An Application of Constraint-Induced Therapy in Patients With Chronic Hemiparesis After Brain Injury

Park, Ji-won,Kim, Jong-man,Kim, Yun-hee 한국전문물리치료학회 2001 한국전문물리치료학회지 Vol.8 No.4

뇌 손상 후 급성기에 기능의 자발적인 회복이 일어나지만 환자들은 환측의 상지를 잘 사용하지 못하게 된다. 그 결과 원하는 움직임을 억제하는 상황을 발생시키는데 이것을 학습 무사용 증후군(learned nonuse syndrome)이라 한다. 이러한 학습 무사용 증후군을 치료하기 위해 억제-유도 치료(constraint-induced therapy)가 고안되었다. 억제-유도 치료는 연속되는 몇 주간에 걸쳐 매일 많은 시간 동안 건측의 상지를 묶어두고 환측 상지를 사용하게 하여 기능을 반복 학습하게 함으로써 기능을 증진시키는 방법이다. 이미 여러 연구자들이 경두개 자기자극(transcranial magnetic stimulation), 움직임 관련 피질전위(movement-related cortical potential), 기능적 자기공명 영상기법(functional magnetic resonance imaging) 등을 통하여 억제-유도 치료 후 운동피질영역에서의 재조직화를 보고함으로써 기능 증진과 관련된 회복 기전을 뒷받침하고 있다. 억제-유도 치료의 영역은 확대되어 뇌졸중, 척수손상, 고관절 치환술 후로 하지에서의 기능증진을 위하여 연구가 진행되고 있으며 특히 뇌졸중 후 실어증 환자에서 새로운 방법으로 제시되고 있다. 따라서, 억제-유도 치료는 신경학적인 손상 후 움직임의 재활에 있어서 치료-유도를 통한 중추신경계의 회복에 효과적으로 작용할 수 있다.

류마티스관절염 환자를 위한 물리치료

원종임 한국전문물리치료학회 1994 한국전문물리치료학회지 Vol.1 No.1

한국전문물리치료학회 제31권 제2호 목차

편집부 한국전문물리치료학회 2024 한국전문물리치료학회지 Vol.31 No.2

심근경색후 물리치료

이정원 한국전문물리치료학회 1994 한국전문물리치료학회지 Vol.1 No.1

21세기 우리나라 적정 물리치료사 인력 수급계획에 관한 연구1)

권혁철,이충휘 한국전문물리치료학회 1998 한국전문물리치료학회지 Vol.5 No.1

Effect of Breathing Exercise on Improvement of Pulmonary Function in Patient With Amyotrophic Lateral Sclerosis : Case Study

Jung, Young-jong 한국전문물리치료학회 2001 한국전문물리치료학회지 Vol.8 No.4

근위축성 측색 경화증(amyotrophic lateral sclerosis: ALS) 환자에게 있어 호흡기능 장애는 죽음에 이르게 하는 주요 원인 중 하나이다. 본 연구는 근위축성 측색 경화증이 있으며 호흡기능이 약화되어 있는 51세의 여성 환자를 대상으로 호흡운동 치료를 시행한 후 폐기능(pulmonary function)이 증진되었는지를 알아보자 실시하였다. 연구 대상자는 6주간의 호흡운동 치료 프로그램에 참여하였다. 호흡운동 치료 프로그램은 횡경막 호흡(diaphragmatic breathing), 복부근육강화(abdominal muscles strengthening), 지갑입술 호흡(pursed lip breathing), 그리고 동기 유발성 흡기폐활량계(incentive spirometer)를 이용한 흡기운동 등으로 구성되었다. 폐기능 검사는 이동식 호흡측정기(spirometer: MICROSPIROHI-198)를 이용해서 시행하였다. 또한 하지 에르고미터(cycle-ergometer)를 이용해 운동 시간을 측정함으로써 폐기능의 증진 여부를 알아보았다. 연구 대상자는 6주간의 호흡운동 치료 기간 동안 노력성 폐활량(forced vital capacity: FVC)과 정상 예측치에 대한 노력성 폐활량의 비율(percentage of the predicted forced vital capacity: %FVC), 그리고 하지 에르고미터의 운동 시간에 있어 현저한 증가를 보였다. 그러나 노력성 폐활량에 대한 1초간 노력성 폐활량 비(FEV1/FVC)에 있어서는 약간의 감소를 보였다. 근위축성 측색 경화증 환자에게 6주간의 호흡운동 치료를 실시한 결과, 폐기능의 증진에 효과적임을 알 수 있었으며, 앞으로 더 많은 연구 대상자에게 그 효과를 알아보는 연구가 필요할 것이다.

