• 수면정신생리
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• 제2권1호
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• pp.23-30
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• 1995

유뇨증은 발병기전이 단일한 원인으로 설명되기 어려운 임상적으로 복합적인 질병이다. 유전적 요인, 신경근육계 및 비뇨기계의 미성숙, 심리사회적 요인이나 대소변 가리기 훈련의 이상, 그리고 생물학적 요인 등 여러 가지 원인론들이 있으나 아직 확실한 것은 없다. 그러나 최근 신경생리학적 연구와 신경 내분비학적 연구들의 결과, 야뇨증과 수면주기와의 관련성이나 야간의 항이뇨호르몬 (antidiuretic hormone) 분비 저하와의 관련성 등 보고되어 야뇨증의 치료에 있어 새로운 접근을 가능하게 하고 있다. Vasopressin 이 우수한 치료율, 안전성, 적은 부작용 등으로 새로운 치료약물로서 시도되고 있으나 재발율이 높아, imipramine또는 vasopressin의 투여와 Bell-alarm행동요법을 병행하여 치료하는 것이 바람직하다.

• 대한통합의학회지
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• 제8권2호
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• pp.211-220
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• 2020

Purpose : The purpose of the present study is to examine the effects of VR training with FES on improving the muscle strength, AROM, and function of the upper limb joints in patients with chronic stroke. Methods : The present study makes use of a pre-post control group design. Thirty patients with chronic stroke were randomly assigned to two groups according to treatment method - the VRFES group and the control group. The VRFES group received 15 minutes of VR training and 15 minutes of FES treatment. The control group received 15 minutes of conservative physical therapy and 15 minutes of VR training. All subjects received 30 minutes of treatment, three times a week, for eight weeks, which amounted to 24 sessions of training. The muscle strength, AROM, and function of the upper extremities were measured before the training and eight weeks after. Upper limb muscle strength was tested using the Digital Manual Muscle Tester while AROM was measured using the Digital Dual Inclinometer. The clinical assessment tools for upper extremity function included the use of the Manual Function Test and the Jebsen-Taylor Hand Function Test. Results : Both groups exhibited great improvements in muscle strength and upper extremity function during the intervention period. The VRFES group exhibited a significant difference in muscle strength, AROM, and function of the upper extremities in comparison with the control group(p<.05). Our results reveal that VRFES is more effective for the muscle strength, AROM, and function of the upper extremities in patients with chronic stroke. Conclusion : VRFES treatment will be used as an important intervention for improving the muscle strength, AROM, and function of the upper extremities in patients with chronic stroke and achieving the functional recovery of the upper extremities.

• The Journal of Korean Physical Therapy
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• 제21권2호
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• pp.1-8
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• 2009

Purpose: This study examined the effect of EMG-stim related to the functional recovery of the upper extremity in chronic stroke patients with an intensive massed practice protocol. Methods: The subjects were assigned randomly to either the EMG-stim group (n=10) or sham treatment group (n=10). Both groups received conventional physical therapy, occupational therapy and FES, five times per week over a four week period. In the EMG-stim group, EMG-stim was applied to the hemiplegic wrist and finger extensors for 2 sessions for 30 minutes per day, 5 times per week over a 4 week period. As the pre- and the post-test, the following four motor tests were assessed as the function of the upper extremity clinical functional test: extensor digitorum strength test, Box and Block test, Fugl-Mayer Assessment, and Jebson-Taylor Hand Function Test. Results: In the Box and Block test and Fugl-Mayer Assessment, there were statistically significant differences between both groups as well as between pre- and post-test. The extensor digitorum and wrist extensor strength were similar in both groups. In the Jebson-Taylor Hand Function Test, there was a significant difference in simulated page turning but not in the other subtests. Conclusion: Intensive massed practice with EMG-stim intervention applied to the hemiplegic upper extremity is an effective therapeutic method for chronic stroke patients. However, a variety of intervention methods designed for stroke patients in clinical settings are needed.

• 한방재활의학과학회지
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• 제34권3호
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• pp.107-117
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• 2024

The objective of this study is to report the clinical effects of applying an integrated rehabilitation protocol to four patients with traumatic cervical spinal cord injuries. The treatments applied included acupuncture, cupping and moxibustion, chuna manual therapy, functional electrical stimulation, and other physical therapies. The evaluation methods included American Spinal Injury Association Impairment Scale, functional independence measure (FIM), modified Barthel index (MBI), numeric rating scale (NRS) and other scales. All patients presented marked improvements in FIM, MBI, NRS and other scales, along with increased muscle strength in the manual muscle test. The application of our protocol resulted in clear clinical benefits and enhanced the recovery and quality of life for the patients in this study.

