• Title/Summary/Keyword: Postural control

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Effect of the Changes in Forward Head Posture and Neutral Head Posture on Respiratory (전방머리자세와 중립자세에 대한 인위적 자세변화가 호흡에 미치는 영향)

  • Bae, Wonsik;Lee, Keoncheol;Park, Seungwook;Baek, Yonghyeon
    • Journal of The Korean Society of Integrative Medicine
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    • v.5 no.1
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    • pp.67-74
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    • 2017
  • Purpose : Forward head posture is typical neck disorders occur in all people. And this attitude causes a shortening and weakening of the muscles in the body. It also causes excessive extension acts as a reward. This attitude has to change if the pain occurs around the neck and shoulders, and are subjected to unusual stress. Patients with chronic neck pain associated with forward head posture was found to be the more severe the fall of the respiratory, forward head posture poor quality of much breath. The purpose of this study was to compare the effect of changes in forward head posture and neutral head posture on respiratory. Method : Forty volunteers were participated in study and divided into two groups [forward head posture group (n=20) and neutral head posture group (n=20)]. We measured cervical alignment with global postural system to find out a forward head posture. Respiratory function was measured with a SPIROVIT SP-1 equipment and we found out a forced vital capacity (FVC), forced expiratory volume at one second (FEV1) and FEV1/FVC. A pared t-test was used to determine a statistical significance for the pulmonary function variation and a independent t-test was used to determine a statistical significance in the two groups. Results : In the experimental group, FVC and FEV1 were significantly higher in the artificial neutral head posture than in the forward head posture. In the control group, FVC and FEV1 were significantly higher in the neutral head posture than in the forward head posture. FVC, FEV1, and FEV1/ FVC were significantly higher in the neutral head posture of control group than the artificial neutral head posture of experimental group and higher in the artificial forward head posture of control group than the forward head posture of experimental group. Conclusion : In conclusion, neutral head posture is considered to be an important factor in correct posture and improvement of lung function and continuous study of posture correction program for posture imbalance will be needed.

Effects of Respiratory Muscle Strengthening Training on Pulmonary Function in Persons with Stroke : A Preliminary Study (호흡근 강화훈련이 뇌졸중환자의 폐 기능에 미치는 영향)

  • Lee, Seong-Ran;Lee, Jeong-Min;Lee, Jung-Eun;Lee, Hea-Jung
    • Journal of Korean Physical Therapy Science
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    • v.19 no.4
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    • pp.47-52
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    • 2012
  • Purpose : The purpose of the study was to examine if a respiratory muscle strengthening training in patients with stroke can improve their pulmonary function. Methods : Volunteers were included for the study if a patient diagnosed stroke more than 6 months and had 24 points or higher in MMSE-K scores. Twenty-eight subjects participated in this study and were randomly divided into two groups; a breathing exercise group(n=14) and a control group(n=14). The intervention for all subjects was conducted for 20minutes, three times a week for 4 weeks. Subjects for the breathing exercise group had the respiratory muscle strengthening training using spiro-tigers, where-as subjects in the control group got their usual treatment ie a postural training. The six-minute walking test(6MWT) and the pulmonary function tests(FVC, $FEV_1$, $FEV_1$/FVC, VC, Vt, IRV and ERV) were employed to assess treatment effects at baseline and after their intervention. Results : Twenty-four subjects finished their 4-week treatment programs. The general characteristics between groups were found to be similar (p>0.05). The pulmonary function between groups were also observed no difference across groups at the baseline measurement (p>0.05). In the post treatment group comparison, subjects in the breathing exercise group showed an increase in lung function with VC ($2.73{\pm}0.80{\ell}$) and Vt ($0.87{\pm}0.38{\ell}$) than those in the control group ($1.91{\pm}0.80{\ell}$ and $0.48{\pm}0.22{\ell}$ respectively) (p<0.05). However, there was no difference found in 6MWT, FVC, $FEV_1$, $FEV_1$/FVC, IRV, and ERV across groups (p>0.05). Conclusion : A significant increase in VC and Vt was found in subjects with stroke, who had four-week training on respiratory muscle strengthening. However, respiratory muscle strengthening showed no effect on walking speed and FVC, $FEV_1$, $FEV_1$/FVC, IRV, and ERV in patients with stroke.

