• 대한통합의학회지
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• 제9권2호
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• pp.109-117
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• 2021

Purpose : This study examined the differences in occupational therapists' jobs depending on their past clinical careers using a survey of the importance of occupational therapy tasks in South Korea. This survey sought to provide fundamental data for strengthening occupational therapists' capacities and developing clinical training programs for therapists' future careers. Methods : An online survey was used to collect data from 93 South Korean occupational therapists. The subjects were divided into three groups for the analysis of the importance of occupational therapy tasks, depending on the length of their clinical careers: less than 3 years, from 4 to 6 years, and over 7 years. Results : A within-groups comparison of task importance found that "occupational therapy evaluation" was most important in all three groups. In between-groups comparisons, "patient information check", "assessment planning and establishment", "sensory function assessment", "social skills assessment", "developmental function improvement", "basic daily activities training", "social skills improvement", and "patient education" demonstrated statistically significant differences (p<.05). Each group showed different priorities. In the less-than-3-years group, "understanding of patient's needs" was most important, followed by "arm function improvement", "arm function assessment", "nerve, musculoskeletal, and motor-related functional improvement", and "basic daily activities training". In the 4-to-6-years group, "arm function assessment" was most important, followed by "basic daily activities assessment", "patient's needs", "arm function improvement", and "patient information check". In the over-7-years group, "understanding of patient's needs" was most important, followed by "patient information check", "basic daily activities assessment", "basic daily activities training", and "sensory function assessment". Conclusion : This study found that what occupational therapists consider important in their jobs varies according to their past clinical career and that occupational therapists with more than 7 years' experience are more aware of the importance of diverse fields of occupational therapy. Differentiated education that considers length of career and a range of training programs for more experienced occupational therapists will be needed in the future.

• 한국정밀공학회지
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• 제19권12호
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• pp.38-44
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• 2002

A walking training robot is proposed to provide stable and comfortable walking supports by reducing body weight load partially and a force control of an arm of walking training robot using sliding mode controller is also proposed. The current gait training apparatus in hospital are ineffective for the difficulty in keeping constant unloading level and for the constraint of patients' free walking. The proposed walking training robot effectively unloads body weight during walking. The walking training robot consists of an unloading manipulator and a mobile platform. The manipulator driven by an electro-mechanical linear mechanism unloads body weight in various levels. The mobile platform is wheel type, which allows patients to walt freely. The developed unloading system has advantages such as low noise level, lightweight, low manufacturing cost and low power consumption. A system model fur the manipulator is established using Lagrange's equation. To unload the weight of the patients, sliding mode control with p-control is adopted. Both control responses with a weight and human walking control responses are analyzed through experimental implementation to demonstrate performance characteristics of the proposed force controller.

• 재활치료과학
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• 제1권1호
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• pp.57-70
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• 2012

목적 : 본 연구는 뇌졸중 환자를 대상으로 신경되먹임(Neurofeedback; NFB)을 통한 뇌파 훈련과 컴퓨터보조 인지 재활(Computer-Assisted Cognitive Rehabilitation; CACR) 훈련이 뇌졸중 환자의 인지, 상지기능에 미치는 영향을 알아보고자 한다. 연구방법 : 뇌졸중 후 3개월에서 1년 이내이며, 경기도 소재 병원에서 입원치료중인 환자 44명을 NFB군(14명)과 CACR군(14명), 대조군(16명)의 세 그룹으로 배치시켰다. NFB 훈련과 CACR 훈련은 6주간에 걸쳐 실시하였으며 사전, 사후 평가기간을 포함하여 총 9주간 연구를 진행하였다. 측정은 인지, 상지 기능을 측정하였으며 훈련 전후와 그룹간의 인지, 상지 기능의 변화를 분석하였다. 결과 : 연구대상자들의 훈련방법에 따른 인지기능의 차이를 알아보기 위해 한국형 간이정신상태 검사(Mini-Mental State Examination-Kore; MMSE-K) 총점의 변화를 분석한 결과 NFB군은 실험전 16.92 점에서 실험 후 20.50 점으로 유의한 차이를 보였고 CACR군은 실험 전 17.85 점에서 실험 후 22.14 점으로 유의한 차이를 보였으며 대조군도 실험 전 18.62 점에서 실험 후 19.25 점으로 유의한 차이를 보였다. 그러나 사후검정 결과 실험방법 간 차이는 보이지 않았다. 상지기능의 차이를 알아보기 위해 뇌졸중 상지 기능인 뇌졸중 상지 기능 검사(Manual Function Test; MFT) 총점을 분석한 결과 상지운동 영역에서 NFB군은 실험 전 4.64 점에서 실험 후 5.50 점으로 유의한 차이를 보였고 CACR군은 실험 전 3.92 점에서 실험 후 5.35 점으로 유의한 차이를 보였으며 대조군도 실험 전 3.68 점에서 실험 후 4.75 점으로 유의한 차이를 보였다. 그러나 사후검정 결과 실험방법 간 차이는 보이지 않았다. 결론 : 본 연구는 NFB 훈련과 CACR 훈련, 전통적 재활훈련 이후 인지기능과 상지 기능의 향상을 제시하였으며 앞으로 각 개인에게 적절한 훈련방법을 적용한 NFB 훈련과 CACR 훈련 프로그램 개발 및 프로토콜이 제시되어야 할 것이다.