• 재활복지공학회논문지
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• 제7권2호
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• pp.55-62
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• 2013

본 논문은 편마비 환자나 장애인의 보행을 지원하는 외골격 로봇에 대해 연구하였다. 2축 자유도를 가진 외골격 로봇 개발 및 관절 운동에 대해 테스트 하였다. 정상적인 사람으로부터 얻어진 EMG 신호를 분석하고, 편마비 환자를 정상적인 사람처럼 보행 할 수 있도록 보조 로봇을 편리하고 자동화된 보행이 되도록 제어신호를 추출 하였다. 편마비 환자의 보행을 위한 기능적 전기 자극(FES)를 사용하는 목적이 손상된 기능을 복원하는 것이다. 그러나 이것은 사용을 잘못하면 환자에게 치명적인 전기 충격을 줄 수 있거나 지속적인 자극으로 근육피로의 원인이 될 수 있다. 최소한의 근육 피로도로 편마비 환자의 편리한 걸음은 제어 신호로 외골격 보조 로봇의 조작을 통해 가능성을 제시하였다. 보행 보조 외골격로봇은 FES 자극기를 사용하는 것보다 보다 효율적으로 동작할 수 있음을 보였다. 본 연구 실험은 앉아, 서, 걷기같이 우리의 생활에 보통의 움직임을 수행하고, 버튼스위치, 피에조 센서와 특별히 피드백 제어 시스템은 부드러운 보행 모션이 되도록 하였다. 그리고 실험결과도 건강한 다리의 근전도 신호를 편마비 환자의 손상된 다리의 보조로봇 시스템의 동작신호로 이용하여 편리하게 이동할 수 있음을 보여준다.

• 대한의용생체공학회:의공학회지
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• 제16권4호
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• pp.507-516
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• 1995

근전도 신호(electromyogram)의 시변 비정상(time varying nonstationary) 특성은 신호의 정확한 모델링 및 인식에 제약 조건으로 받아들여 졌다. 특히, 최근 들어 장애자들을 위한 보철제어분야에서 근전도 신호를 이용한 기능적 전기 자극을 위한 FES(funcitonal electrical stimulation) 시스템에 있어 근전도 신호의 파라메터 인식은 중요한 요소로서 작용한다. 그러나, 근전도 신호는 자세의 변화 및 근육 피로도 등의 요인에 의해서 시변 비정상 특성을 띠고 있기 때문에 시간에 따라 변하는 인식 파라메터를 정확하게 인식할 수 있는 새로운 알고리즘의 개발과 실시간 처리가 가능한 컴퓨터 하드웨어의 설계가 요구된다. 따라서, 본 논문에서는 시평면의 근전도 신호를 이산 여현 변환(discrete cosine transform)을 이용하여 변환 평면으로 옮긴 다음 상태 방정식(state space equation)을 써서 변환 평면상에서의 AR(autoregressive) 모델을 세우고 주어진 근전도 신호에 대해 모델 파라메터를 추정하였으며, 제안한 알고리즘은 실시간 처리를 위하여 2개의 독립적인 중앙 연산 처리 장치를 갖춘 INMOS사의 IMS T-805 병렬 처리 컴퓨터를 이용하여 동시 다발적인 연산을 수행함으로서 알고리즘의 연산 효율을 높였다. 제안된 알고리즘의 타당성을 검증하기 위해 모델의 추정 오차에 영향을 미치는 입력 자기상관 행렬(input correlation matrix)의 condition number의 변화 및 평균자승오차(mean square error)를 구하여 기존의 SLS(sequential least square) 알고리즘과 비교하였다.

• 대한정형도수물리치료학회지
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• 제11권1호
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• pp.11-28
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• 2005

Spasticity has been defined as "a motor disorder characterized by a velocity-dependent increased in tonic stretch reflexes with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex, as one components of the upper motorneuron syndrome". Spasticity is one of the common symptoms of stroke patients and frequently interferes with the motor functions such as gait, posture and activities of daily living. Therefore, its management is becoming a major issue in physical therapy. The purpose of this study was to determined the effects of reciprocal inhibition by isometric contraction of pre-tibia muscle on spasticity in hemiplegic patients through Hoffmann reflex. The subjects were consisted 45 patients who had hemiplegia due to stroke. All subjects randomly assigned to 3 group: manual reciprocal inhibition program group(manual group), neuromuscular electrical stimulation group(NMES group) and control group. The manual group received voluntary isometric contraction of pre-tibia muscle. The NMES group received neuromuscular electrical stimulation on tibialis anterior. The control group was not received any therapeutic intervention. Before and after experiments, Hoffmann reflex, M-wave and Modified Ashworth scale was measure in all patients. The data of 30 patients who complete experimental course were statistically analysed. Modified Ashworth scale were significantly decreased after experiment in manual group(p<.01). The Hmax/Mmax ratios were significantly decreased after experiment in manual group(p<.o1). There were no statistical difference between pre-test and post-test with modified Ashworth scale in NMES group(p>.01). There were no statistical difference between pre-test and post-test with Hmax/Mmax ratios in NMES group(p>.01). There were no statistical difference between pre-test and post-test with modified Ashworth scale in control group(p>.01). There were no statistical difference between pre-test and post-test with Hmax/Mmax ratios in control group(p>.01). The present results revealed that reciprocal inhibition which produced by voluntary isometric contraction of pre-tibia muscle can be reduce spasticity of gastrocnemius. Therefore, reciprocal inhibition is useful to improve functional activities in hemiplegic patient. Further study should be done to analyse the effects of intervention duration of reciprocal inhibition, appropriate muscle contraction, optimal time to apply the reciprocal inhibition in more long period.

