• Safety and Health at Work
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• 제6권3호
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• pp.206-210
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• 2015

Background: Fatigue has a strong impact on workers' performance and safety, but expedient methods for assessing fatigue on the job are not yet available. Studies discuss posturography as an indicator of fatigue, but further evidence for its use in the workplace is needed. The purpose of the study is to examine whether posturography is a suitable indicator of fatigue in clerical workers. Methods: Thirty-six employees (${\emptyset}$ 34.8 years, standard deviation = 12.5) participated in postural tasks (eyes open, eyes closed, arm swinging, and dual task) in the morning and afternoon. Position of their center of pressure (COP) was registered using a Nintendo Wii Balance Board and commercial software. From registered COP time series, we calculated the following parameters: path length (mm), velocity (mm/s), anterior-posterior variance (mm), mediolateral variance (mm), and confidence area ($mm^2$). These parameters were reduced to two orthogonal factors in a factor analysis with varimax rotation. Results: Statistical analysis of the first factor (path length and velocity) showed a significant effect of time of day: COP moved along a shorter path at a lower velocity in the afternoon compared with that in the morning. There also was a significant effect of task, but no significant interaction. Conclusion: Data suggest that postural stability of clerical workers was comparable in the morning and afternoon, but COP movement was greater in the morning. Within the framework of dynamic systems theory, this could indicate that the postural system explored the state space in more detail, and thus was more ready to respond to unexpected perturbations in the morning.

• Physical Therapy Rehabilitation Science
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• 제5권3호
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• pp.113-119
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• 2016

Objective: The effect of abdominal expansion maneuver (AEM) and abdominal draw-in maneuver (ADIM) on postural control in an unsupported position in stroke patients. Design: Randomized controlled trial. Methods: A total of 36 persons with hemiplegic stroke participated in this study. The subjects were randomly divided into an AEM experimental group (n=12), an experimental ADIM group (n=12), and a control group (n=12). We collected the general characteristics of all subjects and the pre-test results before the intervention and after 4 weeks of the intervention. The trunk stabilization training of the ADIM and AEM group were performed 15 minutes a day, 3 times a week for 4 weeks, and general physical therapy was performed 2 times a day, 30 minutes per session, 5 times a week for all three groups. The control group received joint mobilizations, muscle strengthening, endurance strengthening, and gait exercises along with treatment of the central nervous system, such as neuro-developmental treatment, mat, and gait training. The AEM is an inspiratory phase of tidal breathing expanding the lateral lower ribcage in a lateral direction with minimal superior movements of the chest. Then the lower abdomen expands and the navel moves in an anterior-caudal direction. The ADIM is a repeated contraction and relaxation of the anal sphincter during inspiration. The navel pulls the lower abdomen to the direction of the spine without the movement of the trunk and pelvis. Results: Before and after the interventions, medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area 95% was a statistically significant change in all three groups (p<0.05). The post-hoc test showed a significant improvement in medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area in the AEM group compared with the control group, and in the ADIM group compared with the control group (p<0.05). Conclusions: In conclusion, both AEM training and ADIM training are necessary interventions to maintain the independent sitting position according to the characteristics of the patient.

• 한국기계가공학회지
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• 제19권7호
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• pp.41-51
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• 2020

This paper presents the development of a robotic system for rehabilitation of the trunk's ability to maintain postural control under different balance conditions. The system, developed with extensive input from rehabilitation and biomedical engineering experts, consists of a seat mounted on a robotic mechanism capable of moving it with four degrees of freedom (3 rotational and 1 translational). The seat surface has built in instrumentation to gauge the movements of the user's center of pressure (COP) and it can be moved either to track the movements of the COP or according to operator given commands. The system allows two types of leg support. A ground mounted footrest allows participation of legs in postural control while a seat connected footrest constrains the leg movement and limits their involvement in postural control. The design evolution over several prototypes is presented and computer aided structural analysis is used to determine the feasibility of the designed components. The system is pilot tested by a stroke patient and is determined to have potential for use as a trunk rehabilitation tool. Future works involve more detailed studies to evaluate the effects of using this system and to determine its efficacy as a rehabilitation tool.

• Physical Therapy Rehabilitation Science
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• 제4권1호
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• pp.44-48
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• 2015

