• Clinics in Shoulder and Elbow
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• 제12권2호
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• pp.159-166
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• 2009

목적: 압박 긴장대 방법을 이용한 작은 구상 돌기 골절의 견고한 고정과 주관절의 조기 운동을 통한 기능의 향상 및 그 결과를 분석하고자 한다. 재료 및 방법: 주관절 내측접근법으로 K-강선과 철선을 이용하여 고정된 8예의 구상돌기 골절을 대상으로 하였다. 분류상 8예 모두 Regan-Morrey type 2였으며 O'Driscoll 분류12)로는 tip형(subtype 2)가 예, anteromedial 형 (subtype 2, 1예 그리고 subtype 3, 2예)3예였다. 동반 손상으로는 측부인대 파열이 6예, 요골두 및 경부골절이 4예였으며 모두 함께 치료하였다. 술 후 5~7일간의 고정 치료 후 경첩 보조기 (hinge brace)을 착용한 상태에서 술후 6주까지 능동적 운동을 허용하였다. 술 후 통증의 여부, 관절 운동 범위, Mayo elbow performance score(MEPS)을 이용한 기능적 평가 방법을 이용하여 치료 결과를 분석하였다. 평균 11 (6~28)개월 추시 하였으며 척골 신경 증상에 대해서도 함께 조사하였다. 결과: 모든 구상돌기 골절은 내고정용 도구의 실패 없이 모두 유합되었다. 평균 2.2 (2~4)개의 K-강선이 사용되었다. 관절운동 범위에 대해 신전은 평균 $3^{\circ}(0^{\circ}\sim25^{\circ})$, 굴곡는 평균 $137^{\circ}(130^{\circ}\sim140^{\circ})$, 회내전은 평균 $69^{\circ}(45^{\circ}\sim90^{\circ})$, 회외전은 $78^{\circ}(45^{\circ}\sim90^{\circ})$이였다. MEPS는 평균 96 (65~100) 이였다. 척골 신경 증상은 terrible triad 1예에서 첫 수술 (index operation)후 요골두를 절제하고 내측 측부 인대의 기능 부전이 있는 1예에서 관찰되었다. 결론: 쉽게 구할 수 있으며 가격이 저렴한 K-강선과 철선을 이용한 압박 긴장대 방법은 충분히 견고하여 조기에 능동적 운동을 허용할 수 있어 주관절의 기능 향상을 가져올 수 있었다. 이 방법은 특히 다발성 소형 구상 돌기 골절의 경우 유용한 하나의 고정 방법으로 생각된다.

• 대한물리의학회지
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• 제12권2호
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• pp.75-82
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• 2017

PURPOSE: The purpose of this study was to determine the effects of arm training in standing position on balance and walking ability in chronic stroke patients. METHODS: Sixteen chronic stroke patients were allocated equally and randomly to an experimental group (n=8) or a control group (n=8). All participants received 60 minutes of comprehensive rehabilitation treatment, the experimental group additionally received an arm training in standing position for 30 minutes, while the control group additionally performed a treadmill training for 30 minutes. These 30-minute training sessions were held three times per week for six weeks. Upper extremity function was assessed using Fugle-Meyer motor assessment function upper extremity (FMA-UE), balance was assessed using Berg balance scale (BBS), and walking ability (gait speed, cadence, step length, and double limb support period) was assessed using the GAITRite system. RESULTS: Improvement on all outcome measures was identified from pre-to-post intervention for both groups (p<.05). Post-intervention, there was a significant between-group difference on BBS, gait speed, cadence, step length, and double limp support period (p<.05). The experimental group exhibited greater improvement in the BBS (p=.01; z=-2.48), gait speed (p=.01; z=-3.26), cadence (p=.02; z=-2.31), step length (p=.01; z=-3.36), and double limb support period (p=.03; z=-2.84) compared to the control group. CONCLUSION: The findings of this study suggest that arm training in standing position may be beneficial for improving balance and walking ability of patients with chronic stroke.

• 재활치료과학
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• 제4권2호
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• pp.84-91
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• 2015

본 연구는 해외 많은 분야의 재활에서 적용되고 있는 peer mentor 프로그램을 국내에 연구적, 임상적으로 도입하여 뇌졸중 환자의 정신적, 신체적 회복을 돕는 방법을 소개하고자 하였다. 두 집단 실험 설계로 뇌졸중이 발생한지 3-6개월인 환자들을 대상으로 설계하였다. 동료멘토는 뇌졸중이 발생한지 2년이 지난 외래 환자로 서로 다른 회복수준을 보이는 환자들로 구성하고, 프로그램을 운영하기에 앞서 참가자들에게 심리적, 평가적, 정보적인 도움을 주는 방법과 프로그램 운영 방법에 대해 교육한다. 한국판 노인 우울 척도 단축형 (Geriatric Depression Scale Short Form-Korea Version; GDSSF-K)을 사용하여 프로그램 참가자들의 심리적 요인을 측정하고, 뇌졸중 영향척도(Stroke Impact Scale; SIS)를 통해 회복수준을, 노인 상지 기능평가도구(Upper Extremity Function Test for the Elderly; TEMPA)을 사용하여 신체적 요인을 측정한다. 본 연구를 토대로 연구를 진행하고자 하는 연구자는 본 연구에서 제안한 방법과 더불어 뇌졸중 환자의 회복에 더 효과적인 프로그램 적용 방법에 대한 모색이 필요할 것이다.

