[Show abstract][Hide abstract] ABSTRACT: Calculating the estimated resting metabolic rate (RMR) in severely obese patients is useful, but there is controversy concerning the effectiveness of available predictive equations using body weight. This study compared the accuracy of four commonly used RMR predictive equations to measured RMR. We evaluated the efficacy of RMR equations against indirect calorimetry in forth female obese subjects. The subjects had their RMR measured by indirect calorimetry and compared to the most commonly used prediction equations (Harris-Benedict, Owen, and Mifflin-St Jeor, World Health Organization/Food and Agriculture Organization/United Nations University [WHO/FAU/UNU]). The results shows that Owen and Mifflin-St Jeor equations significantly under-estimated to our measured RMR. However, the WHO/FAO/UNU Equation was the most accurately predictive RMR values (1,543.6±110.3 vs. 1,484.3±218.3) compared to measured RMR. As based on data, we suggest that WHO/FAO/UNU equation and Harris-Benedicts equation would be most reasonable and useful for Korean obese women.
[Show abstract][Hide abstract] ABSTRACT: Study Design
Cross sectional study.
To evaluate characteristics of back muscle strength in patients scheduled for lumbar fusion surgery.
Overview of Literature
Little is known regarding muscle strength in patients with symptomatic lumbar degenerative diseases who require fusion surgery.
Consecutive 354 patients scheduled for posterior lumbar interbody fusion due to symptomatic degenerative diseases were approached for participation. 316 patients were enrolled. Before surgery, muscle strength was assessed by measuring maximal isometric extension strength at seven angular positions (0°, 12°, 24°, 36°, 48°, 60°, and 72°) and mean isometric strength was calculated. The Oswestry Disability Index (0-100) and visual analogue scale (0-100) for back pain were recorded. Muscle strength was compared according to gender, age (<60, 60-70, and ≥70 years) and scheduled fusion level (short, <3; long, ≥3).
Isometric strength was significantly decreased compared with previously reported results of healthy individuals, particularly at extension positions (0°-48°, p<0.05). Mean isometric strength was significantly lower in females (p<0.001) and older patients (p<0.05). Differences of isometric strength between short and long level fusion were not significantly different (p>0.05). Isometric strengths showed significant, but weak, inverse correlations with age and Oswestry Disability Index (r<0.4, p<0.05).
In patients with symptomatic lumbar degenerative diseases, back muscle strength significantly decreased, particularly at lumbar extension positions, and in females and older patients.
Asian spine journal 10/2014; 8(5):659-66. DOI:10.4184/asj.2014.8.5.659
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to test the hypothesis that blood pressure (BP) increase before exercise stress testing is associated with the incidence of hypertension in a prospective study of 3,805 normotensive men without hypertension at baseline. Changes in BP were defined as the difference between seated BP at rest and BP measured immediately before exercise stress testing. Hypertension was defined as systolic and diastolic BP ≥140/90 mm Hg or hypertension diagnosed by a physician at the second examination. During 18,923 patient-years of follow-up, 371 new cases of hypertension developed (incidence rate 19.6 per 1,000 patient-years). Men with systolic BP changes >0 mm Hg and diastolic BP changes >7 mm Hg had 1.70 times (95% confidence interval [CI] 1.37 to 2.12) and 2.23 times (95% CI 1.76 to 2.82) increased relative risk for incident hypertension compared with men whose systolic BP changes were <0 mm Hg and diastolic BP changes were <7 mm Hg after adjustment for confounders. Men in the highest quartile of mean BP change (>10 mm Hg) had a higher incidence of hypertension (relative risk 2.98, 95% CI 2.19 to 4.06) compared with those in the lowest quartile (<0 mm Hg), and each 1 mm Hg increment in mean BP was associated with a 6% (95% CI 1.05 to 1.09) higher incidence of hypertension after adjustment for risk factors. In conclusion, BP increase before exercise stress testing is associated with incident hypertension, independent of risk factors in normotensive men. The assessment of BP immediately before exercise testing may be a useful addition to the standard exercise stress testing procedures.
