요추 추간판 탈출증으로 유발된 족무지 신전 근력약화 환자 17례의 임상적 고찰

김우영,한상엽,김기역,이재훈,이현종,김창연 대한침구의학회 2009 대한침구의학회지 Vol.26 No.4

Objectives : To investigate the improvement rate of muscle weakness caused by lumbar disc herniation, 17 patients was treated with oriental medicine. Methods : To evaluate weakness of big toe extensor muscles caused by lumbar disc herniation, we measured the active range of motion(ROM) of big toe extension and muscle grading of big toe extensor muscles. We also measured numerical rating scale(NRS), oswestry disability index(ODI) and compared them with the active ROM of big toe extension. Results : 1. Progressive weakness of big toe extensor muscles was observed in 2 patients. Weakness of big toe extensor muscles were improved in 13 patients(76%). 2. Changes in manual muscle testing(MMT) scores corresponded with improvement rate of big toe extension. 3. Numerical rating scale(NRS) and oswestry disability index(ODI) improvement rate did not correspond with improvement rate of big toe extension. Conclusions : Muscle weakness caused by lumbar disc herniation can be treated with oriental medicine and progressive muscle weakness must be observed constantly.

회색질척수염의 병력이 있는 환자에서 발생한 근력 약화: 소아마비후증후군(Post-polio Syndrome)과 피부근염의 감별

안상희 ( Sang Hee An ),나하영 ( Ha Young Na ),강성희 ( Seong Hui Kang ),박수연 ( Soo Youn Park ),유형민 ( Hyung Min Yu ),임채호 ( Chae Ho Lee ),김지완 ( Ji Wan Kim ),권세웅 ( Se Woong Kwon ),이정화 ( Junghwa Lee ),김해림 ( Hae Rim 대한류마티스학회 2014 대한류마티스학회지 Vol.21 No.3

저자들은 급성회색질척수염과거력이 있는 환자에서 새로 발생한 근육 위약이 소아마비후증후군으로 진단되었다가, 근육위약과 피부발진의 증상이 진행하여 피부근염으로 최종진단 후 고용량의 스테로이드와 면역억제제 사용으로 증상과 검사실 소견이 호전되었던 예를 경험하여 문헌고찰과 함께 보고하는 바이다. Dermatomyositis (DM) is an idiopathic inflammatory myopathy, characterized by inflammation of the proximal skeletal muscles and typical skin manifestations, which results in symmetric muscle weakness. A 43- year-old man was presented with skin rash and left leg weakness, and he had a history of poliomyelitis. Initially, he was diagnosed as having post-polio syndrome (PPS) due to unilateral muscle weakness and a result of an the electromyography (EMG), which had shown patterns of PPS. After 4 months with conservative therapy for PPS, weakness of bilateral upper arms had developed and skin rashes on his entire body had aggravated and progressed. He was diagnosed as having dermatomyositis, based on elevated muscle enzyme levels, typical skin rashes, and typical EMG findings, which indicated muscle disease. When a patient with previous poliomyelitis has a newly developed muscle weakness or pain, we should consider various possible causes other than PPS.

Effect of Isometric Horizontal Abduction on Scapular and Shoulder Muscle Activity During Knee Push-up Plus With Different Shoulder Angles in Individuals With Scapular Winging

Choi Jung-Hoon,Cynn Heon-Seock,Baik Seung-Min,Kim Seok-Hyun 한국전문물리치료학회 2023 한국전문물리치료학회지 Vol.30 No.2

Background: Individuals with scapular winging have a weak serratus anterior (SA) muscle, and to compensate, the pectoralis major (PM) and upper trapezius (UT) muscles excessively activate, which can cause upper extremity dysfunction. This study aimed to compare the effects of isometric horizontal abduction (IHA) on SA, PM, and UT muscle activity, as well as the SA/PM and SA/UT muscle activity ratios during knee push-up plus (KPP) at 90° and 120° of shoulder flexion. Objects: This study aimed to compare the effects of IHA on SA, PM, and UT muscle activity, as well as the SA/PM and SA/UT muscle activity ratios during KPP at 90° and 120° of shoulder flexion. Methods: This study, conducted at a university research laboratory, included 20 individuals with scapular winging. Participants performed KPP with and without IHA at 90° (KPP90) and 120° (KPP120) of shoulder flexion. SA, PM, and UT muscle activity were measured using surface electromyography. Results: PM activity in KPP90 with IHA was significantly lower than KPP90 and in KPP120 was significantly lower than KPP90. UT activity was significantly greater with IHA than without IHA and at 120° than 90° of shoulder flexion. SA/PM muscle activity ratio was significantly higher in KPP90 with IHA than without IHA and in KPP120 than in KPP90. SA/UT muscle activity ratio was significantly lower with IHA than without IHA. Conclusion: KPP90 with IHA and KPP120 are effective exercises to reduce PM activity and increase SA/PM muscle activity ratio. However, applying IHA in KPP90 also reduces SA/UT muscle activity ratio, implying that it would be preferable to apply KPP120 in individuals overusing their UT muscles.

