Passive Knee Joint Proprioception Test in Normal Adults

OBJECTIVE: To establish appropriate test angle of passive knee proprioception test and to compare with active knee proprioception test. METHOD: Thirty one healthy volunteers were tested in seated position on isokinetic machine. For passive test, the knee joints were placed in starting angle of 0degrees, 30degrees in flexion test and 90degrees, 60degrees in extension test. To memorize target angle, they were passively positioned to the target angle and left hold for 10 seconds, and returned to starting position. After these processes, knee joints were passively moved toward flexion and extension target angle. The subjects were instructed to press stop button when the memorized angles were reproduced. The tests were performed 3 times for each 6 different test angle. The active test were performed with the same memorized process but the subjects moved actively to reproduce target angles. The absolute angular errors (AAE) between target angle and produced angle were measured and compared. RESULTS: In passive proprioception test, the AAEs were increased according to the test angle differences were increased from 30degrees to 60degrees. In the same target angle difference, there were no differences between starting positions. When the results of passive test were compared with active test, there were no significant differences in the flexion test, but larger angular error were measured in extension test. CONCLUSION: The passive knee proprioception test could be useful for patients with lower extremity weakness. Considering the possible error of large angular difference, the testing angular differences should be properly selected.

Characteristics of Pain in Professional Golfers Who Visited a Mobile Medical Clinic during the Season

OBJECTIVE: To investigate the distribution of pain and its characteristics reported by professional golfers during playing season. METHOD: From April 2006 to August 2007, we operated a mobile clinic equipped with a physical therapy unit during the professional golf competition. For professional golfers who had visited the clinic during this period of time, we investigated distribution of pain and its characteristics through interviews and medical records. RESULTS: A total of 118 professional golfers visited the mobile clinic during the service period. The analysis of pain distribution showed that spine (56.3%) including low back, cervical, thoracic spine was the most common area of pain complaints, followed by upper extremity (33.1%), lower extremity (9.1%) in order. Based on the detailed anatomical distribution, low back was the most common pain site (22.5%). In case of the upper extremity pain group, left side pain was more prevalent than that of right side. Compared with spine pain group, upper extremity pain group was significantly older and also had more professional career (p<0.05). This implies that upper extremity injury may relatively caused from repetitive stress of golf swing. CONCLUSION: The results imply that golf imposes a relatively high burden on spine and upper extremity in professional golfers.

The Effect of Intramuscular Low Frequency Electrical Stimulation for Hemiplegic Shoulder Pain

OBJECTIVE: To investigate the effects of intramuscular low frequency electrical stimulation on shoulder pain in hemiplegic patients. METHOD: Twenty five hemiplegic shoulder pain patients were divided into two groups. For experimental group, we inserted stainless steel acupuncture needle on the motor points of supraspinatus, infraspinatus, trapezius and middle deltoid muscle and applied intramuscular electric stimulation (4 Hz, unsymmetric spike pulse, 2.0 ms of pulse width) for twenty minutes, three sessions a week, in total 10 sessions. For control group, we applied transcutaneous electrical nerve stimulation for twenty minutes. Visual analog scale(VAS), passive range of motion of shoulder joint, and Korean version of modified Barthel index (K-MBI) were measured before and after the treatment. RESULTS: The VAS of experimental group significantly decreased from 7.23+/-0.83 to 3.04+/-1.52, while control group showed a slight decrease from 7.50+/-0.70 to 5.64+/-0.74. The experimental group showed significant improvement compared to the control group (p<0.05). In the experimental group, there were significant improvements in motion of abduction from 103.6+/-20.5 to 134.0+/-32.3 and external rotation from 60.0+/-19.6 to 68.6+/-19.7 (p<0.05) even though there were no significant differences between the two groups. CONCLUSION: Intramuscular low frequency electrical stimulation improved pain as well as the range of motion. This could be used for the treatment of hemiplegic shoulder pain.