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Effects of 6 Week Thoracic Flexibility Exercise on Balance, Gait Parameters and Fall Risk in Patients with Chronic Stroke; A randomized controlled study (6 주간의 체간 유연성 운동이 만성 뇌졸중 환자의 균형과 보행, 낙상 위험도에 미치는 영향)

  • Park, Donghwan;Lee, Kang-Seong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.6
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    • pp.498-507
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    • 2020
  • The purpose of this study was to examine the effects of thoracic flexibility exercise on sitting balance, static standing balance, gait parameters, and the fall risk of patients with chronic stroke. The participants were randomized into the control (n=12) and thoracic flexibility exercise groups (n=12). Both groups received standard rehabilitation therapy for 30 minutes per session. The subjects in the experimental group performed additional thoracic flexibility exercises 3 times a week for 6 weeks. The trunk impairment scale, static standing balance, gait speed, cadence, and fall risk were assessed for all the participants before and after the intervention. The thoracic flexibility exercise group showed greater improvement than did the control group on the trunk impairment scale (t=-3.57, p=.002), static standing balance (t=5.37, p<.001), gait speed (t=-3.29, p=.003), cadence (t=-2.77, p=.011), and fall risk (t=6.33, p<.001). Furthermore, the thoracic flexibility exercise group significantly improved all the outcomes compared to the baseline values (P<.05). This study showed that the thoracic flexibility exercise improved the functional ability of patients with chronic stroke.

Thoracic Epidural Anesthesia for Upper Abdominal Surgery and Postoperative Pain Control (상복부 수술을 위한 흉추 경막외 마취와 술후 통증관리)

  • Choi, Kyu-Taek;Cheun, Jae-Kyu
    • The Korean Journal of Pain
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    • v.2 no.1
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    • pp.66-71
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    • 1989
  • It has been standard practice in many institutions to use a combination of a light general anesthesia and an epidural block for lower abdominal and pelvic surgery. This combination of a balanced anesthesia can provide various benefits to the patient such as less bleeding in the surgical field, the use of a lower concentration of general anesthetics, less muscle relaxant, and post operative pain management. However, there are several problems associated with hemodynamics such as bradycardia and hypotension etc. In order to block the pain of the high surgical area with a lumbar epidural puncture postoperatively, a large volume of local anesthetic is required and consequently an extensive blockade of sympathetic, sensory and motor functions can occur causing motor weakness, numbness and postural hypotension. Therefore, the patient is unable to have early ambulation postoperatively. In this study, thoracic epidural catheterization was undertaken to locate the tip of the catheter exactly at the surgical level for upper abdominal surgery, and was followed by general anesthesia. Twenty-one patients scheduled for upper abdominal surgery were selected. Fifteen of them had hepatobiliary operations and the remaining 6 had gastrectomies. Thoracic epidural punctures were performed mostly at T9-T10 (57.1%) and T8-T9. Neuromuscular blocking agents were not used in half of the cases and the, mean doses of relaxant were $3.5{\pm}1.0mg$ in gastrectomies, and $2.7{\pm}0.9mg$ in cases of hepatobiliary operation. Epidural morphine was injected 1 hour before the end of the operation for postoperative pain control. Eight patients did not require additional analgesics and the mean dose of epidural morphine was $2.2{\pm}0.9mg$, and 13 cases were given 0.125% epidural bupivacaine when patients complained of pain. Their initial doses of epidural morphine were $1.9{\pm}0.4mg$ and the mean duration of bupivacaine was 6 hours 20 minutes${\pm}40$ minutes. In conclusion. thoracic epidural analgesia is valuable to reduce postoperative pain in patients with upper abdominal surgery, However, it is not easy to maintain this balanced anesthesia with high epidural analgesia-and light general anesthesia for upper abdominal surgery because of marked hemodynamic changes. Therefore, further practice will be required.

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Characteristic Analysis of Flexibility and Muscle Strength according to Exercise using Lumbar Strengthen Exercise Instrument (요추강화 운동기기의 훈련을 통한 유연성 및 근력 특성 분석)

  • Kang, S.R.;Kim, K.;Jeong, G.Y.;Moon, D.A.;Kwon, T.K.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.4 no.1
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    • pp.53-61
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    • 2010
  • In this paper, We investigated the characteristic analysis of flexibility and muscle strength for exercise to verify capacity in rehabilitation exercise of lumbar using lumbar strengthen exercise instrument. We have experiment in 20th years man and woman who are 20 subject with no medical history, we divided subjects into control group with no exercise and training group with lumbar strengthen exercise. We used Hi-Spine(Medicalscience.korea) also, provided exercise 40 minute a day, three days a week and progressed total four weeks. Moreover in our experiment, subjects exercised four postural position as lay down, sit, stand and stretch each ten minute. We measured trunk extension backward, trunk flexion forward, evaluation of based physical fitness and lumbar joint torque. The reults have shown that there more improved all for flexibility, based physical fitness and lumbar joint torque in training group than control group. We indicated that by rotating 3-D axis movement flatform of exercise instrument, muscle spindle in subject have been stimulated and these rotation direction and angle caused muscle tonus and contraction that makes muscle, flexibility and based physical fitness improve more. Our study can be used rehabilitation exercise program to aged people and patient with lumbar injury.

