• The Journal of Korean Physical Therapy
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• 제10권1호
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• pp.53-65
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• 1998

The main purpose of this paper is to analyze the modes of therapeutic intervention. The emphasis is on the neurophysiological perpective arising out of neurological principles and developmental concepts. The obtained results are as follows. 1. The important hypostheses predicted that the group intervened by neurodevelopmental approach would improve motor function better than the group done by traditional approach and it was proved that neurodevelopmental approach was more effective in gross motor region(P<.01) 2. In the comparison of type of involovement, neurodevelopmental intervention group in spastic type showed improvements in the region of gross motor.(P<.001) 3. In the comparision of degree of disorder, neurodevelopmental intervention group showed improvement of motor function in all the gross motor region in the mild, moderate and severe case.(P<.001) 4. In the comparison of ages of intervention beginning, the group of child between 25-36, 49-60 and 61-72 months(P<.001) intervened by neurodevelopmental approach showed improvements of motor function. 5. In the comparison of intervention duration, neurodevelopmental intervention group showed improvements of motor function in gross motor region according to intervention durstion(P<.001)

• The Journal of Korean Physical Therapy
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• 제9권1호
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• pp.185-193
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• 1997

The purpose of this study was to investigate the neurophysiological mechanisms, assessment of muscle spasm and treatments that could apply to clinical field. Spasm is a painful pattern of contraction of muscle caused by chronic or acute trauma, excessive tension, or organic disorders. Aside from pain, muscle spasm creates shortenning of muscles and limits motion. Untreated spasm and protective immobility due to pain lead to decreased local blood flow in the muscles and result in a vicious cycle of muscle spasm and paul. The assessment of muscle spasm involve muscle tone assessment, tissue compliance, and joint ROM. Each of these aessessments utilize as a part of the patient's condition Clinical managements involve drug management and physical therapy. Expecially, physical therapy is one of the most important techniques to reduce muscle spasm. Physical therapy includes applying heat and cold, electrical stimulation, massage, and traction. This investigation should entourage phisical therapists to experiment further with various techniques to reduce muscle spasm.

• The Korean Journal of Physiology
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• 제4권2호
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• pp.19-24
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• 1970

Since the discovery of the muscle spindle by Hassall (1831), an intensive studies of its anatomical and physiological characteristics had been undertaken. Recent morphological studies of Boyd (1962) demonstrated that the muscle spindles have two different intrafusal muscle fibers, nuclear bag and nuclear chain fiber, and these intrafusal fibers are under independent motor innervation by ${\gamma}_1$ and ${\gamma}_2$ motor neurone. Neurophysiological studies of Hunt and Kuffler (1951) showed regulatory effect of ${\gamma}$ motor neurone upon the excitability of the spindle afferents. Harvey and Mathews (1961) observed the dynamic and static characteristics of the two different spindle afferents, the primary and secondary ending. Furthermore, Mathews (1962) postulated the functional existance of two kind of ${\gamma}$ motor neurones, namely, the dynamic and static fusimotor fiber. Recent report of Kim and Partridge(1969) pointed out that the descending vestibular signals had increased the slope of the length-tension relationship in stretch reflex; Kim (1967) demonstrated that the descending vestibular impulses act upon the stretch reflex loop through the ${\gamma}$ motor pathway. These experimental evidences from the morphological and neurophysiological studies on the muscle spindles support the concept that the stretch reflex action of the skeletal muscle operates as a negative feedback control system. The author had discussed the way by which the f system participates in the control of stretch relfex feed back system. that was taken for a prototype of posture and movement.

• 대한물리의학회지
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• 제13권1호
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• pp.1-9
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• 2018

PURPOSE: This study investigated the neurophysiological and behavioral adaptation during one or both hands movement in chronic stroke patients. METHODS: The study included sixteen hemiplegic stroke patients. Neurophysiological data (brain activation and muscle activation) were examined by electroencephalography (EEG) and electromyography (EMG), and behavioral adaptation was examined by wrist extension angle during wrist extension with one hand or both hands. Outcome variables of one hand or both hands were; mu rhythm of the EEG, EMG amplitude of wrist extensor and flexor muscles, and wrist angle of Myomotion 3D motion analysis. RESULTS: Our results revealed that wrist extension angle was significant increased during both hands movement compared to one hand movement (p<.05). Furthermore, in affected sensorimotor area, there was significant increase in the brain activation during both hands movement compared to one hand movement (p<.05). However, there was no significant different between one hand and both hands movement in muscle activation (p>.05). CONCLUSION: According to the findings of this experiment, bilateral arm movement improved brain activity on affected sensorimotor area and wrist extension angle. Therefore, we suggest that bilateral arm movement would positive effect on stroke rehabilitation in terms of increase in brain activation on affected motor area and wrist extension during bilateral arm movement.

