• 한국응용과학기술학회지
• /
• 제38권4호
• /
• pp.1081-1092
• /
• 2021

본 연구의 목적은 파킨슨병 환자를 대상으로 16주간 복합운동을 수행하였을 때 혈중 도파민 농도, 기능적 체력 및 삶의 질에 어떠한 영향을 미치는지를 규명하는데 있다. 이를 위해 본 연구에 참여한 60대 이상의 파킨슨병 환자 24명을 운동군(n=12)과 통제군(n=12)으로 분류한 후 운동군을 대상으로 16주 동안 주 2회, 회기 당 70분의 복합운동을 실시하였다. 복합운동 실시 전·후 항목별 차의 비교를 위해 그룹 내 차이는 대응 t 검정, 그룹 간 차이는 독립 t 검정, 상호작용 검증을 위해 이원 반복측정 분산분석을 사용하였으며, 각 항목별 통계적 유의수준은 .05로 설정하였다. 그 결과 첫째, 도파민 농도는 운동군(p<.01)이 16주간 운동 전보다 운동 후 유의하게 증가하였고, 통제군의 경우 유의한 차이가 나타나지 않았다. 둘째, 기능적 체력에서 악력은 운동군(p<.001)과 통제군(p<.05) 모두 16주간 운동 전보다 운동 후 유의하게 증가하였고, 덤벨들기(p<.001), 의자 일었다 앉기(p<.001), 3m 걸어갔다 돌아오기(p<.01)가 16주간 운동 전보다 운동 후 운동군에서 유의한 차이를 보였고, 통제군은 유의한 차이가 나타나지 않았다. 셋째, 삶의 질은 운동군(p<.001)이 16주간 운동 전보다 운동 후 유의하게 증가하였다. 이상의 결과를 종합해 볼 때 16주간의 복합운동은 파킨슨병 환자에게 매우 효과적임을 알 수 있었으며, 도파민 농도를 증가시키고 근력, 근지구력, 평형성 및 보행능력 등 기능적 체력과 삶의 질을 향상시키는데 도움을 줄 수 있다고 사료된다.

• 대한한방내과학회지
• /
• 제42권2호
• /
• pp.75-85
• /
• 2021

Objectives: This study reported about a patient with a right middle cerebral artery infarction whose gait disturbance was improved by Korean medicine treatment. Methods: The patient was treated with a Korean herbal medicine (Gami-yukmijihwang-tang) along with acupuncture, electroacupuncture, moxibustion, cupping, and physical therapy. The treatment effect was evaluated with the manual muscle test (MMT) and the Korean version of the modified Barthel index (K-MBI). The gait of the patient was evaluated by a 10-m walk test (10MWT), the timed up and go (TUG) test, the functional ambulation profile (FAP) score, and the functional ambulatory category (FAC) score. Spatiotemporal parameters were evaluated using a walkway system (GAITRite®, CIR Systems, Inc., USA). Results: After 83 days of traditional Korean medicine treatment, the K-MBI and FAC scores improved from 50 to 70 and from 1 to 4, respectively. The 10MWT and TUG tests also improved from 24.86 to 16.66 sec and from 22.35 to 17.62 sec, respectively. GAITRite® measurements reflected gait improvements: the FAP score improved from 55 to 86 sec; the step time improved from 0.72 to 0.669 sec; the step length improved from 31.076 cm to 41.284 cm; the gait velocity improved from 42.8 cm/sec to 64.1 cm/sec; the cadence improved from 93.6 steps/min to 90.8 steps/min. No adverse effects resulting from treatment or evaluation occurred during the admission period. Conclusions: This study suggests that traditional Korean medicine treatment may reduce symptoms and improve the quality of life in patients with cerebral infarction.

• 한국운동역학회지
• /
• 제16권1호
• /
• pp.65-79
• /
• 2006

The purpose of this study was firstly to investigate correctional function of custom semi-rigid foot orthotics for excessively pronated people during gait by observing comfort, navicular movement and leg muscles' activity according to short-term and mid-term wearing duration and secondly to understand positive and/or negative point of view of a recently proposed paradigm related to foot orthotics more profoundly. Sixteen subjects who showed excessive pronation at navicular drop test were recruited for this study. Custom semi-rigid foot orthotics were made fitting for foot characteristics of the subjects by podiatry division of Otto Bock Korea company. While wearing the foot orthotics for two months, comfort of wearing were questioned and vertical navicular movement and electromyography of leg muscles during gait were measured at the condition of both immediately after and 2 months after including a control condition, respectively. The subjects were required to walk on a treadmill at the speed of 1.5m/s and four digital video camera filmed the movement of navicular process at the speed of 60 frames/s. In conclusion, in excessively pronated group continuous increase of comfort from short-term to mid-term wearing of custom foot orthotics is assumed to be closely related with short-term and mid term correctional action, of which are consisted the decrease of the range of navicular drop and navicular raisins- the faster timing of minimum navicular position occurring, and the decrease of leg muscles' activities. This conclusion could lead to positively accept new paradigm related to foot orthotics suggested by Nigg and the author suggest that in the future study the variable which could observe navicular movement would be one of major variables to study preferred path of skeleton in the paradigm.