Oral-Motor Facilitation Technique (OMFT): Part I-Theoretical Base and Basic Concept (구강운동촉진기술: 1 부-이론적 배경과 기초 요소)

  • Min, Kyoung Chul;Seo, Sang Min;Woo, Hee-soon
    • Therapeutic Science for Rehabilitation
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    • v.10 no.1
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    • pp.37-52
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    • 2021
  • Introduction : Oral motor function is basic function of sensory exploration, feeding, and communication, that develops from the fetal stage to childhood. Problems with oral motor function result in difficulty within handling food in the oral cavity, decreased swallowing and feeding skills, difficulty with communication, and problems with oral hygiene. To treat these symptoms, oral motor therapy is provided for normalizing sensory adaptation in the oral cavity, and increasing postural control, oral movement and oral motor function. Discussion : The oral motor facilitation technique (OMFT) was developed for increasing general and integrated oral motor function based on the following: 1) understanding orofacial muscular physiology; 2) a comprehensive approach to sensory·adaptation·behavior·cognition; 3) sensorimotor stimulation by a manual approach; 4) motor control and motor learning theory. The OMFT is a new evidence-based treatment protocol, for children and adults with neuromuscular and oral motor problems. Conclusion : The goal of this article is to provide a theoretical background for OMFT development and the basic concept for the clinical application of OMFT. We hope that this article will help oral motor therapy experts to provide effective therapy in a more professional way.

Characteristics of the Buttock Interface Pressure According to Wheelchair Propulsion Speed and Various Back Reclined Seating Position (휠체어 추진속도 및 등받이 경사각도에 따른 둔부 압력 변화 특성)

  • Kwon, Hyuk-Cheol;Kong, Jin-Yong
    • Physical Therapy Korea
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    • v.12 no.2
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    • pp.1-10
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    • 2005
  • Pressure ulcers are serious complications of tissue damage that can develop in patients with diminished pain sensation and diminished mobility. Pressure ulcers can result in irreversible tissue damage caused by ischemia resulting from external loading. There are many intrinsic and extrinsic contributors to the problem, including interface tissue pressure, shear, temperature, moisture, hygiene, nutrition, tissue tolerance, sensory and motor dysfunction, disease and infection, posture, and body support systems. The purposes of this study were to investigate the relationship between buttock interface pressure and seating position, wheelchair propulsion speed. Seated-interface pressure was measured using the Force Sensing Array pressure mapping system. Twenty subjects propelled wheelchair handrim on a motor-driven treadmill at different velocities (40, 60, 80 m/min) and seating position used recline ($100^{\circ}$, $110^{\circ}$, $120^{\circ}$) with a wheelchair simulator. Interface pressure consists of average (mean of the pressure sensor values) and maximum pressure (highest individual sensor value). The results of this study were as follows; No significant correlation in maximum/average pressure was found between a static position and a 40 m/min wheelchair propulsion (p>.05). However, a significant increase in maximum/average pressure were identified between conditions of a static position and 60 m/min, and 80 m/min wheelchair propulsion (p<.05). No significant correlation in maximum pressure were found between a $90^{\circ}$ recline (neutral position) and a $100^{\circ}$, $110^{\circ}$, or $120^{\circ}$ recline of the wheelchair back (p>.05). No significant difference in average pressure was found between conditions of a $90^{\circ}$ recline and both a $100^{\circ}$ and $110^{\circ}$ recline of wheelchair back. However, a significant reduction in average pressure was identified between conditions of a $90^{\circ}$ and $120^{\circ}$ recline of wheelchair back (p<.05). This study has shown some interesting results that reclining the seat by $120^{\circ}$ reduced average interface pressure, including the reduction or prevention in edema. And interface pressure was greater during dynamic wheelchair propulsion compared with static seating. Therefore, the optimal seating position and seating system ought to provide postural control and pressure relief. We need an education on optimal seating position and a suitable propulsion speeds for wheelchair users.

