CDMA망에서의 유선망 계획 및 설계 방법

오덕원 대한전자공학회 1997 대한전자공학회 심포지엄 논문집 Vol.- No.-

뇌졸중 환자에 대한 감각 훈련: 뇌졸중 재활의 중요한 기초

오덕원,박현주,심선미 한국신경근육물리치료학회(구 한국신경근육재활학회) 2015 한국신경근육재활학회지 Vol.5 No.1

In stroke rehabilitation, motor deficits have traditionally been in great attention owing to their influences on functional recovery, and in such reason, therapeutic focus of a variety of approaches should include the concepts of motor relearning. However, clinicians’ interest was not in sensory rehabilitation after stroke despite its essential role to guide normal motor control during daily routine tasks. Accordingly, this study aimed to demonstrate beneficial information for stroke rehabilitation to clinicians as well as provide the description about natures of sensory deficits after stroke and their effects to rehabilitation. Evidences support the effects of sensory rehabilitation therapy to improve sensory ability and hand function of patients with post-stroke hemiparesis. In particular, improvement of discriminative sense and proprioception may be more helpful to increase the level of functional activity. Although many studies have suggested the effects of various treatment methods to enhance sensory function, there was no actually apparent description about the effect size of a sensory re-education using rehabilitation approaches and its influence on physiological mechanism of sensory system. Recent systemic review focused on the necessity of further studies for defining the evaluation criteria with treatment-specific base in subject selection and the assessment of treatment effects appropriately. In general, the benefits of non-specific sensory stimulation have been well known in clinical setting; however, it’s not clear whether it can promote sensory function constantly. Therefore, further studies must be taken under special efforts to develop effective treatment methods for improving sensory deficits of patients with post-stroke hemiparesis. This study provides valuable information for future studies that explore favorable therapeutic solutions of sensory impairments after stroke.

만성 뇌졸중 환자들의 기능 향상을 위한 새로운 접근방법 : ‘신경근육 조절 및 재설정’ 개념의 이론적 배경

오덕원,원상희,박현주,강태우,심재훈 한국신경근육물리치료학회(구 한국신경근육재활학회) 2017 한국신경근육재활학회지 Vol.7 No.2

In stroke rehabilitation, a final goal addresses the successful return to premorbid life and community re-integration, which includes functional recovery and active participation in everyday activities. Individuals with post-stroke hemiparesis have been characterized by sensory and motor paralysis, decreased strength and endurance, spasticity, loss of dexterity, and cognitive deficit. These factors contribute to producing a variety of functional problems in gross and fine motors. In particular, reduced standing balance and walking dysfunction are major components to hinder independence in daily life after stroke; therefore, the recovery of walking function is considered as ultimate goal in stroke rehabilitation. Based on neurophysiological knowledge, numerous traditional approaches such as neurodevelopmental treatment, proprioceptive neuromuscular facilitation, and Brunnstrom and Rood approaches have been commonly used to restore their function, providing theoretical conception and therapeutic procedures to manage stroke patients. Taken under research-based results, recent trends have proven clinical efficacy of task-oriented training, which demonstrates motor learning principles and its contributions in neurological rehabilitation. However, despite training effects, adding basic procedures including the correction of joint malalignment and restoration of kinetic linkage of the body did not have great interest as possible option for reinforcing functional gains in stroke. It requires the development of more organized therapeutic approach based on resolving leading causes to functional problems. Novel concept of ‘Neuromuscular Control and Reset (NCR)’ provides possible mechanism of problem-solving strategies for detecting neutral positions of misaligned joints and keeping them by resetting the ability of neuromuscular control, which facilitates optimal motor control patterns in safe and effective templates. It comprises specific processes to address the correction of pathological joint mechanics, recovery of movement mechanics, and improvement of functional activities. This study describes the theoretical background for applying the NCR concept to regain the level of functional performance of patients with post-stroke hemiparesis.

