• 한국산학기술학회논문지
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• 제12권9호
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• pp.4008-4014
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• 2011

이 연구는 뇌졸중 환자를 대상으로 임상척도를 이용하여 엉덩관절의 근력, 감각과 경직이 균형능력에 미치는 영향을 알아보기 위해 실시되었다. 32명의 뇌졸중 환자를 대상으로 도수근력검사를 사용하여 환측 다리의 가벼운 접촉감각과 엉덩관절굽힘근, 폄근, 모음근, 그리고 벌림근의 근력을 측정하였고, 수정 Ashworth 척도를 이용하여 넙다리근의 경직을 측정하였으며, 기능적 균형 척도를 이용하여 정적 및 동적균형능력을 측정하였다. 수집된 자료는 다중회귀분석을 이용하여 분석하였다. 연구결과 정적균형에 유의한 영향을 미치는 요인은 엉덩관절벌림근력, 넙다리 경직, 가벼운 접촉감각인 것으로 나타났으며(p<0.05), 설명력은 80.5%인 것으로 나타났다. 동적균형능력에 영향을 미치는 요인으로는 엉덩관절벌림근력과 가벼운 접촉감각인 것으로 나타났으며(p<0.05), 설명력은 77.9%인 것으로 나타났다. 엉덩관절벌림근력과 가벼운 접촉감각은 정적균형과 동적균형 모두에 영향을 미치는 것으로 나타나, 앞으로 균형에 대한 검사와 중재 프로그램 제공 시 엉덩관절벌림근력과 가벼운 접촉감각 요인을 고려하는 것이 필요할 것으로 여겨진다.

• 한국산학기술학회논문지
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• 제14권11호
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• pp.5723-5729
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• 2013

본 연구의 목적은 불균형 상태의 근 긴장도와 무리한 보행훈련에 자주 노출되는 만성 뇌졸중 환자에서 경직에 따른 족저근막의 두께 변화를 알아보고자 하였다. 연구대상은 만성 뇌졸중 환자 54명에서 Group I(MAS G0) 18명, Group II(MAS G1) 18명, Gropup III(MAS G3) 18명으로 선정하였다. 측정방법으로는 임상증상 및 이학적 검사, MAS(Modified Ashworth Scale), 초음파영상 촬영장치, ROM(Range of Motion), VAS(Visual Analogue Scale), TUG(Timed Up and Go test)로 측정하였다. 연구결과, 각 그룹 간 정상측과 마비측의 족저근막의 두께는 통계학적으로 유의하게 두꺼워졌다(p<.001). 각 그룹 간 정상측과 마비측의 족관절 배측굴곡 ROM은 통계학적으로 유의하게 작아졌으며(p<.001), VAS(p<.001), TUG(p<.001)는 통계학적으로 유의하게 커졌다(p<.001). 본 연구는 족저근막에 대한 병리역학(pathokinesiology)적 내용을 제시함으로서 뇌졸중 환자의 보행훈련 시 고려해야 할 내용 중 하나임을 제시하였다.

• 대한한방소아과학회지
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• 제18권1호
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• pp.165-177
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• 2004

Objective : The purpose of this study is to report a pediatric patient combined some peculiar diseases of nervous system in childhood. Methods : The patient with preceding five kinds of retardation developed five kinds of flaccidity and five kinds of spasticity after chronic infantile convulsion. We treated the progress of her condition, measured spasticity of both leg by MAS(Modified Ashworth Scale). Results and Conclusion: The general condition of patient, symptoms of five kinds of flaccidity and MAS grade of both leg spasticity had been improved. And so this study requires further studies about peculiar diseases of nervous system in childhood.

