• 제목/요약/키워드: Gait balance

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질환 중심 기공프로그램 개발 사전연구 : 파킨슨병 관리 프로그램을 중심으로 (Development of disease-specific qigong program for Parkinson's disease)

  • 이화진;이혜정;인창식;채윤병;백유상;신용철;이상재;박히준
    • Korean Journal of Acupuncture
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    • 제26권4호
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    • pp.77-88
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    • 2009
  • Background : Qigong is an exercise therapy based on the principles of Traditional East Asian Medicine. The exercises combine the practice of motion and breathing, both guided by mental imagery. Beneficial effects of qigong have been reported on a variety of complaints in chronically ill patients and on gait imbalance in the elderly. Parkinson's disease is a progressive neurodegenerative disorder that affects neurophysiological function, movement abilities, and quality of life. Objectives : We developed a qigong program based on the Traditional East Asian medical theory regarding the improvement of clinical symptoms of Parkinson's disease. Methods and Results : Our qigong program consists of three parts. The first one includes movements which stimulate the meridians that run from the toes to the top of the head. The second one is composed of breathing and qigong movements that create harmony and balance with the circulation of Qi and blood on the Meridians. The third is a stage of finger pressure therapy and massage from Daoyin medical qigong to maintain meridian stability. Conclusions : These qigong program would help relieve the clinical symptoms of Parkinson's disease patients.

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외측 연수경색 및 소뇌경색에 의한 Wallenberg 증후군 환자의 한방 치험 1례 (A Case Report of Wallenberg Syndrome due to Lateral Medullary and Cerebellar Infarction Treated with Korean Medicine Treatment)

  • 남현서;한승희;백태현;김미경;선승호;정의민;한인식
    • 대한한방내과학회지
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    • 제40권5호
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    • pp.768-775
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    • 2019
  • Objective: The aim of this study was to report a case in which Korean medicine treatment with Gami-daebo-tang and acupuncture improved the clinical symptoms in a patient with Wallenberg syndrome. Methods: The patient was treated for 53 days with a Korean medicine treatment consisting of Gami-daebo-tang and acupuncture. We measured dysesthesia based on the number of affected dermatomes. Gait ataxia was estimated with the Korean version of the Berg Balance Scale (K-BBS) and the number of times that the patient had stumbled per day. Dizziness was measured with a numerical rating score (NRS). Results: After treatment, the number of affected dermatomes was decreased. The K-BBS score was improved from 52 to 56, and the frequency of stumbling decreased from 20 to 0 times per day. The NRS score of dizziness decreased from 8 to 0. Conclusion: This case showed that Korean medicine treatment might be helpful for improving the symptoms of patients with Wallenberg syndrome.

맞춤형 건강증진 프로그램이 여성 독거노인의 우울과 인지기능 및 신체 건강에 미치는 효과: 무작위 집락 배정 설계 (Effects of a Customized Health Promotion Program on Depression, Cognitive Functioning, and Physical Health of Elderly Women Living Alone in Community: A Cluster Randomized Controlled Trial)

  • 박예리자;송경애
    • 대한간호학회지
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    • 제49권5호
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    • pp.515-525
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    • 2019
  • Purpose: This study aimed to evaluate the effectiveness of a customized health promotion program (CHPP) on depression, cognitive functioning, and physical health of elderly women living alone in the community. Methods: A randomized comparison of pre-and post-test design was used with 62 participants assigned to either an intervention (n=32 in seven clusters) or a control group (n=30 in seven clusters) in 14 areas of a town. The final sample included 30 intervention participants who completed the CHPP for 10 weeks, and 26 control participants. The intervention group participated in the CHPP weekly; they were provided with instructions about coping with their chronic illnesses, lifestyle modification, risk management, providing emotional support to each other, and floor-seated exercise, which they were encouraged to do three times a week in their homes. Results: Significant group differences were found in depression (U=48.50, p<.001), cognitive functioning (U=2.50, p<.001), left arm flexibility (U=251.50, p=.023), right arm flexibility (U=225.00, p=.007), static balance (U=237.00, p=.012), and gait ability (U=190.50, p=.004). However, there were no significant differences in bothgrip strength and muscle mass between the two groups. Conclusion: The findings indicate that CHPP was overall effective at improving depression, cognitive functioning, and physical functioning of elderly women living alone, and could therefore be considered a positive program for community-dwelling elderly women living alone.

