• 제목/요약/키워드: Lower-limb

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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.

Effect of two types of muscle contraction training on muscle thickness, strength, and delayed onset of muscle soreness in persons with chronic stroke

  • Lim, Seung-yeop;Lee, Wan-hee
    • Physical Therapy Rehabilitation Science
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    • 제7권4호
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    • pp.154-163
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    • 2018
  • Objective: The purpose of this study was to investigate the effects of eccentric contraction training (ECT) and concentric contraction training (CCT) on the muscle thickness (MT), muscle strength (MS) and delayed onset of muscle soreness (DOMS) of the lower extremities in persons with chronic stroke. Design: Randomized controlled trial. Methods: Thirty persons with chronic stroke were randomly assigned to the ECT or the CCT group. The ECT was performed in a specially designed system of eccentric contraction of both legs and, the CCT was performed using a traditional stepper system for concentric contraction of both legs. The training was performed for 30 min/times, 3 times/wk for 6 weeks. Rehabilitation ultrasound imaging was used to measure MT of the vastus medialis/lateralis (VL), and soleus (SOL), a digital muscle tester was used to measure MS, and a visual analog scale was used to assess DOMS. Results: In the ECT group, MT was significantly improved except for SOL resting (p<0.01). In the CCT group, the MT was significantly improved except for VL contraction (p<0.05). The MS was significantly improved in both groups, especially in the ECT group (p<0.01). In the ECT group, muscle soreness was highest in the first week after training but gradually decreased, and in the CCT group, it was highest in the second week of training but gradually decreased (p<0.01). Conclusions: ECT can improve lower limb MT, MS, and DOMS of chronic stroke survivors. Therefore, it is recommended that ECT be used in the rehabilitation of persons with chronic stroke.

Does Strategy of Downward Stepping Stair Due to Load of Additional Weight Affect Lower Limb's Kinetic Mechanism?

  • Ryew, Checheong;Yoo, Taeseok;Hyun, Seunghyun
    • International journal of advanced smart convergence
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    • 제9권4호
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    • pp.26-33
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    • 2020
  • This study measured the downward stepping movement relative to weight change (no load, and 10%, 20%, 30% of body weight respectively of adult male (n=10) from standardized stair (rise of 0.3 m, tread of 0.29 m, width of 1 m). The 3-dimensional cinematography and ground reaction force were also utilized for analysis of leg stiffness: Peak vertical force, change in stance phase leg length, Torque of whole body, kinematic variables. The strategy heightened the leg stiffness and standardized vertical ground reaction force relative to the added weights (p<.01). Torque showed rather larger rotational force in case of no load, but less in 10% of body weight (p<.05). Similarly angle of hip joint showed most extended in no-load, but most flexed in 10% of body weight (p<.05). Inclined angle of body trunk showed largest range in posterior direction in no-load, but in vertical line nearly relative to added weights (p<.001). Thus the result of the study proved that downward stepping strategy altered from height of 30 cm, regardless of added weight, did not affect velocity and length of lower leg. But added weight contributed to more vertical impulse force and increase of rigidity of whole body than forward rotational torque under condition of altered stepping strategy. In future study, the experimental on effect of weight change and alteration of downward stepping strategy using ankle joint may provide helpful information for development of enhanced program of prevention and rehabilitation on motor performance and injury.

앉았다 일어서기 검사 종류와 신체 근육량의 상관관계 연구 (Types of Sit-to-Stand Tests and Research on the Correlation with Body Muscle Mass)

  • 박태성;이소정;신명준;강종호
    • PNF and Movement
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    • 제21권2호
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    • pp.223-229
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    • 2023
  • Purpose: Assessing physical strength and muscle mass is crucial, but many methods rely on specialized equipment, which can be challenging. In situations where a quick and straightforward test is needed, the sit-to-stand test (STST) proves useful. Although several studies have investigated STST and muscle mass separately, the actual correlation between these two factors has not been extensively researched. Hence, the objective was to comprehensively investigate the correlations between the different tests. Methods: The study participants consisted of 20 healthy young men in their 20s. In this study, measurements were taken for muscle mass, the five-times sit-to-stand test, the 30-second sit-to-stand test, and the 1-minute sit-to-stand test. The results of each test were analyzed using Pearson's correlation analysis. Results: Although no significant correlation was found between muscle mass and STST, interestingly, significant correlations were observed among the different types of STST. Conclusion: The STST is a rapid and straightforward test used to assess lower limb strength and balance ability in individuals. However, there is a dearth of research on STST conducted in domestic settings. Based on the findings of this study, further research is necessary to establish age- and gender-specific reference values for STST. This will allow its broader application, encompassing not only older adults and patients but also healthy individuals.