The American Journal of Cardiology 07/2014; 114(8). DOI:10.1016/j.amjcard.2014.07.050 · 3.28 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: A left ventricular assist device (LVAD) is a mechanical circulation support implanted for patients with end-stage heart failure. It may be used either as a bridge to cardiac transplantation or as a destination therapy. The health of a 75-year-old man with a medical history of systolic heart failure worsened. Therefore, he was recommended to have implanted a LVAD (Thoratec Corp.) as a destination therapy. After the surgery, he was enrolled in patient cardiac rehabilitation for the improvement of dyspnea and exercise capacity. In results, there is an improvement on his exercise capacity and quality of life. For the first time in Korea, we reported a benefit of exercise therapy after being implanted with a LVAD.
Annals of Rehabilitation Medicine 06/2014; 38(3):396-400. DOI:10.5535/arm.2014.38.3.396
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND:One of the goals of rotator cuff repair is to restore the torn tendon to its original insertion anatomically. However, it is sometimes difficult to restore the entire footprint. PURPOSE:This study was undertaken to evaluate the variables affecting this repair coverage and to discern the differences in retear rate and clinical results between complete and incomplete footprint coverage in rotator cuff surgery. STUDY DESIGN:Case series; Level of evidence, 4. METHODS:From 2007 to 2009, a total of 85 consecutive repairs for medium-to-large rotator cuff tears were identified as having complete or incomplete coverage of their original footprints. We defined the complete footprint coverage (CC) group as patients who had >50% of their footprint covered during repair and the incomplete (IC) group as <50% of their footprint. Factors affecting the amount of footprint coverage were evaluated, and multivariable analysis was conducted to identify independent factors. To assess the final outcome according to the amount of footprint coverage, retear and clinical outcomes were compared between the CC and IC groups. RESULTS:Fifty-seven repairs were defined in the CC group and 28 repairs in the IC group. Preoperatively, age, tear size in coronal oblique and sagittal oblique planes, Goutallier fatty infiltration, and atrophy of the supraspinatus affected the amount of footprint coverage in univariate analysis. In multivariable analysis, however, tear size in the coronal plane was the only independent factor affecting footprint coverage in rotator cuff repair. On postoperative MRI, 45.6% of the CC group had an intact tendon, 45.6% had a delaminated partial retear, and 8.8% had a full-thickness retear; in the IC group, 17.9% had an intact tendon, 60.7% had a delaminated partial retear, and 21.4% had a full-thickness retear. There was a statistically significant difference in the proportion of tendon integrity between groups (P = .028). Clinical scores and range of motion at final follow-up showed no difference between the 2 groups. CONCLUSION:Tear size in the coronal plane was the only independent factor affecting the amount of footprint coverage. Repair quality based on retear classification was different between the 2 groups. However, both complete and incomplete footprint coverage in rotator cuff repair showed no differences in clinical scores and range of motion at short-term follow-up.
The American Journal of Sports Medicine 02/2014; 42(4). DOI:10.1177/0363546513518581 · 4.36 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Stress fractures are common injuries that begin with repetitive and excessive stress on the bone. It is very rare that stress fracture was occurred in pubis superior ramus in athletics, and the report concerning the exercise therapy for this fracture was not sufficient in the literature. We report of a case of a 17-year-old male soccer player who suffered from left inguinal pain due to the stress fracture of pubis superior ramus. He was conducted an exercise program that consisted of muscle strength, stretching, aerobic and functional exercise for 2 months. After this intervention, all muscle strength was significantly improved (17%) compared to baseline data, and also flexibility and range of motion were improved. This case shows that exercise therapy considered the cause and cyclic formation of bone remodeling is benefit to improve the exercise performance for a soccer player with superior ramus stress fracture.
