주파수에 따른 신경근전기자극치료가 중증 만성폐쇄성폐질환 환자의 호흡근력, 넙다리네갈래근 활성도 및 삶의 질에 미치는 영향

강정일 ( Jeong-il Kang ),정대근 ( Dae-keunjeong ),박준수 ( Jun-su Park ) 대한물리의학회 2019 대한물리의학회지 Vol.14 No.3

PURPOSE: To solve the problems of chronic obstructive pulmonary disease (COPD) patients complaining of muscle fatigue and having limited motor abilities, this study provided the clinical basic data for pulmonary rehabilitation by examining the effects of High·Low-Frequency Neuromuscular Electrical Stimulation (NMES) on the respiratory muscle strength, quadriceps muscle activity, and life quality. METHODS: Samples were collected from 20 COPD patients and placed randomly in a low-frequency group (n=10) and high-frequency group (n=10). For a pretest, the respiratory muscle strength (MIP, MEP), quadriceps muscle activity (LF, VM, VL), and life quality (SGRQ) were measured. After applying NMES to each group for 30 minutes at a time, five times a week, for four weeks, a posttest was conducted in the same way as the pretest. RESULTS: Both groups showed significant differences in the respiratory muscle strength, quadriceps muscle activity, and quality of life within the groups and there were significant differences in the quadriceps muscle activity between the groups. CONCLUSION: The four-weeks NMES positively influenced the respiratory muscle strength and life quality by enhancing the function of the quadriceps and exercise tolerance. In particular, high-frequency(75 ㎐) NMES was more effective than low-frequency (15 ㎐) NMES. This result can be an alternative means to improve the physical functions of COPD patients clinically in the future.

A Study on Risk Factors of Chronic Lung Disease That Threatens National Happiness

Jeong-Il Kang(강정일),Dae-Keun Jeong(정대근) 한국엔터테인먼트산업학회 2015 한국엔터테인먼트산업학회논문지 Vol.9 No.3

국민의 건강을 위협하는 만성질환 중 폐질환은 현재 우리나라에서 사망률 4위로 오를 정도로 그에 따른 관심 또한 고조되고 있는 현실이다. 우리가 알고 있는 만성폐질환에서 골다공증의 위험인자로는 흡연, 낮은 체질량지수, 성선 저하, 비타민 D감소, 과도한 스테로이드 투약과 활동력 저하 등이 알려져 있지만, 폐기능의 시기별 요인 중 골다공증의 관련성이 높은 요인과 시점을 파악하는 것 역시 중요한 요소임을 인식하고 중재를 함에 있어 유념해야 할 필요성이 제시된다. 본 연구에서는 실험군I 보다 실험군II, 실험군III, 실험군IV에서 골밀도가 더 낮아짐을 나타내어 폐질환과 노출됨과 동시에 골다공증에 상당한 위험에 처해 있는 사실을 알 수 있었으며, 적혈구 수는 실험군IV, 실험군III, 실험군II 보다 실험군I에서 낮게 나타났고, 백혈구와 C-단백수치에서는 실험군I 보다 실험군III에서 높았으며, 실험군IV에서 가장 높게 나타났다. 혈청검사의 특징으로는 신체적 염증반응들은 주로 중증에서 심화되는 것으로 나타났고, 흡연과 스테로이드제의 사용역시 골다공증을 일으키는 위험요소로 작용하는 결과를 알 수 있었다. 향 후 임상에서 폐질환 환자의 치료지침을 설정함에 있어 비록 경증 단계라고 하더라도 폐기능의 치료뿐만 아니라 골다공증과 그 위험요소를 같이 인식할 필요성이 제시되며, 폐질환을 관리하는데 중요한 사항 중 하나로 사료된다. This study aims to compare the change patterns vs. risk factors of osteoporosis depending on the classification of the severity of pulmonary function in patients with chronic pulmonary disease, identify the highly relevant factors and points of time among the patient"s period-specific factors, and provide basic analytical data of osteoporosis in patients with chronic pulmonary disease. This study targeted 48 outpatients who were receiving outpatient treatment after being diagnosed with chronic obstructive pulmonary disease at H hospital located at South Jeolla Province. All of them were classified into four groups depending on the classification of the severity of GOLD, and bone density was measured from each group in order to measure and compare the related risk factors. As a result, there was a significant difference in body weight, BMI, FEV1 in FEV1/FVC (p<0.001); there was also a significant difference in changes of T-score between experimental groups (p<0.01); and there was a significant difference in red blood cell count, white blood cell count, and C-protein and erythrocyte sedimertation rate (p<0.01)(p<0.01). It was found that patients with chronic obstructive pulmonary disease were exposed to diseases and simultaneously to the risk of osteoporosis. Physically, inflammation reactions got worse largely in serious cases. Smoking and steroid use were also risk factors. Thus, it is considered that the risk factors should be recognized simultaneously according to the classification of severity as well as pulmonary function in treatment manuals for the patients with chronic obstructive pulmonary disease.

