Running is becoming one of the most popular leisure sports. Part of the growing popularity of running is its easy accessibility and health benefits. The incidence of running injuries rates ranges from 37% to 56%, which incidence rate is still 2 to 6 times lower than in all other sports. Most running injuries are musculoskeletal overuse syndrome of the lower extremity. The risk factors of running injuries can be training errors, improper running surface, worn shoes, body flexibility, prior injury. The knee is the most common site of injury and accouts for 25% to 33% of all, and pa-tellofemoral stress syndrome is the most common known as runner's knee. Iliotibial band syndrome, medial tibial stress syndrome, plantar fascitis, Achilles tendinitis, stress fracture are common injuries in runners. The physical examination includes a biomechanical screening to identify related imbalances. Additionally, each runner is observed walking and running. This comprehensive, running specific approach to diagnosis can be helpful in developing optimum rehabilitation program. (J Korean Acad Rehab Med 2005; 29: 243-253)

Objective
To assess the impacts of stroke on sexual activities and functioning of patients with stroke and to study the associations of clinical and psychosocial factors with sexual changes following stroke. Method: Ninety-seven patients with stroke were interviewed and completed questionnaire concerning their prestroke and poststroke coital frequency, sexual satisfaction, and sexual functions such as erection, ejaculation, and vaginal lubrication. Results: Sexual activities such as coital frequency and sexual satisfaction were decreased in patients after stroke. Sexual dysfunctions including impotence (68%), a decline in ejaculation (66.7%), and a decline in vaginal lubrication(89.5%) were high. Subjective reasons for decreased sexual life after stroke were denial of spouse, impotence, decreased libido, no opportunity of sexual activity due to hospitalization or no sexual partner, fear of relapse, physical discomfort due to hemiparesis and so on. Comparing sexual group with no sexual group after stroke, there were different in age (p=0.040), brain lesion site (p=0.036), prestroke coital frequency (p=0.048), erectile ability (p=0.005), and ejaculation (p＜0.001). Conclusion: The decline in sexual activities and functioning was due to interpersonal, physical, psychological factors among patients following stroke. (J Korean Acad Rehab Med 2005; 29: 254-259)

Objective
To investigate the effect of electromyography (EMG)-biofeedback treatment in children with spastic-diplegic cerebral palsy. Method: Twenty patients with spastic diplegia, who could recognize the auditory and visual stimulation, were recruited. Ten patients underwent EMG-biofeedback treatment with neurodevelopmental treatment (NDT) for 12 weeks, 3 times a week, total 1 hour a day, but age-, sex- and functional-matched ten controls underwent only NDT. Before and after the treatment, active range of motion, spasticity, muscle strength and Functional Independence Measure for Children (WeeFIM) and Gross Motor Function Measure(GMFM) were measured. Results: In experimental group, there was a significant increase in active range of motion of hip and ankle joints (p＜0.05). Spasticity of ankle joint was decreased, but it was not statistically significant (p＞0.05). Muscle strength of ankle dorsiflexor and hip extensor muscles was significantly improved (p＜0.05). WeeFIM and GMFM scores significantly increased in an experimental group (p＜0.05). Conclusion: EMG-biofeedback treatment in children with spastic-diplegic cerebral palsy might be an effective adjuvant to NDT through the muscle reeducation. (J Korean Acad Rehab Med 2005; 29: 260-265)

Objective
Iliac vein compression syndrome is a well-recognized anatomic variant that is associated with the development of symptomatic deep venous thrombosis (DVT) of the left iliac vein. However, its relation with DVT in spinal cord injury has not been established. The purpose of this study was to determine the relation between iliac vein compression syndrome and DVT in spinal cord injured patients. Method: Thirteen spinal cord injured patients diagnosed with DVT from January 2002 to December 2003 were evaluated. After ascending venography, the catheter-directed thrombolytic therapy and balloon angioplasty with stent insertion after 24 hours of thrombolytic therapy were doneResults: Twelve of 13 patients showed that the left iliac vein was compressed by the right iliac artery, with thrombosis shown in the distal venous segment of the crossover point and had a collateral formation. All 12 patients had residual stenosis of left iliac vein in spite of the thrombolytic therapy. The unimpeded venous flow of iliofemoral veins was revealed after the balloon angioplasty with stent insertion. Conclusion: We suggested that the proper evaluation and management about iliac vein compression syndrome be considered when residual stenosis was persistent through the chemical dissolution in spinal cord injured patient with left iliac vein thrombosis. (J Korean Acad Rehab Med 2005; 29: 266-271)