• 대한전기학회논문지:시스템및제어부문D
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• 제50권11호
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• pp.541-549
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• 2001

The term 'silent period(SP)' refers to a transitory, relative or absolute decrease electromyography(EMG) activity, evoked in the midst of an otherwise sustained contraction. Masseteric SP is elicited by a tap on the chin during isometric contraction of masseter muscle. In this paper, a new EMG signal generation model including SP in masseter muscle is proposed. This work is based on the anatomical structure of trigeminal nerve system that related on temporomandibular joint(TMJ) dysfunction. And it was verified by comparing the real EMG signals including SP in masseter muscle to the simulated signals by the proposed model. Through this studies, it was shown that SP has relation to variable neurophysiological phenomena. A proposed model is based on the control system theory and DSP(Digital Signal Processing) theory, and was simulated using MATLAB simulink. As a result, the proposed SP model generated EMG signals which are similar to real EMG signal including normal SP and an abnormal extended SP. This model can be applied to the diagnosis of TMJ dysfunction and can effectively explain the origin of extended SP.

• 대한의료기공학회지
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• 제22권1호
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• pp.1-27
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• 2023

Objective : This paper provides a narrative review of the research literature on the neurophysiological and neurochemical mechanisms of local vibration while studying the treatment principles and mechanisms of Whidam's vibrator Sugi therapy. Methods : Searches related to vibration therapy research were conducted in PUBMED using "Vibration", "Whole Body Vibration", "Localized Vibration", and "Focal Vibration". The Conditions were limited to review and systematic review. Results : Roberto Casale's paper was selected as an inquiry task and reviewed critically and narratively by referring to other papers. The stimulation process of local vibration (LV) was broadly classified into receptor transmission (pain reception phase), ascending sensory pathway to the spinal cord (segmental phase), and action of the cortex and subcortical structures (systemic control phase) according to the pain pathway. In addition, the role of C-tactile mechanoreceptors, changes in neurotransmitters and neurohormones, LV stimulation below perception threshold (lower threshold), pain control and kinesiologic illusions were specially addressed. In addition, the expression and function of Piezo Channels were added to supplement the human pain and tactile sensing mechanism. Conclusions : LV exerts pain control mechanisms through different interactions that can interfere with pain transmission and pain perception. Since LV provides sufficient neurophysiological reasons for clinical application, it is necessary to expand the use of Whidam's vibrator Sugi therapy to a wider range of clinical applications.

• 대한임상검사과학회지
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• 제51권4호
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• pp.453-461
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• 2019

수술 중 발생하는 신경계 손상 여부를 감별하는 검사인 수술 중 신경계 모니터링(intraoperative neurophysiological monitoring, INM) 검사는 다양한 수술에서 안정적으로 수술이 잘 진행되고 있음을 확신하며 수술을 진행할 수 있도록 도움을 주는 매우 중요한 검사다. 수술실이라는 특수한 환경에서 검사의 최적화를 위하여 침 전극을 사용하여 검사를 진행하며, 수술실검사에 대하여 정확한 자극부위와 측정부위에 대한 교재나 안내책자가 없는 것이 실정이다. 그래서 이번 논문에서 운동유발전위검사, 체성감각유발전위검사, 청각유발전위검사, 시각유발전위검사에서 올바른 자극부위와 측정부위에 대하여 자세하게 설명을 하였다. 그리고 자유진행 및 유발근전도검사(free-running and triggered EMG)는 근육에서 발생하는 근전도의 관찰로 대부분의 뇌신경(cranial nerve)과 척수신경근(spinal nerve root)의 기능상태 파악을 한다. 검사의 이해를 돕기 위해 각각의 해당 근육에 전극을 삽입하는 사진을 첨부하였고, 척수신경근에 따른 해당근육도 표로 제시하였다. 검사 후 전극제거를 할 때에도 환자와 검사자 모두 안전한 방법을 제시하여 보다 완벽한 검사가 되었으면 한다.