Reliability of Quantifying Maximal Mouth Opening and Lateral Mandibular Shift in Individuals With and Without Temporomandibular Disorder Using Three-dimensional Ultrasound-based Motion Analysis

Jae-seop Oh,Si-hyun Kim,Moon-su Kyung,Kyue-nam Park 한국전문물리치료학회 2019 한국전문물리치료학회지 Vol.26 No.3

Background: Although magnetic resonance imaging is accurate, it is expensive to measure the movement of temporomandibular joint. The three-dimensional (3D) motion analysis system is an inexpensive measurement tool. Objects: This study examined the reliability of quantifying the mouth opening and lateral mandibular shift and differences between individuals with and without temporomandibular disorder (TMD) using the hygienic method of surface markers on the skin with 3D ultrasound-based motion analysis. Methods: This study included 24 subjects (12 with and 12 without TMD). Temporomandibular joint motion during mouth opening was recorded using two surface markers with 3D ultrasound-based motion analysis. An intraclass correlation coefficient [ICC (3,k)] was used to confirm the intrarater reliability of quantifying kinematic temporomandibular joint motion, and an independent t-test was used to evaluate differences in maximal mouth opening and lateral mandibular shift between the two groups. Results: Assessment of mouth opening and lateral mandibular shift showed excellent test–retest reliability with low standard error of measurement. The lateral mandibular shift and opening-lateral mandibular shift ratio were significantly increased in the TMD group during maximum mouth opening (p<.05). However, no significant difference in maximal mouth opening was observed between the groups with and without TMD (p>.05). Conclusion: This hygienic and simple surface marker method can be used to quantify the mouth opening and lateral mandibular shift at the end-range of mouth opening. The TMD group showed an increased lateral mandibular shift movement at the end-range of mouth opening. The lateral mandibular shift movement can be regarded as a symptom in the diagnosis and treatment of TMD.

Effects of Transcutaneous Electrical Stimulation on Physiological Symptoms and Psychological Satisfaction in Women With Stress Urinary Incontinence: A Preliminary Study

Ji-hyun Kim,Oh-yun Kwon,Hye-seon Jeon,Ui-jae Hwang,Kyeong-tae Gwak,Hyeo-bin Yoon,Eun-young Park 한국전문물리치료학회 2019 한국전문물리치료학회지 Vol.26 No.3

Background: Stress urinary incontinence (SUI) is an involuntary leakage of urine from the urethra when intra-abdominal pressure increases, such as from sneezing, coughing, or physical exertion. It is caused by insufficient strength of the pelvic floor and sphincter muscles, resulting from vaginal delivery, obesity, hard physical work, or aging. The pelvic floor electrical stimulator is a conservative treatment generally used to relieve the symptoms of urinary incontinence. it recommended to applied before surgery is performed. Objects: The purpose of this study was to determine if the transcutaneous electrical stimulation (TCES) would be effective for the physiological symptoms and psychological satisfaction of women with SUI for an 8-weeks intervention. Methods: Easy-K is a specially designed user-friendly TCES. Five female who were diagnosed with SUI by a gynecologist but who did not require surgical intervention were included in this study. Intervention was implemented over an 8-week period. Outcome measures included vaginal ultrasonography, Levator ani muscle (LAM) contraction strength, incontinence quality of life (I-QOL), and female sexual function index (FSFI) questionnaires. Results: The bladder neck position significantly decreased across assessment time. Funneling index and urethral width significantly decreased after 8 weeks of intervention (p<.05). The bladder necksymphyseal distance and posterior rhabdosphincter thickness statistically increased and the anterior rhabdosphincter thickness showed a tendency to increase. All participants demonstrated a significant increase in the LAM contraction score across three assessment times (p<.05). Although the total score of the I-QOL did not show significant improvement, it steadily increased and among I-QOL subscales, only the “avoidance” subscale showed statistical improvements (p<.05). The total score of the FSFI statistically improved and the “desire” score significantly changed (p<.05). Conclusion: The TCES is recommended for women who want to apply conservative treatments before surgery and who have suffered from SUI in aspects of sexual function and quality of life.

