Correction: Changes in Balancing Ability of Athletes With Chronic Ankle Instability After Foot Orthotics Application and Rehabilitation Exercises

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Changes in Balancing Ability of Athletes With Chronic Ankle Instability After Foot Orthotics Application and Rehabilitation Exercises

OBJECTIVE: To compare the effect of foot orthotics and rehabilitation exercises by assessing balancing ability and joint proprioception in athletes who have chronic ankle instability. METHODS: Forty-one athletes who visited hospitals due to chronic ankle instability were randomly assigned to two groups. One group had ankle rehabilitation exercises while the other group had the same rehabilitation exercises as well as foot orthotics. Joint position sense of the ankle joint was examined by using an isokinetic exercise machine. Balancing abilities categorized into static, dynamic and functional balance abilities were evaluated by using computerized posturography. We tested the subjects before and after the four-week rehabilitation program. RESULTS: After the four-week treatment, for joint reposition sense evaluation, external 75% angle evaluation was done, revealing that the group with the application of foot orthotics improved by -1.07+/-1.64 on average, showing no significant difference between the two groups (p>0.05). Static, dynamic and functional balancing abilities using balance masters were evaluated, revealing that the two groups improved in some items, but showing no significant difference between them (p>0.05). CONCLUSION: This study found that athletes with chronic ankle instability who had foot orthotics applied for four weeks improved their proprioceptive and balancing abilities, but did not show additional treatment effects compared with rehabilitation exercise treatment.

Back Pain Secondary to Brucella Spondylitis in the Lumbar Region

Brucellosis is a systemic, infectious disease caused by the bacterial genus Brucella and a common zoonosis that still remains a major health problem in certain parts of the world such as the Mediterranean region, the Middle East, and Latin America. It may involve multiple organs and tissues. Osteoarticular involvement is the most frequent complication of brucellosis, in which the diagnosis of brucellar spondylitis is often difficult since the clinical presentation may be obscured by many other conditions. There are only a few reports on brucellar spondylitis in Korea. Here, we report a case of spondylitis due to brucella in an elderly male.

Gender Differences Associated with Pain Patterns and Psychological Variables in Chronic Musculoskeletal Pain Patients

OBJECTIVE: To investigate gender differences in pain patterns and psychological variables among patients with chronic musculoskeletal pain. METHOD: Thirty-five male and thirty-eight female patients who visited our outpatient clinic due to chronic musculoskeletal pain were evaluated using a questionnaire survey. Chronic musculoskeletal pain was defined as pain lasting longer than 6 months. Patients were evaluated with visual analogue scale (VAS), pain site, pain duration and frequency. Beck depression inventory, state-trait anxiety index, somatization scale of symptom checklist-revised, symptom interpretation questionnaire, and pain catastrophizing scale were checked for psychological variables. Correlations among each variable were evaluated statistically. RESULTS: Female patients with chronic musculoskeletal pain recorded higher scores on number of pain site, pain catastrophizing scale, rumination, magnification and catastrophic attribution than male patients (p<0.05). In female patients, VAS was correlated significantly with depression, static anxiety, somatization, catastrophizing thought. rumination, magnification, helpless, and catastrophic attribution. Pain frequency was correlated significantly with somatization, catastrophizing thought, rumination, and helpless. Number of pain site was correlated with somatization, catastrophizing thought, magnification, and helpless. The correlation between pain patterns and psychological variables was also observed in male patients, but statistically less significant than female patients. CONCLUSION: We found gender difference associated with pain patterns and psychological variables in chronic musculoskeletal pain patients. Consideration of psychological factors may be important for management in female patients with chronic musculoskeletal pain.

Comparison of the Effect of Three Types of Treatment on Plantar Fasciitis: Ultrasonographic Follow-up