기능적전기자극 치료와 신경발달치료가 편마비 환자의 하지 경직에 미치는영향 (The Influence of Functional Electric Stimulus Treatment and Neurological Development Treatment on the lower limbs' Spasticity of the Patients with Hemiplegia)

  • 최현지;오정림;박래준
    • The Journal of Korean Physical Therapy
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    • 제15권3호
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    • pp.388-411
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    • 2003
  • The purpose of this study has been conducted to reduce the lower limbs' spasticity of the patients with hemiplegia caused by cerebral stroke of apoplexy and find differences about spasticity effects among each group. The objects of this study covered 24 patients with hemiplgia who are either in the oo hospital in Daegu or under treatment from home to hospital. The objects fall into three groups which are a group of neurological development treatment, a group of functional stimulus treatment and a group of neurological development treatment and functional stimulus treatment. The result of this study were as follows : 1) The neurological development treatment has been found to reduce the lower limbs' spasticity of patients with hemiplegia caused by cerebral stroke of apoplexy and compared to before-treatment, the MAS value of spasticity has been shown to be statistically meaningful ,and gradually over the period of between 4 weeks and 8 weeks(P <.05). 2) The functional electric stimulus treatment has been shown to reduce the lower limb's spasticity of patients with hemiplegia caused by cerebral stroke of apoplexy and compared to before-treatment, the MAS value of spasticity was statistically meaningful and compared to 4 weeks, even at the time of 8 weeks, the MAS value of spasticity have shown statistical meaningness. (P <.05) 3) When neurological development treatment and functional electric stimulus treatment was applied at the same time, the lower limbs' spasticity of patients with hemiplegia was reduced meaningfully(P <.05). Compared to before-treatment at the time of 4 weeks, the MAS value of spasticity was statistically meaningful and compared to 4 weeks at the time of 8 weeks the MAS value of spasticity was also statistically meaningful(P <.05) 4) In the case of time-based MAS value of each group, functional electric stimulus treatment reduced the spasticity more meaningfully than neurological development treatment, and the group of same application of functional electric stimulus treatment and neurological development treatment showed better statistical meaningness than functional electric stimulus treatment alone(P <.05) and finally the group of same application of neurological development treatment and functional electric stimulus treatment showed more meaningful difference than neurological development treatment alone(P <.05)

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Minimally Invasive Anterior Decompression Technique without Instrumented Fusion for Huge Ossification of the Posterior Longitudinal Ligament in the Thoracic Spine : Technical Note And Literature Review

  • Yu, Jae Won;Yun, Sang-O;Hsieh, Chang-Sheng;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • 제60권5호
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    • pp.597-603
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    • 2017
  • Objective : Several surgical methods have been reported for treatment of ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine. Despite rapid innovation of instruments and techniques for spinal surgery, the postoperative outcomes are not always favorable. This article reports a minimally invasive anterior decompression technique without instrumented fusion, which was modified from the conventional procedure. The authors present 2 cases of huge beak-type OPLL. Patients underwent minimally invasive anterior decompression without fusion. This method created a space on the ventral side of the OPLL without violating global thoracic spinal stability. Via this space, the OPLL and anterior lateral side of the dural sac can be seen and manipulated directly. Then, total removal of the OPLL was accomplished. No orthosis was needed. In this article, we share our key technique and concepts for treatment of huge thoracic OPLL. Methods : Case 1. 51-year-old female was referred to our hospital with right lower limb radiating pain and paresis. Thoracic OPLL at T6-7 had been identified at our hospital, and conservative treatment had been tried without success. Case 2. This 54-year-old female with a 6-month history of progressive gait disturbance and bilateral lower extremity radiating pain (right>left) was admitted to our institute. She also had hypoesthesia in both lower legs. Her symptoms had been gradually progressing. Computed tomography scans showed massive OPLL at the T9-10 level. Magnetic resonance imaging of the thoracolumbar spine demonstrated ventral bony masses with severe anterior compression of the spinal cord at the same level. Results : We used this surgical method in 2 patients with a huge beaked-type OPLL in the thoracic level. Complete removal of the OPLL via anterior decompression without instrumented fusion was accomplished. The 1st case had no intraoperative or postoperative complications, and the 2nd case had 1 intraoperative complication (dural tear) and no postoperative complications. There were no residual symptoms of the lower extremities. Conclusion : This surgical technique allows the surgeon to safely and effectively perform minimally invasive anterior decompression without instrumented fusion via a transthoracic approach for thoracic OPLL. It can be applied at the mid and lower level of the thoracic spine and could become a standard procedure for treatment of huge beak-type thoracic OPLL.