• 한국전문물리치료학회지
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• 제13권1호
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• pp.32-37
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• 2006

The purpose of this study was to investigate the effects of clinical characteristics of chronic stroke patients on physiological cost index (PCI) during walking. Fourteen stroke patients participated in this study. To investigate the clinical characteristics, Fugl-Meyer score (FMS), gait velocity (GV), muscle strength of the knee extensor, modified Ashworth scale (MAS) of ankle plantar flexor, devices, and gait patterns during walking were measured and analyzed. The results were as follows: Firstly, use of devices and high MAS of the ankle plantar flexor significantly increased PCI. Secondly, PCI was significantly correlated with the FMS and MAS of the ankle plantar flexor. In conclusion, inhibition of spasticity of the ankle plantar flexor is considered to reduce PCI during walking for chronic stroke patients.

• 대한한방내과학회지
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• 제35권1호
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• pp.1-11
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• 2014

Objectives : To investigate the effects of Sa-am acupuncture on muscle architecture and elastic properties of the spastic elbow flexor and to evaluate the correlation between clinical findings and parameters of real-time sonoelastography (RTS) in patients with chronic post-stroke hemiparesis. Materials and Methods : Seven patients (five males, two females) with chronic post-stroke hemiparesis were included. Sa-am acupuncture of Ganseunggyeok (肝勝格: LU8 LR4 補, HT8 LR2 瀉) was applied to the unaffected side 3 times a week for 4 weeks. During each acupuncture treatment period, patients were requested to exercise their affected arm, and spasticity and functional recovery outcomes of the affected arm were evaluated before and after Sa-am acupuncture treatment. Clinical outcomes were assessed using motricity index (MI), modified Ashworth scale (MAS), Fugl-Meyer assessment scale (FMA) and modified Barthel index (MBI) for elbow flexor spasticity. RTS images indicate the relative hardness of the examined muscles ranged from red (hard) to purple (soft) for color-scale, and from black (hard) to white (soft) for hue scale. Color and hue histograms of the biceps brachii and brachialis were analyzed using Image J software, and median red, blue, and hue pixel intensity were obtained. Results : MI and FMA score significantly increased and MAS score significantly decreased (p<0.05). F-wave maximal amplitude of affected abductor pollicis brevis significantly decreased (p<0.05). Muscle thickness of affected brachialis significantly increased (p<0.05). Red and green pixel intensity of affected brachialis significantly decreased (p<0.05). Conclusions : Our study revealed that Sa-am acupuncture is effective as a useful and safe treatment for spasticity in chronic post-stroke hemiparesis.

• 한방재활의학과학회지
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• 제31권3호
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• pp.105-114
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• 2021

A 38-year-old Korean man without any other history was diagnosed with myelopathy due to a spinal dural arteriovenous fistula. Following embolization and high-dose steroid therapy, the patient was treated with complex Korean medical therapies including acupuncture, pharmacopuncture, electro-acupuncture, Chuna manual therapy, herbal medicine, and cupping therapy in addition to conventional treatment. To assess the patient's improvement, international standard for neurological classification of spinal cord injury, Korean version of modified Barthel index, functional independence measure, spinal cord independence measure III, walking index for spinal cord injury II, modified Ashworth scale were used. After treatment, the muscle strength and sensory function of the lower extremities were improved, and the spasticity was reduced, resulting in a rapid improvement in performance of daily activities. These results suggest that complex Korean medical therapies may be effective for myelopathy, and further clinical studies are needed to clarify their effects.

• 대한한방내과학회지
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• 제38권5호
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• pp.658-667
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• 2017

Objectives: This is a case report regarding the effect of Korean traditional medicine on vision disorder and quadriplegia in a patient with neuromyelitis optica. Methods: We treated a patient who was diagnosed with neuromyelitis optica with Korean traditional medicine, including acupuncture, moxibustion, and herbal medicine (Gigugyanghyeol-tang gamibang) for 106 days. We evaluated the patient with the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), Modified Barthel Index (MBI), Modified Ashworth Scale (MAS) Grade, and Numeric Rating Scale-11 (NRS-11). Results: After treatment, the patient's symptoms were improved. The ISNCSCI scores increased from 42 to 66 in motor score, from 152 to 196 in sensory score, and from A to D in the ASIA impairment scale; the MBI score increased from 9 to 33, while the score of the MAS Grade decreased from I+ to I, and the NRS-11 scores of vision disorder, spasticity, and tingling decreased from 10 to 7, 3, and 2-3, respectively. Conclusions: Korean traditional medicine may be effective for treatment of vision disorder and quadriplegia in patients with neuromyelitis optica.