• Physical Therapy Rehabilitation Science
• /
• 제9권2호
• /
• pp.82-89
• /
• 2020

Objective: The purpose of this study was to assess the effect of hospital-based pulmonary rehabilitation (PR) on exercise capacity and quality of life as well as barriers to participation in persons with chronic obstructive pulmonary disease (COPD) in South Korea. Design: One-group pretest-posttest design. Methods: A total of 14 patients were enrolled in this study in an 8-week PR program with two 60-minute sessions per week. The program included: flexibility exercises, breathing techniques, strengthening exercises, and aerobic exercises. The outcomes were defined as changes in the variables before and after the PR program. A change in the 6-minute walk distance (6MWD) was defined as the primary outcome, and changes in pulmonary function test, respiratory and grip strength, and the St. George's Respiratory Questionnaire (SGRQ) about quality-of-life results were secondary outcomes. A dropout was defined as missing >3 of the 16 sessions. Results: Patients who completed the program showed a significant improvement of 43.57±39.43 m in the 6MWD (p<0.05), but no significant differences were noted for the other function tests. The SGRQ showed a significant improvement in the activity and total score (p<0.05). The total dropout rate was 53.3%. Newly developed symptoms, exacerbation of COPD, transport problems, and lack of motivation were major barriers to PR. Conclusions: Our study showed that an 8-week hospital-based PR program improved exercise capacity and quality of life but had a high dropout rate in individuals with COPD. Since comprehensive PR has only recently been established in South Korea, patient motivation and education are critical.

• Kidney Research and Clinical Practice
• /
• 제37권4호
• /
• pp.404-413
• /
• 2018

Background: Dynapenic obesity and sarcopenic obesity increase cardiovascular disease (CVD) and mortality in nonuremic patients. The present study was designed to determine the prevalence of dynapenic obesity and sarcopenic obesity and their associations with CVD risk factors in peritoneal dialysis (PD) patients. Methods: All eligible PD patients in Tehran peritoneal dialysis centers were included in this cross-sectional study. Skeletal muscle mass and fat mass were assessed using bioelectrical impedance analysis. Muscle strength and physical performance were determined using hand grip strength and a 4-meter walk gait speed test, respectively. In addition, a 5-mL blood sample was obtained from each patient. Results: The prevalence of dynapenic obesity and sarcopenic obesity were 11.4% and 3.8% in PD patients, respectively. Serum high-sensitive C-reactive protein (hs-CRP), soluble intercellular adhesion molecule type 1, triglyceride, total cholesterol, and low-density lipoprotein cholesterol were significantly higher in PD patients with dynapenic obesity than in dynapenic nonobese and nondynapenic nonobese patients. Similarly, serum concentrations of CVD risk factors in PD patients with sarcopenic obesity were higher than in nonsarcopenic nonobese patients, but these differences were statistically significant only for serum hs-CRP and triglyceride. In addition, muscle strength and skeletal muscle mass percentage were negatively associated with markers of inflammation and dyslipidemia, whereas body fat percentage was positively associated with these CVD risk factors. Conclusion: This study indicates that although the prevalence of dynapenic obesity and sarcopenic obesity are relatively low in PD patients, these disorders may be associated with CVD risk factors.

