• 대한물리의학회지
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• 제5권3호
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• pp.467-476
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• 2010

Purpose : This study was performed to understand the relationship between hand and mouth shapes using functional magnetic resonance imaging(fMRI). Methods : Two healthy volunteers without any previous history of physical or neurological illness were recruited. fMRI was done that volunteers was 6 repeated of natural mouth, close mouth and open mouth while power grip and pinch grip movement. Results : Cerebral cortex activation was not well observed for the natural mouth during the power grip exercise. For the closed mouth, the temporal lobe, Broca's area, the prefrontal area related to thinking and judgment, the supplementary motor area, the auditory area and Wernicke's area were activated. For the open mouth, cortical activation was also observed in the temporal lobe, Wernicke's area, the prefrontal area related to thinking and the orbital frontal area related to visual sense. During the pinch grip exercise, cortical activation was observed for the natural mouth in the primary sensory area, Wernicke's area, the primary and supplementary motor area, and the prefrontal area. For the closed mouth, cortical activation was observed in the temporal lobe, Wernicke's area, the prefrontal area related to thinking, the secondary visual area, the primary sensory area and the supplementary motor area. In the case of the open mouth, cortical activation was observed in a few parts in the temporal lobe as well as Wernicke's area, the prefrontal area related to thinking, and other areas related to visual sense such as the primary visual area, the secondary visual area and the visual association area. Conclusion : Brain was more activation for close mouth and open mouth more than natural mouth movement.

• 재활치료과학
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• 제1권2호
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• pp.35-40
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• 2012

본 연구에서는 가상현실 치료가 뇌졸중 환자의 뇌 가소성을 동반한 상지기능 향상에 미치는 영향을 알아보고 강도 높은 가상현실 훈련이 뇌졸중 환자의 상지기능 향상을 위한 집중치료로써 임상적으로 유용한 훈련인지 알아보고자 하였다. 뇌졸중 환자에게 있어 사용-의존성 즉 운동 강도와 반복은 마비 측 사지의 운동 기능향상에 중요한 치료적 요소이다. 최근에는 상지의 지속적 사용을 통한 뇌-가소성에 기반한 변화를 유도할 수 있는 치료방법으로 가상현실 치료가 대두되었다. 가상현실 치료는 재활 임상환경에서 운동기능 향상을 위한 훈련강도와 반복을 제공할 수 있는 기술적 방법으로 채택되기 시작하였다. 특히 뇌졸중 환자의 상지 기능을 향상시키기 위한 치료적 유용성 측면에서는 강도 높은 반복적 훈련이 가능하다는 것과 게임 같은 형식으로 높은 동기부여가 가능하다는 것, 실제 수행을 통한 다중감각적 피드백 제공, 상호작용이 가능한 과제지향적 치료가 가능하다는 장점을 가지고 있다. 임상 환경에서 작업치료와 더불어 부가적으로 가상현실 치료를 실시하는 것은 뇌졸중 환자의 상지 기능회복을 더욱 촉진할 것이다.

• Clinical and Experimental Pediatrics
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• 제51권12호
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• pp.1350-1354
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• 2008

척수성 근위축증은 상염색체 열성으로 유전되며 사지 및 몸통 근위부와 원위부의 광범위한 근력약화를 특징으로 한다. 5번 염색체 장완(5q11.2-13.3)에 위치한 survival motor neuron (SMN) 유전자의 결손이 그 원인이다. 척수성 근위축증은 순수하게 운동신경만 침범하는 것으로 알려져 있다. 분자유전학적 방법으로 유전자의 결손을 증명하므로써 진단할 수 있다. 저자들은 아주 이른 영아시기부터 심한 근긴장도 저하와 잦은 폐흡인을 보였고, 분자 유전학적 검사로 척수성 근위축증을 진단한 2명의 환아에서 신경전도 검사상 광범위한 감각신경을 침범한 경우를 경험하여 보고하는 바이다. 본 증례는 감각 신경을 침범한 척수성 근위축증에 대해 국내에서는 첫번째 보고로 생각한다.