뇌졸중 후 고유감각 손상에 대한 문헌 고찰

오덕원,박현주 한국신경근육물리치료학회(구 한국신경근육재활학회) 2018 한국신경근육재활학회지 Vol.8 No.2

Stroke leads to functional impairments related to proprioception deficits, which produce compensatory pattern to assure an independence in daily activities. Proprioception is one of essential elements to provide feedback and feedforward control, achieving appropriate motor control and learning. It’s fundamental for functional recovery after stroke. Proprioception is defined as a sense of position, motion, or force. It arises from sensory receptors (mechanoreceptors of muscle and joint) which locate in deep region of the body, or sensory receptors which locate in superficial region of the body. However, proprioception and tactile sense must be recognized to be different each other. Proprioceptors detect the change of proprioceptive information during posture and movement. Afferent information from proprioceptors plays an important role to build optimal motor control strategy for various activities in daily life, which needs integrative control in higher centers. This is completed by an integral mechanism interacting with a variety of environmental factors. Therefore, proprioception deficits after stroke result in serious functional problems. Although proprioceptive function has been essentially considered for functional recovery in clinical setting, there are many conflicts in evaluating the extent of its impairment. To test precisely proprioceptive function, it’s so important to understand that it requires working memory and interhemispheric connection to optimize proprioceptive integration in peripheral and central systems. Unfortunately, in stroke, neural control and its process frequently is difficult to be harmonized to achieve proper goal in motor control. In fact, such problems also contribute to the lack of beneficial treatment protocol in clinical setting. Therefore, clinicians should make an effort to develop objective, accurate, and reliable tools to measure proprioceptive function of patients with stroke. In addition, it needs to establish optimal treatment methods based on evaluation results. Accordingly, this study aimed to provide valuable information about peripheral and central mechanisms of proprioception, influences of proprioception deficits in stroke, and theeir evaluation and treatment using literature review.

지역사회 보행: 뇌졸중 재활에서 치료 계획 및 임상 의사결정을 위한 최종 목표

오덕원 한국신경재활학회 2013 한국신경근육재활학회지 Vol.3 No.1

특발성 척추측만증에 대한 물리치료의 임상적 적용 및 고려사항

오덕원,김선엽 대전대학교 기초과학연구소 2007 自然科學 Vol.18 No.-

특발성 척추측만증은 뚜렷한 원인 없이 나타나며, 전체 척추측만증 환자의 85%를 차지하고 있다. 대부분의 척추측만증이 성장이 진행되는 시기에 발생되므로 조기에 발견하여, 이에 합당한 치료를 시행하는 것이무엇보다도 중요하다 척추측만증은 근골격계의 문제와 심호홉기계의 문제뿐만 아니라 정서적인 문제까지유발할 수 있기 때문에 치료 시기를 놓치게 되면 심각한 합병증을 초래할 수도 있다. 그러나 척추측만증에대해 보편적으로 시행되고 있는 여러 치료 방법들에 대한 효율성이 분명히 입증되지 않았기 때문에 정확한치료 프로토콜이 설립되어 있지 않다 이에 본 연구는 특발성 척추측만증에 대한 이해를 높이고 최신 치료경향을 알아보기 위하여 문헌 고찰을 시행하였다 문헌 고찰의 결과로 미루어 보았을 때 보편적으로 사용되고 있는 보조기 , 바이오피드백 , 견인치료, 전기자극 치료 및 카이로프락틱과 같은 보존적인 방법들은객관적인 근거보다는 임상적인 효과가 더욱 강조되어 있다는 것을 알 수 있었다. 최근의 특발성 척추측만증에 대한 치료는 과학적인 방법으로 치료 효과가 입증된 치료적 운동에 많은 비중을 두고 있으며, 또한 이를 통한 신체적, 정신적인 긍정적인 효과들에 관심을 두고 많은 연구들이 시행되고 있다.