[Show abstract][Hide abstract] ABSTRACT: The life situation has been changed in patients who underwent anterior cruciate ligament (ACL) rupture and subsequent reconstruction. The main purpose of this study was to assess the quality of life (QOL) of patients with ACL reconstruction through Short-Form 36 (SF-36) survey. And secondary aim was to investigate a relationship between health-related QOL survey and the correlation of results with other clinical test. 70 patients (age, 32.0±11.7 years) with an after 1 year ACL reconstruction participated in this study. As clinical evaluations, the SF-36 Questionnaire was used for the QOL and isokinetic strength test was performed for the knee extensors and flexors. And the anterio tibial translation was measured by KT-2000. Spearman's correlation coefficient showed significant correlations between knee strength (extensor and flexor) deficit and SF-36 score including physical functioning, bodily pain, vitality, social function score (p<0.05). However, there was no correlation between SF-36 scores and mean ratio of anterior tibial translation (p>0.05). In conclusion, the Knee strength is significantly associated with QOL. Therefore after ACL reconstruction, a speedy recovery of muscular strength will help to improve the QOL.
[Show abstract][Hide abstract] ABSTRACT: Abstract This study investigated the relationship of cardiorespiratory fitness (CRF) with incident metabolic syndrome in 810 middle aged Korean men. All subjects were free of metabolic syndrome at baseline examination. The metabolic syndrome was defined by NCEP criteria and CRF was directly measured by peak oxygen uptake during a treadmill test. During an average of 3.3 years of follow-up, 155 (19.1%) men developed the metabolic syndrome. The incidence of metabolic syndrome was inversely associated with CRF quartiles (p < 0.05). The relative risk (RR) of incident metabolic syndrome in the lowest CRF quartile vs the highest CRF quartile was 1.67 (95% CI = 1.07-2.60) after adjustment for covariates. Each metabolic equivalent (MET) increment in peak oxygen consumption was associated with a 17% (RR = 0.83, 95% CI = 0.73-0.94) lower incidence of metabolic syndrome. These results demonstrate that cardiorespiratory fitness was associated with the incidence of metabolic syndrome independent of covariates in middle aged Korean men.
Annals of Human Biology 11/2013; 41(5). DOI:10.3109/03014460.2013.849756 · 1.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to assess the effects of knee pain on the quadriceps strength, proprioception and balance in subjects with bilateral knee osteoarthritis and the correlation between muscle strength, proprioception, and balance in knee osteoarthritis patients with knee pain. The inclusion criteria were symptomatic and radiographic bilateral knee osteoarthritis (Kellgren-Lawrence grade ≥2), visual analogue scale difference of the both knees ≥2. Thirty three participants (32 women, 1 men: mean age, 59.18 years) underwent assessment of maximal voluntary contraction of quadriceps and hamstring muscles, knee proprioceptive acuity (measure passive joint reposition sense) and balance index using Biodex System 3 isokinetic dynamometer and Biodex balance System. In this study, the more pain knee had weaker quadriceps strength than less pain knee (p<0.05) but proprioceptive acuity and balance index did not show significant differences in both knees (p>0.05). Poor proprioception was associated with low quadriceps strength and poor Medio-lateral Stability Index (p<0.05). Future studies needed to account the influence of pain on neuromuscular factors as well as attempt to further clarify the relationships between these factors.
[Show abstract][Hide abstract] ABSTRACT: The aims of this study were to evaluate the incidence of anchor penetration of the far cortex of the glenoid neck after arthroscopic Bankart repair and to compare the biomechanical properties of anchors in the 4- and 5:30- to 6-o'clock positions on the glenoid.
Twelve (6 matched pairs) fresh-frozen human cadaveric shoulders were used to simulate arthroscopic Bankart repair in the lateral decubitus position. The most inferior anchor (5:30 to 6 o'clock) and that above it (4 o'clock) were inserted via the anteroinferior portal on the glenoid using the standard technique. After both anchor insertions, anchor perforation of the glenoid far cortex was identified. Biomechanical properties were measured to determine cyclic displacement of anchors at 100 and 500 cycles, stiffness, yield load, and ultimate failure strength.
