기능적 전기 자극을 사용한 호흡보조훈련이 사지마비 환자의 호흡기능에 미치는 효과

장우남 ( Woo-nam Chang ),민원규 ( Won-kyu Min ),이혜경 ( Hye-kyeong Lee ) 대한신경치료학회 2016 신경치료 Vol.20 No.2

Purpose Paralysis of abdominal muscles is the main cause of respiratory dysfunctions in patients with cervical spinal cord lesion. Activation of the abdominal muscles using functional electrical stimulation (FES) improved respiratory function in these patients. However, studies evaluating the effect of assisted respiratory training using FES on abdominal muscles in tetraplegia with cervical spinal cord lesion are sparse. Methods FES was applied to the abdominal muscles. Respiratory function tests were performed before and after therapy, and at 2 weeks follow-up. In addition to chest physical therapy, patients received training to improve respiratory function (experimental group) or training for increasing muscle tone of lower limb (control group). Both groups received 10 hours of additional training on FES; 30 minutes a day, 5 times a week, for 4 weeks. Results After 4-week therapy, both groups displayed significant improvement in their MIC, FVC, FEV1, assisted PCF, and unassisted PCF (p<0.05). At the follow-up test (2 weeks after 4-week therapy), the experimental group was improved cough capacity (APCF and UPCF), compared with in the control group (p<0.05). Conclusion Our results suggest that, in addition to chest physical therapy, FES over the abdominal muscles aimed at improving respiratory function and cough capacity in cervical spinal cord injury with tetraplegia have beneficial effects on maintaining and developing a cough function.

어깨내밈 촉진이 뇌졸중 환자의 팔 기능과 균형에 미치는 효과

장우남 ( Woo-nam Chang ) 대한신경치료학회 2018 신경치료 Vol.22 No.2

Purpose This study aimed to investigate the effect of facilitating shoulder protraction on upper limb function, static and dynamic balance in hemiplegic patients with stroke. Methods A total of 23 patients were randomly allocated into either the study group (SG) of 13 patients or the control group (CG) of 10 patients, respectively. All subjects in the two groups were trained for 30 minutes a session, 10 sessions for 2 weeks. Manual Function Test (MFT) for the upper limb function, Functional Reaching Test (FRT) and Timed Up and Go Test (TUG) for the balance, and the 2D video analysis program (Dartfish ProSuite 9.0) for the trunk displacement and elbow extension angles during reaching to grasping were used for the outcome measures. Results In the result of the MFT and TUG, there were significantly improvements in the SG, within and between the groups. FRT was significantly increased in distances in both groups, within and between the groups. During the arm reaching to the task for grasping on the table, elbow extension angle was significantly increased and trunk forward displacement was decreased in the SG. Conclusion This study demonstrated that facilitation of shoulder protraction showed significant improvements in function of the affected upper limb and postural control by decreasing compensatory trunk strategies during arm reaching.

보바스개념에 근거한 체간 촉진이 체간정렬과 체중분포에 미치는 효과

장우남 ( Woo-nam Chang ),김중환 ( Jung-hwan Kim ),황병용 ( Byong-yong Hwang ) 대한신경치료학회 2017 신경치료 Vol.21 No.3

Purpose The purpose of this study was to investigate the effects of trunk facilitation based on the Bobath concept on trunk alignment and weight distribution on standing in patients with stroke. Methods This study was designed as an assessor-blinded, randomized controlled trial. A total of 27 stroke patients were randomly allocated into the two groups: trunk facilitation group (n=14), and conventional physiotherapy group (n=13). All the patients were trained for 30 minutes a day, 5 times a week for 5 weeks. Results The mean age of the patients in the study group was 50.29 years and that of the control group was 52.54 years. In the results of the trunk alignments, there were significant decreases in spinal length(VP-DM), forward trunk inclination in sagittal plane, trunk imbalance in frontal plane and thoracic angle in the trunk facilitation group(p<0.05). But, there was no difference between the two groups. There were significant increases in backward weight distribution and covered area on affected foot(p<0.05). There was a significant decrease in the forefoot pressure of the unaffected limb in standing(p<0.05). Between the two groups, there were significant difference in the AP weight distribution, covered area on the affected foot, and forefoot pressure on the unaffected foot(p<0.05). Conclusion The study was demonstrated that the trunk facilitation based on the Bobath concept showed significantly recovery of midline orientation in standing posture.