건강한 노인의 양손 협응성 변화 패턴: 체계적 문헌고찰 및 메타분석 연구 (Age-related Bimanual Coordination Impairments in Elderly People: a Systematic Review and Meta-analysis)

  • Kim, Rye Kyeong;Kang, Nyeonju
    • 한국운동역학회지
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    • 제31권4호
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    • pp.259-269
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    • 2021
  • Objective: The purpose of this systematic review and meta-analysis was to investigate age-related bimanual coordination functions in older adults. Method: Thirteen studies that compared bimanual coordination functions in older adults with those in healthy young adults qualified for this meta-analysis. We additionally categorized 21 total comparisons from the 13 qualified studies into two types of task-related moderator variables: (1) kinematic versus kinetic movements and (2) symmetry versus asymmetry movements. Results: Random effects model meta-analysis found that older adults revealed significant bimanual coordination impairments as compared with young adults (Hedges's g = -0.771; p < .0001; I2 = 74.437%). We additionally confirmed specific bimanual coordination deficits using two moderator variables: 1) kinematic (Hedges's g = -0.884; p < .0001; I2 = 0.000%) and kinetic (Hedges's g = -0.666; p = .023; I2 = 86.170%). 2) symmetry (Hedges's g = -0.712; p = .001; I2 = 74.291%) and asymmetry (Hedges's g = -0.817; p < .0001; I2 = 76.322%). The moderator variable analysis indicated older adults indicated bimanual coordination deficits in the upper extremities than healthy young adults while performing kinematic bimanual coordination tasks and asymmetry coordination tasks. Conclusion: These findings suggest that developing motor rehabilitation programs based on asymmetric bimanual movement task for enhancing interlimb coordination functions of older adults may be crucial for increasing their independence in everyday activities. Given that elderly revealed the deficits in lower extremities coordination when older adults perform gait, posture, and balance, future studies should estimate lower limb coordination functions in elderly people.

Understanding and Exercise of Gluteus Medius Weakness: A Systematic Review

  • Baik, Seung-min;Cynn, Heon-seock;Kim, Seok-hyun
    • 한국전문물리치료학회지
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    • 제28권1호
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    • pp.27-35
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    • 2021
  • A weak or dysfunctional gluteus medius (Gmed) is related to several pathologies, and individuals with hip abductor weakness have Gmed weakness. This study aimed to systematically review the literature associated with the anatomy and function of the Gmed, and the prevalence, pathology, and exercise of Gmed weakness. Papers published between 2010 and 2020 were retrieved from MEDLINE, Google Academic Search, and Research Information Sharing Service. The database search used the following terms: (glut* OR medius OR hip abduct*) AND weak*. The Gmed plays an important role in several functional activities as a primary hip abductor by providing pelvic stabilization and controlling hip adduction and internal rotation. Weakness of the Gmed is associated with many disorders including balance deficit, gait and running disorders, femoroacetabular impingement, snapping hip, gluteal tendinopathy, patellofemoral pain syndrome, osteoarthritis, iliotibial band syndrome, anterior cruciate ligament injury, ankle joint injuries, low back pain, stroke, and nocturia. Overuse of the tensor fasciae latae (TFL) as a hip abductor due to Gmed weakness can also cause several pathologies such as pain in the lower back and hip and degenerative hip joint pathology, which are associated with dominant TFL. Similarly, lateral instability and impaired movements such as lumbar spine lateral flexion or lateral tilt of the pelvis can occur due to compensatory activation of the quadratus lumborum for a weakened Gmed while exercising. Therefore, the related activation of synergistic muscles or compensatory movement should be considered when prescribing Gmed strengthening exercises.

비위허약으로 변증된 전정신경염 환자의 삼출건비탕가감방을 포함한 한의 치료 치험 1례 (A Case Report of Korean Medicine Treatment Including Samchulgunbi-tang-gagambang in a Patient with Vestibular Neuritis)

  • 박예슬;김정희;송주연;유호룡;설인찬;김윤식
    • 대한한방내과학회지
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    • 제44권4호
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    • pp.757-764
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    • 2023
  • Background: Vestibular neuritis is a common cause of acute unilateral peripheral vestibulopathy. Vestibular neuritis is the second most common disease among patients with dizziness. Clinical symptoms of vestibular neuritis include the sudden onset of vertigo with spontaneous nystagmus, unsteady gait, nausea, and vomiting that last from days to weeks. However, even after the vertigo disappears, difficulty maintaining balance while walking may persist for weeks to months. Antihistamines, serotonin receptor blockers, and benzodiazepine vestibular suppressants are widely used as symptomatic treatments to reduce the severity of symptoms that occur in the acute phase. Case Summary: A patient diagnosed with acute vestibular neuritis was treated with acupuncture, moxibustion, and herbal medicine. We used the visual analog scale (VAS) to assess each symptom and the vertigo score to observe the effect of treatment. After treatment, the VAS scores for each symptom and the vertigo score decreased, and the severity of nystagmus was reduced. Conclusion: This study suggests that Korean medicine treatments, including Samchulgunbi-tang-gagam, could be effective in improving the clinical symptoms of vestibular neuritis.

