• 한국전문물리치료학회지
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• 제3권2호
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• pp.55-76
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• 1996

The objective of this study was to identify the immediate effects of the short leg brace on the weight bearing distribution and gait patterns of hemiplegic patients. The subjects of this study were 18 hemiplegic patients who had been hospitalized or visited out-patient department of Rehabilitation Hospital, Yonsei University College of Medicine, from January 5, 1996 through March 23, 1996. PLS(Posterior Leaf Spring) on and off changes in gait patterns were measured using ink foot print as well as by recording weight bearing distribution using a limb load monitor. The data were analyzed by the correlation and paired t-test. The findings were as follows: 1. Eighteen subjects were more weighted on the affected leg when PLS was put off(42.74%) than on(40.08%). 2. The defference in gait patterns between PLS on and off was statistically significant, with an increase in step length by 1.7cm on the involved side; a decrease in foot angle by 4.41 degree on the involved side; and a narrowing of base of support by 1.46cm when PLS were off. In conclusion, this study showed that PLS did not affect the weight bearing distribution and gait patterns of hemiplegic patients. Since, the evaluation method used in this study has limitations in regard to temporal distance gait values. Further studies are required to numerous experiments for subject and extensive study.

• 한국전문물리치료학회지
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• 제14권1호
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• pp.21-27
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• 2007

The purpose of this study was to evaluate isometric trunk extension strength in hemiplegic patients, and to compare that with normal subjects to find a correlation between trunk extension strength and the functional independent degree in hemiplegic patients. Fifteen hemiplegic male patients (mean age $55.2{\pm}10.2$ years) and twenty-five healthy male subjects (mean age $54.6{\pm}10.3$ years) completed isometric trunk extension. Strength was measured at 0, 12, 24, 36, 48, 60, and 72 degrees of trunk flexion. The functional independent degree was assessed by Functional Independence Measure (FIM). Mean isometric trunk extension strength was 91.2 ft-lbs, 120.7 ft-lbs, 142.3 ft-lbs, 156.4 ft-lbs, 173.5 ft-lbs, 184.1 ft-lbs, and 195.3 ft-lbs in the hemiplegic patients group, and 135.6 ft-lbs, 175.6 ft-lbs, 204.4 ft-lbs, 221.9 ft-lbs, 231.2 ft-lbs, 246.8 ft-lbs, and 259.7 ft-lbs in the normal subjects group. The values of isometric trunk extension strength had a descending linear correlation pattern from trunk flexion angle to extension angle. Trunk extension strength in hemiplegic patients was significantly lower than that of normal subjects (p<.05) but did not correlate with the FIM total score (p>.05). Therefore, the isometric trunk extension strength in hemiplegic patients was lower than that of normal subjects and did not correlate with the functional independent degree.

• The Journal of Korean Physical Therapy
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• 제16권3호
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• pp.97-111
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• 2004

This study, adopting the pretest-post test experimental study, is designed to find out how the functional electrical stimulation makes effect on the balance of a patient with spasticity of the ankle plantarflexor muscle caused by hemiplegic after stroke. The 46 subjects for this study were randomly sampled out of the patients who were hospitalized from September 1, 2003 to November 30, 2003 in H sanitarium in Yangpyung. The patients were with spasticity of the ankle plantarflexor muscle caused by hemiplegic after stroke and able to walk without supporting implements. The purpose of the study is firstly to analyze the change of ROM, FRTof a patient with spasticity of the ankle plantarflexor muscle when the functional electrical stimulation is applied and secondly to find out how the sex, age, height, weight, part of the diagnosis, duration of pain, experience of relapse and getting hurt from a fall of a patient make effect on the change. The experimental group for the study is divided into two to compare the differences of the effect. The exercising treatment only was performed for the conrtol group, and the functional electrical stimulation to the ankle dorsiflexor muscle as well as the exercising treatment was applied to the experimental group. The ROM test was performed to check the range of motion of the ankle with a double armed universal goniometer. The test was done 3 times to take an average. FRT were performed to check the balance. The statistical test was conducted using the SPSS 10.0/PC program by means of the following methods: χ2-test and t-test for testing homogeneity between the groups; paired t-test, independent sample t-test, F-test, and two-way ANOVA for analyzing the changes before and after the treatment. The levels of statistical significance of all the data were maintained at p<.05. According to the test, ROM has more decreased in experimental group than in control group when the functional electrical stimulation was applied only to the experimental group. However, the significant statistic difference was not shown (p=.059). FRT showed remarkable differences in the experimental group compared to the control group, showing the significant statistic difference (p=.000). On the one hand, the change of ROM, FRT related with the sex, age, height, weight, part of the diagnosis, and experience relapse was a meaningless minimum value. The change of ROM related to the duration of pain and the experience of falling down was also meaningless. However, FRT showed significant statistic difference (p<.05). According to the test above, the application of functional electrical stimulation to a patient with spasticity of the ankle dorsiflexor muscle caused by hemiplegic after stroke makes significant effect on the balance of a patient, but the result has nothing with the sex, age, height, weight, part of the diagnosis, duration of pain, experience of relapse and getting hurt from a fall of a patient. However, it is regarded to give contribution to the balance improvement of a patient. Therefore, this study expects to be a valuable clinical material for a patient with spasticity.