디지털경사계를 사용한 체간재위치오류 검사의 신뢰도 분석

장우남,이경보,염준우,황병용,Chang, Woo-Nam,Lee, Kyoung-Bo,Yeom, Jun-Woo,Hwang, Byong-Yong 대한물리치료학회 2013 대한물리치료학회지 Vol.25 No.4

Purpose: A cost effective tool for the clinical measurement of trunk reposition sense is clearly needed. This study was to analyze intrarater and interrater Reliability of trunk repositioning error (TRE) test which assesses trunk position sense using a portable digital inclinometer. Methods: Twenty four normal healthy subjects were recruited. TRE was measured using a portable digital inclinometer. A digital inclinometer (Acumar-ACU360; Lafayetter Instrument) with precision to $1^{\circ}$ was placed on skin over the spinous process from first to second thoracic vertebra (T1-T2) and secured with double-sided tape. TRE test during sitting forward and lateral flexion movement was assessed. When they reached a point approximately 50% of full trunk flexion range, the examiner instructed the subjects to stop and told them. This was the target position that they should try to reproduce exactly. Each subject performed six trials. Results: ICC (2,1) for intrarater reliability (with-day and between-day) of TRE test in sagittal and frontal plane of movement was 0.75 and 0.78 (excellent reliability). Interrater reliability was 0.66 in sagittal and 0.64, frontal plane (fair to good reliability). However, there were poor correlations between an average of TRE test in sagittal and frontal plane. Conclusion: TRE test using a portable digital inclinometer demonstrated good to excellent reliability. The device may be a cost effective clinical measurement for trunk reposition sense measurement.

편마비 환자의 밀기증후군 유무에 따른 기능 회복의 특성

김승원,장우남,황병용,Kim Seung-Won,Chang Woo-Nam,Hwang Byong-Yong 대한물리치료학회 2003 대한물리치료학회지 Vol.15 No.4

A 'pusher syndrome' encompassing postural imbalance and hemi-neglect is believed to aggravate the prognosis of stroke patients. The patients with pusher syndrome show a particular posture that pushing away from the unaffected side of the body. The objective of this study was to investigate associated proprioception, associated neuro-psychological symptoms and characteristics of functional outcome with and without pusher syndrome. The subjects of this study were 58 acute stroke patients who been rehabilitated at two university hospitals in Seoul and Buchun. Data were collected using proprioception test and line bisection test. The ability of ADL was assessed by the Modified Barthel Index, transfer by the Functional Independence Measure, and balance by the Modified Motor Assessment Scale. The results were that significant difference was found in the presence of proprioception, in the incidence of hemineglect and anosognosia, and in the score of ADL, transfer and balance between patients with and without pusher syndrome. Patients without pusher syndrome gained more motor score than patients with pusher syndrome. From improvement of view, patients with pusher syndrome gained the lowest score in ability of transfer. The finding suggest that the patients with pusher syndrome is a poorer functional outcome, be related to proprioception, hemineglect and anosognosia.

체간조절이 앉은 자세와 선 자세에서 균형에 미치는 영향 - 성인 보바스 치료를 적용하여

은나래 ( Na-rae Eun ),장우남 ( Woo-nam Chang ),송보경 ( Bo-kyung Song ) 대한신경치료학회 2015 신경치료 Vol.19 No.3

The purpose of this study is to find out how the trunk stability and trunk posture control ability affect the balance and the gross-motor functional movement of children with cerebral palsy in sitting and standing postures. Methods The two children with cerebral palsy of spastic type were participated in this study. The two girls`` age is 11 years and 13 years old. They received the intervention of trunk control of bobath concept. Therapeutic interventions have received treatment for 4 weeks, 30 minutes a day, and the score was measured every week by using the assessment tool of SAROMM, PBS and GMFM-88. Results Before and after the trunk control intervention of bobath concept, The score of SAROMM, PBS and GMFM-88 showed a improvement in which the balance ability and the gross-motor functional movement. Conclusion The trunk control of bobath concept can be a way to improve the gross-motor functional movement and balance of sitting and standing postures of children with cerebral palsy.

마비쪽 팔의 플레이싱 훈련이 뇌졸중 환자의 팔 뻗기 동작에 미치는 효과: 단일사례연구

박혜미 ( Hye-mi Park ),장우남 ( Woo-nam Chang ) 대한신경치료학회 2019 신경치료 Vol.23 No.2

Purpose The purpose of this study was to investigate the effects of facilitating paretic arm through placing training in variety space with single case report. Method The subject was elderly men aged 55. The intervention was performed for 1hour per section, 13 times in total. The outcome measure was used 2D video analysis program (Dartfish ProSuite Express) for the angle of upper limb motion segment and measuring arm reach time with video analysis. In a supine position, a subject’s arm was reached vertically with being opened wirst and finger by the therapist, and then maintaining the arm in space. This process was under the assistance of a therapist. Since then, resistance and task-oriented exercises were additionally implemented. Result In a supine position, the compensatory angle of shoulder joint abduction decreased and the supination of wrist joint increased. Improving supine position also helped improve arm functional movement in a sitting position. The angle of shoulder flexion was increased, and the compensatory angle of shoulder abduction was decreased. Also, the time it took to reach subject’s arms 90 degrees from supine position was significantly reduced. Conclusion This study demonstrated placing training on reaching movement showed significant improvement in function of the affected upper limb reaching movement.