뇌졸중 환자를 위한 가상현실 기반의 원격재활 효과에 관한 체계적 고찰 (A Systematic Review on the Effects of Virtual reality-based Telerehabilitation for Stroke Patients)

  • 임영명;이지용;조성준;안예슬;유두한
    • 대한지역사회작업치료학회지
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    • 제7권1호
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    • pp.59-70
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    • 2017
  • 목적 : 본 연구의 목적은 뇌졸중 환자를 대상으로 가상 현실 기반의 원격재활 효과를 체계적으로 고찰하여 그 효과와 국내 적용방법을 알아보고자 하였다. 연구방법 : 자료의 검색을 위해 EMBASE, CINAHL의 데이터베이스를 이용하였다. 주요 용어는 "Virtual Reality", "Telerehabilitation", "Stroke"으로 관련 연구를 검색하였다. 선정기준에 적합한 총 7편의 연구를 대상으로 질적 수준, 일반적 특성, PICO를 사용하여 연구 주제에 따른 자료를 분석하였다. 결과 : 선정된 7편의 연구는 가상현실 기반으로 한 원격재활 시스템으로 중재를 실시하였으며, 가상현실은 게임 프로그램과 수동적인 팔 보조 그리고 Balance Trainer등을 활용하여 원격재활 중재를 실시하였다. 주된 결과 측정도구는 상지기능, 균형 및 보행, 일상생활 등을 평가하기 위한 도구가 사용되었다. 가상현실 기반의 원격재활 중재방법은 모든 연구에서 상지기능, 균형감각능력에서 효과를 보였으며, 일상생활 활동에서의 부분적인 효과를 확인하였다. 환경적 특이성을 보완하기 위한 원격재활 서비스는 클라이언트의 만족감을 향상시키고 기능의 유지를 위한 중재법으로 그 효과를 확인할 수 있었다. 결론 : 가상현실 기반의 원격재활 시스템은 대부분 상지기능과 균형감각, 일상생활 활동을 위한 중재가 적용되었으며, 가정환경에서도 치료사의 중재, 감독, 교육 등을 통해 기능향상에 도움이 되는 것으로 나타났다. 본 연구는 가상현실 기반의 원격재활의 임상적 적용에 대한 근거와 가능성을 제시하고자 한다. 향후 연구에서 다양한 가상현실의 중재방법과 원격재활을 활용한 재활 프로그램 개발과 같은 추가적인 연구가 필요할 것이다.

Rheumatic Arthritis-induced Alteration of Morphology and Function in Muscles

  • Hong, Yun-Kyung;Kim, Joo-Heon;Javaregowda, Palaksha Kanive;Lee, Sang-Kil;Lee, Sang-Rae;Chang, Kyu-Tae;Hong, Yong-Geun
    • Reproductive and Developmental Biology
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    • 제35권2호
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    • pp.151-157
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    • 2011
  • Clinical arthritis is typically divided into rheumatoid arthritis (RA) and osteoarthritis (OA). Arthritis-induced muscle weakness is a major problem in aged people, leading to a disturbance of balance during the gait cycle and frequent falls. The purposes of the present study were to confirm fiber type-dependent expression of muscle atrophy markers induced by arthritis and to identify the relationship between clinical signs and expression of muscle atrophy markers. Mice were divided into four experimental groups as follows: (1) negative control (normal), (2) positive control (CFA+acetic acid), (3) RA group (CFA+acetic acid+type II collagen), and (4) aging-induced OA group. DBQA/1J mice (8 weeks of age) were injected with collagen (50 ${\mu}g/kg$), and physiological (body weight) and pathological (arthritis score and paw thickness) parameters were measured once per week. The gastrocnemius muscle from animals in each group was removed, and the expression of muscle atrophy markers (MAFbx and MuRF1) and myosin heavy chain isoforms were analyzed by reverse transcription-polymerase chain reaction. No significant change in body weight occurred between control groups and collagen-induced RA mice at week 10. However, bovine type II collagen induced a dramatic increase in clinical score or paw thickness at week 10 (p<0.01). Concomitantly, the expression of the muscle atrophy marker MAFbx was upregulated in the RA and OA groups (p<0.01). A dramatic reduction in myosin heavy chain (MHC)-$I{\beta}$ was seen in the gastrocnemius muscles from RA and OA mice, while only a slight decrease in MHC-IIb was seen. These results suggest that muscle atrophy gene expression occurred in a fiber type-specific manner in both RA- and OA-induced mice. The present study suggests evidence regarding why different therapeutic interventions are required between RA and OA.