OBJECTIVE: To compare effectiveness of corticosteroid injection, foot orthoses and oral anti-inflammatory medication for the management of the plantar fasciitis by sequential ultrasonographic follow-up. METHOD: Thirty-three patients with plantar fasciitis were assigned to one of 3 treatment groups. Twelve patients received steroid injection and ten were applied with custom-made foot orthoses and eleven received 4-week course of a non-steroidal anti-inflammatory medication. All patients of each group were instructed to perform self stretching exercise of the Achilles tendon and plantar fascia for the follow-up period. Ultrasonographic evaluation and clinical assessments were performed during 12 weeks; before treatment, every week during the first 8 weeks, and then every 2 weeks during the last 4 weeks. RESULTS: On ultrasonographic examination, fascial thickness decreased significantly in all three groups (p<0.05) but earlier and greater change was noticed in injection group (p<0.05). Hypoechoic lesions were observed less commonly after treatment in injection and orthoses groups (p<0.05). Pain was not significant different among three groups after two or three weeks of treatment. CONCLUSION: Corticosteroid injection showed earlier and greater effect on pain and ultrasonographic feature than other treatments. Although pain aspects of three groups were similar after 12 weeks of follow-up, improved ultrasonographic features were well preserved in injection and orthoses groups. Ultrasonographic feature that was mostly related to the symptom relief was the decrease in fascial thickness other than resolution of hypoechoic lesion.

Quality of Life and Anxiety in Patients with Acute and Chronic Pain

OBJECTIVE: To compare the factors such as quality of life (QOL), anxiety and pain intensity in patients with acute and chronic pain. METHOD: Twenty patients with acute (pain duration 3 months) musculoskeletal pain were recruited. Pain intensity was assessed using 3 measures: ratings of average pain on a visual analogue scale (VAS), ratings of average pain on the short form McGill pain questionnaire (SF-MPQ), and ratings of pain on the present pain intensity (PPI) verbal rating scale. Quality of life and anxiety were assessed using 2 measures: the SF-36 (medical outcomes study 36-item short-form health survey) and the STAI (state-trait anxiety inventory). RESULTS: The SF-36 scale was lower and state anxiety scale was higher in chronic pain group. The SF-36 and the state anxiety scale revealed significant difference between the acute and chronic groups (p<0.05), but there was no significant difference between the the groups regarding pain intensity and the trait anxiety scale. CONCLUSION: Patients with chronic pain showed low well-being status and increased anxiety level compared to acute pain patients. According to the above results, proper management of chronic pain might be helpful for enhancing their psychosocial function.

Influence of Hemispatial Neglect on Trunk Control in Stroke Patients

OBJECTIVE: To evaluate the influence of hemispatial neglect on trunk balance control and functional ability in stroke patients. METHOD: Fourty eight inpatients exhibiting (n=25) or not exhibiting (n=23) hemispatial neglect following strokes within 6 months were matched for age and sex. Hemispatial neglect was assessed with a line bisection test (LBT) and a baking tray task test (BTT). Static and dynamic trunk balance control was assessed using a Balance Master System. Static balance control was measured with a weight bearing test and a Modified Clinical Sensory Interaction Balance Test (mCSIBT). Dynamic balance control was measured using a Limit of Stability (LOS) test and a rhythmic weight shift (RWS) test. A Functional Independence Measure (FIM) for functional ability and the Brunnstrom stage assessment for motor recovery were also recorded. RESULTS: There was no statistical difference in the achievement of static trunk balance control between neglect and non-neglect patients. Where dynamic balance control was concerned, both LOS and RWS tests showed a deterioration in neglect patients compared to non-neglect patients (P <0.05). The Brunnstrom stage correlated significantly with dynamic balance control only in non-neglect patients (p<0.05) and the FIM score of neglect patients was significantly lower than that of non-neglect patients (p<0.05). CONCLUSION: Stroke patients with hemispatial neglect displayed pronounced dynamic trunk instability and functional dependency compared to patients without it. However, the recovery of dynamic balance control may not relate to the degree of motor recovery in stroke patients with hemispatial neglect.

Buttock Pain Secondary to Segmental Neurofibromatosis: A case report

Neurofibromatosis (NF) is a dysplastic disease which consists of multiple cafe-au-lait spots and neurofibromas from neural sheath. The 61-year-old male patient complained of sudden severe pain on the left buttock started one month ago. On physical examination, multiple "lentigines" were seen on his left buttock which spreaded to the thigh and small soft protruding nodules were observed on the right side of the back and left shoulder. Histopathologic finding of a specimen obtained from a nodule was consistent with neurofibroma. Magnetic resonance imaging (MRI) and ultrasonography revealed asymmetrical hypertrophy of neurovascular bundle located in the left greater sciatic foramen. On diagnosing as NF, he was treated with medication, physical modalities and therapeutic intervention (caudal block). Visual analogue scale (VAS) went down to 3/10 with these treatments and he was discharged. We report successful treatment of buttock pain rarely associated with segmental neurofibromatosis.