All 12 suture anchors (100%) at 5:30 to 6 o'clock penetrated throughout the far cortex, whereas only 4 anchors (33%) at 4 o'clock did so (P = .005). The mean distance the anchor tip traveled into far cortex was significantly longer at 5:30 to 6 o'clock than at 4 o'clock (6.8 ± 1.6 mm v 2.0 ± 1.6 mm, P = .001). In terms of mechanical strength, anchors at 5:30 to 6 o'clock had greater 100- and 500-cycle mean displacements than those at 4 o'clock (3.0 ± 0.5 mm v 2.5 ± 0.3 mm, P = .018 for 100 cycles; 3.5 ± 0.7 mm v 2.8 ± 0.3 mm, P = .018 for 500 cycles), although no differences in ultimate failure strength after cyclic loading were found between 2 positions (133.4 ± 40.3 and 133.7 ± 29.2 N, respectively; P = .985).
For arthroscopic Bankart repair, insertion of the most inferior anchor via the anteroinferior portal with standard technique, in the lateral decubitus position, carries a high risk of perforating the inferior far cortex of the glenoid (100% in our study). This may result in mechanical weakness of the most inferior repair specifically in the early postoperative period.
Perforation of the glenoid far cortex by the most inferior anchor and its mechanical weakness should be taken into consideration. Further study is needed to improve surgical technique to place the most inferior anchor in an optimal position by arthroscopy.
Arthroscopy The Journal of Arthroscopic and Related Surgery 01/2013; 29(1):31-6. DOI:10.1016/j.arthro.2012.08.013 · 3.21 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To identify how influence preoperative predictable factors for knee function after one year of anterior cruciate ligament reconstruction (ACLR). The purpose of this study is to investigate the relationship of preoperative quadriceps strength and post-operative knee function scores (Lysholm score and International Knee Documentation Committee [IKDC] score) after surgery. We extracted seventy-one subjects who underwent hamstring autograft reconstruction to evaluate randomly. Muscle strength deficits were measured with CSMI isokinetic dynamometer. One year after ACLR, we collected these scores from subjects completed. After identification of baseline independent variables between quadriceps muscle strength deficits and both Lysholm score and IKDC score, we examined that how relevant influence in these relationship with these factors by classifying quartile groups. We demonstrated that quadriceps muscles strength and knee function scores were identified as significant correlation. It was compared with quartile outcome in order to analyze that how different result comes out as a degree of deficit. As a result, the only Q1 group who indicated less quadriceps muscle strength deficit (within 23% deficits) effected to knee function scores after one year surgery. The less of quadriceps muscle strength deficit indicated before surgery, the better functional knee score level turns up. Therefore, the result verified that there are significantly positive influences between these relationships after one year of ACLR.
[Show abstract][Hide abstract] ABSTRACT: Hypothesis
Needle lavage is frequently performed before consideration of surgical removal in shoulders with calcific tendinitis because this may avoid surgery. However, its role in nonoperative treatment has not been fully investigated in terms of clinical and radiographic response. We hypothesized that needle decompression and subacromial steroid injection would show good clinical results in chronic calcific tendinitis patients.
Materials and methods
Thirty-five shoulders in 30 consecutive patients with painful calcific tendinitis were treated by ultrasound-guided needle decompression and subacromial corticosteroid injection. Patients were prospectively evaluated using American Shoulder and Elbow Surgeons (ASES) and Constant scores at 1, 3, and 6 months after the intervention. Size and morphology of the calcific deposits were compared with those in baseline radiographs at each visit.