• 한국전문물리치료학회지
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• 제13권1호
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• pp.38-46
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• 2006

The purposes of this study were to investigate the median frequency (MDF) between initiation and termination of muscle contraction through surface electromyographic (sEMG) analysis and to propose the basis of clinical treatment for movement problems in early hemiparetic upper limbs. Thirteen patients who had stroke with onset less than 3 months prior to the study and seven control subjects participated in the study. The median frequency in initiation and termination of muscle contraction was recorded from wrist flexor and extensor muscles using the sEMG, with 3 second beeper signals, during maximal isometric wrist flexion and extension. Flexion and extension must be done as quickly and forcefully as possible. The results of the study were as follows: 1. The MDF of the onset and offset sections were significantly lower on the paretic than the nonparetic and control sides. 2. The MDF of the offset section significantly decreased on the paretic and nonparetic sides. Consequently, this study showed that the lowering of the MDF was due to the hemiparetic wrist motor impairment and muscle weakness. These results are also related to Fugl-Meyer motor assessment (FMA) scores in hemiparetic upper limbs. This study also suggests that since muscle weakness of early stroke patients affects the functional decrease of upper limbs, further studies must focus on the treatment to improve muscle agility and muscle fiber recruitment efficiency that can induce the functional recovery correlated to motor control.

• 융합정보논문지
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• 제10권12호
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• pp.216-225
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• 2020

본 연구는 체계적 고찰을 통해 선정된 연구를 질적 분석하여 인지장애가 있는 노인에게 실시된 이중과제의 적용방법, 결과측정방법, 중재효과를 알아보고자 시행되었다. 본 연구는 2010년 1월부터 2019년 12월까지 등록된 연구를 검색하였다. 전자 데이터베이스 PubMed, ProQuest를 이용하였으며, 검색어는'dual task' OR 'multi modal' AND 'mild cognitive impairment' OR 'dementia' OR 'Alzheimer's disease' AND 'intervention' OR 'rehabilitation를 사용하였다. 최종 선정된 연구는 8편이었다. 이중과제는 단독중재로서 적용되기보다 다른 운동중재와 함께 구성된 복합중재의 부분으로 이용되고 있었다. 이중과제의 인지 및 운동과제는 각각 별개의 내용으로 서로 독립적인 과제가 대부분이었다. 평가는 MMSE, CERAD와 같은 전반적인 인지기능평가와 집행기능평가, 기억력평가 등이 포함되었고 이중과제의 직접적인 향상을 보기위하여 Dual task cost를 이용하기도 하였다. 본 연구는 이중과제의 연구 및 임상적 적용을 위한 기초적인 자료로서 이용될 수 있을 것으로 생각된다.

• 인간행동과 음악연구
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• 제14권2호
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• pp.71-90
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• 2017

본 연구의 목적은 만성 뇌졸중 환자를 대상으로 악기연주 시 동반되는 노래부르기 과제의 유무에 따라 피로도 및 운동 수행력이 달라지는지 비교함으로써 뇌졸중 환자의 신체 재활 시 활용 가능한 악기연주 및 노래부르기에 대한 기초 자료를 제공하는 것이다. 연구 대상자는 서울시 소재 노인 복지관과 주간보호센터를 이용하고 있는 12명의 만성 뇌졸중 환자로, 실험 집단과 비교 집단에 각각 6명씩 무작위 배정하였다. 연구 진행 시 2회기에 걸쳐 실험 집단은 전자 드럼 연주와 함께 노래부르기를, 비교 집단은 전자 드럼 연주만을 수행하였으며, 각 집단에 따라 피로도, 운동자각도, 활동 참여도, 드럼 타력값을 비교 분석하였다. 연구 결과, 전자 드럼 연주와 함께 노래부르기를 한 실험 집단이 전자 드럼 연주만 실시한 비교 집단에 비해 피로도와 운동자각도가 낮은 것으로 나타났으며 집단 간 유의한 차이를 보였다. 전자 드럼 연주와 노래부르기를 복합 과제로 제시하였을 때 활동 참여도 역시 높게 나타남에 따라 향후 이를 사용한 음악치료 중재 시 뇌졸중 환자의 상지 운동에 긍정적인 영향을 미칠 수 있음을 나타냈다. 본 연구는 만성 뇌졸중 환자의 상지 운동 시 동반되는 노래부르기가 신체 운동에 대한 주의를 노래부르기로 전환시키고 참여 동기를 증진시켜 지속적인 움직임 유도 시에도 피로도 또는 운동자각도를 감소시킬 수 있음을 시사한다. 이러한 결과를 통해 신체 재활 시 반복적인 운동에 대해 긍정적으로 인식하고 운동 수행력을 높일 수 있는 복합적인 치료적 개입을 위한 기초 자료를 제시할 수 있을 것이다.