• Tuberculosis and Respiratory Diseases
• /
• 제81권4호
• /
• pp.281-288
• /
• 2018

Background: There are limited number of studies that investigate clinical variables instead of chronic obstructive lung disease (COPD) management according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 classification. The aim of the study was to investigate whether there was a difference between GOLD 2017 classification and spirometric stage in clinical variables in patients with COPD. The data of 427 male patients with stable COPD were investigated retrospectively. Methods: Patients were allocated into combined assessment of GOLD 2017 and spirometric stage. Age, amount of smoking, pulmonary function, modified Medical Research Council (mMRC), incremental shuttle walk test (ISWT), Hospital Anxiety-Depression Scale (HADS), St. George's Respiratory Questionnaire (SGRQ), body mass index (BMI), and fat free mass index (FFMI) were recorded. Results: Seventy-three (17%) patients were in group A, 103 (24%) constituted group B, 38 (9%) were included in group C, and 213 (50%) comprised group D according to the combined assessment of GOLD 2017. Twenty-three patients (5%) were in stage 1, 95 (22%) were in stage 2, 149 (35%) were in stage 3, and 160 (38%) were in stage 4 according to spirometric stage. According to GOLD 2017, age, amount of smoking, mMRC, BMI, FFMI, SGRQ, HADS, forced vital capacity, forced expiratory volume in 1 second ($FEV_1$), and ISWT were significantly different between groups. Ages, amount of smoking, FFMI, BMI, HADS of group A were different from B and D. Smiliar values of $FEV_1$ were found in A-C and B-D. A and C had smiliar ISWT. According to spirometric stage, BMI, FFMI of stage 4 were statistically different. mMRC, ISWT, and SGRQ of stages 3 and 4 were different from other stages, amongst themselves. $FEV_1$ was correlated with mMRC, SGRQ, anxiety scores, BMI, FFMI, and ISWT. Conclusion: This study showed that the GOLD ABCD classification might not represent the severity of COPD sufficiently well in terms of lung function or exercise capacity. The combination of both spirometric stage and combined assessment of GOLD 2017 is important, especially for estimating clinical variables.

• 대한물리의학회지
• /
• 제17권4호
• /
• pp.103-111
• /
• 2022

PURPOSE: This study was performed to investigate the effects of the whole-body vibration exercise combined with ankle joint mobilization on the gait and balancing ability in patients with hemiplegic stroke. METHODS: A total of 19 patients at a rehabilitation hospital who had suffered a hemiplegic stroke were randomly assigned to the experimental group (whole-body vibration exercise combined with ankle joint mobilization, n=10) or control group (whole-body vibration exercise, n=9). All participants underwent 30 min of comprehensive rehabilitation therapy (5 × /week for 6 weeks). Additionally, the experimental group performed the whole body vibration exercise and ankle joint mobilization (15 minutes each, 30 minutes total, 3 × / week for 6 weeks). In the control group, only the whole- body vibration exercise was performed in the same manner and not the ankle joint mobilization. The gait and balancing abilities were measured before and after the 6-week training. RESULTS: Significant improvements were observed in the 10-m walk test, timed up-and-go (TUG) test, center of pressure (COP) path length, and COP path velocity in the experimental group (p < .05). The experimental group showed a larger decrease in the COP path length and velocity than the control group (COP path length, -10.27 mm vs. -3.67 mm, p < .05; COP path velocity, -.33 cm/sec vs. -.13 cm/sec, p < .05, respectively). CONCLUSION: The whole-body vibration exercise combined with ankle joint mobilization could be effective in improving the gait and balancing ability of stroke patients and could also be more effective for improving the static balance ability than the general whole-body vibration exercise alone.

• 대한건축학회논문집:계획계
• /
• 제34권11호
• /
• pp.85-94
• /
• 2018

This study aims to investigate how easy pedestrians get around within/through the "Apartment Complexes (AC), " a common style of high-rise multi-family housing in Korea. Over the past six decades, the AC has been the most conventional way to provide standardized housing efficiently to address the problems of the shortage of housing and the substandard housing, due to the explosion of urban population with the rapid industrialization. The AC is a huge chunk of homeogenous multi-family housing, mostly condos with decent infrastructure, including parks, pedestrian passages, schools, ect. Both in the new town development and urban renewal programs have utilized the advantages of the AC. Since the design principals of AC tend to adopt the "protective design" to prevent cars and pedestrians coming outside from passing it, it has been criticised for dissecting the continuity of socioeconomic context in neighborhoods. The neo-traditional planning urbanists, including Jane Jacobs, emphasize that smaller blocks and grid road newtworks are the key in improving social, cultural, and economic vitality of the neighborhoods, because these design concepts allow more pedestrians and different types of people to be mixed in a neighborhood. In this study, we first adopted objective measures for pedestrian accessibility and pedestrian efficiency. These measures were used to calculate the lengths of shortest paths from residential buildings to the edges of AC. We tested the difference in shortest paths between the current pedestrian networks of AC and hypothetical grid networks on the AC, and the relative difference is considered as the pedestrian efficiency, using the network analysis function of Geographic Information Systems (GIS) and Python programming. We found from the randomly selected 30 ACs that the existing non-grid road networks in ACs are worse than the hypothesized grid networks, in terms of pedestrian efficiency. In average, pedestrians in AC with the conventional road networks have to walk than 25%, 26%, and 27% longer than the networks of $125{\times}45m$, $100{\times}45m$, and $75{\times}45m$, respectively. With the t-test analysis, we found the pedestrian efficiency of AC with the conventional network is lower than grid-networks. Many new urbanists stress, easiness of walking is one of the most import elements for community building and social bonds. With the findings from the objective measures of pedestrian accessibility and efficiency, the AC would have limitations to attract people outside into the AC itself, which would increase dis-connectivity with adjacent areas.