깊은 목굽힘 강화운동이 만성뇌졸중 환자의 폐기능과 호흡근활성도에 미치는 영향

강정일(Jeong-il Kang),정대근(Dae-Keun Jeong) 인문사회과학기술융합학회 2019 예술인문사회융합멀티미디어논문지 Vol.9 No.9

본 연구는 뇌졸중 환자에게 깊은 목 굽힘 강화운동을 중재하여 호흡근의 변화와 예후 및 폐기능 정도를 파악함으로써 호흡의 기능향상을 위한 임상적 중재방법 설정에 대한 임상적 기초자료를 제시하고자 한다. 실험 전 호흡근 운동을 중재한 9명을 대조군으로 호흡근 운동을 병행하여 깊은 목굽힘 강화운동을 중재한 11명을 실험군으로 중재 전 폐활량측정기를 이용하여 폐기능을 알아보고 호흡보조근 활성도를 알아보기 위하여 표면근전도를 측정한 후 이들의 항목을 동일하게 재측정하여 비교 분석하였다. 실험결과 대조군 집단 내 변화비교에서는 FEV1과 FVC에서 유의하게 증가하였으며(p<0.05), 목빗근과 앞목갈비근에서 유의한 차이가 있었다(p<0.05). 실험군 집단 내 변화비교에서 폐기능은 FEV1과 FVC에서 유의한 차이가 있었으며(p<0.01)(p<0.05), 목빗근과 앞목갈비근에서 유의하게 증가하였다(p<0.001). 집단 간 변화비교에서는 목빗근과 앞목갈비근에서만 차이가 있었다(p<0.05). 뇌졸중 환자에게 깊은 목 굽힘강화 운동은 이 근육들의 협응능력을 잘 유지하여 잘못된 수축을 감소시켜 호흡을 보조해주기 위한 중재방법으로 향 후 뇌졸중 환자에게 호흡운동 시행 시 목의 기능적인 측면을 향상하기 위한 연구가 필요할 것으로 판단된다. The purpose of this study is to present clinical basic data on the establishment of clinical intervention method for improvement of respiratory function by understanding the changes of respiratory muscle, prognosis and pulmonary function by mediating deep neck flexion exercise in stroke patients. Nine patients who mediated respiratory muscle exercise before the experiment as a control group, and 11 patients who mediated deep neck flexion exercise by the respiratory muscle exercise as a control group. Four weeks after measuring EMG, the items were re-measured in the same manner and analyzed. The experimental results showed that the change in the control group was significantly increased in FEV1 and FVC (p<0.05) and significantly increased in the neck and anterior ribs (p<0.05). Pulmonary function was significantly different between FEV1 and FVC (p<0.01) (p<0.05) and significantly increased in neck and anterior ribs (p<0.001). There was a difference only between the neck and anterior ribs in the comparison of changes among the groups (p<0.05). Deep neck flexion exercise for stroke patients is a mediation method to maintain the joints of these muscles to reduce false contraction and to assist breathing. I think it will be necessary

신경근 재교육이 뇌졸중 환자의 신체구성, 혈액점도 및 신체운동기능에 미치는 영향

강정일,백현희,신홍철,Kang Jeong-IL,Beak Heon-Hee,Shin Hong-Cheul 대한물리치료학회 2003 대한물리치료학회지 Vol.15 No.4

This study aims to investigate the effect of Neuromuscular Re-education Program and Traditional Intervention Program and is focusing on the difference between changes of experimental before and after on 30 stroke patient's body composition, blood lipid levels, physical motor function. The obtained results are as follows; 1. Change in body composition 1) The change due to the Neuromuscular Re-education Program and Traditional Intervention Program before and after, the Fat Mass and Soft Lean Mass were changed but not significantly. 2) In the comparison of change according to duration, Significant differences were not shown in Fat Mass and Soft Lean Masss between The experimental group and control group. 2. Change in blood lipid levels 1) The change due to the Neuromuscular Re-education Program and Traditional intervention Program before and after, the Cholesterol, Glucose and TG were changed but not significantly. 2) In the comparison of change according to duration, Significant differences were not shown in the Cholesterol, Glucose and TG between the Experimental group and Control group. 3. Change in physical motor function 1) The change due to Neuromuscular Reeducation Program before and after. The physical motor function was significantly changed(p<0.01; p<0.05). but Traditional Intervention Program was changed but not significantly. 2) In the comparison of change according to duration, Signicant differences between the Experimental group and Control group was significantly changed in only the Neuromuscular Reeducation Program(p<0.05). In conclusion, The Neuromuscular Reeducation Program were not changed significantly but it can be said that the Neuromuscular Reeducation Program was more suitable for intervention to improve physical motor function of stroke patients than Traditional Intervention Program. Therefore if further studies increase the experimental duration of Reeducation Program and make the patient's reeducation continuously for improvement of physical motor function in stroke patient are needed.