뇌졸중 환자들의 지역사회 보행을 위한 고려사항 : 문헌고찰

오덕원 청주대학교 보건의료과학연구소 2012 보건의료과학연구 Vol.1 No.1

In treating patients with post-stroke hemiparesis, the highest goal is to walk within their community without any difficulties and to promote the return to participation in their community. This study aimed to identify a variety of factors to influence on the improvement of the requirement skills in community ambulation by reviewing literatures. In patients with chronic stroke, community ambulation depends on physical and cognitive function associated with walking. Some factors have been considered to predict their ability for community ambulation: walking velocity, endurance, self-efficacy, attention, and strength. In addition, there are environmental components that should be included for suitable walking program for community ambulation. Recent studies support that walking training taken under actual community environment may be more beneficial to improve the skills for community ambulation, considering these factors. It is important that clinicians try to establish a treatment plan for them after full consideration and the recognition of community ambulation, and study effort should be continued to underline the necessity of community ambulation in stroke rehabilitation.

뇌졸중 재활에서 운동상상 훈련의 구성을 위한 이론적인 개념

오덕원 한국신경재활학회 2014 한국신경근육재활학회지 Vol.4 No.1

좌골신경통 환자에서 통증 및 기능 장애에 대한 신경가동화 기법의 효과

오덕원 청주대학교 보건의료과학연구소 2015 보건의료과학연구 Vol.3 No.2

This study aimed to demonstrate the effects of nerve mobilization technique in patients with sciatica. Two patients were volunteered to participate in this study. This study adopted single experimental A-B-A design (baseline, intervention, and withdrawal phases). Measurement sessions of subject1 were 3, 6, 8, and 2 in each phase respectively. Subject 2 performed 2 sessions for the baseline phase, 7 sessions for the follow-up phase, and 6 sessions for the intervention phase. Straight leg raise test was performed to measure th lower limb’s movement range. Data collected from subjects were more increased in the intervention phase than in the baseline phases, and trends of data point appeared to be increased during the intervention phase. This findings suggest that nerve mobilization technique may be beneficial to improve the ower limb’s range of motion. Further studies with large sample size and long-term follow-up are required in this field.

척수손상 환자들의 만성 통증 : 분류, 평가, 치료방법에 대한 문헌 고찰

오덕원 한국신경근육물리치료학회(구 한국신경근육재활학회) 2016 한국신경근육재활학회지 Vol.6 No.2

Chronic pain may be one of major challenging factors to interfere the functional recovery and rehabilitation of persons with spinal cord injury, regardless either incomplete or complete paralysis. Hence, it needs to provide a literature review for establishing optimal protocol and guideline of treatment and management of chronic pain after spinal cord injury. The aims of this study were to describe prevalence, classification, assessment, and therapeutic intervention of chronic pain after spinal cord injury by reviewing literatures. Severity and quality of the pain might not be different depending on the completeness and level of injury. Types of pain can be classified into ‘nocioceptive pain’, ‘neuropathic pain’, and ‘unknown pain’. Musculoskeletal pain is most prevalent in patients with spinal cord injury, followed by neuropathic and visceral pains. In general, clinical decision-making process to decrease chronic pain of spinal cord injury should depend on the types of pain. Use of valid and refined assessment tools are imperative to build the efficacy of treatment and management of chronic pain, and prevent the complications of chronic pain. Despite the lack of evidence of pharmacological management, medication has been known to be beneficial to control pain condition following spinal cord injury. In addition, physical therapy, including therapeutic exercise and massage, stimulation of central nerve system such as brain and spinal cord injury, and acupuncture may be favorable therapeutic options to reduce the perceived level of pain. Based on biopsychosocial mechanisms of chronic pain, psychological interventions is helpful to develop coping strategies, cognitive-behavioral treatments, and social supports. Therefore, clinicians are necessary to include pain control management in creating rehabilitation plan and treatment protocol, facilitating functional recovery and rehabilitation to return to community and premorbid life.