Elaborate Corrective Exercise Program after Surgical Correction for Sprengel’s Deformity: A Case Study

황의재,정성훈,이현정,은지연,김문환 KEMA학회 2018 근골격계과학기술학회 Vol.2 No.2

ABSTRACT Background Sprengel’s deformity is a malpositioning anomaly characterized by dysplasia and elevation of the scapula. After Sprengel’s deformity corrective surgery, an abnormal scapulohumeral rhythm can be generated because of relative stiffness. An elaborate corrective exercise program is needed to prevent the recurrence of the deformity and maintain the effect of the surgery. Study design A single-subject case study. Observations The scapular elevation height and scapular upward rotation angle were measured to confirm the scapulohumeral rhythm during 80° shoulder abduction using am electromagnetic system in an 8-y-old girl who had undergone Sprengel’s deformity corrective surgery 3 y earlier. Shoulder abductor strength were measured using a Smart KEMA strength measurement system, with and without restricted scapular elevation. An elaborate corrective exercise program, including five types of exercises, was prescribed for 6 wk. The child’s parents were instructed to ensure that scapular elevation was restricted during the exercises. Scapular elevation and upward rotation were measured pre, 2, 4, and 6 wk after an elaborate corrective exercise program. Scapular elevation and upward rotation during 80° shoulder abduction were significantly decreased, and shoulder abductor strength with restricted scapular elevation was significantly increased 6 wk after the elaborate corrective exercise program. Conclusions After Sprengel’s deformity corrective surgery, an elaborate corrective exercise program is necessary to enable control of scapular elevation during humeral elevation. ABSTRACT Background Sprengel’s deformity is a malpositioning anomaly characterized by dysplasia and elevation of the scapula. After Sprengel’s deformity corrective surgery, an abnormal scapulohumeral rhythm can be generated because of relative stiffness. An elaborate corrective exercise program is needed to prevent the recurrence of the deformity and maintain the effect of the surgery. Study design A single-subject case study. Observations The scapular elevation height and scapular upward rotation angle were measured to confirm the scapulohumeral rhythm during 80° shoulder abduction using am electromagnetic system in an 8-y-old girl who had undergone Sprengel’s deformity corrective surgery 3 y earlier. Shoulder abductor strength were measured using a Smart KEMA strength measurement system, with and without restricted scapular elevation. An elaborate corrective exercise program, including five types of exercises, was prescribed for 6 wk. The child’s parents were instructed to ensure that scapular elevation was restricted during the exercises. Scapular elevation and upward rotation were measured pre, 2, 4, and 6 wk after an elaborate corrective exercise program. Scapular elevation and upward rotation during 80° shoulder abduction were significantly decreased, and shoulder abductor strength with restricted scapular elevation was significantly increased 6 wk after the elaborate corrective exercise program. Conclusions After Sprengel’s deformity corrective surgery, an elaborate corrective exercise program is necessary to enable control of scapular elevation during humeral elevation.

Comparison of Elbow Extensor Muscle Strength and EMG Activity in Supine and Prone Positions in Healthy Subjects

황의재,김준희,곽경태,김문환 KEMA학회 2018 근골격계과학기술학회 Vol.2 No.1

ABSTRACT Background There is little research on the strength and electromyograph (EMG) activity of elbow extensors according to the measuring posture. Purpose We investigated which posture influenced strength and EMG activity of elbow extensors in evaluating postures (supine and prone). Study design Comparative, repeated measures design. Methods Twenty-one healthy subjects performed maximal elbow extension in two postures (supine and prone). EMG activity was measured in the anconeus, long head of triceps (LoT), and lateral of triceps (LT). When measuring EMG activity of elbow extensors, the strength of elbow extensors was also measured by Smart KEMA strength measurement system. Results In supine, EMG activity of anconeus and LT was significant increased. The other way, EMG activity of LoT and strength of elbow extensors were significant increase in the prone position. Conclusions We recommend the prone position to increase EMG activity of LoT and to improve strength of elbow extensors. In addition, supine position should be considered to increase muscle activity of anconeus and LT.

Is There a Correlation between the Pelvic Floor Muscle Functions and the Strength of the Hip Muscles in Female with Stress Urinary Incontinence?