0.5보다 큰 시비율로 동작하는 전류원 하프-브릿지 컨버터의 무손실 스너버 설계

강정일(Jeong-il Kang),한상규(Sang-Kyoo Han),윤현기(Hyun-Ki Youn),김정은(Chong-Eun Kim),윤명중(Myung-Joong Youn),김윤호(Youn- Ho Kim) 전력전자학회 2002 전력전자학술대회 논문집 Vol.- No.-

전류원 컨버터는 전압원 컨버터에 비해 스위치 차단 시 발생하는 서지에 연루되는 에너지가 커, 무손실 스너버가 필수적인데, 이 스너버는 그 동작원리가 복잡하고 동작조건이 바뀜에 따라 성능의 변동이 심하여 설계가 어렵고, 적용되는 회로에 따라서도 설계식이 달라진다. 본 논문에서는 0.5 이상의 시비율로 동작하는 전류원 하프-브릿지 컨버터를 위한 무손실 스너버의 동작을 완전히 분석하고 설계사항에 대해 고찰한 뒤 실험을 통해 검증한다.

시간 지연 제어를 이용한 영전압 스위칭 PWM 하프 브릿지 컨버터의 제어 성능 개선

강정일(Jeong-il Kang),정영석(Young-Seok Jung),이준영(Jun-Young Lee),윤명중(Myung-Joong Youn) 전력전자학회 1998 전력전자학술대회 논문집 Vol.- No.-

A switching power stage is a very nonlinear system because it has two or more operation modes in one switching cycle To model a switching power stage, the state space averaging method has been developed. Though it allows a unified treatment of a large variety of switching power stages, the model it yields is always very nonlinear. So, it is required to linearize the averaged model But it is well known that a controller for a nonlinear plant designed by the linearization frequently fails in showing satisfactory control performance. Hence it is very natural to try to design a nonlinear controller for a switching power stage. In design of a switching power system, nonlinear control approaches such as adaptive control and fuzzy control have been widely studied so far. In this research, a recently developed control method, time delay control is briefly studied and a design example for a ZVS PWM half bridge converter is given. The performance of the time delay controller is compared to its conventional counterpart, PI controller by computer simulations.<br/> <br/>

전류연속 모드 탭인덕터 부스트 컨버터의 분석과 설계

강정일(Jeong-Il Kang),한상규(Sang-Kyoo Han),한종희(Jonghee Han) 전력전자학회 2014 전력전자학회 논문지 Vol.19 No.4

중증 만성폐쇄성폐질환 환자를 위한 복합호흡운동과 신경근전기자극의 효과

강정일(Jeong-Il Kang),박준수(Jun-Su Park),정대근(Dae-Keun Jeong) 한국엔터테인먼트산업학회 2019 한국엔터테인먼트산업학회논문지 Vol.13 No.7