Understanding and Exercise of Gluteus Medius Weakness: A Systematic Review

Seung-min Baik,Heon-seock Cynn,Seok-hyun Kim 한국전문물리치료학회 2021 한국전문물리치료학회지 Vol.28 No.1

A weak or dysfunctional gluteus medius (Gmed) is related to several pathologies, and individuals with hip abductor weakness have Gmed weakness. This study aimed to systematically review the literature associated with the anatomy and function of the Gmed, and the prevalence, pathology, and exercise of Gmed weakness. Papers published between 2010 and 2020 were retrieved from MEDLINE, Google Academic Search, and Research Information Sharing Service. The database search used the following terms: (glut* OR medius OR hip abduct*) AND weak*. The Gmed plays an important role in several functional activities as a primary hip abductor by providing pelvic stabilization and controlling hip adduction and internal rotation. Weakness of the Gmed is associated with many disorders including balance deficit, gait and running disorders, femoroacetabular impingement, snapping hip, gluteal tendinopathy, patellofemoral pain syndrome, osteoarthritis, iliotibial band syndrome, anterior cruciate ligament injury, ankle joint injuries, low back pain, stroke, and nocturia. Overuse of the tensor fasciae latae (TFL) as a hip abductor due to Gmed weakness can also cause several pathologies such as pain in the lower back and hip and degenerative hip joint pathology, which are associated with dominant TFL. Similarly, lateral instability and impaired movements such as lumbar spine lateral flexion or lateral tilt of the pelvis can occur due to compensatory activation of the quadratus lumborum for a weakened Gmed while exercising. Therefore, the related activation of synergistic muscles or compensatory movement should be considered when prescribing Gmed strengthening exercises.

Trunk Muscles Strength as a Risk Factor for Nonspecific Low Back Pain: A Pilot Study

Kang Hee Cho,Jae Won Beom,Tae Sung Lee,Jun Ho Lim,Tae Heon Lee,Ji Hyun Yuk 대한재활의학회 2014 Annals of Rehabilitation Medicine Vol.38 No.2

Objective To investigate the effects of asymptomatic back muscle weakness and spinal deformity on low back pain (LBP).Methods Sixty healthy subjects without LBP participated in this study. Radiography and an isokinetic/isometric dynamometer were used to respectively measure spinal scoliosis/lordosis and the strength of the trunk flexors/extensors. After 2 years, 48 subjects visited the hospital again and LBP episodes, its severity and the Korean version of the Oswestry Disability Index were assessed. Differences between the group with LBP and the group without LBP were evaluated and the association with LBP incidence and severity was determined. Results Sex, age, and trunk strength were significantly different in both group. Sex and age were significantly positive associated with LBP incidence. The isometric trunk flexor and extensor strength, maximum isokinetic trunk flexor and extensor strength were significantly and negatively associated with the LBP severity. The maximum isokinetic trunk extensor and maximum isometric trunk extensor strength was significantly negative associated with the LBP incidence.Conclusion LBP incidence is associated with isometric and isokinetic trunk extensor weakness, whereas LBP severity is associated with age, sex, isokinetic trunk extensor and flexor weakness, isometric trunk extensor and flexor weakness.

Association between Temporomandibular Disorder and Masticatory Muscle Weakness: A Case report

김지후,박현정,유지원 대한안면통증∙구강내과학회 2021 Journal of Oral Medicine and Pain Vol.46 No.4

The masticatory muscle disorder is the most common problem that patients with temporomandibular disorder often complain. For such complaints, treatment is directed towards reducing hyperactivity of muscles or effects of the central nervous system. However, if nonspecific occlusal change or pain persists, it is necessary to consider that muscle weakness might be the cause of the persistence of temporomandibular disorder. Stabilization of occlusion and improvement of the pain symptoms were achieved in both cases through the chewing gum exercise. This exercise may enable masticatory movements done in normal function by using muscle engram and achieve reinforcement of the masticatory muscles with balanced, simultaneous contacts of the teeth. In addition, it may be a viable method for treating temporomandibular disorders that do not respond well to conventional mandibular stabilization therapies.