• 대한물리치료사협회지
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• 통권4호
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• pp.39-44
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• 1982

• 동의생리병리학회지
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• 제26권4호
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• pp.539-545
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• 2012

To evaluate of the ultrasonographic changes in hemiplegic and unaffected knee joints of hemiplegic ambulators with recent onset stroke. Twenty patients (40 knees) with prevalence duration of 14-39 weeks (mean 24.70 weeks) after a stroke insult were included. All participants were walking independently without leg dragging, had no previous knee injury. There were significant differences in intercondylar cartilage thickness and pes anserinous tendinopathy (PAT) between hemiplegic and unaffected knees (p<0.05). There were no differences in cartilage thickness of medial condyle and lateral condyle, patellar tendinitis/bursitis, suprapatellar effusion, synovitis, joint space narrowing, and Baker's cyst of ultrasonographic findings and x-ray findings in hemiplegic knee compared to the control except PAT (p<0.05). In hemiplegic knee, medial or lateral condylar cartilage thickness was significantly correlated with body weight, intercondylar cartilage thickness, and PAT (p<0.05). PAT was significantly correlated with Brunnnstrom stage and condylar cartilage thickness (p<0.05). Knee pain was significantly correlated with lateral condylar cartilage thickness (p<0.1). The hemiplegic knee had more ultrasonographic abnormalities including PAT and more cartilage thickness preservation in patient with recent onset stroke. Intraarticular sonographic findings including cartilage thickness was significantly correlated with extraarticular findings including PAT and a symptom of knee pain.

• 대한물리치료과학회지
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• 제8권1호
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• pp.859-867
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• 2001

The purpose of this single subject care study was to evaluate the effectiveness of a functional electrical stimulation(FES) treatment program designed to prevent glenohumeral pint stretching and subsequent subluxation and shoulder pain in hemiplegic patients. The subject was a 43-year-old male who had left side hemiparesis with shoulder pain and subluxation on affected side. He received conventional physical therapy and additional FES therapy where two flaccid shoulder muscles, supraspinatus and posterior deltoid. were induced to contract repetitively up to 20 minutes for 2 weeks. As a result. the patient showed improvements in hemiplegic arm function, reduction in subluxation(as indicated by Jig test) and range of motion(SLROM). But it was difficult to generalize. We concluded that the FES program was effective in reducing the severity of shoulder subluxation and pain. Further study must be evaluated its statistical significance.

• The Journal of Korean Physical Therapy
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• 제13권3호
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• pp.537-549
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• 2001

The isometric torque of the elbow flexor and extensor muscles were measured for 6 seconds at a joint angle of 90$^{\circ}$ , in 10 normal subjects (control group) and 10 hemiplegic subjects(patient group), using the Cybex NORMTM System. The peak torque, the time to peak torque were measured for each exercise. In addition, heart rate and blood pressure were recorded simultaneously at rest and immediately following exercise completion at 1 and 3m mutes. Statistical analysis was performed using SPSS 8.0 for Windows software and mean and standard deviations were calculated. The results are as follows. 1) In the patient involved group. the isometric values for flexors and extensors were significantly lower than in the normal nondominant group(p<.05). 2) The extensor to flexor strength ratio in the isometric mode was 121.0% in the patient involved group compared with 78.7%in the normal nondominant group, a significant difference(p<.05). 3) The mean increment ratio was increased 19.0% for systolic blood pressure and 25.2% for disatolic blood pressure in the patient group. 4) The mean increment ratio was increased 36.0% heart rate in the patient group.