• 한국전문물리치료학회지
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• 제14권2호
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• pp.1-10
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• 2007

The purpose of this experiment was to investigate the applicability of audio-visual modeling for improving the efficiency of rehabilitative programs by analyzing the effects of observing these various models on the capacity of stroke patients to perform upper limb activities. Twenty-one stroke patients participated in the experiment and were randomly assigned to either task modeling, sport modeling, or control group. During 2 weeks of intervention, subjects in all groups participated in the physical practice of experimental tasks. These tasks comprised of a Nine Hole Peg Test, the Jebsen-Taylor Hand Function tests, and locomotion. These tasks were performed 5 days a week, 30 min per day. In addition to the physical practice, the task modeling group observed a model performing experimental tasks and locomotive activities for 20 min, while the sport modeling group observed a model performing various sport activities for 20 min. Subjects' ability to perform the experimental tasks was measured 3 times, before, immediately after, and 1 week after the intervention. Analyses of the capacity to perform upper extremity activities displayed significant improvement from the pre-test to immediate and delayed post-tests in all groups. However, the amount of improvement was the highest in the task modeling group. The task modeling group was superior to the control group in the post-test of all experimental tasks, whereas the sport modeling group did not display significant differences from the control group. These results suggest that audio-visual modeling can be used as an effective cognitive intervention for facilitating the rehabilitation of stroke patients, and its rehabilitative effect can be maximized when the program is comprised of performance scenes directly related to the target task.

• 대한물리치료과학회지
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• 제4권1호
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• pp.229-242
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• 1997

This study was performed to figure out effects of stroke rehabilitation on education using isokinetic exercise on physical function recovery. It is considered isokinetic exercise will playa primary role in muscle strength, ROM of joint, and body balance recovery for stroke rehabilitation and so far can be used as a basic references to increase the health of all people. The study consisted of 42 stroke patient(21 training group, 21 control group) diagnosed as cerebral hemorrhage from Oriental Rehabilitation Department of Kyung Hee University. Upper extremity and lower extremity exercise was performed in the training group using isokinetic ergometer. The recovery of physical function(muscle strength, ROM of joint, body balance) data between the two groups were compared and ana lysed by paired t-test are as followed. 1. Muscle testing record showed increased in the strength of elbow flexion, knee flexion, knee extension, ankle extension of the training group com paired to control group(p < .05). In the measurement of ROM, however other parts of the body motion showed no significant changes, only shoulder extension of the training group was increased(p < .05). 2. Body balance increase was highly significant in all training group compaired to control group(p<001). Based on these findings, stroke rehabilitation education with isokinetic ergometer showed available effects on recovery of physical function rehabilitation program with isokinetic exercise will play a primary role in the recovery of physical function of stroke or brain injury patients as well as to promote the health of all people.

• 재활간호학회지
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• 제5권1호
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• pp.7-17
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• 2002

The purpose of this study was to investigate the effect of taping therapy on activities of daily livings (ADL), hand function and range of motion in poststroke-hemiplegic patients. Sample were selected from 20 poststroke-hemiplegic patients at public health center in the period from September 5 to November 21, 2001. The research design was one group pretest-posttest design. The hemiplegia period of the participants was from one year to five years. The pretest and posttest included measuring activity of daily livings(ADL), instrumental activity of daily livings(IADL), hand function, range of motion, quality of life. In this research design, a treatment were to expose taping therapy who were received self-help management program. This self-help management program was composed of five sessions and each session had health education on stroke, diet, risk factor, ROM exercise and recreation. 20 patients were treated with kinesio taping(Nippon Sigmax Co., Ltd., Benefact(r), width 50mm). Tapes were applied to the Deltoid, Supraspinatus, Infraspinatus, Brachioradialis with paralyzed upper extremity. The taping therapy was performed once a week for 5 weeks. SPSS Win 8.0 was used for the data analysis. The results of this study were as follows: 1) The score of BADL was increased from 30.5 to 33.95 after program, and that was statistically significant(p=.019). 2) The score of IADL was increased from 11.6 to 12.75 after program, but that was statistically insignificant(p=.161). 3) The score of hand function was increased from 17 to 20.35 after program, and that was statistically significant(p=.026). 4) The shoulder's ROM(p=.000) and wrist's ROM(p= .004) were significantly increased. According to the results of this study, taping therapy is effective for improving ADL, hand function, ROM, quality of life. However, this study found no significant differences in IADL. Consequently, these findings showed that the taping therapy was effective in improvement of physical aspects(BADL, hand function, upper extremity's ROM) in poststroke-hemiplegic patients.

