September, 2008. Results The subjects used in this study were 114 men and 136 women patients with a mean age of 43.8 years and mean heel pain duration of 13.3 months. Causes of plantar heel pain were PF (53.2%), FPA (14.8%), pes cavus (10.4%), PF with FPA (9.2%), pes planus (4.8%), plantar fi bromatosis (4.4%), plantar fascia rupture (1.6%), neuropathy (0.8%), and small shoe syndrome (0.8%). PF and FPA were most frequently diagnosed. First-step pain in the morning, and tenderness on medial calcaneal tuberosity correlated with PF. FPA mainly involved bilateral pain, pain at night, and pain that was aggravated by standing. Heel cord tightness was the most common biomechanical abnormality of the foot. Heel spur was frequently seen in X-rays of patients with PF. Conclusion Plantar heel pain can be provoked by PF, FPA, and other causes. Patients with PF or FPA typically show diff erent characteristics in clinical features. Plantar heel pain requires differential diagnosis for appropriate treatment. Objective The objectives of this study were to investigate the causes of plantar heel pain and find diff erences in the clinical features of plantar fasciitis (PF) and fat pad atrophy (FPA), which are common causes of plantar heel pain, for use in differential diagnosis. Method This retrospective study analyzed the medical records of 250 patients with plantar heel pain at the Foot Clinic of Rehabilitation Medicine at Bundang Jesaeng General Hospital from January to September, 2008. Results The subjects used in this study were 114 men and 136 women patients with a mean age of 43.8 years and mean heel pain duration of 13.3 months. Causes of plantar heel pain were PF (53.2%), FPA (14.8%), pes cavus (10.4%), PF with FPA (9.2%), pes planus (4.8%), plantar fi bromatosis (4.4%), plantar fascia rupture (1.6%), neuropathy (0.8%), and small shoe syndrome (0.8%). PF and FPA were most frequently diagnosed. First-step pain in the morning, and tenderness on medial calcaneal tuberosity correlated with PF. FPA mainly involved bilateral pain, pain at night, and pain that was aggravated by standing. Heel cord tightness was the most common biomechanical abnormality of the foot. Heel spur was frequently seen in X-rays of patients with PF. Conclusion Plantar heel pain can be provoked by PF, FPA, and other causes. Patients with PF or FPA typically show diff erent characteristics in clinical features. Plantar heel pain requires differential diagnosis for appropriate treatment.

Femoral Neuropathy and Meralgia Paresthetica Secondary to an Iliacus Hematoma

Tae Im Yi,Tae Hee Yoon,Joo Sup Kim,이가은,Bo Ra Kim 대한재활의학회 2012 Annals of Rehabilitation Medicine Vol.36 No.2

Compressive femoral and lateral femoral cutaneous neuropathies from an iliacus hematoma are unusual presentation. We report a case of a 16-year-old boy who developed right femoral and lateral femoral cutaneous neuropathies as a complication of traumatic ipsilateral iliacus hematoma formation. The patient complained of numbness in the right thigh and calf as well as right leg weakness, and pain in the right inguinal area. Nerve conduction study and needle electromyography identifi ed the neuropathies. After the electrodiagnostic studies,the pelvic bone MRI revealed a large, 9×5×4.5 cm right iliacus hematoma. As a result, diagnosis of a right iliacus hematoma compressing the femoral and lateral femoral cutaneous nerves was made, and the patient underwent an operation to remove the hematoma. Symptoms and neurological signs showed notable improvement after surgical decompression. Subsequent follow-up electrodiagnostic studies after 11 weeks demonstrated regeneration evidence.