Concise Bedside Surgical Management of Profound Reperfusion Injury after Vascular Reconstruction in Severe Trauma Patient: Case Report

  • Chung, Hoe Jeong;Kim, Seong-yup;Byun, Chun Sung;Kwon, Ki-Youn;Jung, Pil Young
    • Journal of Trauma and Injury
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    • 제29권4호
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    • pp.204-208
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    • 2016
  • For an orthopaedic surgeon, the critical decisions to either amputate or salvage a limb with severe crushing injury with progressive ischemic change due to arterial rupture or occlusion can become a clinical dilemma at the Emergency Department (ED). And reperfusion injury is one of the fetal complications after vascular reconstruction. The authors present a case which was able to save patient's life by rapid vessel ligation at bedside to prevent severe reperfusion injury. A 43-year-old male patient with no pre-existing medical conditions was transported by helicopter to Level I trauma center from incident scene. Initial result of extended focused assessment with sonography for trauma (eFAST) was negative. The trauma series X-rays at the trauma bay of ED showed a multiple contiguous rib fractures with hemothorax and his pelvic radiograph revealed a complex pelvic trauma of an Anterior Posterior Compression (APC) Type II. Lower extremity computed tomography showed a discontinuity in common femoral artery at the fracture site and no distal run off. Surgical finding revealed a complete rupture of common femoral artery and vein around the fracture site. But due to the age aspect of the patient, the operating team decided a vascular repair rather than amputation even if the anticipated reperfusion time was 7 hours from the onset of trauma. Only two hours after the reperfusion, the patient was in a state of shock when his arterial blood gas analysis (ABGA) showed a drop of pH from 7.32 to 7.18. An imminent bedside procedure of aseptic opening the surgical site and clamping the anastomosis site was taken place rather than undergoing a surgery of amputation because of ultimately unstable vital sign. The authors would like to emphasize the importance of rapid decision making and prompt vessel ligation which supply blood flow to the ischemic limb to increase the survival rate in case of profound reperfusion injury.

성격과 신체만족도에 따른 패션 제품의 이미지 선호도(제 2보) -35$\sim$59세 중년 여성을 중심으로- (A Study on Image Preferences of Fashion Product According to Personality and Body-Cathexis -Focused on Middle-Aged Women between 35 and 59 Years Old-)

  • 심정희;연명흠
    • 디자인학연구
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    • 제20권3호
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    • pp.5-14
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    • 2007
  • 본 연구의 목적은 성격과 신체 만족도에 따라 선호하는 패션 제품의 이미지에 관해 알아보고자 한다. 연구 방법은 선행 문헌 자료를 분석한 후 이를 토대로 설문지를 작성, 배포, 회수한 후 통계처리 하였다. 연구 대상은 만 35$\sim$59세의 우리나라 중년 여성 352명이다. 자료 분석은 SAS와 SPSS를 사용하여 인자분석, 군집분석, ANOVA, Duncan's Multiple Range Test를 실시하였다. 연구 결과 자신의 신체에 대한 만족도가 높을수록 정서적 안정성과 자신감이 높았으며, 보다 대담하고 여성스러운 이미지의 패션 제품을 선호하였다. 성격 특성과 선호하는 패션 제품 이미지와의 관계를 살펴본 결과 지배성이 높은 사람일수록 대담한 이미지의 패션 제품을 선호하였으며, 책임성이 높은 사람일수록 패션 제품에서 실용성을 추구하였으나 대담성에 관해서는 선호도가 낮았다. 정서적 안정성이 높은 사람일수록 품위 있고 실용적인 패션 제품을 선호하였으나 대담스러운 이미지에 관해서는 선호도가 낮았다. 한편 사교성이 높은 사람일수록 품위있고 남성스러운 이미지를 선호하였다. 그리고 자신감이 높은 사람일수록 대담하고 남성스러운 이미지의 패션 제품을 선호하였다.

