• The Journal of Korean Physical Therapy
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• v.10 no.1
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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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• v.9 no.1
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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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• v.4 no.2
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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.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.1
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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.

• The Transactions of the Korean Institute of Electrical Engineers D
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• v.50 no.11
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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.

• Journal of Korean Medical Ki-Gong Academy
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• v.22 no.1
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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.

• Korean Journal of Clinical Laboratory Science
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• v.51 no.4
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• pp.453-461
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• 2019

Intraoperative neurophysiological monitoring (INM) examination identifies the damage caused to the nervous system during surgery. This method is applied in various surgeries to validate the procedure being performed, and proceed with confidence. The assessment is conducted in an operating room, using subdermal needle electrodes to optimize the examination. There are no textbooks or guides for the correct stimuli and recording areas for the surgical laboratory test. This article provides a detailed description of the correct stimuli and recording parts in motor evoked potential (MEP), somatosensory evoked potential (SSEP), brainstem auditory evoked potentials (BAEP) and visual evoked potentials (VEP). Free-running Electromyography (EMG) is an observation of the EMG that occurs in the muscle, wherein the functional state of most cranial nerves and spinal nerve roots is determined. In order to help understand the test, an image depicting the inserting subdermal needle electrodes into each of the muscles, is attached. Furthermore, considering both the patient and the examiner, a safe method is suggested for removal of electrodes after conclusion of the test.

• Brain Tumor Research and Treatment
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• v.6 no.2
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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.

• Korean Journal of Clinical Laboratory Science
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• v.53 no.1
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• pp.122-130
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• 2021

The types of artifacts that are observed in intraoperative neurophysiological monitoring (INM) is truly diverse. The removal of artifacts that interfere with the examination is essential. In addition, improving the quality of the examination by removing artifacts is a reflection of the competency of the examiner and is also the best way to ensure patient safety. However, if knowledge of the equipment or anesthesia in the operating room is insufficient due to lack of experience, artifacts cannot be removed even with a method appropriate to the situation. If artifacts are not separated and removed, the reading of the examination results in confusion in the operation process. This can be a fatal problem in neurosurgery that requires rapid and sophisticated procedures. In this paper, the causes of artifacts that occur during surgery are classified into electrical factors, non-electrical factors, and other factors, and a method and examination method for removing artifacts according to the specific situation is mentioned. Although the operating room environment is a very critical place to simultaneously consider various scenarios, we hope that a stable and optimal INM will play a role by knowing the types and causes of various artifacts and how to tackle them.

• Korean Journal of Clinical Laboratory Science
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• v.54 no.1
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• pp.61-67
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• 2022

Intraoperative neurophysiological monitoring (INM) ensures the stability and safety of specific surgeries in high-risk groups. As part of INM, intensive tests are conducted during the surgical process. When INM tests are applied during surgery, a delay in notifying the operating surgeon in cases of neurological defects can cause serious irreversible sequelae to the patient. Aortic replacement, which is necessitated due to aortic aneurysms and aortic dissection, is a complicated procedure that blocks the blood flow to the heart. When arteries that branch out from the aorta and supply blood to the spinal cord are replaced, blood flow to the spinal cord decreases, resulting in spinal ischemia. In aortic surgery, INM plays an important role in preventing spinal ischemia and serious complications by quickly detecting the early signs of spinal ischemia during cross-clamping and reporting it to the surgeon. Therefore, this paper was prepared to help examiners who conduct INM by detailing the process, method, time, and warning criteria for INM. This paper identifies the need for INM in aortic surgery and the process flow for a smooth test, accurate and rapid examination, and subsequent reporting.