At 6 months after the index procedure, 25 shoulders (71.4%) showed ASES and Constant score improvements from 48.0 and 53.7 to 84.6 and 87.9, respectively (P < .01). Ten shoulders (28.6%) showed no symptom relief at the last follow-up. In shoulders with pain improvement, the mean size of calcific deposits reduced from 13.6 to 5.6 mm (P < .01), and in shoulders with no pain improvement or that underwent operation, mean size was 13.1 mm at initial visits and 12.7 mm at final visits (P = .75).
Shoulders showing little evidence of deposit size reduction at 6 months after needle decompression are less likely to achieve symptomatic improvement and may be considered as candidates for surgical removal.
Needle decompression with subacromial steroid injection is effective in 71.4% of calcific tendinitis within 6 months. The size of calcific deposits in patients that achieved symptom relief was reduced.
[Show abstract][Hide abstract] ABSTRACT: Objectives To determine which ultrasonographic [US] features of epicondylitic lesions are more treatable using extracorporeal shock wave therapy [ESWT]. Methods: Thirty patients [9 men and 21 women; mean age 47.8 years] with chronic lateral epicondylitis lasting at least 12 months were included. They were diagnosed and classified by US into three groups: simple tendinosis, tendinosis with calcification, and tendinosis with tear. Each patient was treated with low-energy ESWT for three to four sessions of 2000 shocks. Clinical evaluations [the 100-point scoring system and the Nirschl score] to evaluate symptomatic or functional improvement were performed before, three, and six months after treatment. Success rates were measured three and six months after treatment using the Roles and Maudsley score. Follow-up US was performed three months after treatment. Results: Lesions with calcifications showed only 33.3 percent [4 of 12 patients] of improvement after treatment on follow-up US, which was much lower than other two groups with 73 percent [8 of 11 patients with simple tendinosis] and 71 percent [five of seven patients with tear] of US improvement, but there was no significant difference among results of clinical evaluations of three groups. The overall success rate six months after treatment was 63.3 percent, but patients classified as having tendinosis with tear showed a significantly lower success rate [14.3 percent, P = 0.008]. Conclusions: ESWT is effective for chronic lateral epicondylitis, especially lesions with simple tendinosis or soft tissue calcification detectable on US. In addition, US has value as a predictor for ESWT outcomes.
[Show abstract][Hide abstract] ABSTRACT: Arterial stiffness is increased in hypertension, even at an earlier stage. The blood pressure (BP) response to exercise reflects the future risk of developing hypertension. We investigated the relationship between the pulse wave velocity (PWV) and the BP response to exercise to evaluate whether arterial stiffness is increased in normotensive persons with higher exercise BPs.
The participants of the study were adults with normal BP (SBP < 120 mmHg and DBP < 80 mmHg) without history of clinical cardiovascular diseases, who had undergone health screening. Treadmill exercise tests were done by modified Bruce protocol, and brachial-ankle PWV (baPWV) was measured.
The participants were 2156 men and women (69 : 31%) with mean age of 52 ± 5 years. The baPWV correlated significantly to variables such as age, sex, baseline SBP and DBP, pulse pressure, maximal oxygen consumption (VO(2max)), SBP at stage 1, at stage 2 and peak exercise and hemoglobin A1c (HbA1c). In multiple regression model, SBP at stage 1 had a significant association with baPWV after an adjustment with age, sex, VO(2max) and SBP at rest, current smoking and HbA1c. For every 10 mmHg increase in exercise SBP, baPWV increased by 18 ± 0.3 cm/s (P < 0.001).
In normotensive individuals, increased arterial stiffness, as reflected by baPWV, is accompanied by higher SBP at the early stage of treadmill exercise test. This finding suggests that arterial stiffening processes are present even in the normotensive setting and are correlated with BP changes during exercise.