• Restorative Dentistry and Endodontics
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• 제15권1호
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• pp.1-15
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• 1990

The aim of this study was to investigate the effect of dental therapeutic agent on conduction velocity and threshold current of intradental A- and C-fibers in the cat. Inferior alveolar nerve of cat anesthetized with sodium pentobarbital was exposed and dissected until response of functional single pulp nerve until could be evoked by monopolar electrical stimulation of the crown of the lower left canine teeth. 10ms rectangular pulse was used to determine the threshold current and 1ms rectangular pulse was used to determine conduction velocity. After application of calcium chloride (1, 2, 6M), calcium hydroxide mixed with saline, potassium chloride (0.2, 0.8, 1.6M), eugenol, zinc oxide eugenol to the cavity on the labial surface, conduction velocity and threshold current of single pulp nerve unit were compared with the control. In 10 cats, 24 $A{\delta}$- and 11 C- pulp nerve units were recorded. The mean conduction velocities of $A{\delta}$- and C-fibers were 7.5m/sec (SD=5.8) and 1.2m/sec (SD=0.4), respectively. The mean threshold current was $12.3{\mu}A$ (SD=5.3) for $A{\delta}$-fibers and $24.9{\mu}A$ (SD=8.1) for C-fibers. 1, 2, 6M calcium chloride caused decrease of conduction velocity and remarkable increase of threshold current in $A{\delta}$- and C-fibers. The effect of calcium hydroxide mixed with saline was similar but smaller than calcium chloride solution. 0.2M potassium chloride had insignificant effect. In 0.8M potassium chloride, the threshold current was increased although conduction velocity was not affected. In 1.6M potassium chloride, the threshold current was increased and the conduction velocity was slowed down. Spontaneous activity was recorded frequently for first 5 min but gradually reduced both in $A{\delta}$- and C-fibers. Eugenol had irreversible effect on pulp nerve in that initially there were not certain changes in the conduction velocity and threshold current of $A{\delta}$- and C-fibers, but the responses to electrical stimulation were abruptly disappeared after sustained application and were not recovered. Contrary to eugenol, zinc oxide eugenol did not caused significant increase of the threhold current and caused time dependent decrease of the conduction velocity, and did not show any irreversible change.

• 한국전기전자재료학회논문지
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• 제35권5호
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• pp.431-438
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• 2022

기능성 소재연구에서 in situ 분석 기법은 외부 자극 (전기장, 자기장, 빛, 등) 또는 주변 환경 (온도, 습도, 압력, 등)과 같이 주어진 자극에 의해 소재의 물리적 특성이 어떻게 활성화/진화되는지 분석하는데 있어서 매우 중요하다. 특히, 전기장 인가에 따른 in situ X-선 회절(XRD) 실험은 다양한 강유전체, 압전체, 전왜 재료의 외부 전기장 인가에 따른 전기-기계적 반응의 기본 원리를 이해하기 위해 광범위하게 활용되었다. 본 튜토리얼 논문에서는 일반 실험실 규모의 XRD 장비를 이용하여 전기장 인가에 따른 in situ XRD 분석의 기본 원리/핵심 개념을 간략하게 소개한다. In situ XRD 측정법은 외부 전기장을 인가하여 구동되는 다양한 전기-기계 재료의 구조적 변형을 체계적으로 식별/모니터링하는 데 매우 유용할 것으로 기대한다.

• 대한한의학회지
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• 제29권4호
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• pp.205-212
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• 2008

Background and purpose: So far it was reported that acupuncture increased cerebral blood supply and stimulated the functional activity of brain nerve cells. A previous study demonstrated a correlation between LI4-11 electro-acupuncture (EA) and rCBF increase in frontal lobe. However, there remained a need to study further using various controls in acupuncture research. Transcutaneous electrical nerve stimulation (TENS) has been used as a non-invasive control in acupuncture study. This study was to evaluate the effect of LI4-LI11 TENS on regional cerebral blood flow (rCBF) in normal volunteers using single photon emission computed tomography (SPECT) and statistical parametric mapping (SPM). Methods: In the resting state, $^{99m}Tc-ECD$ brain SPECT scans were performed on 10 normal volunteers (9 males, 1 female, mean age 26.6$\pm$0.5 years; age range from 26 to 27 years). On the other day, 7 days after the resting examination, 15 minute TENS were applied at LI 4 and LI 11 on the right side of the subjects. Immediately after LI4-LI11 TENS, the second SPECT images were obtained in the same manner as the resting state. Significant increases and decreases of regional cerebral blood flow after LI4-LI11 TENS were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by statistical parametric mapping with a threshold of p = 0.001, uncorrected (extent threshold: k=100 voxels). Results: TENS applied at right LI4-LI11 increased rCBF in the left somatosensory association cortex (Brodmann area 5, 7). However there was no area where LI4-11 TENS decreased rCBF. Conclusion and suggestions: These results demonstrate that right LI4-LI11 TENS increased rCBF only in corresponding somatosensory association cortex, which was different from the previous results using LI4-11 EA. It is suggested that there be a different mechanism between TENS and EA.