• 대한의용생체공학회:의공학회지
• /
• 제32권2호
• /
• pp.165-176
• /
• 2011

The femoral nerve innervates the quadriceps muscles and its dermatome supplies anteromedial thigh and medial foot. Paralysis of the quadriceps muscles due to the injury of the femoral nerve results in disability of the knee joint extension and loss of sensory of the thigh. A child could walk independently even though he had injured his femoral nerve severely due to the penetrating wound in the medial thigh. We measured and analyzed his gait performance in order to find the mechanisms that enabled him to walk independently. The child was eleven-year-old boy and he could not extend his knee voluntarily at all during a month after the injury. His gait analysis was performed five times (GA1~GA5) for sixteen months. His temporal-spatial parameters were not significantly different after the GA2 or GA3 test, and significant asymmetry was not observed except the single support time in GA1 results. The Lower limb joint angles in affected side had large differences in GA1 compared with the normal normative patterns. There were little knee joint flexion and extension motion during the stance phase in GA1 The maximum ankle plantar/dorsi flexion angles and the maximum knee extension angles were different from the normal values in the sound side. Asymmetries of the joint angles were analyzed by using the peak values. Significant asymmetries were found in GA1with seven parameters (ankle: peak planter flexion angle in stance phase, range of motion; ROM, knee: peak flexion angles during both stance and swing phase, ROM, hip: peak extension angle, ROM) while only two parameters (maximum hip extension angle and ROM of hip joint) had significant differences in GA5. The mid-stance valleys were not observed in both right and left sides of vertical ground reaction force (GRF) in the GA1, GA2. The loading response peak was far larger than the terminal stance peak of vertical ground reaction curve in the affected side of the GA3, GA4, GA5. The measured joint moment curves of the GA1, GA2, GA3 had large deviations and all of kinetic results had differences with the normal patterns. EMG signals described an absence of the rectus femoris muscle activity in the GA1 and GA2 (affected side). The EMG signals were detected in the GA3 and GA4 but their patterns were not normal yet, then their normal patterns were detected in the GA5. Through these following gait analysis of a child who had selective injuries on the knee extensor muscles, we could verify the actual functions of the knee extensor muscles during gait, and we also could observe his recovery and asymmetry with quantitative data during his rehabilitation.

• 한국임상수의학회지
• /
• 제28권3호
• /
• pp.310-313
• /
• 2011

6년령 암컷 시츄견이 체중 부하하는 파행을 동반한 좌측 앞다리굽이관절 주위의 종괴를 주증으로 충북대학교 동물의료센터에 내원하였다. 초음파 검사결과 피막에 싸인 고에코성의 종괴가 앞다리굽이관절에서 확인되었으며, 방사선학적 검사 결과 흉부나 복부로의 전이 소견은 관찰되지 않았다. Gun-biopsy 샘플을 이용한 세포학적 검사 결과 세포부동증, 다형성 등 악성의 지표를 보이는 종양세포들이 다수 확인되었으며, 치료를 위하여 좌측 전지의 절단술이 시행되었다. 절제된 조직의 조직병리학적 검사 결과 악성 말초 신경집종으로 진단되었다. 환자는 수술 후 보행이나 전신활력 등이 양호하였으나 술 후 5개월째에 좌측 전지 절단술을 시행했던 부위의 피하 종괴와 다른 두 곳의 피부 종괴가 발생하였다. 종괴는 수술적으로 제거되었으며, 절제된 조직의 세포학적 검사 결과 원발 종양과 유사한 소견으로 종양이 재발되었음이 확인되었다. 술 후 종양의 또 다른 재발을 막고 의심되는 폐 전이의 속도를 늦추기 위한 목적으로 cyclophosphamide와 piroxica을 병용한 화학요법이 시행되었다. 첫 수술로부터 26개월이 경과한 현재 환자는 만족할만한 삶의 질을 유지하며 생존하고 있다. 개의 악성 말초 신경집 종양에서 적극적인 외과적 절제와 metronomic chemotherapy의 병행은 효과적인 치료법이 될 수 있다.