Electromyographic Analysis of Left Leg Muscle Activity during Golf Driver Swing

OBJECTIVE: To analyze activities of left lower extremity muscles throughout phases of the golf swing, using surface electromyography. METHOD: We evaluated muscle activities during the golf swing of 5 amateur and 5 professional golfers using surface electromyography. Surface electrodes were placed in the left gluteus medius, gluteus maximus, biceps femoris, gastrocnemius, rectus femoris, peroneus longus, and tibialis anterior. RESULTS: Muscle activities of professional golfers in the left gluteus medius, gluteus maximus, biceps femoris, tibialis anterior, rectus femoris abruptly increased from top-swing phase to impact phase but muscle activities of amateur golfers in these muscles increased to top-swing phase and decreased at follow swing phase. Muscle activities of professional golfers in left peroneus longus, gastrocnemius abruptly increase from forward swing to impact but muscle activity of amateur golfers in these muscles continuously increase to impact and abruptly increase at follow swing. CONCLUSION: Our findings demonstrate the importance of the muscles in the golfer's swing.

Reliability and Validity of Korean Version of Falls Efficacy Scale-International (KFES-I)

OBJECTIVE: To develop and validate the Korea version of falls efficacy scale-international (KFES-I) in Korean elderly which was developed to assess fear of falling in older people and have been already validated in some European countries. METHOD: Surveys of 385 older persons from the public health center in Korea based on KFES-I and fall questionnaire such as presence, frequency of fracture within last 6 months, and combined medical illness were taken. KFES-I was composed with 16 items of activities of daily living including social activities and graded from 1 to 4 in each item. Two-week KFES-I re-test data were collected. Reliability and validity estimates were computed as well as KFES-I sum scores according to age, sex, and falls history. RESULTS: Cronbach's alpha was 0.971 and mean inter-item correlation was 0.665. Test-retest Pearson correlation coefficient was 0.960 (p<0.01). As expected, KFES-I scores were associated with age, sex, and falls history (p<0.05). In addition, the KFES-I discriminated between sub-groups somewhat better than the original ten-item KFES scale. CONCLUSION: KFES-I appears to be a reliable and valid method for measuring fear of falling in older adults. This study provides the preliminary evidence that KFES-I is a useful tool in evaluating Korean elderly who fear falling.

The Relationship between Korean Version of Falls Efficacy Scale - International and Frequency of Falls in the Healthy Elderly Visiting the Public Health Centers

OBJECTIVE: To see whether there is a relationship between Korean Falls Efficacy Scale-International (KFES-I) developed for measuring fear of falling and frequency of fall. METHOD: KFES-I was composed with 16 items of activities of daily living including social activities and graded from 1 to 4 in each item. Surveys of 250 patients over 65 years of age from the public health center of Kang-dong and Seong-buk based on KFES-I and fall questionnaire such as presence, frequency and severity of fracture within last 6 months, and combined medical illness were taken. The data of KFES-I, fall questionnaire, and the inter-relationship of KFES-I items had been analyzed by Spearman and Kendall test. RESULTS: There was strong positive correlation between KFES-I total score and the frequency of falls. Four items (item 4, 7, 11, 15) of KFES-I showed strong correlation with the frequency of falls. There was significant difference in KFES-I total score between control and fracture groups (p<0.05). CONCLUSION: Our results showed that there was strong positive correlation between frequency of falls and KFES-I. It is suggested that frequency of falls can be predicted by KFES-I.