황의재,오재섭,김문환 KEMA학회 2020 근골격계과학기술학회 Vol.4 No.2

Background: Because the hip muscles could affect pelvic floor muscle (PFM) function and tension of endopelvic fascia, contraction of hip muscles has been applied for stress urinary incontinence (SUI) intervention as co-contraction between hip muscles and PFM. Purpose: The purpose of current study was to confirm the relationship between hip muscles strength and PFM functions in female with SUI. Study design: Cross sectional study Methods: Thirty-three female with SUI were recruited for the present study. PFM strength and endurance were measured by perineometer (unit: mmHg). Hip extensor, abductor, adductor and gluteal squeeze strength were measured by Smart KEMA tension sensor (unit: kg/body weight). The significance of the correlations between hip muscles strength and PFM functions were assessed using Pearson correlation coefficients. Results: There were not significant correlations between PFM functions (strength and endurance) and hip extensor, abductor, adductor and gluteal squeeze strength. Conclusions: These findings could indicate the difficulty of co-contraction of hip abductor, adductor, extensor and gluteal squeeze with PFM in female with SUI, which is caused by PFM dysfunction.

Reliability of Hamstring Flexibility Test with Hip Inferior Glide Mobilization in Patients with Low Back Pain

김준석,황의재,권오윤,박규남 KEMA학회 2019 근골격계과학기술학회 Vol.3 No.1

ABSTRACT Background Hamstring tightness is a major cause of low back pain (LBP). The active knee extension (AKE) test is frequently used to measure hamstring tightness in supine-positioned subjects. In patients with musculoskeletal pain, it is important to maintain the axis of rotation for accurate range of motion assessment. Purpose The purpose of this study was to investigate the intrarater test-retest reliability of an AKE test with belt-guided inferior gliding of the hip, which was designed to minimize excessive anterior-superior gliding of the hip in LBP patients with hamstring tightness. We also compared the range of AKE with versus without inferior gliding of the hip in this study population. Study design Reliability study. Methods Thirty-eight patients with LBP and hamstring tightness were recruited to this study. Hamstring tightness was measured in a supine AKE test, with and without inferior gliding of the hip, using the Smart KEMA device. Test–retest reliability was assessed by the intraclass correlation coefficient (ICC). Significant differences in the range of AKE between the groups were detected using a paired sample t-test. Results The hamstring flexibility tests with and without inferior gliding of the hip exhibited good to excellent test-retest reliability (ICC=0.89 for both). The range of AKE with inferior gliding of the hip was significantly less than that of AKE without inferior gliding of the hip. Conclusions Assessment of hamstring flexibility via an AKE test with inferior gliding of the hip is reliable when applied to patients with LBP; the range of AKE was lower in this test compared to those that do not incorporate inferior gliding of the hip. ABSTRACT Background Hamstring tightness is a major cause of low back pain (LBP). The active knee extension (AKE) test is frequently used to measure hamstring tightness in supine-positioned subjects. In patients with musculoskeletal pain, it is important to maintain the axis of rotation for accurate range of motion assessment. Purpose The purpose of this study was to investigate the intrarater test-retest reliability of an AKE test with belt-guided inferior gliding of the hip, which was designed to minimize excessive anterior-superior gliding of the hip in LBP patients with hamstring tightness. We also compared the range of AKE with versus without inferior gliding of the hip in this study population. Study design Reliability study. Methods Thirty-eight patients with LBP and hamstring tightness were recruited to this study. Hamstring tightness was measured in a supine AKE test, with and without inferior gliding of the hip, using the Smart KEMA device. Test–retest reliability was assessed by the intraclass correlation coefficient (ICC). Significant differences in the range of AKE between the groups were detected using a paired sample t-test. Results The hamstring flexibility tests with and without inferior gliding of the hip exhibited good to excellent test-retest reliability (ICC=0.89 for both). The range of AKE with inferior gliding of the hip was significantly less than that of AKE without inferior gliding of the hip. Conclusions Assessment of hamstring flexibility via an AKE test with inferior gliding of the hip is reliable when applied to patients with LBP; the range of AKE was lower in this test compared to those that do not incorporate inferior gliding of the hip.