Calcaneal Osteomyelitis due to Non-tuberculous Mycobacteria: A Case Report

Tae Im Yi,Seung-A Ha,Yeo-Reum Choe,Joo Sup Kim,Kye Won Kwon 대한재활의학회 2016 Annals of Rehabilitation Medicine Vol.40 No.1

Osteomyelitis is a bone infection caused by bacteria or other germs. Gram-positive cocci are the most common etiological organisms of calcaneal osteomyelitis; whereas, non-tuberculous mycobacteria (NTM) are rarely documented. We reported a case of NTM calcaneal osteomyelitis in a 51-year-old female patient. She had been previously treated in many local clinics with multiple local steroid injection over 50 times and extracorporeal shock-wave therapy over 20 times with the impression of plantar fasciitis for 3 years prior. Diagnostic workup revealed a calcaneal osteomyelitis and polymerase chain reaction assay on bone aspirate specimens confirmed the diagnosis of non-tuberculous mycobacterial osteomyelitis. The patient had a partial calcanectomy with anti-tubercular therapy. Six months after surgery, a follow-up magnetic resonance imaging showed localized chronic osteomyelitis with abscess formation. We continued anti-tubercular therapy without operation. At 18-month follow-up after surgery and comprehensive rehabilitation therapy, she was ambulating normally and able to carry out her daily activities without any discomfort.

Posturography를 이용한 한발 서기 균형능력 검사의 신뢰도 분석

이태임 ( Tae Im Yi ),강연 ( Yeon Kang ),이윤수 ( Yoon Soo Lee ) 한국정책학회 2014 The KAPS Vol.39 No.-

Posturographic examination is commonly used by clinicians to evaluate standing balance. Because it is perfomed with double leg standing, it cannot sensitively detect the minor balance problem like functional ankle instability. This study aims to evaluate the test retest reliability of the single leg balance test using Tetrax posturography and its correlation with modified star excursion balance test (mSEBT). 30 healthy participants (16 male, 14 female, mean age 26.3±3.3) were volunteered for this study. We manufactured a specially designed wood plate to assess their single leg standing balance. It was set on each of the 4 force plates of Tetrax posturography (Sunlight Medical Ltd., Ramat Gan, Israel). Stability index were measured based on each single leg stance. Participants performed the single leg balance test on Tetrax posturography in three different times, and they also performed the mSEBT. The test retest reliability of stability index measured by Tetrax posturography was assessed by the intraclass correlation coefficient, and its correlation with the normalized composite distance of mSEBT was assessed by Pearson correlation coefficient. The single leg balance test using Tetrax posturography showed good test retest reliability. There was a negative correlation between the stability index of Tetrax posturography and the normalized composite distance of mSEBT, based on right and left leg stance, respectively. These findings suggest that Tetrax posturography is a useful and reliable tool for single leg balance assessment.

Posturography를 이용한 한발 서기 균형능력 검사의 신뢰도 분석

이태임 ( Tae Im Yi ),강연 ( Yeon Kang ),이윤수 ( Yoon Soo Lee ) 대한스포츠의학회 2014 대한스포츠의학회지 Vol.32 No.2

Posturographic examination is commonly used by clinicians to evaluate standing balance. Because it is perfomed with double leg standing, it cannot sensitively detect the minor balance problem like functional ankle instability. This study aims to evaluate the test retest reliability of the single leg balance test using Tetrax posturography and its correlation with modified star excursion balance test (mSEBT). 30 healthy participants (16 male, 14 female, mean age 26.3±3.3) were volunteered for this study. We manufactured a specially designed wood plate to assess their single leg standing balance. It was set on each of the 4 force plates of Tetrax posturography (Sunlight Medical Ltd., Ramat Gan, Israel). Stability index were measured based on each single leg stance. Participants performed the single leg balance test on Tetrax posturography in three different times, and they also performed the mSEBT. The test retest reliability of stability index measured by Tetrax posturography was assessed by the intraclass correlation coefficient, and its correlation with the normalized composite distance of mSEBT was assessed by Pearson correlation coefficient. The single leg balance test using Tetrax posturography showed good test retest reliability. There was a negative correlation between the stability index of Tetrax posturography and the normalized composite distance of mSEBT, based on right and left leg stance, respectively. These findings suggest that Tetrax posturography is a useful and reliable tool for single leg balance assessment.