마비쪽 발목의 키네지오테이핑이 만성뇌졸중 환자의 아래다리근 활성도와 보행에 미치는 효과

최유식 ( Yu-sik Choi ),손동백 ( Dong-baek Son ),정상미 ( Sang-mi Jung ),장우남 ( Woo-nam Chang ) 대한신경치료학회 2021 신경치료 Vol.25 No.2

Purpose This study was conducted to identify the effect of Kinesio-taping on the paretic ankle for changes in Electromyography (EMG) activity, gait in Chronic Stroke Patients. Methods Sixteen patients were selected for the study and randomly divided into the experimental (n = 8), and the control group (n = 8). The flexible Kinesio-taping was attached on the skin of the study group patients. And inflexible taping was attached on the skin of control group patients. The tape was attached on the fibularis longus, fibularis tertius, extensor digitorum longus, and tibialis anterior muscle. The intervention was provided for five sessions per week for four weeks with each session lasting 30 minutes. EMG, the Time Up and Go Test (TUG), and the 10 Meter Walk Test (10MWT) were used to measure changes in variables before and after the intervention. Results There were statistically significant differences before and after the intervention especially in the paretic tibialis anterior of the experimental group, who performed Kinesio-taping for the paretic ankle (p< .05). While other parts of the leg showed some increase or decrease, the differences were not significant (p >.05). A comparison of the groups showed a statistically significant difference between the experimental group and the control group in the paretic tibialis anterior (p<.05). In the TUG and 10MWT, the experimental group and the control group showed significant changes in variables before and after the intervention (p< .05). A comparison of the groups showed no statistically significant difference between the experimental group and the control group (p >.05). Conclusion Kinesio-taping on the paretic ankle for 4 weeks has an effect on muscle activity changes in the paretic tibialis anterior and improving gait speed for stroke patients.

어깨뼈근의 등척성 훈련이 뇌졸중 환자의 몸통근 활성과 몸통조절에 미치는 효과

박영훈 ( Young-hun Park ),조현준 ( Hyun-joon Cho ),장우남 ( Woo-nam Chang ) 대한신경치료학회 2021 신경치료 Vol.25 No.3

Purpose This study was to identify the effects of isometric training of the scapular muscles on trunk muscle activity and trunk control in patients with stroke. Methods A total of 25 subjects with stroke were recruited. Subjects were assigned as block randomization to either the study group (n = 13), or the control group (n = 12). Electromyography (EMG) measured muscle activation of trunk flexor and extensors, and trunk control was measured with a Trunk Impairment Scale (TIS). Results Isometric training was significantly improved in the symmetricity of erector spinae thoracic (p<0.05). Trunk control was significantly increased in TIS score (p<0.05). Conclusion Isometric training of the scapular muscle can improve trunk muscle activity symmetry and trunk muscle control in patients with stroke.

목뼈 안정화 훈련이 뇌졸중 환자의 자세정렬 및 균형에 미치는 효과: 단일사례연구

이구형 ( Ku-hyoung Lee ),안광빈 ( Kwang-bin An ),장우남 ( Woo-nam Chang ) 대한신경치료학회 2021 신경치료 Vol.25 No.2

Purpose The purpose of this study was to investigate the effects of cervical stabilization on postural alignment and balance in patient with stroke. Methods The study was designed in ABA format with a single subject design. The study was conducted on men diagnosed with a 52-year-old stroke, and after 30 minutes of cervical stabilization training in supine and sitting, 20 minutes of functional movement exercise were conducted with cervical stabilization orthosis, 50 minutes a day, 5 times a week for two weeks. Craniovertebral Angle(CVA), Functional Reach Test(FRT), Modified Functional Reach Test(MFRT), Timed Up and Go test(TUG) and collected information every time. Results As a result of the study, the CVA, FRT, MFRT showed significant changes in both baseline and regression period after intervention. There was no significant change in the total time of the TUG, but the sit to stand time increased and the walking speed increased. Conclusion This study demonstrates that cervical stabilization training has shown significant improvements in posture alignment and balance in stroke patient.