다리움직임을 동반한 척추 가동술(SMWLM)과 통합한방치료를 활용하여 호전된 급성 하지 근력저하 4례 : 증례보고

문영주(Young-Joo Moon),신원빈(Won-Bin Shin),류광현(Gwang-Hyun Ryu),이지연(Ji-Yun Lee),전현아(Hyun-A Jeon),임수연(Su-Yeon Lim),김성현(Seong-Hyun Kim),구승혁(Seng-Hyuk, Koo),문현우(Hyun-Woo Moon) 척추신경추나의학회 2020 척추신경추나의학회지 Vol.15 No.2

Objectives The purpose of this study was to investigate the possibility of spinal mobilization with leg movement (SMWLM) using Korean Medicine treatment on acute lower limb muscle weakness through four case studies. Methods SMWLM , with other Korean Medicine treatments, was performed on four patients who underwent treatment at OOOO Korean Medicine Hospital from August 2017 to July 2018. Additionally, results of the Numerical Rate Scale(NRS), EuroQol-FiveDimensions(EQ-5D),Oswestry lowback pain disability questionnaire(ODI), Straight Leg Raise(SLR) test, and Manual Muscle Test(MMT) were evaluated. Results There was a significant increase in NRS, ODI, and EQ-5D scales with im-rovements of SLR angle and MMT figures to a normal range. Conclusions This study suggested that Korean Medicine treatment combined with SMWLM may affect treating acute lower limb muscle weakness. Further clinical studies are needed to establish a definite conclusion.

Nasopharyngeal Cancer with Temporomandibular Disorder and Neurologic Symptom: A Case Report

홍정훈,권정승,안형준,김성택,최종훈 대한안면통증∙구강내과학회 2014 Journal of Oral Medicine and Pain Vol.39 No.1

Nasopharyngeal cancer is malignant tumor of nasopharyngeal area that is characterized of lymphadenopathy, pain, otitis media, hearing loss and cranial nerve palsy and may present symptoms similar to temporomandibular disorder such as facial pain and trismus. In this case, the patient with symptoms similar to temporomandibular disorder after surgery for otitis media presented with facial paresthesia and masticatory muscle weakness. Examinaion of trigemimal nerve was shown sensory and motor abnormaility. The patient was referred to a neurologist. Nasopharyngeal cancer was suspected on computed tomography and magnetic resonance imaging and was confirmed by biopsy. If the patient presenting with paresthesia and muscle weakness the cranial nerve examination should be performed regardless of typical temporomandibular disorder symptom. The neurologic symptom can be caused by neoplasm such as brain tumor and nasopharyngeal cancer. Nasopharyngeal cancer on rosenmuller fossa can develop otitis media. Therefore, the patient with otitis media history should be consulted to otorhinolaryngologist to examin the nasopharyngeal area.

Surgical Treatment of Compressive Radial Neuropathy Presenting with Motor Weakness and Pain: A Case Report

Choi Gwang Yoon,양진서,Cho Yongjun,최혁재,전진수,Kang Sukhyung 대한말초신경학회 2020 The Nerve Vol.6 No.2

Compressive radial neuropathy, a type of nerve entrapment, can cause pain, extensor weakness, and sensory change. Usually, clinicians draw a distinction between posterior intero-posterior interosseous nerve (PIN) syndrome in which weak extensor function is the main symptom, and radial tunnel syndrome (RTS), which causes pain but not motor weakness. Here, we present a case of a 55-year-old patient who experienced pain and tenderness in his right forearm, followed by extensor weakness, leading to finger and wrist drop. After undergoing surgical intervention, the patient showed improvement in both pain and motor weakness. This report indicates that clinical diagnosis should focus on clinical presentation before distinguishment as PIN syndrome or RTS. We suggest surgical intervention as an effective treatment for entrapment symptoms.

Nasopharyngeal Cancer with Temporomandibular Disorder and Neurologic Symptom: A Case Report

Hong, Jung-Hun,Kwon, Jeong-Seung,Ahn, Hyung-Joon,Kim, Seong-Taek,Choi, Jong-Hoon Korean Academy of Orofacial Pain and Oral Medicine 2014 Journal of Oral Medicine and Pain Vol.39 No.1

Nasopharyngeal cancer is malignant tumor of nasopharyngeal area that is characterized of lymphadenopathy, pain, otitis media, hearing loss and cranial nerve palsy and may present symptoms similar to temporomandibular disorder such as facial pain and trismus. In this case, the patient with symptoms similar to temporomandibular disorder after surgery for otitis media presented with facial paresthesia and masticatory muscle weakness. Examinaion of trigemimal nerve was shown sensory and motor abnormaility. The patient was referred to a neurologist. Nasopharyngeal cancer was suspected on computed tomography and magnetic resonance imaging and was confirmed by biopsy. If the patient presenting with paresthesia and muscle weakness the cranial nerve examination should be performed regardless of typical temporomandibular disorder symptom. The neurologic symptom can be caused by neoplasm such as brain tumor and nasopharyngeal cancer. Nasopharyngeal cancer on rosenmuller fossa can develop otitis media. Therefore, the patient with otitis media history should be consulted to otorhinolaryngologist to examin the nasopharyngeal area.