Objective
To investigate the frequency of carpal tunnel syndrome (CTS) according to the severity of diabetic polyneuropathy. Method: Electrophysiologic study was performed in 456 patients (male 222, female 233, average age 58) with diabetes mellitus. Electrophysiologically diagnosed diabetic neuropathy was classified as suspected, probable or definite. CTS was also diagnosed both in cases with and without underlying diabetic peripheral neuropathy. The ANOVA test was used for statistical analysis. Results: Out of 456 diabetic patients, 228 patients were diagnosed as diabetic peripheral neuropathy. The patients with diabetic neuropathy consisted of 107 cases (23.5%) of sus-pected group, 95 cases (20.8%) of probable group and 26 cases (5.7%) of definite group. The frequencies of concomitant CTS were 49 cases (21.5%) in 228 diabetic patients without diabetic polyneuropathy, 31 cases (29%) in suspected group and 30 cases (31.6%) in probable group. These were statistically significant. However, only one case showed concomitant CTS in 26 cases of definite group. Conclusion: The frequency of CTS was higher in probable group compared to suspected group. However the frequency decreased in definite group because there is a difficulty in the differential diagnosis of two disease in the cases of advanced peripheral neuropathy. (J Korean Acad Rehab Med 2005; 29: 272-275)

Objective
The aim of this study was to evaluate the efficacy of the local steroid injection in the patients with medial superior cluneal nerve entrapment. Method: The participants were 20 (13 men, 7 women) patients with medial superior cluneal nerve entrapment diagnosed by Maigne's criteria (unilateral buttock pain, tender point at iliac crest, and relieved pain by nerve block). All patients were injected with 1% lidocaine 1.75 ml and triamcinolone 10 mg at maximal tender point which was 7∼8 cm away from spinous process horizontally on the iliac crest. The visual analogue scale (VAS) and the modified Oswestry questionnaire (MOQ) were checked at before, 2 weeks and 4 weeks after injection. And the VAS waschecked 10 min after injection to determine the accuracy of injections. Results: The mean VAS scores of before injection, 10 min, 2 weeks, and 4 weeks after injection were 7.7, 2.8, 4.0, and 4.0 respectively. The mean MOQ of before injection, 2 weeks, 4 weeks after injection were 35.7, 23.8, and 23.8 respectively. Both VAS and MOQ were significantly different in before injection, 2 weeks and 4 weeks after injection (p＜0.05). Conclusion: The local steroid injection is an effective treatment of medial superior cluneal nerve entrapment. (J Korean Acad Rehab Med 2005; 29: 276-280)

Objective
The aim of this study was to compare the therapeutic and functional values between the L5-S1 transforaminal epidural steroid injection (TFESI) and L4-5 TFESI in patients with L5 radiculopathy. Method: Among 30 patients with unilateral herniated nucleus pulposus (HNP) and L5 radiculopathy, 15 patients received L5-S1 TFESI and 15 patients received L4-5 TFESI. All patients were checked visual analogue scale (VAS) and functional score before injection, after 1 day, 2 weeks and 4 weeks.Results: The VAS of before injection, after 1 day, 2 weeks and 4 weeks were 6.6, 4.0, 3.0, and 2.8 in L5-S1 TFESI, 6.2, 3.9, 2.7, and 2.6 in L4-5 TFESI, respectively. The functional score of before injection, after 1 day, 2 weeks and 4 weeks were 1.8, 2.3, 2.6, and 3.0 in L5-S1 TFESI, 1.6, 2.2, 2.5, and 2.8 in L4-5 TFESI, respectively. There was no statistical difference between the groups (p＞0.05). Conclusion: This study suggested that either L5-S1 TFESI or L4-5 TFESI could be a valuable treatment of L5 radicular pain. (J Korean Acad Rehab Med 2005; 29: 281-285)