날개 어깨뼈 대상자들에게 어깨 내밈 운동시 벌림 각도와 외부 무게에 따른 앞톱니근, 큰가슴근, 위 등세모근의 활성도 및 비율에 미치는 영향

야담바담허럴,김태호,박한규 한국전문물리치료학회 2019 한국전문물리치료학회지 Vol.26 No.3

Background: Winged scapular (WS) causes muscle imbalance with abnormal patterns when moving the arm. In particular, the over-activation of the upper trapezius (UT) and decrease in activity of the lower trapezius (LT) and serratus anterior (SA) produce abnormal scapulohumeral rhythm. Therefore, the SA requires special attention in all shoulder rehabilitation programs. In fact, many previous studies have been devoted to the SA muscle strength training needed for WS correction. Objects: The purpose of this study was to investigate the effect of shoulder girdle muscle and ratio according to the angle of shoulder abduction and external weight in supine position. Methods: Twenty three WS patients participated in this experiment. They performed scapular protraction exercise in supine position with the weights of 0 ㎏, 1 ㎏, 1.5 ㎏, and 2 ㎏ at shoulder abduction angles of 0˚, 30˚, 60˚, and 90˚. The angle and weight applications were randomized. Surface electromyography (EMG) was used to collect the EMG data of the SA, pectoralis major (PM), and UT during the exercise. The ratio of PM/SA and UT/SA was confirmed. Two-way repeated analyses of variance were used to determine the statistical significance of SA, PM, and UT and the ratios of PM/SA and UT/SA. Results: There was a significant difference in SA according to angle (p<.05). Significant differences were also identified depending on the angle and weight (p<.05). The angle of abduction at 0˚, 30˚ and weight of 2 ㎏ showed the highest SA activity. However, there was no significant difference between PM and UT (p>.05). There was a significant difference between PM/SA and UT/SA in ratio of muscle activity according to angle (p<.05). Significant differences were found at PM/SA angles of 30˚, 60˚ and 90˚ (p<.05). For UT/SA, significant difference was only observed at 90˚ (p<.05). Conclusion: Based on the results of this study, in order to strengthen the SA, it was found to be most effective to use 1 and 1.5 ㎏ weights with abduction angles of 0˚ and 30˚ at shoulder protraction in supine position.

Electromyographic Analysis of Gluteus Maximus, Gluteus Medius, Hamstring and Erector Spinae Muscles Activity During the Bridge Exercise With Hip External Rotation in Different Knee Flexion Angles in Healthy Subjects

Kyung-eun Lee,Seung-min Baik,Chung-hwi Yi 한국전문물리치료학회 2019 한국전문물리치료학회지 Vol.26 No.3

Background: The bridge exercise targets the gluteus maximus (Gmax) and gluteus medius (Gmed). However, there is also a risk of dominant hamstring (HAM) and erector spinae (ES) muscles. Objects: To analyze the muscle activity the of Gmax, Gmed, HAM and ES during the bridge exercise with and without hip external rotation in different degrees of knee flexion. Methods: Twenty-three subjects were participated. The electormyography (EMG) activity of the Gmax, Gmed, HAM and ES muscles was recorded during the exercise. The subjects performed the bridge exercise under four different conditions: (a) with 90˚ knee flexion, without hip external rotation (b) with 90˚ knee flexion, with hip external rotation (c) with 135˚ knee flexion, without hip external rotation (d) with 135˚ knee flexion, with hip external rotation. Results: There was no significant interaction effect between the degree of knee flexion and hip external rotation. There was a significant main effect for degree of knee flexion in Gmax, HAM muscles activity. Gmax muscle activity was significantly greater in the 135˚ knee flexion position than in the 90˚ knee flexion position (p<.001). While HAM muscle activity was significantly less in 135˚ knee flexion position than in the 90˚ knee flexion position (p<.001). ES muscle activity was significantly less in the 135˚ knee flexion position than in the 90˚ knee flexion position (p=.002). The activity of both the Gmax and Gmed muscles was significantly greater with hip external rotation (p<.001 and p=.005, respectively). Conclusion: For patients performing the bridge exercise, positioning the knee in 135° of flexion with hip external rotation is effective for improving Gmax and Gmed muscle activity while decreasing HAM, and ES muscle activity.