• 대한물리의학회지
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• 제12권4호
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• pp.19-28
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• 2017

PURPOSE: The purpose of this study was to describe the Proprioceptive Neuromuscular Facilitation (PNF) Intervention strategy applied International Classification of Functioning, Disability and Health (ICF) Tool about strength, range of motion, scapular stability, pain and function of shoulder for patients with adhesive capsulitis. METHODS: The data was collected by patient with adhesive capsulitis. The patient was a 50-year-old male diagnosed with right shoulder with adhesive capsulitis. We applied the PNF Intervention strategy applied ICF Tool to patient with adhesive capsulitis. PNF interventions were consisting of such as combination of isotonic and stabilizing reversal technique and various positions. PNF interventions were applied, such as those aiming at decreasing pain and disability and increasing range of motion and function for the four weeks. Parameters of result were collected for strength, range of motion, scapular stability, pain and function of shoulder using the hand held dynamometer, goniometer, lateral scapula slide test, and shoulder pain and disability index, respectively. RESULTS: Clinical benefits were observed the patient with adhesive capsulitis for strength, range of motion, scapular stability, pain, and function of shoulder. The patient with adhesive capsulitis improved strength, range of motion, scapular stability, pain, and function of shoulder. CONCLUSION: Patient reported improved strength, range of motion, scapular stability, pain, and function of shoulder after intervention.

• 대한물리의학회지
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• 제15권4호
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• pp.101-109
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• 2020

PURPOSE: This study investigates the therapeutic effect of a prototype of a hand rehabilitation device based on magnetic forces. METHODS: Using an electromagnet and permanent magnets, we developed an end effector type device that induces various movements of the finger in accordance with the magnetic field direction. A total of 26 subacute stroke patients were enrolled and assigned to two groups in this randomized controlled trial. The intervention group received 30 minutes hand rehabilitation therapy per day for 4 weeks, using the device developed by us. Conventional physical therapies were conducted equally twice a day, 30 minutes per session, during the same period in both groups. RESULTS: After 4 weeks, rate of the Wolf Motor Function Test as a primary outcome measure showed significant improvement in the intervention group as compared to control group(p = .036). Scores of the Manual Function Test and Fugl-Meyer Assessment of upper limb were also significantly increased in the intervention group as compared to control group(p = .038 and p = .042, respectively). Moreover, the Korean version of Modified Barthel Index tended to improve after subjecting to physical therapy in both groups. CONCLUSION: Our results indicate that the novel hand rehabilitation device developed using a magnetic force, improves the hand motor functions and activities of daily life in subacute stroke patients.

• 재활치료과학
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• 제8권2호
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• pp.43-53
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• 2019

목적 : 본 연구의 목적은 Upper extremity performance test for elderly (TEMPA)의 한국 노인 표준치를 제시하고, 수집된 자료를 바탕으로 한국 노인의 연령별, 성별 손 기능의 특성과 근력의 차이를 알아보는 것이다. 연구방법 : 연구에 참여한 대상자는 60세 이상의 손 기능에 장애가 없는 노인 103명이었다. 손 기능의 특성을 알아보기 위하여 모든 대상자에게 TEMPA 평가를 시행하였고, Jarmar dynamometer, pinch gauge를 사용하여 손과 손가락 근력을 평가하였다. 결과 : 나이가 증가함에 따라 수행 속도와 소 근육의 움직임의 질이 유의미하게 감소하였다. 남성 노인의 수행 속도와 소 근육 움직임의 질이 여성 노인보다 더 높게 유지 되었다. 노인의 손과 손가락의 근력 또한 연령이 증가함에 따라 유의미하게 감소하였다. 결론 : 작업치료사는 노인의 손 기능과 근력 감소에 대한 관심을 가지고 그 기능 수준을 유지하기 위한 중재를 제공하는 것이 필요할 것이다. 본 연구를 통해 TEMPA의 한국 노인 표준치가 확립되었다. 이 자료가 임상적 평가 및 근거 기반의 연구에 있어 유용하게 쓰이기를 기대한다.

• 대한물리치료과학회지
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• 제12권3호
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• pp.7-12
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• 2005

Constraint-induce therapy(CIT) has been documented to improve motor function in the upper extremity of people with hemiparesis. The exercise program uses the training technique 'shaping'. Shaping involves repetitive exercise that are progressed in small steps, where only positive feedback is given to the patients. It involves 14 days of using a restraint on the unaffected arm after stroke for 90% of waking hours. In conjunction with this, ten days of intensive exercise with the affected arm are undertaken for around six hour daily. CIT produces great improvement of motor function with a period of 2 weeks, that the treatment effect remains stable for many months after the end of therapy, and that it transfers into the everyday lives of patients. The purpose of this study is to introduce about the principles of CIT charactieristic, techniques, therapeutic effects-throughout reference books.