• 재활복지공학회논문지
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• 제6권2호
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• pp.23-30
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• 2012

본 연구에서는 로드셀 센서를 활용하여 편바미 환자의 환측에 부하되는 체중부하에 따른 청각적 피드백을 적용한 대칭 보행유도와 보행패턴 분석이 가능한 무선 보행훈련 시스템을 개발하였다. 또한 개발된 시스템의 유효성을 검증하기 위해 정상인군 및 편마비군 대상자에게 수행한 임상실험을 진행하였으며, 각 대상군마다 피드백 적용 후 보행 속도와 체중 부하량, 그리고 보행 시 입각기비율과 분속수가 증가하였음을 확인하였다. 연구 결과를 토대로 편마비 환자 뿐만 아니라 대칭적 체중부하가 요구되는 다양한 하지 질환자들에 대한 임상실험을 확대하고 장기간 훈련의 효과를 관찰한다면, 본 연구에서 개발된 청각적 대칭 체중부하 피드백 보행 시스템은 다양한 패턴 분석과 함께 보행 향상을 위한 기기 적용이 가능할 것으로 기대된다.

• 재활복지공학회논문지
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• 제10권4호
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• pp.295-303
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• 2016

편마비 환자의 상지 운동 기능 재활 치료에 대한 지속적인 관심과 훈련의 정량적인 평가를 위한 다양한 장치가 요구되고 있다. 이러한 문제를 해결하기 위해서 본 논문에서는 거치대와 핸들, 밸런스 볼을 결합한 밸런스 핸들 장치를 개발하였다. 피험자 7명을 대상으로, 개발된 상지 훈련 장치를 기울일 때 주요 상지 근육에 대한 근전도 신호의 변화를 측정하여 재활 훈련 장치로 사용이 가능한지에 대한 유효성을 검토하였다. 밸런스 핸들 장치를 앞뒤로 기울였을 때의 상지 신전 굴곡 운동 동작과 좌우 기울임을 이용한 상지 운동 동작에서 근 수축과 이완이 기준이 되는 주동근과 길항근에서 근 활성화 신호를 분석하였다. 실험결과, Fugl-Meyer Assessment(FMA)의 신전 굴곡 운동 평가 항목에서 편마비 환자의 상지 운동 기능 평가에 이용되는 이두근, 삼두근, 삼각근에서 근 활성화 경향을 보였다. 이러한 결과를 바탕으로 개발된 장치를 활용하여 편마비 환자의 상지 재활 훈련에 도움이 될 수 있다고 볼 수 있다.

• 대한물리치료과학회지
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• 제14권1_4호
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• pp.55-60
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• 2007

The purpose of this case report is to investigate whether an attempt to hold the repeated upright posture under blocking the patient's vision affects the deficits to push away from the paralytic side and the relapse time from down to stand up position without push away in patients with hemiplegia with pusher syndrome. Two hemiplegic patients with pusher syndrome were assessed. The task was performed 4 times per day for 6 weeks. The modified barthel index (MBI) was performed to assess activities of daily living (ADL). For assessing balance, the "balanced sitting" and "sit to stand" are analyzed using by modified motor assessment scale (MMAS). The scale for contraversive pushing (SCP) was used for determination of push away from paralyzed side. MBI, MMAS and SCP were assessed before and after trial of the task. In patient 1, total score of the scale is 0 in sitting posture and standing posture within 3 weeks and 4 weeks, respectively, In patient 2, total score of the scale is 0 in sitting posture and standing posture within 4 weeks and 6 weeks, respectively. These results demonstrated that pusher syndrome was completely resolved in at least 6 weeks. Our findings indicate that this physical therapy seems to be relevant for the hemiplegic patients with pusher syndrome.