Journal of Hypertension 03/2012; 30(3):587-91. DOI:10.1097/HJH.0b013e32834f41b1 · 4.72 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to survey the athletic trainers' recognition, need and evaluation for balance training and to investigate training and evaluation methods in the actual implementation. One hundred fifty trainers were participated in the survey. The study questionnaire of 24 encompassed five separated issues; basic characteristics of trainers, awareness and the need for balance, balance assessment and training content, assessment and training equipment, and education and need. Balance training were recognized as simple balance training in 20.7% of trainers, and as proprioception in 64.9%. Trainers with high needs of balance training were 69.4%. The percentage of trainers with protocol of balance training were 73.9%, and the trainers with complex equipments including software and hardware were 66.7%. Trainers with needs of education for training protocol, theoretical education for balance, and training equipment were 79.3%, 56.8%, and 63.1%. The results showed that educations for concept of balance training and sports injury rehabilitation, and research opportunities had to be provided to athlete trainers. We think that the results of this study can help athlete trainers to apply high-quality sports rehabilitation for athletes.
[Show abstract][Hide abstract] ABSTRACT: In this study, the cause, diagnosis, and treatment of common lower limb injuries during the sports activities were presented. Sports injuries of the lower limbs are the most common injuries in the sports medicine field due to the high level of use of the lower limbs during sports activities. The common causes of leg injuries in athletes are traumatic force over the critical limit of normal tissue, repetitive microtrauma, and overuse. Common hip and pelvis problems encountered by the authors include trochanteric bursitis, snapping hip syndrome, and labral tears. The anterior and posterior cruciate ligaments, medial and lateral collateral ligaments, and meniscus have been most frequently involved in sports injuries affecting the knees. Lateral ankle sprain represents one of common injuries in the athletic population. Common overuse injuries are tendinopathies, stress fractures, chronic exertional compartment syndrome, and shin splints. Athletic activity provides a variety of positive benefits to participants' health. To safely continue those activities, an injury prevention program focusing on injuries that may occur in specific sports activities is recommended for participants. Early diagnosis and proper treatment are also important in promoting prompt recovery and preventing secondary injuries.
Journal of the Korean Medical Association 07/2011; 54(7):715. DOI:10.5124/jkma.2011.54.7.715 · 0.18 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to do the surveillance study of sports injuries which were suffered to National players of South Korea Team during the summer Asian Games 2010 in Guangzhou. All medical staffs of Korea Delegation were asked to report all sports injuries newly incurred during the Games on injury report form, and the physicians made clinical diagnoses of the injuries. Total 725 injuries (430 athletes) were reported, and 288 injuries (209 athletes) were newly incurred: 68 injuries (58 athletes) were recurrent with previous history, resulting in total incidence rate: 45.5 injuries/1000 athlete exposures (AE) (95% confidence interval [CI]: 40.1-50.6 injuries/1000 AE) and incidence proportion: 26% (95% CI: 23-29). The new injury was highest in athletics (n=37, 12.8%), hockey (n=26, 9.0%), and basketball (n=23, 8.0%). While 162 injuries (56.2%) were incurred during practice, 126 injuries (43.8%) were incurred in competition. The most frequent diagnoses were lateral ankle ligament sprain (n=28, 9.7%, 95% CI: 6.3-13.1), calf muscle cramp (n=23, 95% CI: 4.9-11.1), and hamstring strain (n=22, 95% CI: 4.6-10.7). The relapsed injury was highest in athletics (n=16, 23.5%), basketball (n=6, 8.8%), and wrestling (n=5, 7.4%). While 50 injuries (73.5%) were recurred during practice, 18 injuries (26.5%) were recurred in competition. The most frequent diagnoses of relapsed injury were calf muscle cramp (n=11, 16.2%, 95% CI: 7.4-25.0), low back strain (n=6, 8.8%, 95% CI: 2.1-15.6), and hamstring strain (n=6, 8.8%, 95% CI: 2.1-15.6). Our data indicated incidence rates, incidence proportions, characteristics and frequent diagnoses of acute and recurrent sports injuries during the games, therefore these results could provide relevant information for the sports injury prevention at elite level.