• 제어로봇시스템학회논문지
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• 제14권7호
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• pp.672-678
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• 2008

This paper proposes a new rehabilitation robot with upper and lower limb connections for gait training. As humans change a walking speed, their nervous systems adapt muscle activation patterns to modify arm swing for the appropriate frequency. By analyzing this property, we can find a relation between arm swinging and lower limb motions. Thus, the lower limb motion can be controlled by the arm swing for walking speed adaptation according to a patent's intension. This paper deals with the design aspects of the suggested gait rehabilitation robot, including a trajectory planning and a control strategy. The suggested robot is mainly composed of upper limb and lower limb devices, a body support system. The lower limb device consists of a slider device and two 2-dof footpads to allow walking training at uneven and various terrains. The upper limb device consists of an arm swing handle and switches to use as a user input device for walking. The body support system will partially support a patient's weight to allow the upper limb motions. Finally, we showed simulation results for the designed trajectory and controller using a dynamic simulation tool.

• The Journal of Korean Physical Therapy
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• 제23권2호
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• pp.31-36
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• 2011

Purpose: We investigated the effects of physical practice, mental practice, and cross education using serial reaction time (SRT) in the non-dominant left arm of right-handed individuals. Methods: Subjects were divided into three groups; physical practice (n=8), mental practice (n=8) and controls (n=8). They did, respectively, physical training or mental training, or had no intervention for three weeks. Super lab 4.0 displayed four symbols on the monitor and subjects were asked to push the matching button. Reaction time was assessed pre- and post-intervention. Results: Reaction time was significantly lower after physical practice (p<0.05), but mental practice did not significantly lower reaction time? in the left hand. Also, reaction time was not significantly lower after physical practice or mental practice in the right hand. Conclusion: Physical practice can improve motor learning, but mental practice is not sufficient. Also, neither physical practice nor mental practice is sufficient for cross education from the nondominant to the dominant arm.

• 국제물리치료학회지
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• 제11권1호
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• pp.2012-2020
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• 2020

Background: Multifaceted approaches will be needed, such as global synkinesis (GS) achieve functional improvements in the arms of stroke patients from involuntary movements during exercise. Objective: To identify changes in arm GS and muscle activity, functional evaluation and the correlation with variables through action observation training, combined with functional electrical stimulation (FES), thereby verifying the effect on stroke patients. Design: A quasi-experimental study. Methods: The subjects of this study were 20 stroke patients who were divided into two groups: Control group (n=10) and experimental group (n=10). Before the intervention, arm GS and muscle activity were measured using surface electromyography (EMG), and arm function was evaluated using the Fugl-Meyer Assessment (FMA) scale. At the end of the intervention, which lasted 4-wk, arm GS and muscle activity were measured again using the same scale. Results: There was a decrease statistically significant difference in GS during the bending action in experimental group (P<.01). Both groups showed a significant difference increased only in the activity of the anterior deltoid (AD) and biceps brachii (BB) (P<.05). The results of the arm functional assessment revealed a significant difference increase in both groups (P<.05). In the between-group comparison, there was a significant difference decrease in GS during the bending action (P<.05). Only the muscle activity of the AD and BB were significantly increase different (P<.05). There was a significant between-group difference increase in the arm functional assessment (P<.05). There was a positive correlation between GS and muscle activity on the FMA in the control group (r=.678, P<.05). In experimental group, GS during the bending arm action exhibited a negative correlation (r=-.749, P<.05), and the muscle activity of the AD and BB showed a positive correlation (r=.701, P<.05). Furthermore, in experimental group, the activity of the extensor carpi radialis increased, and the activity of the flexor carpi radialis decreased, which exhibited a negative correlation (r=-.708, P<.05). Conclusion: These results suggest that brain plasticity could be more efficiently stimulated by combining surface stimulation in the affected arm of stroke patients.