Objective
This study was conducted to assess the analgesic effect of intraarticular injection with morphine and hyaluronic acid in comparison with intraarticular injection with hyaluronic acid only in the patients with osteoarthritis of knee. Method: Twenty four patients with degenerative osteoarthritis of the knee were assigned randomly to a morphine group (morphine⁢hyaluronic acid) and a hyaluronic acid group. In the morphine group, intraarticular injection with morphine and hyaluronic acid at first was applied to the knee 2 times. Then intraarticular injection with hyaluronic acid without morphine was applied in the remaining 3 times. In the hyaluronic acid group, intraarticular injection with hyaluronic acid was applied to the knee 5 times. Effects were assessed on the 1st week, 5th week after treatment, and on the last follow up day by pain rating score (PRS). Results: Significant change of PRS improvement was noticed in the morphine group in the 1st week after treatment compared with the hyaluronic acid group. Conclusion: These results showed that intraarticular injection with morphine and hyaluronic acid was a more effective treatment method than intraarticular injection with hyaluronic acid only for pain control in patients with osteoarthritis of knee. (J Korean Acad Rehab Med 2005; 29: 286-290)

Objective
To determine the association between the type and severity of rotator cuff tear and ultrasonographic findings. Method: Total 91 cases with rotator cuff tear were classified into partial- or full-thickness tear according to arthrographic and ultrasonographic findings. Partial-thickness tear was divided into the tear on the bursal or articular side. Full-thickness tear was divided into small (2 cm＜) or large (2 cm≧) tear by the length of retraction. Combined findings which included biceps tenosynovitis, subacromial-subdeltoid (SASD) bursitis, acromio-clavicular (AC) joint osteoarthritis and the cortical irregularity of greater tubercle (GT) were evaluated by ultrasonography. Results: Sixty five cases (71.9%) were full-thickness tear and 26 cases (28.1%) were partial-thickness tear. Forty two cases (46.1%) were SASD bursitis, 33 cases (36.2%) were biceps tenosynovitis, 24 cases (26.3%) were cortical irregularity of GT, and 26 cases (28.5%) were AC joint osteoarthritis. The incidence of SASD bursitis was higher in full- thickness tear than partial-thickness tear. The SASD bursitis and cortical irregularity of GT were more frequently shown in large tear than small tear. Conclusion: SASD bursitis showed higher association with full-thickness tear than partial-thickness tear. The length of retraction was more severe when SASD bursitis or cortical irregularity of GT was associated with full-thickness tear. (J Korean Acad Rehab Med 2005; 29: 291-296)

Objective
To investigate static posturographic characteristics during balance control under virtual moving surround (VMS) using force platform and head mount display (HMD) device in patients with chronic ankle sprain as compared with that of normal adults. Method: Ten patients with chronic ankle sprain and 24 healthy adults participated. Center of pressure (COP) parameters were obtained for 20 seconds using force platform as total path distance and total sway area in following conditions (1) comfortable standing with opened and closed eyes, (2) VMS delivered using HMD with four different moving patterns. The virtual moving patterns composed of close-far, superior-inferior tilting (pitch), right-left tilting (roll) and horizontal rotation (yaw) movement. Results: No significant difference was found between patients with chronic ankle sprain and healthy adults on comfortable standing with both open and closed eyes. But, patients revealed significantly increased total path distance and sway area of COP on all VMS conditions. Conclusion: These results showed that under VMS conditions patients with the weaker balance control problem were more sensitive to balance control than simple comfortable standing conditions with opened and closed eyes. (J Korean Acad Rehab Med 2005; 29: 297-302)