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연부 조직 육종에 대한 무계획적 절제술: 환자의 임상적 특징 및 치료 결과 (Unplanned Excision of Soft Tissue Sarcoma: Patient Profile and Treatment Outcomes)

  • 이재후;조용진;김승현;신규호
    • 대한골관절종양학회지
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    • 제18권2호
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    • pp.72-77
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    • 2012
  • 목적: 악성 연부조직 종양이라는 의심 없이 무계획적으로 절제한 후 육종으로 판명되어 전원된 환자에서 임상적 특징과 치료 결과를 알아보고자 하였다. 대상 및 방법: 양성 연부 종양이라고 판단하고 절제한 후 육종으로 판명되어 본원으로 전원된 환자 31명을 대상으로 연구를 시행하였다. 본 환자들의 연령, 성별, 종양 크기, 위치, 깊이, 최초 수술 전 예상되었던 진단명, 의뢰된 의료기관, 조직학적 진단명, 무계획적 절제술과 재절제 수술의 간격, 최종 추시 시 재발 여부에 대해 조사하였다. 결과: 남자 19명 여자 12명이었으며, 평균 48세(17-75세)였다. 종괴의 위치는 상지가 6예, 하지가 17예, 체간이 8예였으며, 평균 6개월(1-24개월)의 증상 지속기간을 보였다. 종괴가 천층에 위치한 경우와 깊이 위치한 경우는 각각 8예, 22예였다. 무계획적 절제술과 재절제 술까지 소요 기간은 평균 5주(2주-1년)이었다. 최종 추시 시 국소 재발은 2예에서 발견되었으며, 폐전이를 포함한 타장기 전이는 모든 예에서 발견되지 않았다. 결론: 무계획적 절제가 종합 병원 급 상급 의료 기관에서도 발생하고 있으며, 심부에 위치한 비교적 큰 종괴에 대해서는 술 전 충분한 영상 검사 및 조직 검사 후 적절한 치료 계획을 수립해야 할 것이다.

아급성 뇌졸중 환자의 상지재활을 위한 악기 연주의 임상적 활용 근거 연구 (A Rationale for Instrumental Music Playing for Upper Extremity Rehabilitation in Subacute Stroke)

  • 정은주
    • 인간행동과 음악연구
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    • 제10권1호
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    • pp.1-23
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    • 2013
  • 상지의 운동기능 장애는 뇌졸중 환자에게서 빈번히 보고되는 증상 중의 하나이다. 뇌졸중의 원인인 신경학적 손상의 회복은 발병 초기인 6개월 동안 가장 활발히 일어나며, 이 시기의 회복은 이후 기능회복에 결정적 영향을 미친다. 독립적인 일상생활 수행과 상지 운동기능의 재활을 위하여 다양한 재활치료 접근이 적용되어 왔으나 그 효과성에 있어서 일관성이 결여된 결과가 보고되어 왔다. 따라서 뇌졸중 환자의 신경학적, 기능적 상지 운동 기능의 재활을 촉진할 수 있는 보다 효과적인 치료 방안 마련이 시급하다고 할 수 있다. 재활의학 분야의 연구에서 음악은 운동기능의 향상에 긍정적인 영향을 미치고 있으며, 특히 하지 운동기능 향상에 있어서 리듬 적용의 근거 및 그 효과성이 입증되고 있다. 하지만, 음악연주를 활용한 뇌졸중 환자의 상지 운동기능 재활에 대한 근거는 아직 확립되어 있지 않으며, 적용 대상 또한 만성 뇌졸중 환자에 제한 되어 있는 실정이다. 본 연구에서는 운동기능을 촉진하는 음악의 역할을 근거로, 뇌졸중 환자의 상지 운동기능 재활을 위하여 다양한 음악활동을 사용한 선행 연구를 고찰 및 분석하였다. 이를 바탕으로 아급성 뇌졸중 환자의 상지 운동기능의 재활을 도모하기 위한 악기연주 활용 방안에 대한 근거를 마련하고자 하였다.