Objective: The purpose of this study was to investigate the relationship between anticipatory postural adjustment (APA), single task, dual tasks and physical performances. The trunk muscles of APA consist of bilateral erector spinae (ES) and bilateral internal oblique (IO) adnominal muscles, during rapid stepping with the affected or unaffected leg in a sitting posture. Design: Cross-sectional study. Methods: In patients with chronic stroke, electrodes of surface electromyography (EMG) were attached on the bilateral erector spinae (ES), bilateral internal oblique adnominal (IO), and bilateral rectus femoris (RF) muscles. RF acts as the prime mover. The stroke patients performed hip flexion until $20^{\circ}$ as fast as possible at each leg in a sitting posture according to a visual cue. The visual cue unexpectedly appeared on monitor in front of the stroke patient. The single task was the Timed Up and Go (TUG) test. The dual tasks were the TUGconitive, which increased cognitive capacity, and the TUGmanual task, which had an external focus. Results: All EMG data showed earlier onset latency before the prime mover. In affected leg raising, the onset time of unaffected ES muscle of the stroke patients was correlated with the single and dual tasks (p<0.05). In unaffected leg raising, the onset time of the affected IO muscle was related to all the tasks (p<0.05). Gait speed showed a relationship with the unaffected ES muscle only. Conclusions: The trunk muscles of the bilateral ES and bilateral IO play an important role in APA. The single and dual tasks using TUG test were correlated with the APA s of ES and IO muscles. Dual task by the TUG test is a good measuring tool for reflecting the real life in patients with chronic stroke.

• 한국전문물리치료학회지
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• 제7권2호
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• pp.35-54
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• 2000

The purposes of this study were to assess variation of body sway prior to and after submaximal treadmill exercise; to determine the time course of the effects of a fatiguing performed on a treadmill on body sway; and to compare position sense prior to and after exercise in order to assess any variance in proprioception caused by submaximal treadmill exercise. The subjects were twenty-four healthy men in their twenties. They stood barefoot on the Kinesthetic Ability Training Balance Platform to measure body sway. Control trials were performed with eyes alternately open and closed. In the eyes open condition, they were asked to look at a target placed at eye level 1 m in front them. A total of 10 trials, each lasting 20 seconds, were performed. After this series of trials, position sense was measured. Subjects then exercised on the treadmill until 85% of each person's maximal heart rate was reached. The first series of postural sway measurements began immediately after this exercise. The second identical series of postural sway trials was performed at approximately 10 minutes after exercise. The third series was performed approximately 20 minutes after exercise. This allowed approximately 5 minutes of rest between each experimental series. Position sense was measured at approximately 15 and 25 minutes after exercise. The results were as follows: 1) There was a significant increase in body sway after submaximal treadmill exercise compared to pre-exercise values under both visual conditions (p<.05). 2) After submaximal treadmill exercise, under the eyes open condition, the mean value of body sway was significantly increased after both the first and second series (p<.05). Under the eyes closed condition, the mean value of body sway increased significantly after the first series but decreased significantly after the third series (p<.05). 3) Position sense, measured repeatedly after submaximal treadmill exercise, did not change significantly with respect to pre-exercise values (p>.05). These results suggest that fatigue induced by submaximal treadmill exercise produced an increase in body sway in young healthy subjects with or without visual input, but the increase appeared to be lasting less than 15 minutes. No significant change in position sense suggested that proprioception was unaffected by submaximal treadmill exercise-induced fatigue.

• 한국엔터테인먼트산업학회논문지
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• 제13권4호
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• pp.411-417
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• 2019

본 연구의 목적은 노인을 대상으로 균형기능에 대해 치료행위가 아닌 균형기능 평가척도를 활용한 평가과정 자체가 균형능력에 어떠한 영향을 미칠 수 있는지를 알아보는 데에 있다. 이를 위하여 전주시 노인복지관 2곳에 소속되어져 있는 65세 이상의 노인 36명을 대상으로 각 12명씩 3군으로 나누어 균형기능에 대해 매일 평가를 시행한 군, 주간 단위로 평가를 시행한 군, 전후 평가군 형태로 구분하여 총 4주간 실시하였고 연구결과 모든 군 중에서 일일단위 평가군이 가장 높은 균형능력 향상결과를 보였고, 전후 평가군에서는 가장 적은 향상결과를 확인할 수 있었다. 군 간 비교에서는 일일단위 평가군-주간단위 평가군 사이에서 그리고 일일 평가군- 전후 평가군 에서 균형능력향상을 확인할 수 있었다. 이상의 결과를 통해 보았을 때 치료적 행위가 아닌 균형기능 척도를 활용한 평가과정 자체가 노인의 균형능력향상에 영향을 미칠 수 있음을 확인할 수 있었는데 치료적 목적이 아니더라도 노인을 위한 사회 시설들이나 기관에서 정기적으로 균형기능에 대해 평가관리 한다면 이것만으로도 균형기능 향상과 독립적 일상수행에 필요한 자세조절 능력을 강화시킬 수 있음을 참고하고 활용할 수 있기를 바란다.