Comparison of Subjective and Objective Sleep Quality in Subjects with and without Hyper-kyphosis

김준희,황의재,최슬아,정성훈 대한물리치료학회 2022 대한물리치료학회지 Vol.34 No.5

Purpose: This study compared the subjective and objective sleep quality between subjects with and without thoracic hyper-kyphosis. Methods: Forty participants were divided into a hyper-kyphosis (n=17) and normal group (n=17) by thoracic spinal angle measurement. The subjective sleep quality was measured using PSQI, a self-report, and objective sleep quality was measured using an actigraphy that measures time according to sleep patterns. Results: The PSQI scores of subjects with thoracic hyper-kyphosis were significantly higher than those with normal thoracic curvature (p=0.013). The total sleep time and real sleep time were less in subjects with hyper-kyphosis than in normal subjects (p=0.006; p=0.029). The light sleep time was less in subjects with excessive spondylolisthesis than in normal subjects (p=0.010). Light sleep time was less in those with hyper-kyphosis, but deep sleep time was similar to the subjects with a normal thoracic curvature (p=0.003; p=0.140). Conclusion: Subjects with thoracic hyper-kyphosis had a decrease in subjective sleep quality, such as sleep discomfort, and objective sleep quality, such as a decrease in sleep time compared to normal subjects.

How Well can Machine Learning Models Classify Individuals with and without Non-Specific Chronic Neck Pain based on Cervical Movements during Protraction and Retraction?

김준희,황의재 KEMA학회 2023 근골격계과학기술학회 Vol.7 No.2

Background The human cervical spine, vital for supporting head movements, is susceptible to degenerative changes, especially non-specific chronic neck pain (NSCNP). Cervical protraction and retraction, which are key components of cervical spine motion, have been studied to assess their role in NSCNP. However, the existing research lacks quantitative assessments and explores nonlinear relationships. Purpose This study explored the relationship between cervical movements during protraction and retraction and NSCNP using machine learning (ML) techniques for classification. Study design Cross sectional study. Methods This study included 277 non-NSCNP and 463 NSCNP office workers. Data were collected from the musculoskeletal screening tests. Two-dimensional video analysis was used to track markers during cervical protraction and retraction. The head tilt angle (HTA), craniovertebral angle (CVA), head excursion angle (HEA), and protraction/retraction distances were measured. Six ML algorithms (random forest, neural network, decision tree, gradient boosting, logistic regression, and support vector machine) were employed to classify individuals with and without the NSCNP. The model performance was evaluated using the area under the curve (AUC), accuracy, recall, precision, and F1 score. Results Random forest performed best, with a test AUC of 0.800, followed by decision trees (0.790), and gradient boosting (0.701). Logistic regression and support vector machine had the lowest performance. CVA during retraction, CVA and HEA during protraction were significant predictors of NSCNP in the random forest model, indicating the importance of cervical retraction and protraction kinematics. Conclusions ML models can enhance our understanding of NSCNP and the role of cervical movements. These findings offer potential targets for assessment and intervention in NSCNP cases, and suggest the clinical utility of random forests for classification. Further research is needed to explore these relationships in diverse populations and investigate the underlying mechanisms.

MEDLINE 검색을 통한 산업안전보건 분야에서의 인간공학 연구동향 : 워드임베딩을 활용한 초록 단어 모델링을 중심으로

김준희,황의재,안선희,곽경태,정성훈,Kim, Jun Hee,Hwang, Ui Jae,Ahn, Sun Hee,Gwak, Gyeong Tae,Jung, Sung Hoon 한국안전학회 2021 한국안전학회지 Vol.36 No.5

This study aimed to analyze the research trends of the abstract data of ergonomic studies registered in MEDLINE, a medical bibliographic database, using word embedding. Medical-related ergonomic studies mainly focus on work-related musculoskeletal disorders, and there are no studies on the analysis of words as data using natural language processing techniques, such as word embedding. In this study, the abstract data of ergonomic studies were extracted with a program written with selenium and BeutifulSoup modules using python. The word embedding of the abstract data was performed using the word2vec model, after which the data found in the abstract were vectorized. The vectorized data were visualized in two dimensions using t-Distributed Stochastic Neighbor Embedding (t-SNE). The word "ergonomics" and ten of the most frequently used words in the abstract were selected as keywords. The results revealed that the most frequently used words in the abstract of ergonomics studies include "use", "work", and "task". In addition, the t-SNE technique revealed that words, such as "workplace", "design", and "engineering," exhibited the highest relevance to ergonomics. The keywords observed in the abstract of ergonomic studies using t-SNE were classified into four groups. Ergonomics studies registered with MEDLINE have investigated the risk factors associated with workers performing an operation or task using tools, and in this study, ergonomics studies were identified by the relationship between keywords using word embedding. The results of this study will provide useful and diverse insights on future research direction on ergonomic studies.