An Analysis of the Surface Anatomical Location of the Posterior-inferior Margin of the Sacroiliac Joint

BACKGROUND: The blind sacroiliac joint (SIJ) block cannot always be performed accurately; it is commonly performed in the office based setting because intraarticular and periarticular injections are effective for SIJ pain. However, knowledge on the surface anatomy of the SIJ is lacking. The purpose of this study was to analyze the surface anatomical location of the posterior-inferior margin of the SIJ. METHODS: After informed consent was obtained, fifty patients undergoing SIJ block in the prone position were examined. The oblique angles where the anterior-inferior margin and the posterior-inferior margin of the SIJ overlap on X-ray were evaluated. In addition, the surface anatomical relationships between the posterior-inferior margin of the SIJ on X-ray and the posterior superior iliac spine (PSIS) and sacral hiatus by palpation were assessed. RESULTS: The oblique angle was 5.4 +/- 2.9degrees. The vertical and transverse distance between the posterior-inferior margin of the SIJ and PSIS were 3.8 +/- 0.8 cm and 0.9 +/- 0.6 cm, respectively. The vertical and transverse distance between the posterior-inferior margin of the SIJ and the midpoint of the sacral hiatus were 3.4 +/- 0.7 cm and 3.9 +/- 0.6 cm, respectively. Only the vertical distance between the posterior-inferior margin of the SIJ and PSIS showed significant difference between the male and the female groups (P = 0.0016). CONCLUSIONS: The measurements in this study can be used as a reference standards for the blind SIJ block.

The Incidence of Low Saturation by Pulse Oximetry in the Postanesthesia Care Unit / 대한마취과학회지

BACKGROUND: Patients are most likely to develop severe arterial desaturation during the early postoperative period. Respiratory complications in postanesthesia care unit (PACU) increase the risk of major adverse cardiac outcomes, unanticipated ICU admission or delay in PACU discharges. The increased use of inhalation agents with low blood : gas partition coefficient, intermediate-acting muscle relaxants and continuous pulse oximeter monitoring over the past 10 years may have altered the incidence of immediate postoperative hypoxemia. This study was undertaken to determine the overall incidence of immediate postoperative hypoxemia in PACU. METHODS: Hypoxemia was defined as a pulse oxygen saturation (SpO2) of less than 90% lasting for at least 20 sec. The occurrence of hypoxemia was documented and notified to the anesthesiologist by PACU nurses. The anesthesiologist recorded contributory factors and the management modalities used in patients with hypoxemia. RESULTS: The incidence of hypoxia was 3.5 per 1,000 patients after general anesthesia. Most hypoxemic events (88%) occurred during the first 5 minutes after arrival in PACU. Upper airway obstruction was the major contributory factor for hypoxemia (75.5%) and most of these patients recovered simply after a jaw thrust or the insertion of an oral or nasal airway. CONCLUSIONS: Postoperative hypoxemia does not occur often in PACU, but when it does, it is associated with major morbidity and increased medical costs. Therefore, oxygen supply is recommended in patients with risk factors of hypoxemia during transfer from operating rooms to PACU. Close monitoring of hypoxemia in PACU is needed in all patients after general anesthesia.

Anthropometric Variables and Security against Fecal Contamination due to Caudal Catheter Indwelling in Children / 대한마취과학회지

BACKGROUND: There is an increasing interest in regional anesthesia for pediatric patients, in particular, the efficacy of the caudal approach is similar to that of lumbar epidural anesthesia, and reduces the risk of damage to the spinal cord and vessels. Although caudal catheterization may increase the likelihood of urofecal contamination, especially in children who are not toilet trained, no significant infection has been reported after caudal epidural catheter indwelling. The purpose of this study was to clarify the anatomic characteristics of the sacrococcygeal area in children by comparing the anthropometric variables of children and adults, and to reconsider the caudal epidural catheter safety with respect to fecal contamination. METHODS: Thirty-eight children aged 3-9 years and 47 adults aged 30-75 years, without bony deformities, were enrolled in this study. In left lateral position, Tuffier's line (A), sacral hiatus (B) and greater trochanter (C) were marked. The shortest distances from A to B, from A to C and from B to the anus (D) were measured and the ratios of BD to subject height, BD to AB and BD to AC were calculated. RESULTS: The shortest AB, AC and BD distances were significantly shorter in children and conversely the ratios of BD/height, BD/AB and BD/ AC were significantly larger. CONCLUSION: Considering anatomical characteristics of pediatric patients, if a child is toilet trained and the catheter insertion site is well sealed, there should be no difference between the incidence of infection in adults and children after caudal epidural catheter indwelling.