• Physical Therapy Rehabilitation Science
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• 제6권3호
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• pp.106-112
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• 2017

Objective: Robot assisted gait training is implemented as part of therapy for the recovery of gait patterns in recent clinical fields, and the scope of implications are continuously increasing. However clear therapy protocols of robot assisted gait training are insufficent. The purpose of this study was to investigate the effects of robot-assisted gait training applied with guidance force on balance and gait performance in persons with hemiparetic stroke. Design: Two group pre-test post-test design. Methods: Nineteen persons were diagnosed with hemiparesis following stroke participated in this study. The participants were randomly assigned to the unilateral guidance group or bilateral guidance group to conduct robot-assisted gait training. All participants underwent robot-assisted gait training for twelve sessions (30 min/d, 3 d/wk for 4 weeks). They were assessed with gait parameters (gait velocity, cadence, step length, stance phase, and swing phase) using Optogait. This study also measured the dynamic gait index (DGI), the Berg balance scale (BBS) score, and timed up and go (TUG). Results: After training, BBS scores were was significantly increased in the bilateral training group than in the unilateral guidance group (p<0.05). Spatiotemporal parameters were significantly changed in the bilateral training group (gait speed, swing phase ratio, and stance phase ratio) compared to the unilateral training group (p<0.05). Conclusions: The results of this study suggest that robot-assisted gait training show feasibility in facilitating improvements in balance and gait performance for subacute hemiparetic stroke patients.

• The Journal of Korean Physical Therapy
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• 제20권4호
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• pp.7-13
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• 2008

Purpose: We compared T-type and I-type canes on postural balance in 28 hemiplegic patients. Methods: Subjects were allocated randomly into two groups: a T-shape cane group (n=14) and an I-shape cane group (n=14). Before the test, subjects were trained by a physical therapist to walk with a cane for 6 weeks. The Main Outcome Measures were measured as maximal sway velocity, sway path, sway area, and partial weight bearing using a Balance Performance Monitor (BPM) and ambulation velocity using a 'Timed up and go test'. We also measured the maximal ambulation velocity. Results: The distribution of weight bearing on the affected side without the cane was 35% in the I-shape cane group and 36% in the T-shape cane group. After training, weight bearing on the affected side increased by 45% in the I-shape cane group and 40% in the T-shape cane group. With the cane held in the hand, weight bearing on the affected side in the T-shape cane group decreased by 3%. Conclusion: The I-shaped cane increased static standing balance, including hemiplegic side weight bearing. Therefore, I-shape canes can improve the balance of hemiplegic patients.

• Physical Therapy Rehabilitation Science
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• 제5권1호
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• pp.34-39
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• 2016

Objective: Hip abductors play a role in providing stability and movement to the lower limbs. The purpose of this study was to examine the effects of hip abductor fatigue on static balance and gait in the general population. Design: One group pre-test post-test design. Methods: Thirteen university students in their twenties volunteered for the study and had underwent a functional assessment. To induce fatigue, the subjects were instructed to raise their dominant lower extremity up against a load of 50% of 1 repetition maximum while producing hip abduction in a side-lying position. Subjects were instructed to maintain an abduction speed of 30 repetitions per minute to induce fatigue. Muscle fatigue was considered to be established when subjects were unable to perform hip abduction three consecutive times along with the metronome. A post-test of balance and gait was performed immediately in order to prevent fatigue recovery. The center of pressure (COP) distance area was measured using the Zebris FDM-S Multifunction Force measuring plate. Gait performance was analyzed using the GAITRite. Results: The COP distance was increased after fatigue was induced. There was a significant increase in the standard deviation of the medio-lateral and antero-posteror distance (p<0.05). Although there was no significant difference in gait parameters, there was a significant decrease in single support time after fatigue was induced (p<0.05). Conclusions: There was an increase in static balance instability and a significant decrease in single support time during gait due to hip abductor muscle fatigue.

• 대한물리의학회지
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• 제11권4호
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• pp.105-114
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• 2016

PURPOSE: This study is to investigate the therapeutic effect of Tetrax on balance dysfunction caused by ataxia in cerebellar stroke. METHODS: A total of thirty subjects with cerebellar stroke were recruited. The participants was divided into two groups, the experimental (n=15) and the control group (n=15). Tetrax training and conventional physical therapy (CPT) were performed in experimental group, whereas the patients in the control group were treated with CPT twice a day. Each session of the Tetrax and CPT was carried out for 30 minutes, 5 times per week for 4 weeks. Korean version of the Scale for the Assessment and Rating of Ataxia (K-SARA) was the primary outcome measure, and the secondary outcomes covered Berg balance scale (BBS), falling index (FI), Timed up and go (TUG), and modified Barthel index of Korean version (K-MBI). All outcome measures were evaluated before and after 4 weeks. RESULTS: K-SARA was decreased significantly after 4 weeks intervention in both the experimental (p<.05) and the control group (p<.05). Furthermore, the experimental group produced significantly better outcomes in K-SARA, BBS, FI, and TUG compared with the control group (p=.012, p=.027, p=.008, and p=.048). There were significant correlations between K-SARA and BBS, FI, TUG, and K-MBI (p<.001, p<.001, p=.004, and p<.001). CONCLUSION: The restoration of ataxia was related with the improvement of the balance, falling risk, mobility, and activity of daily living. Tetrax training was effectively aided recovery of ataxia after cerebellar stroke.