Objective
The aims of this study were to verify that the newly developed ankle control elastic band (ACE band) can improve the gait pattern of hemiplegic patients by assessment of objective and subjective data. Method: ACE band consisted of medial ring, lateral ring, and elastic band was devised and 11 ambulatory stroke patients were evaluated with gait measurements, functional ambulation categories (FAC), functional reach test (FRT), and questionnaires for the effect of ACE band. Gait measurements were of 10 m walking time, cadence, stride length, stride period, stance phase, single support time, and single support time asymmetry ratio. Results: Gait measurements with the ACE band showed significant improvement (p＜0.05 or p＜0.01). FAC and FRT with the ACE band were significantly increased (p＜0.01), and the questionnaires suggested that wearing the ACE band helped improve toe dragging, swinging leg forward, taking weight through foot, confidence of gait, safety of gait, gait distance and gait velocity. Conclusion: ACE band was invented for improvement of hemiplegic gait, and its evaluation of gait measurements, FAC, FRT, and questionnaire showed that the ACE band was effective for hemiplegic gait after stroke. (J Korean Acad Rehab Med 2005; 29: 303-308)

Objective
To investigate the change in plantar skin temperature in normal subjects wearing five different kinds of insoles. Method: Twenty normal subjects were chosen and were made to walk on a treadmill for five 30-minute sessions wearing the same shoes, and wearing five different kinds of insoles (four types were endothermic insoles, but one type was a normal insole) respectively. Subjects sat on a chair for 10 minutes before and after walking. The plantar skin temperature was recorded on 4 sites (from channel 1 to 4) on each left insole. The plantar skin temperature was recorded every 10 seconds for a total of 50 minutes, with T-type Thermocouple^Ⱂ.Results: There were no statistical differences in the change of plantar skin temperature for each insole before, during and after walking. No statistical differences in subjective thermal sense and Borg Rating on perceived exertion scale for each insole before, during and after walking. Time in peak plantar temperature was 25.9∼28.3 minutes (after subjects starts walking), wearing normal insole. Conclusion: There was no statistical difference in the change of plantar skin temperature for the five different kinds of insoles However, we found this method to be effective in examining plantar skin temperature during walking. (J Korean Acad Rehab Med 2005; 29: 309-316)

Objective
To verify the interrater and intrarater reliability of Korean Wolf Motor Function Test (K-WMFT) for assessing upper extremity function after stroke. Method: Twenty patients with chronic hemiparesis after stroke participated in the study. The Wolf Motor Function Test consists of 15 functional tasks. Performances were timed and rated by functional ability scale. The K-WMFT were administered to the subjects by an occupational therapist. All test sessions were videotaped and scored by 2 physiatrists and another occupational therapist to examine interrater reliability. They were reevaluated at a later time by thesame occupational therapist to examine intrarater reliability. Results: Intraclass correlation coefficient of the performance time of K-WMFT was 0.94 and that of the functional ability scale of K-WMFT was 0.99. Intrarater correlation coefficient of the performance time of K-WMFT was 1.00 and that of the functional ability scale of K-WMFT was 0.97. Conclusion: The interrater and intrarater reliability of K- WMFT were verified. K-WMFT can be used as a reliable tool to measure upper extremity function of the stroke patients in Korea. (J Korean Acad Rehab Med 2005; 29: 317-322)

VATER association represents vertebral defects, anal atresia, tracheo-esophageal fistula with esophageal atresia, renal abnormalities and radial limb dysplasia. The probability of the simultaneous occurrence of any three of these defects is so unlikely that it suggests a sporadic non-random association. This non-random association appears to be related to mesodermal defects in early developmental period. Weexperienced one case of VATER association in 21 months old male child having vertebral anomalies with severe scoliosis, rib defects, imperforated anus, right renal agenesis, lipomyelomeningocele, spinal cord tumor. We reported a case of VATER association with brief review of related literature. (J Korean Acad Rehab Med 2005; 29: 323-327)