• 재활치료과학
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• 제9권4호
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• pp.7-20
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• 2020

목적 : 본 연구는 뇌졸중 환자들의 상지기능 개선을 위해 말초신경감각자극과 과제지향적 훈련의 동시적용하여 효과를 알아보는 것이다. 연구방법 : 본 연구는 29명의 편마비 환자를 대상으로 수행하였다. 말초신경감각자극과 과제지향적 훈련을 동시에 적용한 실험군은 14명, 과제지향적 훈련만 실시한 대조군은 15명으로 주5회, 회기당 30분씩, 총 4주간 진행하였다. 결과측정은 손목과 어깨근육의 자발적 근수축 비율과 상자와 나무토막 검사, 잡기와 쥐기의 근력, Action Research Arm Test를 사용하여 중재 전·후로 측정하였다. 결과 : 4주간의 중재 후 짧은노쪽손목폄근, 노쪽손목굽힘근의 근 활성도와 잡기 근력, Action Research Arm Test에서 실험군은 대조군 보다 유의한 개선을 나타냈다. 결론 : 말초신경감각자극과 과제지향적 훈련의 동시적용은 과제지향적훈련만 하는 것보다 뇌졸중 환자의 상지기능 개선에 보다 효과적이었다.

• 대한의용생체공학회:의공학회지
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• 제15권4호
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• pp.465-474
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• 1994

This study is concerned with a method which helps human to generate EMG signals accurately and consistently to make reliable design samples of function discriminator for prosthetic arm control. We intend to ensure a signal accuracy and consistency by training human as a signal generation source. For the purposes, we construct a human training system using a digital computer, which generates visual graphes to compare real target motion trajectory with the desired one, to observe EMG signals and their features. To evaluate the effect which affects a feature variance and a feature separability between motion classes by the human training system, we select 4 features such as integral absolute value, zero crossing counts, AR coefficients and LPC cepstrum coefficients. We perform a experiment four times during 2 months. The experimental results show that the hu- man training system is effective for accurate and consistent EMG signal generation and reduction of a feature variance, but is not correlated for a feature separability, The cepstrum coefficient is the most preferable among the used features for reduction of variance, class separability and robustness to a time varing property of EMG signals.

• 한국치위생학회지
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• 제18권3호
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• pp.269-280
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• 2018

Objectives: The purpose of this study was to investigate the change in the posture of dental hygiene students and clinical dental hygienists when implementing dental scaling before and after posture correction training using the rapid upper limb assessment (RULA) method and 3D motion analysis. Methods: Thirty-two healthy volunteers performed dental scaling to remove artificial calculus on dental manikin. The movement and angle of the joints were verified by RULA and 3D motion analysis during the procedure. The subjects were also photographed for 1 minute during the procedure for 10 minutes while the calculus was removed. After the removal of the calculus, the subject and the instructor checked the video together. Posture correction training was conducted by the instructor so that the subject could perform the calculus removal operation in the correct posture. Artificial calculus of the adjacent teeth was then removed for the same period of time, and the change in posture was reviewed. Results: The total score of the posture change using RULA was $5.72{\pm}0.58$ before training and $4.31{\pm}0.10$ after training, showing a significant decrease after training (p<0.001), and upper arm, lower arm, wrist position, neck and waist position showed significant decrease after training. The three-dimensional motion analysis showed significant differences according to the criteria measured at all measurement sites except the left shoulder (p<0.05) Conclusions: It was confirmed through RULA and 3D motion analysis that postural correction training using calculus removal images was effective, and that correct postural education is essential to preventing musculoskeletal diseases caused by removal of calculus.

• 대한물리치료과학회지
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• 제27권3호
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• pp.67-74
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• 2020

Background: The purpose of this study was to investigate the change of lower limb muscle activation according to the use of arm sling in normal subjects. Design: Cross-sectional Study Methods: Seven healthy subjects (6 males and 1 female, 25.42 years, 173.57 cm, 71.71 kg) were recruited on a voluntary basis. To measure the lower limb muscle activation during walking with and without arm sling, we used a wireless surface electromyography (sEMG) (FreeEMG1000, BTS Bioengineering, Milano, Italy). Six wireless sEMG electrodes were attached to the following three major muscle groups of the both side lower limb: rectus femoris, biceps femoris, medial gastrocnemius. All subjects wore arm sling on their right side during measurement. Results: In the stance phase, there was a significant increase in right side rectus femoris muscle activation in walking without arm sling compared to the walking with arm sling (p<.05). Additionally, In the stance phase, there was a significant increase in left side tibialis anterior muscle activation in walking without arm sling compared to the walking with arm sling (p<.05). Conclusion: The results of this study suggest that there is a significant association between the arm swing restriction and lower limb muscle activation. Therefore, it seems that it can be applied as basic data for gait training with an arm slings.