• 대한통합의학회지
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• 제2권3호
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• pp.9-14
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• 2014

Purpose : The purpose of this research was to determine the effects of nap between therapeutic interventions on motor learning in patients with stroke. Method : Thirty stroke patients with hemiplegia were participated in this study. After the screening by questionnaire about nap time, the patients were assigned to nap or non-nap group. Therapeutic interventions for 30 min were provided two times per day for 5 days per week and the serial reaction time tasks were conducted 2 times before and after a nap per day for 3 days per week. Between the therapeutic interventions, a nap for 60~120 minutes was allowed to the nap group while non-nap group was not. Intervention programs were carried out during the total 15-day. Result : Compared with the non-nap group, the reaction-precision level of nap group was increased (p<.05) for the non-affected upper extremity in the serial reaction time tasks. Conclusion : This study demonstrated that nap between therapeutic interventions has positive effects on motor learning in patients with stroke.

• The Journal of Korean Physical Therapy
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• 제15권3호
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• pp.202-222
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• 2003

Chronic upper extremity hemiparesis is a leading cause of functional disability after stroke. The purpose of this study were to identify effects of a 6weeks repetitive bilateral arm training on upper motor function and the reorganization of motor network. Four chronic stroke patients participated in this study. They performed for 6 consecutive weeks, 3 days a week, 30 minutes a day. In the single group study, four 5-minute periods per session of bilateral arm training were performed with the use of a custom-designed arm training machine. The results of this study was as follows. 1. Following the 6weeks period of RBAT, patient exhibited a improvement in FMA and BBT. 2. Following the 6weeks period of RBAT, it showed improvement in reaching time, symbol digit substitution and finger tapping speed of KCNT. 3. fMRI activation after RBAT showed a focal map in lesional cortical area and perilesional motor areas. These fMRI data suggest that hemodynamics response to RBAT reflect sensorimotor reorganization in contralateral hemisphere. In conclusion, these date suggest that improved upper extremity function induced by repetitive bilateral arm training after stroke is associated with reorganization of motor network as a neural basis for the improvement of paratic upper extremity function.

• The Journal of Korean Physical Therapy
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• 제27권1호
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• pp.78-80
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• 2015

Purpose: Many studies have attempted to elucidate the motor recovery mechanisms of stroke. In the current study, we report on a patient with infarction who showed recovery of an injured corticospinal tract (CST), using diffusion tensor imaging (DTI). Methods: A 20-year-old male presented with severe paralysis of the left extremities following an infarction in the right corona radiate and basal ganglia. The patient showed good motor recovery as much as being able to manipulate object using his left hand and could walk independently on stairs at 9 months after onset. Results: At 1 month after onset, the right CST showed decreased fiber volume due to the partial injury at the level of the corona radiate, and no (motor evoked potential) MEP was evoked from the right hemisphere. By contrast, the results at 9 months showed increased fiber volume of the right CST and the amplitude of MEP had improved to normal range on TMS. Conclusion: These results suggest that the severely injured right CST and MEP amplitude had been recovered during 9 months. Therefore, this result has important implications for brain plasticity and brain rehabilitation in patients with infarction.

• The Journal of Korean Physical Therapy
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• 제15권4호
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• pp.65-81
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• 2003

The purpose of this study was to investigate the balance of stroke patient appling Task-Oriented Functional training program. Sixteen subjects were recruited from KeiMyung university Dongsan Medical Center inpatient satisfying requirement for this study. They were divided into Task-Oriented Functional training group and Conventional therapy group. They were measured by Sensory organization test and Motor control test items using EquiTest Version 8.0 machine before and after the test. The result of this study were to follow: 1. In Sensory organization test, there were no significant differences in static eguibrium score in both groups(p<.05). 2. In Sensory organization test, there were significant differences in dynamic eguibrium score in both groups(p<.05). 3. In Motor control test, there were significant differences in both groups(p<.05). 4. In exercise group, there were no significant differences in static Sensory organization test(p<.05). 5. In exercise group, there were significant differences in dynamic Sensory organization test(p<.05). 6. In exercise group, there were significant differences in Motor control test(p<.05). 7. In control group, there were no significant differences in static Sensory organization test(p<.05). 8. In control group, there were no significant differences in dynamic Sensory organization test(p<.05). 9. In control group, there were no significant differences in Motor control test(p<.05).