Correlation among Non-radiological Measurements for Thoracic Kyphosis

정성훈,황의재,김준희,하성민,권오윤 KEMA학회 2020 근골격계과학기술학회 Vol.4 No.1

Background: Although there are many measurements for thoracic kyphosis using non-radiological, correlation between the continuous measurement and selective measurement is unclear. Purpose: The purpose of this study is to investigate the correlation among Spinal Mouse (continuous measurement), Flexicurve and Arcometer (selective measurement). Study design: Correlation study Methods: 89 healthy participants were measured by non-radiological measurement tools (Spinal Mouse, Flexicurve and Arcometer) for thoracic kyphosis. Results: The correlation between the Spinal mouse and Flexicurve measurements of thoracic kyphosis was good (ICC=0.53, 95% CI=0.37–0.67). And the correlation between the Spinal Mouse and Arcometer measurements of thoracic kyphosis was good (ICC=0.58, 95% CI=0.42–0.70). The mean difference between the Spinal Mouse and Arcometer was 12.70 degree (difference between Spinal Mouse and Arcometer), between the Spinal mouse and Flexicurve was 23.83 degree (difference between Spinal Mouse and Flexicurve). Conclusions: While Flexicurve, Arcometer are highly correlated to the Spinal Mouse, they have poor agreement. Therefore, physical therapists should take caution when interpreting its results.

Search for Medical Information and Treatment Options for Musculoskeletal Disorders through an Artificial Intelligence Chatbot: Focusing on Shoulder Impingement Syndrome

곽경태,김준희,황의재,정성훈 KEMA학회 2023 근골격계과학기술학회 Vol.7 No.1

Background The ChatGPT is an artificial intelligence chatbot that processes natural language text learned through reinforcement learning based on the GPT-3.5 architecture, a large-scale language model. Natural language processing models are being used in various fields and are gradually expanding their use in the medical field. Purpose This study aimed to investigate the medical information and treatment options that ChatGPT can provide for shoulder impingement syndrome (SIS). Study design Descriptive study. Methods Using ChatGPT, which is provided as a free beta test, messages related to SIS were entered, and responses to medical information and treatment options were received and analyzed. Results ChatGPT not only provided answers to the definition, prevalence, and risk factors of SIS, but also symptoms, diseases with similar symptoms, and orthopedic tests according to the messages input. Additionally, a list of treatment options and exercises were provided. Conclusions ChatGPT will be able to provide overall useful medical information and treatment options to patients unfamiliar with SIS. However, caution is required as it contains content that may be biased or inappropriate information for patients with SIS. Nevertheless, if natural language processing technology develops further, it is expected to be able to express more detailed medical information and treatment options.

Comparison of Sesamoid Bone Position and Hallux Valgus Angle in Weight Bearing Conditions between Subjects with and without Hallux Valgus

김문환,전인철,황의재,김영 대한물리치료학회 2016 대한물리치료학회지 Vol.28 No.6

Purpose: Previous studies reported changes in the first metatarsophalangeal (MTP) joint angle in relation with and without weight bearing, but it is unclear whether sesamoid bone of the great toe changes in weight bearing conditions particularly in subjects with hallux valgus (HV). To investigate how weight bearing conditions can affect the position of the medial sesamoid bone (MSB), first MTP joint angle, and second intermetatarsal angle (IMA) in the recruited subjects. Methods: Subjects were recruited 24 with HV and 21 without HV in study. X-rays were taken in the weight bearing and non-weight bearing conditions. The distance of the MSB, first MTP joint angle, and second IMA were measured from the radiographs. Data were analyzed by paired and Independent t-test. The statistical significance level was p<0.05. Results: In both groups, the first MTP joint angles and the distance of the MSB were significantly smaller, while the second IMA was significantly greater in the weight bearing condition. The difference in the distance of the MSB between the two postures was significantly greater in the group with HV. Conclusion: Weight bearing can affect the first MTP joint angle, second IMA, and position of the MSB; the change in the position of the MSB in weight bearing was greater in the group with hallux valgus. The difference in these variables between weight bearing and non-weight bearing conditions may be considered when measuring HV.