복합호흡운동과 넙다리네갈래근의 신경근전기자극 치료가 중증 만성폐쇄성폐질환 환자들의 폐기능과 대뇌겉질 활성도에 미치는 효과를 알아보고자 하였다. 60~80세 중증 만성폐쇄성폐질환 환자 20명을 대상으로 실험군은 복합호흡운동과 넙다리네갈래근의 신경근전기자극을, 대조군은 복합호흡운동만을 실시하였다. 사전 검사로 폐기능과 대뇌겉질 활성도를 측정하였고, 중재는 6주 간, 주 4일, 1일 1회, 30분씩 각 집단에 시행한 후, 사후검사를 사전검사와 동일하게 재측정하였다. 그 결과 집단 내 폐기능 변화는 실험군과 대조군 모두 1초간 노력성 날숨량에서 유의한 차이가 있었고(p<.001)(p<.05), 집단 간 폐기능 변화 비교에서 1초간 노력성 날숨량의 변화는 유의한 차이가 있었다(p<.05). 집단 내 대뇌겉질의 영역 별알파파 변화 비교에서는 Fp1, Fp2, F3, F4 영역에서 대조군과 실험군 모두 유의한 차이가 있었다(p<.01)(p<.05). 따라서 6주 동안의 복합호흡운동과 넙다리네갈래근의 신경근전기자극은 중증 만성폐쇄성 폐질환들의 폐기능을 향상시키고, 대뇌겉질 활성도에서 앞이마부 영역의 알파파가 증가되어 긍정적인 호흡의 변화가 나타났음을 알 수 있었다. 따라서 중증의 만성폐쇄성폐질환 환자들에게 복합호흡운동 뿐만 아니라 부가적으로 넙다리네갈래근에 신경근전기자극을 병행하면 보다 좋은 치료적 효과를 볼 수 있을 것으로 생각된다. This study was designed to examine the effects of complex breathing exercise and neuromuscular electrical stimulation of Quadriceps Femoris muscle on pulmonary function and cerebral cortex activity in patients with severe chronic obstructive pulmonary disease. After collecting samples from 20 patients with severe chronic obstructive pulmonary disease aged 60 to 80, 10 patients each were randomly placed in an experimental group and a control group. The experimental group conducted complex breathing exercise and neuromuscular electrical stimulation of Quadriceps Femoris muscle, and the control group only conducted complex breathing exercise. As a pretest, pulmonary function and cerebral cortex activity were measured. The intervention program was applied to each group for 30 minutes, once a day, for 4 days a week, for 6 weeks, and the posttest was carried out the same way as the pretest. As a result, both groups showed significant differences in FEV1.0(Forced Expiratory Volume in One Second)(p<.001)(p<.05), and there were significant differences between the groups as well(p<.05). When comparing alpha waves in each domain of cerebral cortex, both of the experimental and control groups showed significant differences in Fp1, Fp2, F3 and F4 domains (p<.01)(p<.05). During the 6-week experiment, complex breathing exercise and neuromuscular electrical stimulation of Quadriceps Femoris muscle improved pulmonary function of patients with severe chronic obstructive pulmonary disease, and in relation to cerebral cortex activity, a positive breathing change was found due to the increase of alpha waves in the forehead domain. Therefore, it is considered that applying neuromuscular electrical stimulation of Quadriceps Femoris muscle to patients with severe chronic obstructive pulmonary disease additionally along with complex breathing exercise will bring a better therapeutic effect.

자가 신장운동이 전방머리자세를 동반한 만성 목통증 환자의 자세개선에 미치는 영향

강정일 ( Jeong-il Kang ),정대근 ( Dae-keun Jeong ),박승규 ( Seung-kyu Park ),양대중 ( Dae-jung Yang ),김제호 ( Je-ho Kim ),문영준 ( Young-jun Moon ),백승윤 ( Seung-yun Baek ) 대한물리의학회 2020 대한물리의학회지 Vol.15 No.3

PURPOSE: The purpose of this study was to provide clinical basic data to reduce pain and improve function by comparing neck muscle activity and neck alignment using self-stretching and passive stretching exercises for chronic neck pain caused by forward head posture. METHODS: The subjects were divided into 15 subjects assigned to perform self-stretching exercise and 15 subjects assigned to perform passive stretching exercise. The intervention was conducted for a total of 4 weeks. The muscle activity in the neck was measured by surface electromyography (EMG) before intervention, and craniovertebral and cranial rotation angles were measured by X-ray. The 4-week intervention was conducted and the above items re-measured in the same manner and analyzed. RESULTS: Muscle activity within both groups after intervention using self-stretching or passive stretching exercise was significantly different (p < .05)(p < .01). Neck alignment of both groups was significantly different (p < .001)(p < .01). Further, muscle activities of the upper trapezius and splenius capitis muscles showed significant differences (p<.05). Lastly, neck alignment showed statistically significant difference (p < .05). CONCLUSION: Self-stretching exercise activated motor nerves as a posture correction exercise, thereby improving inhibition of muscle activity, muscle contraction delay, and pathological conditions of the muscle. For future research, interventions of self-stretching exercise will be needed for patients with chronic back pain accompanied by forward head posture, and various clinical studies on postural improvement of forward head posture by maintaining a normal muscle tone state are needed.

새로운 위상전이 병렬입력/직렬출력 모듈화를 적용한 듀얼 컨버터

강정일(Jeong-il Kang),노정욱(Chung-wook Roh),한상규(Sang-Kyoo Han),윤명중(Myung-Joong Youn) 전력전자학회 2000 전력전자학술대회 논문집 Vol.2000 No.11

A new phase shift PWM parallel-input/series-output modularized dual converter is proposed in this paper, This converter is operated with a fixed duty ratio and its output voltage is regulated by phase shift between each module, Since the operating duty ratio of each module is fixed, it is sufficient to implement a simple open loop drive circuitry for each module and the cost of total system can be much reduced, The operation of the converter is analyzed in this paper and verified by computer simulation