뇌졸중 후 편마비 환자의 Global Synkinesis 수준이 보행능력에 미치는 영향

임재헌,임영은,김수현,박경순,김태열,Lim, Jae-Heon,Lim, Young-Eun,Kim, Su-Hyon,Park, Kyeong-Soon,Kim, Tae-Youl 대한물리치료학회 2008 대한물리치료학회지 Vol.20 No.3

Purpose: We determined the effect of global synkinesis(GS) on gait ability, muscle contraction, and central neuron action potentials in post-stroke hemiplegic subjects. Methods: Thirty hemiplegia patients were evaluated for walking ability, muscle contraction, central neuron action potential, and comparing differences between the H-GS(high-global synkinesis) group and L-GS(low-global synkinesis) group. To obtain the GS level, surface electromyography(EMG) data were digitized and processed to root mean square(RMS). Walking ability was tested with a modified motor assessment scale(MMAS), a 10 m walking test, timed up and go(TUG) test, and a Fugl-Meyer assessment(FMA). Muscle contraction ability was measured as maximal isometric contraction(MIC) peak, MIC slope, and MIC ramp up using mechanomyography(MMG). Central neuron action potential was measured as the H/Mmax ratio or V/Mmax ratio using EMG. The data were analyzed with t-tests to determine the statistical significance. Results: MMAS(p<0.01), 10 m walking velocity(p<0.01), TUG(p<0.01), FMA-HKA(Hip, Knee, Ankle)(p<0.05), FMA-coordination(p<0.05), MIC peak (p<0.05), MIC slope(p<0.01), and MIC ramp up(p<0.05) were significantly different between H-GS and L-GS, as was the V/Mmax ratio(p<0.05), but H/Mmax was not. Conclusion: Lower GS levels indicated better walking ability and motor function. Therefore, intervention programs should consider GS levels in gait training of chronic hemiplegia.

협응이동훈련을 위한 PNF 패턴의 결합

임재헌,이문규,김태윤,고효은,Lim, Jae-Heon,Lee, Moon-Kyu,Kim, Tae-Yoon,Ko, Hyo-Eun 대한고유수용성신경근촉진법학회 2013 PNF and Movement Vol.11 No.1

Purpose : To identify importance of coordinative locomotor training, we reviewed the coordinative locomotor training using sprinter & skater with respect to motor control theory. Methods : We reviewed literatures related with sprinter & skater and coordination.. Results : The coordinative locomotor training is useful tool to improve interlimb coordination. A problem of interlimb coordination ability is to minimize the degree of freedoms during walking and to solve with context-condition variability and how to make a interlimb coordinative structures. A way of solving method is coordinative locomotor training using sprinter & skater in PNF. The coordinative locomotor training set to fit the gait steps can be applied with gait tasks and can be extended by applying the irradiation of the PNF. Conclusion : The coordinative locomotor training using sprinter & skater in PNF is a useful way method to improve interlimb coordination during walking.

고유수용성신경근촉진법 이완기법이 뒤넙다리근 유연성과 점프수행력에 미치는 영향

임재헌,이민국,박종혁,정태호,조은비,Lim, Jae-Heon,Lee, Min-Kook,Park, Jong-Hyuk,Jung, Tae-Ho,Jo, Eun-Bi 대한고유수용성신경근촉진법학회 2015 PNF and Movement Vol.13 No.3