고령자 보행변수 실측을 통한 보행시설물 설계기준 정립 1: 고령자 보행특성을 고려한 계단 챌면 높이 연구 (A Study on the Design Criteria of Pedestrian Facility (Stairs) by Motion Analysis of Walking Parameters in the Elderly)

  • 노창균;박범진
    • 대한교통학회지
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    • 제35권5호
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    • pp.396-408
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    • 2017
  • 한국은 고령자가 폭발적으로 증가하고 있다. 또한 고령자의 경제활동과 고령자의 통행빈도 또한 증가 할 것으로 예상된다. 반면에 고령자의 보행 중 낙상 등의 사고는 꾸준히 증가하고 있으며, 고령자의 보행시설 만족도는 최하위이다. 본 논문에서는 이러한 결과의 이유들 중에 하나를 고령자들의 보행능력(일반인 대비 약 75%)을 고려하지 않은 보행 교통 시설물에서 찾았다. 이에 고령자들이 가장 불편함을 호소하는 계단 이용시 나타나는 고령자의 운동역학적인 보행특성을 동작분석시스템으로 알아보았다. 여러 보행변수들을 분석한 결과, 현재의 계단 높이로 규정되어 있는 18cm의 계단 높이는 고령자가 오름과 내림 보행 시 과도한 힘이 소요되며, 신체 중심이 흔들려 몸의 균형을 잡기에도 어려운 것으로 분석되었다. 이에 본 논문에서는 고령자 집단의 보행특성을 보여주는 보행변수들 간의 군집분석을 통하여 계단 챌면의 높이를 15cm 이하로 설정할 것 등의 계단 설계 기준을 제시하였다. 이는 일반인에게는 큰 변화는 아니지만 고령자에게는 통행빈도와 활동범위를 넓혀 보다 많은 사회경제 활동을 촉진 시킬 수 있을 것이다.

케톤음료를 보충한 저탄수화물·고지방식이 섭취가 치매고위험 노인의 인지기능 및 신체활동 능력 변화에 미치는 영향 (Effects of Low-carbohydrate and High-fat Diet Supplemented with Ketogenic Drink on Cognitive Function and Physical Performance in the Elderly at High Risk for Dementia)

  • 김은지;박정식;최원선;박유경
    • 대한지역사회영양학회지
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    • 제24권6호
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    • pp.525-534
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    • 2019
  • Objectives: Reduced glucose utilization in the main parts of the brain involved in memory is a major cause of Alzheimer's disease, in which ketone bodies are used as the only and effective alternative energy source of glucose. This study examined the effects of a low-carbohydrate and high-fat (LCHF) diet supplemented with a ketogenic nutrition drink on cognitive function and physical activity in the elderly at high risk for dementia. Methods: The participants of this study were 28 healthy elderly aged 60-91 years showing a high risk factor of dementia or whose Korean Mini-Mental State Examination (K-MMSE) score was less than 24 points. Over 3 weeks, the case group was given an LCHF diet with nutrition drinks consisting of a ketone/non-ketone ratio of 1.73:1, whereas the control group consumed well-balanced nutrition drinks while maintaining a normal diet. After 3 weeks, K-MMSE, body composition, urine ketone bodies, and physical ability were all evaluated. Results: Urine ketone bodies of all case group subjects were positive, and K-MMSE score was significantly elevated in the case group only (p=0.021). Weight and BMI were elevated in the control group only (p<0.05). Grip strength was elevated in all subjects (p<0.01), and measurements of gait speed and one leg balance were improved only in the case group (p<0.05). Conclusions: We suggest that adherence to the LCHF diet supplemented with a ketogenic drink could possibly influence cognitive and physical function in the elderly with a high risk factor for dementia. Further, we confirmed the applicability of this dietary intervention in the elderly based on its lack of any side effects or changes in nutritional status.