• Brain Tumor Research and Treatment
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• 제6권2호
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• pp.60-67
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• 2018

Background Recently, modern technology such as diffusion tensor imaging (DTI), neuro-navigation and intraoperative neurophysiological monitoring (IOM) have been actively adopted for the treatment of thalamic tumors. We evaluated surgical outcomes and efficacy of the aforementioned technologies for the treatment of pediatric thalamic tumors. Methods We retrospectively reviewed clinical data from 37 children with thalamic tumors between 2004 and 2017. There were 44 operations (27 tumor resections, 17 biopsies). DTI was employed in 17 cases, neuro-navigation in 23 cases and IOM in 14 cases. All diagnoses were revised according to the 2016 World Health Organization Classification of Tumors of the Central Nervous System. Progression-free survival (PFS) and overall survival (OS) rates were calculated, and relevant prognostic factors were analyzed. The median follow-up duration was 19 months. Results Fifteen cases were gross total resections (GTR), 6 subtotal resections (STR), and 6 partial resections (PR). Neurological status did not worsen after 22 tumor resections. There were statistically significant differences in terms of the extent of resection between the groups with DTI, neuro-navigation and IOM (n=12, GTR or STR=12) and the group without at least one of the three techniques (n= 15, GTR or STR=9, p=0.020). The mean PFS was $87.2{\pm}38.0$ months, and the mean OS $90.7{\pm}36.1$ months. The 5-year PFS was 37%, and the 5-year OS 47%. The histological grade ($p{\leq}0.001$) and adjuvant therapy (done vs. not done, p=0.016) were significantly related to longer PFS. The histological grade (p=0.002) and the extent of removal (GTR/STR vs. PR/biopsy, p=0.047) were significantly related to longer OS. Conclusion Maximal surgical resection was achieved with acceptable morbidity in children with thalamic tumors by employing DTI, neuro-navigation and IOM. Maximal tumor resection was a relevant clinical factor affecting OS; therefore, it should be considered the initial therapeutic option for pediatric thalamic tumors.

• 대한임상검사과학회지
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• 제53권1호
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• pp.122-130
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• 2021

수술중신경계감시에서 혼입되는 artifact의 종류는 매우 다양하고 검사에 방해 되는 artifact의 제거 또한 필수적이다. 그리고 artifact를 제거해서 검사의 질을 향상시키는 것이 검사자의 역량이며 환자의 안전을 위한 최선의 방법이다. 하지만 경험이 부족해서 수술실의 장비나 마취에 관한 사항들에 대한 숙지가 미흡한 경우 상황에 맞는 적절한 방법으로 artifact를 제거할 수 없다. 만약 artifact가 구별 및 제거되지 않고 진행된 검사의 판독은 수술 진행에 혼선을 초래하며 이는 신속하고 정교함이 요구되는 신경외과 수술에 치명적인 문제가 될 수 있다. 본 논문에서는 수술 중에 발생하는 artifact의 원인을 전기적요인과 비전기적인 요인 그리고 기타 요인들로 분류하였고 상황에 맞게 artifact를 제거하는 방법과 검사법에 대해 언급하였다. 수술실의 환경이 동시에 여러가지 상황을 고려해야 하는 매우 민감한 조건이지만, 다양한 artifact의 형태와 원인을 숙지하여 안정적이고 원활한 수술중신경계감시가 되길 바란다.

• 대한임상검사과학회지
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• 제54권1호
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• pp.61-67
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• 2022

INM은 수술의 안정성을 더해주고 고위험군의 수술을 안전하게 진행할 수 있게 도움을 주고 있다. INM검사가 적용이 되는 모든 수술에서의 수술 과정과 신경학적 결손이 발생할 수 있는 과정에서 집중적으로 검사를 진행해 보다 신속하게 수술자에게 알리지 않으면 손상이 되었을 때 그에 대한 대처가 늦어서 환자에게 돌이킬 수 없는 심각한 후유증을 가져다 줄 수 있다. 대동맥류 및 대동맥 박리로 발생되는 대동맥 치환술은 개흉 및 개복술이 진행되며 심장의 혈류를 차단하는 매우 위험한 수술이다. 대동맥에서 분지되어 척수에 혈류를 공급하는 혈관들을 교체할 때 척수로 가는 혈류가 감소해 척수 허혈이 올 수 있다. 대동맥 수술에서의 INM은 겸자시에 유발전위를 이용하여 빠르게 척수 허혈이 시작되는 시점을 찾아내고 수술자에게 보고해 척수 허혈을 방지하며 심각한 합병증을 막는 중요한 역할을 수행한다. 이에 수술의 과정과 TceMEP, SSEPs의 검사 방법 및 검사 시점, 검사 기준에 대하여 작성을 하여 INM을 시행하는 검사자들에게 도움이 되고자 본문을 작성하였다. 본문으로 인해 대동맥수술에서 INM의 필요성, 대동맥 수술에서의 흐름을 파악하고 정확하고 신속한 검사를 통한 보고로 원활한 검사가 진행되길 바라는 바이다.