Purpose: The purpose of this study was to assess the effect of the proprioceptive neuromuscular facilitation (PNF) relaxation technique (hold relax; HR, contract relax; CR) and static stretch (SS) on hamstring flexibility and vertical jump performance in healthy adults over a four-week period. Methods: Twenty-four healthy adults volunteered to participate in PNF and static stretch sessions. The subjects were divided into three groups as follows: 8 subjects in the SS group, 8 subjects in the HR group, and 8 subjects in the CR group. In the HR and CR groups, contractions lasted 15 seconds per trial and consisted of 5 sets of 15 seconds of hamstring contraction immediately followed by 15 seconds of passive static hamstring stretching. For the static group, the participants were asked to stretch by hanging a leg over a table for 30 seconds. Subjects in all groups performed the exercises three days per week for 4 weeks. The active straight leg raising (ASLR) test, active knee extension (AKE) test, and vertical jump test were performed before the intervention and after 1, 2, and 4 weeks. Results: The SS, HR, and CR techniques effected positive improvement in hamstring flexibility and vertical jump performances but neither of the stretching methods had any statistically significant different effects according to group, although there were interactions (between group and time) in the ALSR group from 1 week to 2 week and in the AKE test from pretest to 1 week. Conclusion: Based on the results of the current study, SS, HR, and CR were shown to affect hamstring flexibility and vertical jump performance in healthy adults. In particular, it was determined that within a short period, hamstring flexibility could be attributed more to CR than to SS.

성별에 따른 몸통근육의 초음파 영상 구조 비교

임재헌 ( Jae Heon Lim ),최수희 ( Su Hee Choi ),서삼기 ( Sam Ki Seo ) 대한물리의학회 2015 대한물리의학회지 Vol.10 No.2

PURPOSE: The purpose of this study is to compare ultrasound images of trunk muscles according to gender in healthy subjects. METHODS: Twenty six subjects(13 males and 13 females) were enrolled in this study. The thickness of trunk muscles was measured for transverse abdominis (TrA), external oblique abdominis (EOA), internal oblique abdominis (IOA), and multifidus (MF) using ultrasound. The thickness of the muscles was measured for the length of cross-section except for fascia. The muscle thickness wasmeasured at the both side, then the mean value was calculated. Also, each of trunk muscle wasanalysed by echodensity, white area index. RESULTS: As a results, there was significant difference in muscle thickness of EOA, IOA according to gender (p<0.05). The male was significant increase than female of EOA, IOA in muscle thickness. There was significant difference in echo intensity of TrA, MF according to gender(p<0.05). The female was significant increase than male of TrA, MF in echo intensity. There was significant difference in white area index of EOA according to gender(p<0.05). The female was significant increase than male of EOA in white area index. CONCLUSION: The findings of this study suggest that healthy male have a greater EOA, IOA trunk muscle thickness than female. However, the difference of muscle quality between male and female was showed through thisexperiment. Therefore, the ultrasonography images will be useful tool for seeing quantitative and qualitative difference of trunk muscles according to gender.

대학생의 배가로근과 뭇갈래근 두께와 척추정렬간의 상관관계

임재헌,Lim, Jae-Heon 대한고유수용성신경근촉진법학회 2014 PNF and Movement Vol.12 No.4

Purpose: The transverse abdominis and themultifidus muscle are located in the core. They surround one's trunk and help in body stabilization. Specifically, they control spine articulation to maintain posture and balance. Therefore, weakened deep muscle in the trunk may cause spinal malalignment. This study aims to compare the correlation between the thickness of the transverse abdominis and the multifidus muscle and the spine alignment among college students in their 20s. Methods: This study measured the thickness of the transverse abdominis and the multifidus muscle of 42 healthy college students in their 20s using ultrasonic waves. The thickness of the muscle was measured for the length of the cross-section except for fascia. The thickness of the left and right muscles was measured, and the mean value was calculated. As the thickness of the transverse abdominis can increase because of pressure during exhalation, it was measured at the last moment of exhalation. Spinal alignment was measured by the kyphosis angle, lordosis angle, pelvic tilt, trunk inclination, lateral deviation, trunk imbalance, and surface rotation using Formetric III, which is a three-dimensional imaging equipment. They were measured for three times, and the mean values were calculated. The general characteristics of the subjects were analyzed using descriptive statistics. The correlations between each factor were analyzed using Pearson's correlation analysis. Results: The transverse abdominis showed asignificant correlation with trunk inclination (p<.05). The multifidus muscle showed a significant positive correlation with pelvic tilt and a negative correlation with surface rotation (p<.05). Conclusion: The thickness of transverse abdominis and the multifidus muscle appears to influence spinal alignment. Specifically, the multifidus muscle, which plays an important role on the sagittal plane, influences surface rotation, thus making it an important muscle for scoliosis patients. Therefore, a strengthening training program for the transverse abdominis and the multifidus muscle is necessary according to specific purposes among adults with spinal malalignment.