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The Effect of Types of Weight-Bearing Surfaces on Muscle Activities of Lower Limbs and Weight Distribution During Semi-Squat Movement of Patients With Hemiplegia (편마비 환자의 반 쪼그려 앉기(semi-squat)동작 시 양하지 지지면의 형태가 하지 근활성도와 체중분포에 미치는 영향)

  • Yang, Yong-Pil;Roh, Jung-Suk
    • Physical Therapy Korea
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    • v.19 no.1
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    • pp.28-36
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    • 2012
  • This study used an unstable platform to change the support surface type and position of both lower limbs in order to determine changes in weight distribution and muscle including the vastus medialis, tibialis anterior, lateral hamstring, and lateral gastrocnemius of both lower limbs were evaluated during knee joint flexing and extending in a semi-squat movement in 32 hemiplegic patients. The support surface conditions applied to the lower limbs were divided into four categories: condition 1 had a stable platform for both lower limbs; condition 2 had an unstable platform for the non-hemiplegic side and a stable platform for the hemiplegic side; condition 3 had a stable platform for the non-hemiplegic side and an unstable platform for the hemiplegic side; and condition 4 had an unstable platform for both sides. The normalized EMG activity levels of muscles and weight bearing ratio of both sides in the four surface conditions were compared using repeated measures ANOVA. A significant increase was found in the weight support distribution for the hemiplegic side in flexing and extending sessions in condition 2 compared to the other conditions (p<.05). A statistically significant decrease in significant decrease in asymmetrical weight bearing in flexing and extending sessions was observed for condition 2 compared to the other conditions (p<.05). A similar significant decrease was found in differences in muscular activity for both lower limbs in condition 2 (p<.05). The muscular activity of the hemiplegic side, based on the support surface for each muscle showed a significantly greater increase in condition 2 (p<.05). An unstable platform for the non-hemiplegic side and a stable platform for the hemiplegic side therefore increased symmetry in terms of the weight support distribution rate and muscle activity of lower limbs in hemiplegic patients. The problem of postural control due to asymmetry in hemiplegic patients should be further studied with the aim of developing continuous effects of functional training based on the type and position of the support surfaces and functional improvement.

The Effect of Sensory Integration Intervention Program on Body-scheme and Praxis Ability in Children With Developmental Disability (감각통합치료프로그램이 발달장애아의 신체도식과 실행능력에 미치는 영향)

  • Kim, Hyun-Ho;Yoo, Byung-Kook;Jang, Yong-Su
    • The Journal of Korean Academy of Sensory Integration
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    • v.7 no.1
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    • pp.47-57
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    • 2009
  • Objective : Purpose of this study is to study how Sensory Integration (SI) Intervention Program affect body-scheme and praxis ability of children with Developmental Disability (DD). Method : The SI intervention was programmed based on the theory of SI by Jean Ayres. Thirty children with DD underwent the SI program for six weeks. The effect of the SI intervention was evaluated in terms of body-scheme and praxis ability. Assessments used in this study are One-Point Imitation Test (OPIT) and 6 Body Puzzle Test (6BPT) for body-scheme; Praxis Test Sheet (PTS) for linguistic order, oral motor control, sequential praxis and Sensory Integration and Praxis Tests (SIPT) for postural praxis. Data of this study was analyzed by the paired t-test to compare before- and after the SI intervention. Results : Results of this study are (1) in the OPIT, there is significant difference on body-scheme ability (p<0.01); (2) in the PTS, there is significant difference on all three items (p<0.01); and (3) in the SIPT, there is significant difference on sensory integration and praxis function. Conclusions : From the results, it is concluded that sensory integration intervention is effective on body-scheme and praxis functions for children with developmental disability.

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A Systematic Review on Sensory Integration Intervention in Korea: Focusing on Ayres Sensory Integration (ASI) (국내 감각통합치료 중재에 관한 체계적 고찰 - Ayres의 감각통합중재(ASI)를 중심으로)

  • Jung, Hyerim;Choi, Yeon-Woo;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.11 no.2
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    • pp.27-40
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    • 2013
  • Objective : The aim of this study was to investigate how many studies for sensory integration intervention in Korea reflect the principle of Ayers' sensory integration through a systemic review. Methods : The systemic review was executes using RISS, NDSL, KISS, DBpia. The key words for search were 'sensory integration therapy', 'sensory integration intervention', 'sensory integration program', 'sensory integration training' to search the articles, published in 2000-2012. To analyze ASI fidelity of 49 studies included in the present study, the numbers of items were calculated if the study describe the ASI principle. Results : The IV was the most levels of evidence, and the subjects for the studies were mental intellectual disability (15), developmental disability (14) and autism spectrum disorders (13) etc. It was described the most that presenting sensory opportunities (43), challenging postural, ocular, oral and/or bilateral motor control (37) of ASI fidelity. The studies using more than 4 ASI principle were 26.5%(13), and 7 studies using 8 or more than 8 were studied in OT. Conclusion : In OT, 34 of 49 studies performed, and they used several principles of ASI. To have unity for sensory integration principle and to improve therapy professionalism the study using various data and systematic review study will be needed in the future.

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