Single Symptom of 'Pure' Mechano-allodynia Secondary to Acute Herniated Cervical Disc: A case report

Allodynia is pain following a non-noxious stimuli which does not provoke pain normally and develops after incomplete spinal cord injury more commonly in cervical rather than thoracic level, and central cord syndrome. This article presents an unusual patient who presented with the single symptom of an intense allodynia after cervical intervertebral disc herniation. This 36-year-old male patient developed acute lancinating and burning pain aggravated by skimming light touch on both thenar area. Cervical magnetic resonance imaging (MRI) revealed central disc herniation and spinal cord compression. The allodynia secondary to acute herniated cervical disk has been successfully disappeared through pharmacotherapy with pulsed-use of steroid, gabapentin and comprehensive rehabilitation.

The Relations among Pain, Emotional and Cognitive-behavioral Factors in Chronic Musculoskeletal Pain Patients

OBJECTIVE: To investigate the relations among pain, emotional factors and cognitive-behavioral factors in chronic musculoskeletal pain patients. METHOD: This study was designed as a questionnaire survey. 73 patients who visited our outpatient clinics due to chronic musculoskeletal pain were evaluated. They checked visual analogue scale (VAS), pain site and frequency. Beck depression inventory (BDI) and state-trait anxiety index (STAI) were checked for evaluation of emotional factors. Somatization scale of symptom checklist-revised (SCL-R- 90) and pain catastrophizing scale (PCS) were checked for cognitive-behavioral factors. Correlations among each variable were evaluated by statistical analysis. RESULTS: VAS was correlated with pain frequency (r=0.538, p0.05). CONCLUSION: Cognitive-behavioral factors such as catastrophizing thought are strongly correlated with both pain aspects and emotional factors. Consideration of cognitive- behavioral factors as well as emotional factors may be important for management of chronic musculoskeletal pain.

Effect of Slow Walking Speed on Gait

OBJECTIVE: To investigate the effect of slow walking speed on the gait. METHOD: Twenty healthy young male subjects were recruited. The temporospatial data, kinematic and kinetic data in sagittal plane at two different walking speed (2 km/hr, 4 km/hr) were obtained through three dimensional analyzer with the force plate, and compared these parameters at slow gait speed to those at normal gait speed. RESULTS: The cadence and step length decreased significantly and double support time increased significantly (p<0.05) at slow speed compared to at normal speed. The most peak angle of hip, knee and ankle joint decreased, maximal ankle dorsiflexion angle in stance phase increased significantly at slow speed compared to at normal speed (p<0.05). The most maximal extension and flexion moment and power in sagittal plane decreased compared to at normal speed (p<0.05). CONCLUSION: The results of this study demonstrate that only slow walking speed without any pathology may change the temporospatial, kinematic and kinetic parameters of gait, and these results may be useful to interpret the data of gait analysis in the disabled persons with slow walking speed.

Intrahemispheric Diaschisis in Subcortical Lesions

OBJECTIVE: The aim of this study was to investigate the incidence of intrahemispheric diaschisis in subcortical lesions and relationships between involved structures and intrahemispheric diaschisis using positron emission tomography (PET). METHOD: Thirty stroke patients with unilateral subcortical lesions without cortical structural abnormality were recruited. The findings of [18F]Fluoro-2-Deoxy-D-Glucose PET were interpretated by experienced radiologist. RESULTS: In the lesions around basal ganglia, hypometabolism of ipsilateral whole hemisphere was observed in 8 of 20 patients and ipsilateral parietal, frontal, temporal, occipital lobe was observed in order of incidence. Intrahemispheric diaschisis had a tendency to expand when the centrum semiovale was involved. Crossed cerebellar dia-schisis was observed in 17 of 20 patients. In the lesions around thalamus, hypometabolism of ipsilateral whole hemisphere was observed in 6 of 8 patients, and ipsilateral frontal, temporal, parietal lobe was observed in order of incidence. Intrahemispheric diaschisis had a tendency to expand when the internal capsule was involved. Crossed cerebellar diaschisis was observed in 5 of 8 patients. CONCLUSION: This study shows that intrahemispheric diaschisis was observed in all patients with subcortical lesions without cortical structural abnormality and had a tendency to expand to larger area of the cerebral cortex when the connecting fibers between cortical and subcortical structures were involved.

Nonoperative decompression treatment of intestinal obstruction

No abstract available.