승마기구의 훈련속도가 정상성인의 안뜰기능과 정적자세 균형에 미치는 영향

임재헌,박장성,조운수,Lim, Jae-Heon,Park, Jang-Sung,Cho, Woon-Su 대한물리치료학회 2013 대한물리치료학회지 Vol.25 No.5

Purpose: This study was conducted in order to determine whether mechanical horseback-riding training depending on velocity can improve vestibular function and static postural balance on standing in healthy adults. Methods: For evaluation of vestibular function, electrooculography (EOG) of vertical and horizontal was performed for identification of the motion of eyes. For evaluation of static postural balance, COP distance, time spent on the sharpened Romberg test with neck extension (SRNE) were measured. Measurements were performed three times before training, three weeks after training, and six weeks after training. Participants were randomly assigned to three groups: fast velocity-mechanical horse -riding training (FV-MHRT, n=12), moderate velocity-mechanical horse-riding training (MV-MHRT, n=12), and slow velocity-mechanical horse-riding training (SV-MHRT, n=12). Results: According to the result for vertical, horizontal EOG, there was significant interaction in each group in accordance with the experiment time (p<0.05). The FV-MHRT group showed a significant decrease compared with the MV- MHRT, SV-MHRT groups (p<0.05). According to the result for static postural balance, the time spent, COP distance in SRNE showed significant interaction in each group in accordance with the experiment time (p<0.05). The time spent on the SRNE showed a significant increas in FV-MHRT, SV-MHRT (p<0.05). The COP distance of SRNE showed a significant increase in MV-MHRT (p<0.05). Conclusion: The MHRT velocity activated mechanism of vestibular spinal reflex (VSR), vestibular ocular reflex (VOR), also helped to strengthen vestibular function and static postural balance. In addition, it should be applied to different velocity of MHRT according to the specific purpose.

불안정 지면에서 적용한 운동프로그램이 뇌졸중 환자의 균형에 미치는 효과: 국내 연구의 메타분석

임재헌(Jae-Heon Lim) 한국산학기술학회 2024 한국산학기술학회논문지 Vol.25 No.1

This study was undertaken to determine the effect size of balance exercises performed on unstable surfaces in stroke patients by systematic and comprehensive analysis. A randomly assigned clinical trial was performed on stroke patients who participated in an exercise program. Outcomes (balance results) were compared with those of age matched stroke patients who did not perform balance exercises. The literature was searched for studies published from January 2014 to June 2023 in four domestic databases. The 11 selected articles were tested for homogeneity, and effect sizes were calculated using a random effects model. The effect size of individual studies calculated using the R project for Statistical computing version (4.3.1) was 0.48 (95% CI: 0.23-0.73), indicating a medium effect size. Effect sizes determined by balance tests were 0.43 (95% CI : 0.09-0.76) for the timed up and go test (TUG) and 0.57 (95% CI : 0.13-1.02) for the Berg balance scale (BBS). Exercise programs conducted on unstable support surfaces had positive effects on the balance abilities of stroke patients. We recommend that future research be conducted on the effectiveness of various intervention programs for stroke patients.