• PNF and Movement
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• 제20권3호
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• pp.359-370
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• 2022

Purpose: Physical therapists are required to properly choose the most appropriate treatment for each patient within the framework of the International Classification of Functioning, Disability, and Health (ICF model). The aims of this study were to determine whether neurological physical therapists in clinical settings in South Korea know about the ICF model and to investigate the current trends of outcome measures (OMs) used by them. Methods: Two hundred and one physical therapists who worked with patients with neurological disorders participated in this study. The survey was conducted via e-mail and asked about commonly used OMs and the considerations for selecting OMs. Results: All physical therapists involved in this study responded completely, and 45.8% of participants learned about the ICF model, while 37.3% understood the detailed information related to the ICF model. The rest of the participants did not know or just heard about the ICF model. The most frequently used tools at the body function/structure level were the Range of Motion (98%), Manual Muscle Test (97%), Berg Balance Scale (83.1%), and Modified Ashworth Scale (70.6%) when allowing repetition. At the activity level, the 10-meter walk test (71.1%), 6-minute walk test (54.2%), and Functional Ambulatory Category (43.3%) were used, while the Activity-Specific Balance Confidence Scale (23.9%) was used at the participation level. There was a positive relationship between the number of tools used and years of work, as well as the level of understanding of the ICF model. Conclusion: The results of this study suggest that it is necessary to learn the ICF model in a clinical setting. In addition, the medical system needs to be modified to encourage physical therapists in South Korea to use proper OMs within the ICF model.

• 대한약침학회지
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• 제9권1호
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• pp.139-154
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• 2006

Objective : This experiment was conducted to evaluate the effectiveness of Acupuncture, Bee Venom Acupuncture (BVA) and Bee Venom Herbal Acupuncture (BVHA) on post-stroke hemiplegic shoulder pain. Methods : 30 patients were randomly allocated into Acupuncture group, BVA group and BVHA group and was monitored weekly for 4 weeks; initial($T_0$), 1 week($T_1$), 2 weeks($T_2$), 3 weeks($T_3$) and 4 weeks($T_4$). Results : Visual analogue scale of shoulder pain showed significant decrease in BVA and BVHA groups compared to the Acupuncture group at T4 evaluation. Painless passive ROM of shoulder external rotation and Fugl-Meyer Motor Assessment of Upper Limb motor function showed significant increase in all groups. Modified Ashworth scale of the spasticity of upper limb showed no differences between the three groups. Conclusion : BVA & BVHA appears to be an effective in treating post-stroke hemiplegic shoulder pain. Further clinical studies must be done to obtain more concrete findings.

• 전기학회논문지
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• 제58권6호
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• pp.1180-1185
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• 2009

Spasticity is a velocity-dependent stretch reflex disorder of the body motor system developing after the injury of the central nervous system, in which certain muscles are continuously contracted involuntarily. Conventional methods such as the modified Ashworth scale, Spasm frequency scale, pendulum test and isokinetic dynamometer had some disadvantages: limitation in discriminating the increase of resistance, immovable and expensive device, not enough study parameters. Therefore, it is necessary to introduce clinically more useful instrument, which can produce objective data and are more convenient on spasticity measurement. Spasticity measuring methods were reviewed and a new measuring instrument was designed and introduced. The new measuring system is a portable spasticity-measurement system, which encompass various scopes of spasticity-related human signals such as electrophysiologic, kinematic and biomechanical data. Our device was designed in order to measure the joint angle, angular velocity, electromyographic signals and force. We suggest that this new system can diagnose the spasticity of the muscles, objectively.