정적 기립 자세에서 족저압 분포와 척추 정렬과의 상관관계 연구

임재헌,고효은,Lim, Jae-Heon,Ko, Hyo-Eun 대한고유수용성신경근촉진법학회 2014 PNF and Movement Vol.12 No.1

Purpose: To determine the normative data for the correlation of spinal, pelvic parameters with foot pressure in the young subjects. Methods: The subjects of this study were 39 patients in healthy adults. The Formetric-III was used to measure of spinal alignment. The pedoscan was used to measure of foot pressure. The correlation of trunk imbalance, trunk inclination, lateral deviation with foot pressure. The foot pressure measurement was consisted of maximal/mean pressure, weight contribution. Result: There was a negative correlation of trunk inclination with Max_R. There was a negative correlation of trunk inclination with Max_R. There was a positive correlation of trunk imbalance with Max_L. There was a positive correlation of lumbar lordosis with Mean_R_front, Lt. posterior weight distribution. There was a negative correlation of lumbar lordosis with Lt., Rt. in distribution There was a negative correlation of pelvic tilt with Mean_R_front, Lt. posterior weight distribution. There was a positive correlation of pelvic tilting with Rt. weight distribution, Lt. posterior weight distribution. There was a negative correlation of pelvic torsion with Lt. weight distribution, Rt. posterior weight distribution. There was a negative correlation of pelvic rotation with Lt. weight distribution, Lt. posterior weight distribution. Conclusion: The data obtained from the study may be used for future studies related to correlation of the spinal, pelvic deviation with foot pressure.

신경계물리치료에서의 근거중심실기(1) -임상의사결정과정에 EBP 적용하기-

이문규,임재헌,김태윤,Lee, Moon-Kyu,Lim, Jae-Heon,Kim, Tae-Yoon 대한고유수용성신경근촉진법학회 2016 PNF and Movement Vol.14 No.3

Purpose: The purpose of this study was to share an experience about processes and lessons learned to execute evidence-based practice (EBP) in neurological physical therapy. Methods: The most important thing in applying EBP to practice is to search, find, and appraise the existing evidence. Many evidence databases are available, such as CENTRAL, PEDro, PUBMED, and EMBASE. However, the knowledge represented in these databases is not always perfect. The practice model is a set of processes to resolve client problems. Therapists should make hypothesis-focused decisions through EBP. Integrating clinical reasoning and evidence is most important when it comes to the execution of EBP. Results: The process of EBP consisted of following: coming up with clinical questions, followed by searching for, appraising, evaluating, and integrating evidence. To integrate EBP into practice, it is necessary to consider clinical expertise, patient value and preferences, as well as research wth the best evidence. We provided an example of a clinical case with a stroke patient to show how this process and framework concerning clinical reasoning through evidences can be integrateds. During this process, we also utilized information technology to improve EBP ability. Conclusion: We should recognize what manner of information is needed to resolve eash patient's problem, and we should search for this information efficiently. Then, we should judge the value of the information obtained as it applies, to the clinical setting.

신경계물리치료에서의 근거중심실기(2) -지속가능한 EBP 수행을 위한 정보검색 기술-

이문규,김태윤,임재헌,Lee, Moon-Kyu,Kim, Tae-Yoon,Lim, Jae-Heon 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.2

Purpose: Researchers found that blocks of evidence-based practice (EBP) implementation lacked opportunities for EBP education. The study found that physical therapists had negative views of research as well as their roles in EBP, lacked confidence in EBP, and had limited access to web-based materials. The purpose of this study was to highlight the importance of information research technology for efficient EBP in a clinical environment. Methods: The web-based information research technologies that should be used for sustainable EBP include: the clinical practice guideline (CPG) and PubMed's My NCBI service. Journal mailing services and other academic information sources should also be used to gather information from RSS feeds. An EBP library or archive must be created. A site that provides EBP-specific information is also needed. Results: We should usually do EBP. Practitioners must learn and use information technologies that will help them improve their EBP skills. Conclusion: Facilitating EBP implementation and building an EBP system require related education as well as a practical work environment and equipment. However, the highest priority is individual efforts and trial. Information technology will complement the lack of time. It is important to use information research technology to overcome real obstacles. Lasting EBP must use a number of web-based information research technologies to overcome the practical challenges encountered in EBP implementation.